B1. CHN – Care of the Normal and At-Risk 4.

The current-day definition of family refers to

Families, Population Groups, and Communities two or more individuals who depend on one
another for emotional, physical, and/or
CH. 18 FAMILY DEVT. AND NSG AX - NCLEX
financial support. Which of the following is the
1. The family systems theory encourages nurses most important principle to support this
to view both the individual clients as broader definition?
participating members of a whole family. What a. Families are defined by genetic ties.
is the major weakness of the systems b. Family names are needed to confer
framework? status.
a. Views families from both a subsystem c. Members of a family are self-
and a suprasystem approach defined.
b. Defines the direction of interactions d. Traditional family functions have been
c. Views the family as an agent of change redefined.
d. Focuses on the interaction of the 5. Which of the following social science theories
family with other systems is used by public health nursing to describe
2. A nurse in community health is working with a how environments and systems outside of the
single parent of three children, ages 4, 6, and 8. family influence the development of a child
The 6-year-old has cerebral palsy. The 4-year- over time?
old has asthma. The maternal grandmother a. Life cycle theory
lives with the family and has diabetes. The b. Family developmental theory
nurse understands the importance of working c. Family systems theory
within the context of the existing family d. Bioecological systems theory
structure and community resources because 6. What terms are used to describe healthy
families are: families? Select all that apply.
a. Resistive to outside intervention or a. Families with strengths
involvement. b. Dysfunctional
b. Responsible for providing/managing c. Functional families
the care of their members. d. Resilient families
c. Unable to manage the stress of e. Resistant families
complex health needs. 7. The nurse in community health uses
d. Restricted in their ability to identify information about family structure, household
interventions. composition, marriage, divorce, birth, death,
3. The family nurse conducts the family nursing adoption, and other family life events to
assessment with the family as a unit. Using a forecast and predict stresses and
systematic process, family problems are developmental changes experienced by
identified and family strengths are emphasized families and identify possible solutions to
as building blocks for interventions. Which of family challenges. This best describes the study
the following best completes the statement to of:
demonstrate the importance of assessment to a. Family demographics.
outcomes? Integrating the extended families: b. Family functions.
a. Fosters equal family and provider c. Family health.
commitment to success. d. Family resilience.
b. Facilitates outcomes-oriented family 8. Family health can be defined as a dynamic,
nursing research. changing, relative state of well-being that
c. Decreases the need for nurse contact includes the biological, psychological,
and intervention. sociological, cultural, and spiritual factors of a
d. Removes barriers to needed services to family system. This family health approach
achieve success.
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 would best include which of the following b. Changing a patient's oxygen tank
underlying principles? Select all that apply. c. Providing materials for a patient who
a. Assessment of the individual's health likes to draw
does not determine the overall family d. Helping a patient eat his dinner
system's health. e. Facilitating a visit from a spouse
b. Family functioning affects the health f. Referring a patient to a cancer support
of individuals. group.
c. Family system assessment specifically Physiologic needs—oxygen, water, food,
addresses the individual's health. elimination, temperature, sexuality, physical
d. The individual's health affects family activity, and rest—must be met at least
functioning. minimally to maintain life. Providing food and
e. Simultaneous assessment of oxygen are examples of interventions to meet
individual family members and the these needs. Preventing falls helps meet safety
family system as a whole is and security needs; providing art supplies may
important to family health. help meet self-actualization needs; facilitating
9. In applying the developmental theory, a family visits from loved ones helps meet self-esteem
nurse determines the developmental stage of needs; and referring a patient to a support
the family based on: group helps meet love and belonging needs.
a. Age of the eldest child. 3. The nurse caring for patients postoperatively
b. Family strengths. uses careful hand hygiene and sterile
c. Individual growth patterns. techniques when handling patients. Which of
d. Overall tasks of the family. Maslow's basic human needs is being met by
10. A family nurse is working with a married couple this nurse?
that has decided to remain child-free. The a. Physiologic
nurse recognizes this decision as a: b. Safety and security
a. Biological necessity. c. Self-esteem
b. Contemporary family function. d. Love and belonging
c. Religious belief decision. By carrying out careful hand hygiene and using
d. Threat to family survival. sterile technique, nurses provide safety from
infection. An example of a physiologic need is
CHAPTER 4: HEALTH OF THE INDIVIDUAL,
clearing a patient's airway. Self-esteem needs
FAMILY, AND COMMUNITY - NCLEX
may be met by allowing an older adult to talk
1. A nurse uses Maslow's hierarchy of basic about a past career. An example of helping
human needs to direct care for patients on an meet a love and belonging need is contacting
intensive care unit. For which nursing activities a hospitalized patient's family to arrange a visit.
is this approach most useful? 4. A nurse caring for patients in a long-term care
a. Making accurate nursing diagnoses facility uses available resources to help patients
b. Establishing priorities of care achieve Maslow's highest level of needs: self-
c. Communicating concerns more actualization needs. Which statements
concisely accurately describe these needs? Select all that
d. Integrating science into nursing care. apply.
Maslow's hierarchy of basic human needs is a. Humans are born with a fully developed
useful for establishing priorities of care. sense of self-actualization.
2. The nurse is prioritizing nursing care for a b. Self-actualization needs are met by
patient in a long-term care facility. Which depending on others for help.
examples of nursing interventions help meet c. The self-actualization process
physiologic needs? Select all that apply. continues throughout life.
a. Preventing falls in the facility
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 d. Loneliness and isolation occur when e. What family traditions do you pass on
self-actualization needs are unmet. to your children?
e. A person achieves self-actualization f. Do you live in an environment that you
by focusing on problems outside consider safe?
self. The five major areas of family function are
f. Self-actualization needs may be met physical, economic, reproductive, affective and
by creatively solving problems. coping, and socialization. Asking who provides
Self-actualization, or reaching one's full emotional support in times of stress assesses
potential, is a process that continues the affective and coping function. Assessing
throughout life. A person achieves self- the breadwinner focuses on the economic
actualization by focusing on problems outside function. Inquiring about having more children
oneself and using creativity as a guideline for assesses the reproductive function, asking
solving problems and pursuing interests. about family traditions assesses the
Humans are not born with a fully developed socialization function, and checking the
sense of self-actualization, and self- environment assesses the physical function.
actualization needs are not met specifically by 7. The nurse caring for families in a free health
depending on others for help. Loneliness and care clinic identifies psychosocial risk factors
isolation are not always the result of unmet for altered family health. Which example
self-actualization needs. describes one of these risk factors?
5. A nurse works with families in crisis at a a. The family does not have dental care
community mental health care facility. What is insurance or resources to pay for it.
the BEST broad definition of a family? b. Both parents work and leave a 12-
a. A father, a mother, and children year-old child to care for his younger
b. A group whose members are brother.
biologically related c. Both parents and their children are
c. A unit that includes aunts, uncles, and considerably overweight.
cousins d. The youngest member of the family has
d. A group of people who live together cerebral palsy and needs assistance
and depend on each other for from community services.
support Inadequate childcare resources is a
Although all the responses may be true, the psychosocial risk factor. Not having access to
best definition is a group of people who live dental care and obese family members are
together and depend on each other for lifestyle risk factors. Having a family member
physical, emotional, or financial support. with birth defects is a biologic risk factor.
6. A nurse performs an assessment of a family 8. A nurse working in an "Aging in Place" facility
consisting of a single mother, a grandmother, interviews a married couple in their late
and two children. Which interview questions seventies. Based on Duvall's Developmental
directed to the single mother could the nurse Tasks of Families, which developmental task
use to assess the affective and coping family would the nurse assess for this couple?
function? Select all that apply. a. Maintenance of a supportive home
a. Who is the person you depend on for base
emotional support? b. Strength of the marital relationship
b. Who is the breadwinner in your family? c. Ability to cope with loss of energy and
c. Do you plan on having any more privacy
children? d. Adjustment to retirement years
d. Who keeps your family together in The developmental tasks of the family with
times of stress? older adults are to adjust to retirement and
possibly to adjust to the loss of a spouse and
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 loss of independent living. Maintaining a create a diagram for the family that displays the
supportive home base and strengthening family unit across generations. Further
marital relationships are tasks of the family with discussions occur regarding the patterns of
adolescents and young adults. Coping with loss health and illness that relate to biological
of energy and privacy is a task of the family health risks. The diagram is called:
with children. a. An ecomap
9. A visiting nurse working in a new community b. A family plan
performs a community assessment. What c. A genogram
assessment finding is indicative of a healthy d. A risk plot
community? 2. One member of an older couple has just
a. It meets all the needs of its inhabitants retired. This is considered a:
b. It has mixed residential and industrial a. Developmental stage that will help the
areas family with stress reduction
c. It offers access to health care services b. Nonnormative event that will have
d. It consists of modern housing and psychological impact on the family
condominiums c. Normative event and can increase the
A healthy community offers access to health family's risk for illness
care services to treat illness and to promote d. Normative event and will have little
health. A healthy community does not usually effect on the family' well-being
meet all the needs of its residents, but should 3. Many families have financial resources that
be able to help with health issues such as allow them to maintain themselves but limit the
nutrition, education, recreation, safety, and quality of their purchasing power. Food high in
zoning regulations to separate residential fat and calories may be affordable, whereas
sections from industrial ones. The age of fresh fruits and vegetables may not be
housing is irrelevant as long as residences are affordable. A federal program that attempts to
maintained properly according to code. promote healthier diets for vulnerable
10. A nurse is practicing community-based nursing populations is:
in a mobile health clinic. What typically is the a. Medicaid
central focus of this type of nursing care? b. Medicare
a. Individual & family health care needs c. Supplemental Security Income (SSI)
b. Populations within the community d. Women, Infants, and Children (WIC)
c. Local health care facilities 4. A parent with two school-age children has just
d. Families in crisis finished a family health assessment
In contrast to community health nursing, which questionnaire. The parent asks the nurse why
focuses on populations within a community, one of the questions asks whether there is a
community-based nursing is centered on neighborhood playground. The nurse's best
individual and family health care needs. response would be:
Community-based nurses may help families in a. "Don't worry about it. We are going to
crisis and work in health care facilities, but talk about all this anyway."
these are not the focus of community-based b. "It's important to good health to
nursing. have adequate recreation resources."
c. "We want to be able to report any
CH. 19 FAMILY HEALTH RISKS - NCLEX
dangerous playground equipment to
1. A nurse in community health is conducting an the city."
assessment on a family of four. During the d. "We want to know what kind of
course of the assessment, the nurse collects neighborhood you're in so we can
information about previous generations of the assess income."
family and siblings. The results are used to
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5. Nursing interventions and approaches for a. Make sure the family does what is
helping individuals and families to assume an expected.
active role in their care should focus on b. Encourage the family to put plans in
empowerment rather than on enabling. The writing.
underlying principle to empowerment is: c. Let the family know that this is a legal
a. Client dominance. agreement.
b. Decreased competence. d. Shift the responsibility so that it
c. Professional dominance. becomes a shared effort.
d. Professional-client partnership. 10. The problem of the working poor and
6. A nurse in community health is conducting a uninsured places a major burden on the current
parenting class for prospective parents that will health care system that affects those families
focus on the development of new skills, and the community in general. Nurses in
identification of needed resources, planning, community health see this as a major: (select all
and other preparations for the arrival of a that apply) Select all that apply.
newborn. This intervention is addressing a a. Behavioral issue.
potential risk associated with: b. Policy issue.
a. Biology. c. Health risk issue.
b. Behavior. d. Social issue.
c. Environment. e. Nursing issue.
d. Transitions.
CH. 1 COMMUNITY HEALTH PRACTICE
7. A nurse doing a family assessment asks the
client, "Have any of your blood relatives had 1. Which of the following best describes
mental illness?" The nurse is asking this community-based nursing?
question to: a. A philosophy that guides family-
a. Determine whether the family is stable. centered illness care
b. Assess for biological risk factors. b. Providing care with a focus on the
c. Decide whether this family member group's needs
needs medication. c. Giving care with a focus on the
d. Demonstrate open-mindedness about aggregate's needs
mental illness. d. A value system in which all clients
8. During a family nursing assessment, a parent receive optimal care
questions whether God is punishing the family, 2. Which of the following best describes
because one of the children has just been community-oriented nursing?
diagnosed with leukemia. The most facilitative a. Focusing on the provision of care to
response by the nurse would be: individuals and families
a. "God is loving and doesn't punish b. Providing care to manage acute or
people." chronic conditions
b. "Tell me more about your family's c. Giving direct care to ill individuals
spiritual beliefs." within their family setting
c. “That is not part of my religious belief d. Having the goal of health promotion
system, so I don't know." and disease prevention
d. "Why do you think your family needed 3. Which of the following is the primary focus of
to be punished?" public health nursing?
9. A nurse in community health decides to form a a. Families and groups
contract with a family. The contract states that b. Illness-oriented care
the family will designate one night as a family c. Individuals within the family unit
night. The nurse is most likely using the d. Promotion of quality of life
contract to:
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4. Which of the following is responsible for the d. Working with community groups to
dramatic increase in life expectancy during the create policies to improve the
twentieth century? environment
a. Technology increases in the field of 8. Which of the following public health nurses
medical laboratory research most clearly fulfills the responsibilities of this
b. Advances in surgical techniques and role?
procedures a. The nurse who met with several groups
c. Sanitation and other public health to discuss community recreation issues
activities b. The nurse who spent the day
d. Use of antibiotics to fight infections attending meetings of various health
5. A nurse is developing a plan to decrease the agencies
number of premature deaths in the c. The nurse who talked to several people
community. Which of the following about their particular health concerns
interventions would most likely be d. The nurse who watched the city council
implemented by the nurse? meeting on local cable television
a. Increase the community's knowledge 9. Which of the following best defines aggregate?
about hospice care. a. A large group of persons
b. Promote healthy lifestyle behavior b. A collection of individuals and families
choices among the community c. A group of persons who share one or
members. more characteristics
c. Encourage employers to have wellness d. Another name for demographic group
centers at each industrial site. 10. A registered nurse was just employed as a
d. Ensure timely and effective medical public health nurse. Which question would be
intervention and treatment for the most relevant for the nurse to ask?
community members. a. "Which groups are at the greatest
6. Which of the following is a basic assumption of risk for problems?"
public health efforts? b. "Which patients should I see first as I
a. Health disparities among any groups begin my day?"
are morally and legally wrong. c. "With which physicians will I be most
b. Health care is the most important closely collaborating?"
priority in government planning and d. "With which nursing assistants will I
funding. partner the most?"
c. The health of individuals cannot be 11. Making sure that essential community-
separated from the health of the oriented health services are available defines
community. which of the core public health functions?
d. The government is responsible for a. Policy development
lengthening the life span of Americans. b. Assessment
7. Which of the following actions would most c. Assurance
likely be performed by a public health nurse? d. Scientific knowledge-based care
a. Asking community leaders what 12. When talking to a women's group at the senior
interventions should be chosen citizens' center, the nurse reminded them that
b. Assessing the community and deciding the only way the center would be able to afford
on appropriate interventions to provide transportation services for them
c. Using data from the main health care would be for them to continue to write letters
institutions in the community to to their local city council representatives
determine needed health services requesting funding for such a service. What
was the nurse trying to accomplish through this
action?
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 a. Ensure that the women did not expect b. To demonstrate their courage and
the nurse to solve their problem commitment
b. Demonstrate that the nurse understood c. To distribute some of their own surplus
the women's concerns and needs clothes to those who can use them
c. Express empathy, support, and concern d. To share with various churches and
d. Help the women engage in political other charities what is needed
action 17. Which of the following variables have led to a
13. The public health nurse has a clear vision of stronger commitment to population-focused
what needs to be done and where to begin to services? (Select all that apply.)
improve the health of the community. Why a. Economic turmoil and demand for
would the nurse spend time meeting with high-technology care
community groups to discuss the most b. Emergence of new or drug-resistant
important task to be addressed first? infectious diseases
a. To increase the group's self-esteem c. Emphasis on overall health care
b. To maintain communication links with needs rather than only on acute care
the groups treatment
c. To make the groups feel good about d. Threat of bioterrorism
their contribution 18. Which of the following actions demonstrate(s)
d. To work with the groups, not for the effective public health nursing practice in the
groups community? (Select all that apply.)
14. The nurse often has to make resource a. Epidemiologic investigations
allocation decisions. Which of the following examine the environment for health
best describes the criterion the nurse should hazards.
use in such cases? b. New services are organized where
a. The specific moral or ethical principle particular vulnerable populations
related to the situation live.
b. The cheapest, most economical c. Partnerships are established with
approach community coalitions.
c. The most rational probable outcome d. Staff members at the public health
d. The needs of the aggregate rather agency continue to increase in number.
than a few individuals 19. Why are nurses increasingly providing care in
15. Which of the following actions best represents clients' homes rather than in hospitals? (Select
public health nursing? all that apply.)
a. Assessing the effectiveness of the a. Home care is less expensive.
large high school health clinic b. It is much more efficient to give care in
b. Caring for clients in their home the home.
following their outpatient surgeries c. Nurses prefer to give home care with
c. Providing care to children and their individual attention.
families at the school clinic d. People prefer to receive care in their
d. Administering follow-up care for homes rather than in hospitals.
pediatric clients at an outpatient clinic 20. Which of the following actions to promote
16. Two nurses plan to walk under a huge health would the public health nurse choose?
downtown bridge where various homeless a. Asking community leaders what
persons live. Why would the nurses go to such interventions should be chosen
an unsafe area? b. Asking hospital administrators what
a. To assess the needs of the homeless interventions are needed
who live there c. Assessing the community and planning
interventions
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 d. Working with community groups to c. Demonstrating caring as the basis of
create health policies nursing practice
21. Which of the following best defines aggregate? d. Seeking evidence based outcomes to
a. A large group of persons provide nursing care
b. A group of persons who share one or 27. A nurse is caring for a client of another culture.
more characteristics Which action is most appropriate?
c. A collection of individuals and families a. Adapt care to reflect the cultural
d. Another name for demographic group needs of the client
22. What is the best explanation for public health b. Rely on friendly gestures to show caring
nurses to be involved in health care reform? for the client
a. To promote the nursing profession c. Keep care cultural neutral to avoid
b. To share the concerns of the misinterpretations
community d. Treat the client in the same way as any
c. To increase funding for public health other client
nursing 28. Which of the following is most closely
d. To help improve access to health care correlated with poor health outcomes?
23. Which nurse is famous for creating public a. Age and gender
health nursing in the U.S.? b. Minority race status
a. Florence Nightingale c. Low SES
b. Lillian Wald d. High-risk lifestyle behaviors
c. Frances Root
COMMUNITY NCLEX QUESTIONS EXAM 1
d. Jean Watson
24. What is the primary purpose of Healthy People 1. A community health nurse has conducted a
2020? needs assessment in a rural community and
a. To serve as roadmap to improve established a diagnosis of knowledge deficit
holistic health care in the U.S. related to IV drug use and HIV transmission.
b. To minimize disparities in US urban and She wants to implement an educational
rural communities program to reduce the fear and stigma
c. To link public and private healthcare surrounding IV drug use. Which of the
initiatives following aggregates within the community
d. To encourage all people to have health would be the most appropriate targets for this
insurance program (select all that apply)?
25. How would the public health nurse best a. Police officers and first responders
describe the health care system in the U.S.? b. Certified nursing assistants at the local
a. Only essential needs are met, which nursing home
primarily controls cost c. Parents of the local high school
b. It is divided into two systems: public d. Kindergarten teachers within the school
and private healthcare corporation
c. It is a system which focuses on primary e. The nursing staff at the local clinic
prevention 2. A community health nurse has noticed an
d. It is the best healthcare service in the increase in childhood obesity and a decrease in
world physical activity among the local students. She
26. Which of the following depicts the core nursing wants to perform a needs assessment
ethic? regarding the local sidewalks and ability for
a. Adapting to technologies such as kids to walk to school. Which forms of data
electronic medical records collection would be useful in her assessment
b. Distinguishing nursing care from (select all that apply)?
medical care
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 a. Interviewing parents on the c. Mail surveys to members of the
condition of their neighborhoods, community who were not willing to talk
their feeling of safety, and if they in person
would allow their child to walk to d. Form focus groups to promote more
school interaction and expression of ideas
b. Initiating a community forum in 5. A high school nurse is collaborating with the
which members of the community sexual education instructor to educate young
are able to share their thoughts on women on ways to prevent breast cancer.
the local sidewalks, physical activity, Which of the following is an example of
and walking to school primary prevention?
c. Extracting data regarding the average a. Perform a breast self-exam every
family income of each neighborhood month
d. Creating a focus group to determine b. Education on when to start getting
cafeteria workers feel about the lunches routine mammograms
they serve c. Educate young girls on how to care
e. Direct observation of the ways in for their own body
which children get to school, and the d. Contact your primary health care
usage of sidewalks in the community provider if you notice an abnormal
3. A nurse is hoping to implement a Syringe lump during a self-breast exam
Access Program into her community due to the 6. A community health nurse in paoli, IN has
recent increase in individual's newly diagnosed recently launched a diabetes prevention
with hepatitis C. She is experiencing pushback program. The nurse wants to begin nutrition
from local officials. Which of the following is classes for the elementary schools in Orange
the best response to the effectiveness of SAPs. County. She plans to assess the progress of the
a. Once we have made contact with users, program in 1 year. Which of the following
it will be easy to convince them to enter would a nurse NOT use to evaluate the
a treatment program progress the community has made toward the
b. The addicts will find needles on their goal of the program?
own, we might as well give them clean a. Construct benchmarks to gauge
ones achievement of the program goal
c. Saps will increase the number of b. Compare data from the entire us to the
syringes in the community data in orange county
d. SAPs are an example of harm c. Compare the current data to the
reduction which proves to be baseline data
effective in preventing disease d. Ask the parents to evaluate the
transmission and linking individuals progress of their children
to social services and health care 7. A student nurse is interested in how Indiana's
they might require tobacco use compares to the national average
4. A nurse wants to assess a community's tobacco use --what is the best source to gather
perspective and concerns regarding health this data from?
care needs in this community. What would be a. Conduct a windshield survey to collect
the best first approach for the nurse to take to first hand observation of tobacco use
gather data about the community? among the community
a. Hold a community forum to discuss b. Twitter
concerns in the community c. Use a reliable and up to date source
b. Interview key informants in the such as CDC --National Center for
community Health statistics to compare

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 Indiana's tobacco prevalence among a. Increasing physical activity can improve
the US the overall health in the community by
d. Use MMWR (morbidity and mortality helping people place an importance on
weekly report) their health. Leading to healthier food
8. A research team at a hospital are about to open choices and lifestyle choices
up an online community forum to start their b. Having more sidewalks placed
data collection --what are some disadvantages around the community could not
to this approach that they must keep in mind increase physical activity
when analyzing their data? (select all that c. The assessments a nurse makes about a
apply) community are important because they
a. Online forums decrease collaboration can then lead to a diagnosis, planning,
and engagement intervention, and evaluation
b. Online forums exclude some people d. Community health is important for
such as those without access to a prevention of diseases
computer and those who can't write 11. A nurse is performing a full assessment on a
or read patient who came in reporting uncomfortable
c. The lack of physical cues may lead to and difficult breathing. The nurse discovers
miscommunication through assessment that the patient works in a
d. Participants who may ordinarily feel factory and suspects this could be the cause of
embarrassed or nervous to participate difficulty breathing. What is this community
in discussion feel freed by the nurse’s first priority?
anonymity of the forum a. Make a public service announcement to
e. Participants may accidentally go off the community to prevent further cases
topic within a particular discussion b. Inform the factory of this finding so
thread they can make improvements to
9. A public health worker has completed a needs prevent further cases
assessment and determined the lack of access c. Inform the physician of your
to nearby grocery stores leading to inadequate assessment findings
nutrition to be a problem within her d. Call the insurance so they can start a
community, what would be her next step in the lawsuit for the employees against the
ADPIE process? company
a. Plan her goas relating to this 12. There is a current community flu pandemic
problem diagnosis using evidence occurring in many places around the world.
based practice Fortunately, it has not impacted your
b. Open up her own grocery store in the community yet. In regards to community
center of the community health, what is the community health nurse’s
c. Nothing, she determined the problem top priority?
now it's somebody else's responsibility a. Preventing an outbreak of the flu
to fix it through community awareness
d. Evaluate the effectiveness of her efforts
interventions b. Treating the patient with the flu
10. The nurse is precepting a new nurse on their c. Researching the flu symptoms
current assignment of assessing the various d. Diagnosing the patient with the flu
communities surrounding their community. 13. Factors related to the determinants of health
Which of the following comments made by the identified in Healthy People 2020 include which
new nurse should be corrected by the of the following (select all that apply)?
precepting nurse? a. Education and literacy
b. Genetic endowment
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 c. Gender made by the new nurse would require
d. Culture intervention by the experienced nurse?
e. Social status a. "A windshield survey offers the nurse an
14. When applying the nursing process to opportunity to observe people and
environmental health, the nurse would: their role in the community"
a. Conduct an assessment focused on the b. "a windshield survey helps gain an
client's presenting problem understanding of environmental and
b. Coordinate interventions with the geographic features"
primary care provider of record c. "a windshield survey can help gather
c. Examine criteria that are limited to the subjective information from
client's immediate response members of a particular population"
d. Include outcome measures that d. "a windshield survey is one way a
involve mitigation and elimination of researcher gathers information on the
the contributing factors location of agencies, services,
15. A nurse teaches an asthmatic client to businesses, and industries in a
recognize and avoid exposure to asthma particular area through sight, sense,
triggers and assists the client's family in and sound"
implementing specific protection strategies in 18. A nurse is planning to conduct a study to
the home, such as removing carpets and address the opioid crisis in a particular
avoiding pets. the nurse's activities can be southern Indiana county. The nurse is
described as: examining the community's functions and
a. Comprehensive assessment subsystems to determine existing and potential
b. Primary prevention health problems that may be related to the
c. Secondary prevention opioid crisis. Which of the following would be
d. Treatment intervention examples of community functions?
16. A community health nurse is planning to a. Education opportunities
conduct a study to address health disparities in b. Number of safe and clean parks
Paoli, IN. to set the focus for the study, the c. High school graduation rate
nurse is conducting a needs assessment. Which d. Accessible health services
of the following would be the most important e. Prevalence of polypharmacy within the
first intervention to begin the needs county
assessment? 19. A nurse is developing a community education
a. Compile local, regional, and state program about the risk factors for childhood
government reports to identify certain obesity. Which of the following aggregates of
trends in the population over time people should the nurse address in her
b. Determine if the sample will be teaching? Select all that apply.
representative of the whole population a. Parents of school-aged children
c. Gather subjective information from b. Local construction workers
community members to identify the c. A small group of 1st grade students
specific gaps in services and d. P.E. teachers within the school
community access corporation
d. Collect samples from local water way to e. Nursing staff at the advanced dementia
compare water quality in Paoli, IN to care facility
surrounding aggregates 20. A community health nurse has been assigned
17. A new nurse is educating a group of nursing to care for a group of clients in Indianapolis, IN
students on the purpose of a windshield where cardiovascular disease is a major health
survey. Which of the following statements concern. Which of the following is the BEST way

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 for the nurse to gain an understanding of the a. The identification of the health
community and its environmental features? problem
a. Conduct an interview with the local b. The affected aggregate or
homeless shelter supervisor community
b. Perform a windshield survey c. The etiological or casual or
c. Analyze and interpret local census data statement
d. Organize an education program for the d. The evidence or support for the
students at IUPUI diagnosis
21. A public health nurse is providing education to e. The nurses' recommendation on how to
a client who was recently diagnosed with type solve the identified health promotion
2 diabetes. During the teaching, the nurse 25. A nurse is doing a windshield survey in a rural
emphasized the importance of inspecting the population that she is about to work in. What
skin daily for dryness, cuts, or redness. this can should she be looking for during this
be described as an example of: windshield survey? Select all that apply.
a. Primary prevention a. Determine areas that need further
b. Secondary prevention investigations
c. Tertiary prevention b. Tone of the community
d. Comprehensive assessment c. Communicating with politicians about
22. If a nurse researcher needed to know certain available resources
demographic variables such as the distribution d. Available resources that the
of age, sex, etc. for the community in which community has access to
they are performing their research, where e. Discussing resources that need to be
would they look to find this information? implemented
a. The US census 26. A patient wants to know what are some
b. The local physician's office resources that are available to her since she
c. The American community survey lives in a food desert. The nurse is concerned
d. Ask the first 50 people you see to fill out that this patient will not be able to get the
a survey for you proper food that she needs to better her health
23. A nurse researcher is conducting a needs and decrease her blood sugar. What should the
assessment in a community where there is an nurse communicate in this situation?
obesity problem. What would be the first a. There are resources further away that
approach to gather data for this needs you could take advantage of
assessment? b. Here are some pamphlets that discuss
a. Look at the US census for crime levels growing groceries in your backyard
in the area c. Could there be someone else that could
b. Interview local doctors, school get groceries for you and your family?
officials d. What type of resources would you
c. Interview the manager of the local like to learn about and are there
restaurant resources that you have already
d. Interview individuals who are tried?
overweight as you pass them on the 27. In order to best control the spread of diseases
street in rural communities, what should the nurse
24. A nurse researcher surveyed a community and communicate to her community and patients?
came up with a community diagnosis of the 1. Implementing a needle exchange
health problems affecting the community. 2. Providing education about the spread of
Which components of her community diseases
diagnosis followed the correct format of a 3. Present patients with the statistics about the
community diagnosis? spread of diseases
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 4. Identify risk factors that the patients could the lack of awareness of healthy
come across choices
a. 1, 2, 3, 4 c. Increased risk of cardiovascular disease
b. 3, 1, 2 in older white men due to lack of
c. 2, 4, 1 healthy food choices
d. 4, 3, 1 d. The community has a high risk of COPD
28. A community health nurse is trying to gain an which is related to their lack of
understanding of the environmental layout to education in smoking cessation
locate any concern through the idea of "sight, 31. You have decided to carry out a needs
sense, and sound." Which is the following ways assessment focusing on sexual assault victims.
is the best way for the nurse to observe the You have reviewed several existing data
community and their roles? sources and are now ready to collect new data.
a. The nurse should take a look at the Which method would likely yield the most
social system of the community to results given the chosen aggregate?
understand the relationships a. In-person interviews
b. The nurse should analyze the b. A public forum
geographic community to define c. Surveys
landmarks in each neighborhood d. Focus groups
c. The nurse should conduct a 32. A nurse has noticed increasing numbers of
windshield survey in order to learn childhood obesity in her area of practice. She
about the community has decided that she wants to address this
d. The nurse should assess the important problem from a community standpoint. What
determinants of a healthy community is the first step the nurse needs to take moving
29. A community health nurse is trying to figure forward?
out why chronic diseases like breast cancer are a. Use demographic and epidemiological
more prevalent in women in rural areas. Which data to assess the aggregate
of the following do you think are the main b. Perform a windshield survey of the area
reasons for this? Select all that apply. c. Define the community
a. Distance for preventative screenings d. Interview key informants in the
are more than 20 miles community
b. There is greater amount of carcinogens 33. A student is working with a public health nurse
in rural areas to perform a community assessments on a
c. There is a lack of health insurance for local town. During the assessment phase of the
people in rural areas process, the student nurse volunteers to carry
d. People in rural areas are more likely to out a windshield survey of the area. Which
drink and smoke statement made by the student indicates a
e. Finances are usually limited for need for further teaching?
people in rural areas a. "I will drive around the area and make
30. After visiting a rural town in her state, a organized observations of what I see"
community health nurse is trying to put b. "I will interview locals to further
together a community health diagnosis. Which clarify my observations"
of the following is the correct way to format c. "I will take note of health resources
this diagnosis? being utilized and look for evidence of
a. The town has an increased risk of wellness care"
diabetes due to nutrition problems d. "I will assess the conditions of the built
b. Increased risk of hypertension environment"
among pregnant women related to 34. The nurse is educating the patient on disease
poor nutrition as demonstrated in prevention regarding a recent outbreak of
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 influenza within the community. Which d. "A few examples of data collection
statement below is the most correct? instruments that I may use are surveys
a. Getting the flu vaccine is a great or interviews"
example of tertiary prevention as it 37. A community health nurse must perform a
reduces your chances of getting the flu needs assessment before implementing any
significantly intervention so as to identify gaps in access and
b. Be sure to stay clear from anyone who not waste resources. Which is the first step of a
may cough or sneeze, even if they cover needs assessment?
their face a. Identify required information
c. Going for a checkup when you b. Select data collection method
exhibit muscle aches and a cough is a c. Identify aggregate
good practice of secondary d. Engage community
prevention for the flu 38. A community health or public health nurse has
d. Primary prevention is used for early noticed an increase in youth tobacco use in her
detection and treatment of the flu community. Which of the following aggregates
35. A community nurse is interested in gathering would a nurse want to direct education about
data about a random community for a research tobacco use towards? Select all that apply.
project. What is the best first step in gathering a. School-aged children
this information? b. Parents of school aged children
a. The nurse should conduct a windshield c. Older adults
survey to make an observation of the d. Administrators/educators
community's businesses, schools, e. Pediatric nursing staff
sidewalks, homes, and restaurants 39. A public health nurse has noted an increase in
b. Checking the census should be the HIV and hepatitis C cases in her county over the
nurse's first step as it obtains past two years. She has begun an initiative to
information regarding sex, screen at-risk populations in her community.
population, age, race, and ethnicity Which level of prevention would this be
c. The nurse should check into vital considered?
statistics to check records of deaths, a. Primary prevention
births, and marriages b. Secondary prevention
d. The national center for health statistics c. Tertiary prevention
(NCHS) should be the first step as this d. General prevention
would tell the nurse statistics on 40. A community health nurse is trying to obtain
disability, illness, and other health data about diabetes and sugar intake rates in
variables an elderly population in Bloomington, IN.
36. A new community nurse wants to do a needs Which of the following intervention should the
assessment for her community. Which nurse take first?
statement made by the nurse is incorrect? a. Identifying gaps in service/access
a. "Before I can identify required b. Collecting health data from a local
information needed, I must engage the hospital
community. Otherwise, it will not work c. Interviewing key informants
out" d. Starting a diabetes prevention program
b. "My very first step should be identifying for the elderly population
where the community is lacking in
COMMUNITY HEALTH NSG NCLEX QUESTIONS
access so that I do not repeat what does
not work" 1. The nurse is preparing a smoking cessation
c. "Key informants are helpful for data class and is amazed at how many people still
collection, but not needed" smoke even with the information on lung
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 cancer so readily available. She believes that 3. The patient is describing moderate incisional
her class will convert many smokers to pain that was not relieved by the last dose of
nonsmokers once they get all the latest hydromorphone (Dilaudid) given 90 minutes
information. The nurse is a believer in which of earlier. The patient is not due for another dose
the following health care models? of medication for another 2 1/2 hours. The
a. Health Belief Model nurse repositions the patient, asks what type of
b. Health Promotion Model music she likes, and puts on the music channel
c. Basic Human Needs Model on the television, setting it to play that type of
d. Holistic Health Model music. The nurse is attempting to utilize which
The Health Belief Model addresses the health care model?
relationship between a person's beliefs and a. Health Belief Model
behaviors. The Health Promotion Model is b. Health Promotion Model
more complex than the Health Belief Model in c. Basic Human Needs Model
that it notes that each person has unique d. Holistic Health Model
personal characteristics and experiences that The Holistic Health Model recognizes the
affect subsequent actions. The Basic Human natural healing abilities of the body and
Needs Model is based on the theory that all incorporates complementary and alternative
people share basic human needs, and the interventions such as music therapy. The
extent to which basic needs are met is a major Health Belief Model addresses the relationship
factor in determining a person's level of health. between a person's beliefs and behaviors. The
The Holistic Health Model recognizes the Health Promotion Model notes that each
natural healing abilities of the body and person has unique personal characteristics and
incorporates complementary and alternative experiences that affect subsequent actions. The
interventions such as music therapy. Education Basic Human Needs Model believes that the
is important but is not the sole determinant of extent to which basic needs are met is a major
change. factor in determining a person's level of health.
2. The health care model that utilizes Maslow's Maslow's hierarchy of needs is a model that
hierarchy as its base is the _____ Model. nurses use to understand the interrelationships
a. Health Belief of basic human needs.
b. Health Promotion 4. Many variables influence a patient's health
c. Basic Human Needs beliefs and practices. Internal and external
d. Holistic Health variables influence how a person thinks and
The Basic Human Needs Model believes that acts. An example of an internal variable would
the extent to which basic needs are met is a be
major factor in determining a person's level of a. Perception of functioning.
health. Maslow's hierarchy of needs is a model b. Family practices.
that nurses use to understand the c. Socioeconomic factors.
interrelationships of basic human needs. The d. Cultural background.
Health Belief Model addresses the relationship Internal variables include a person's
between a person's beliefs and behaviors. The developmental stage, intellectual background,
Health Promotion Model notes that each perception of functioning, and emotional and
person has unique personal characteristics and spiritual factors. External variables influencing a
experiences that affect subsequent actions. The person's health beliefs and practices include
Holistic Health Model recognizes the natural family practices, socioeconomic factors, and
healing abilities of the body and incorporates cultural background.
complementary and alternative interventions 5. The nurse is admitting a patient with
such as music therapy. uncontrolled diabetes mellitus. It is the fourth
time the patient is being admitted in the last 6
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 months for high blood sugars. During the immunizations. As such, this clinic is designed
admission process, the nurse asks the patient to provide
about her employment status and displays a a. Primary prevention.
nonjudgmental attitude. Why does the nurse b. Secondary prevention.
do this? c. Tertiary prevention.
a. Noncompliant patients thrive on the d. Diagnosis and prompt intervention.
disapproval of authority figures. Primary prevention precedes disease or
b. External variables have little effect on dysfunction and is applied to people
compliance. considered physically and emotionally healthy.
c. A person's compliance is affected by Health promotion includes health education
economic status. programs, immunizations, and physical and
d. Employment status is an internal nutritional fitness activities. Secondary
variable that impacts compliance. prevention focuses on individuals who are
A person's compliance with treatment is experiencing health problems or illnesses and
affected by economic status. A person tends to who are at risk for developing complications or
give a higher priority to food and shelter than worsening conditions. Activities are directed at
to costly drugs or treatments. A person diagnosis and prompt intervention. Tertiary
generally seeks approval and support from prevention occurs when a defect or disability is
social networks, and this desire for approval permanent and irreversible. It involves
affects health beliefs and practices. Internal and minimizing the effects of long-term disease or
external variables influence how a person disability through interventions directed at
thinks and acts toward health care. preventing complications and deterioration.
Employment status is an external variable, not 8. The patient is admitted to the emergency
an internal variable. department of the local hospital from home
6. The nurse is working on a committee to with reports of chest discomfort and shortness
evaluate the need for increasing the levels of of breath. She is placed on oxygen, has labs and
fluoride in the drinking water of the blood gases drawn, and is given an
community. In doing so, the nurse is fostering electrocardiogram and breathing treatments.
the concept of What level of preventive care is this patient
a. Illness prevention. receiving?
b. Active health promotion. a. Primary prevention
c. Wellness education. b. Secondary prevention
d. Passive health promotion. c. Tertiary prevention
Fluoridation of municipal drinking water and d. Health promotion
fortification of homogenized milk with vitamin Secondary prevention focuses on individuals
D are examples of passive health promotion who are experiencing health problems or
strategies. With active strategies of health illnesses and who are at risk for developing
promotion, individuals are motivated to adopt complications or worsening conditions.
specific health programs such as weight Activities are directed at diagnosis and prompt
reduction and smoking cessation programs. intervention. Primary prevention precedes
Illness prevention activities such as disease or dysfunction and is applied to people
immunization programs protect patients from considered physically and emotionally healthy.
actual or potential threats to health. Wellness Health promotion includes health education
education teaches people how to care for programs, immunizations, and physical and
themselves in a healthy way. nutritional fitness activities. Tertiary prevention
7. The nurse is working in a clinic that is designed occurs when a defect or disability is permanent
to provide health education and and irreversible. It involves minimizing the
effects of long-term disease or disability
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 through interventions directed at preventing 11. Risk factors can be placed in the following
complications and deterioration. interrelated categories: genetic and
9. Just as health and health behavior are affected physiological factors, age, physical
by internal and external variables, so are illness environment, and lifestyle. The presence of any
and illness behavior. Which external variables of these risk factors means that
can affect illness and behavior? (Select all that a. A person with the risk factor will get the
apply.) disease.
a. Perception of the seriousness of the b. The chances of getting the disease
illness are increased.
b. Patient's coping skills c. The disease is guaranteed not to
c. Cultural background develop if the risk factor is controlled.
d. Social support d. Risk modification will have no effect on
e. Socioeconomic status disease prevention.
External variables influencing a patient's illness The presence of risk factors does not mean that
behavior include the visibility of symptoms, a disease will develop, but risk factors increase
social group, cultural background, economic the chances that the individual will experience
variables, accessibility of the health care a particular disease or dysfunction. Control of
system, and social support. Internal variables risk factors does not guarantee that a disease
include the patient's perceptions of symptoms will not develop. However, risk factor
and the nature of the illness, as well as the identification assists patients in visualizing
patient's coping skills and locus of control. those areas in life that can be modified or even
10. A patient is admitted to a rehabilitation facility eliminated to promote wellness and prevent
following a stroke. The patient has right-sided illness.
paralysis and is unable to speak. The patient 12. Models of health offer a perspective by which
will be receiving physical therapy and speech to understand the relationships between the
therapy. What are these examples of? concepts of health, wellness, and illness. Nurses
a. Primary prevention are in a unique position to assist patients in
b. Secondary prevention achieving and maintaining optimal levels of
c. Tertiary prevention health because nurses (Select all that apply.)
d. Health promotion a. Understand the challenges of today's
Tertiary prevention occurs when a defect or health care system.
disability is permanent and irreversible. It b. Identify actual and potential risk
involves minimizing the effects of long-term factors.
disease or disability through interventions c. Have coined the term "illness behavior."
directed at preventing complications and d. Can minimize the effects of illness
deterioration. Secondary prevention focuses and assist to the return of optimal
on individuals who are experiencing health health
problems or illnesses, and who are at risk for Nurses are in a unique position to assist
developing complications or worsening patients in achieving and maintaining optimal
conditions. Activities are directed at diagnosis levels of health. Nurses understand the
and prompt intervention. Primary prevention challenges of today's health care system and
precedes disease or dysfunction and is applied embrace the opportunity to use wellness
to people considered physically and activities to promote health and wellness and
emotionally healthy. Health promotion to prevent illness. Nurses can identify actual
includes health education programs, and potential risk factors that predispose a
immunizations, and physical and nutritional person or group to illness. Nurses who
fitness activities. understand how patients react to illness can
minimize the effects of illness and assist
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 patients and their families in maintaining or are ready to take action regarding their health
returning to the highest level of functioning. behavior problems. Only a minority of people
Medical sociologists call the reaction to illness are actually in this action stage. Changes will be
"illness behavior." maintained over time only if they are
13. The nurse is caring for a patient who has been integrated into an individual's overall lifestyle.
trying to quit smoking. She has been smoke As individuals attempt a change in behavior,
free for 2 weeks but had two cigarettes last relapse followed by recycling through the
night and at least two this morning. What stages occurs frequently.
should the nurse anticipate? 15. Which is the primary goal of community health
a. The patient does not want to and never nursing?
will quit smoking. a. To support and supplement the efforts
b. The patient will return to the of the medical profession in the
contemplation or pre-contemplation promotion of health and prevention of
phase. illness
c. The patient will need to adopt a new b. To enhance the capacity of
lifestyle for change to be effective. individuals, families and
d. The patient must pick up her attempt communities to cope with their
right where she left off. health needs
When relapse occurs, the person will return to c. To increase the productivity of the
the contemplation or precontemplation stage people by providing them with services
before attempting the change again. The that will increase their level of health
patient cannot pick up her attempt where she d. To contribute to national development
left off. It is believed that change involves through promotion of family welfare,
movement through a series of stages. These focusing particularly on mothers and
stages range from no intention to change children.
(precontemplation), to making small changes 16. When assessing a community's health care
(preparation), to actively engaging in strategies needs, an advanced public health nurse
to change behavior (action), to maintenance. interviews a first-grade teacher and the editor
The action phase indicates a desire to change of the weekly news bulletin. The nurse is using
and a potential to do so. Changes will be which data collection method?
maintained over time only if they are a. Key informant
integrated into an individual's overall lifestyle. b. Nominal group
14. The nurse is working in a drug rehabilitation c. Participant observer
clinic and is in the process of admitting a d. Social survey
patient who says that she wants to be Key informant interviews are qualitative in-
"detoxified." It is important for the nurse to depth interviews with people who know what
a. Identify the patient's stage of is going on in the community. The purpose of
change. key informant interviews is to collect
b. Realize that the patient is ready to information from a wide range of people—
change. including community leaders, professionals, or
c. Instruct the patient that she will have to residents—who have firsthand knowledge
change her lifestyle. about the community.
d. Instruct the patient that relapses are 17. The three essential elements of informed
not tolerated. consent are:
Processes of change, or nursing interventions, a. Accountability, beneficence, and
should be appropriately chosen to match the paternalism.
stage of change. Most behavior change b. Confidentiality, truthfulness, and
programs are designed for those people who advocacy.
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 c. Financial risk, rule of utility, and a higher rate of death or hospitalization than a
protection of privacy. county with a younger population, merely
d. Information, comprehension, and because the elderly are more likely to die or be
freedom from coercion. hospitalized. (The same distortion can happen
Informed consent is a process for getting when comparing races, genders, or time
permission before conducting a healthcare periods.) Age adjustment can make the
intervention on a person. A health care different groups more comparable.
provider may ask a patient to consent to 21. An advanced public health nurse investigates a
receive therapy before providing it, or a clinical cluster of cases of learning disabilities, hearing
researcher may ask a research participant impairment, and developmental delays in
before enrolling that person into a clinical trial. school-age children who live in an apartment
18. Which program is an example of secondary complex that was built in 1971. The nurse
prevention? suspects exposure to:
a. A community-wide nutrition program a. Carbon monoxide.
at fast-food establishments b. Lead.
b. A program to immunize persons c. Nitrogen dioxide.
exposed to infectious disease with d. Radon.
immunoglobulin G within two weeks Lead used to be very common in gasoline and
of exposure house paint in the U.S. Children living in cities
c. Alcoholics Anonymous with older houses are more likely to have high
d. An exercise program for persons who levels of lead. Houses painted before 1978.
have had a stroke Even if the paint is not peeling, it can be a
19. A tornado strikes a mobile home community in problem. Lead paint is very dangerous when it
a small rural town. Approximately 10 families is being stripped or sanded. These actions
are left without food and shelter. Which release fine lead dust into the air. Infants and
reaction demonstrates the community's children living in pre-1960's housing (when
viability? paint often contained lead) have the highest
a. Community leaders activate the risk of lead poisoning. Small children often
community disaster plan. swallow paint chips or dust from lead-based
b. Community leaders contact the federal paint. Toys and furniture painted before 1976.
government about disaster relief. 22. What is the vision of the Department of Health
c. Relief workers run out of bottled water a. Responsible for the formulation,
and bedding supplies. planning, implemented, and
d. Tornado victims are sent to a boarding coordination of policies and programs
home in the nearest urban area. in the field of health
20. Mortality rates from two communities can best b. Regulates health goods and services
be compared after calculating: c. Health as Right. Health for all
a. The age-adjusted rates. Filipinos by the year 2000 and Health
b. The crude rates. in the hands of the People by the
c. The gender-specific rates. year 2020
d. The prevalence rates. d. All of the above
The age-adjusted rates are rates that would 23. Concerned with the care of school-children, the
have existed if the population under study had nurse does the following, EXCEPT:
the same age distribution as the "standard" a. Provides for a safe environment
population. Therefore, they are summary b. Detects, diagnose, and treats
measures adjusted for differences in age children with health problems
distributions. For example, a county having a c. Identifies and refers children with eye
higher percentage of elderly people may have problems
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 d. Conducts health education classes with caution to an individual with a moderate
24. A nurse provides home care instructions to the or severe acute illness, with or without fever.
parents of a child hospitalized with pertussis. Options 1, 3, 4 and 6 are not contraindications
The child is in the convalescent stage and is to receiving a live vaccine.
being prepared for discharge. Which statement 26. A child is scheduled to receive inactivated polio
by a parent indicates a need for instructions? vaccine (IPV), and a nurse preparing to
a. We need to encourage our child to administer the vaccine reviews the child's
drink fluids record. The nurse questions the administration
b. Coughing spells may be triggered by of IPV if which of the following is documented
dust or smoke in the child's record?
c. Vomiting may occur when our child has a. Recent recovery from a cold
coughing episodes b. A history of frequent respiratory
d. We need to maintain droplet infections
precautions and a quiet environment c. A history of an anaphylactic reaction
for at least 2 weeks to neomycin
Pertussis is transmitted by direct contact or d. A local reaction at the site of a previous
respiratory droplets from coughing. The IPV
communicable period occurs primarily during IPV contains neomycin. A history of
the catarrhal stage. Respiratory precautions are anaphylactic reaction to neomycin is
not required during the convalescent phase. considered a contraindication to IPV. The
Options 1, 2, 3 are accurate components of presence of a minor illness such as the
home care instructions. common cold is not. IN addition, a history of
25. A clinic nurse is assessing a child who is frequent respiratory infections is not a
scheduled to receive a live virus vaccine contraindication to receiving a vaccine. A local
(immunization). Which of the following are reaction to an immunization is not a
general contraindications associated with contraindication to receiving a vaccine.
receiving a live virus vaccine? (Select all that 27. A clinic nurse is instructing the mother of a
apply) child with human immunodeficiency virus (HIV)
a. The child has symptoms of a cold infection regarding immunizations. The nurse
b. The child had a previous tells the mother that:
anaphylactic reaction to the vaccine. a. The hepatitis B vaccine will not be given
c. Mother reports that the child is having to the child.
intermittent episodes of diarrhea. b. The inactivated influenza vaccine will
d. Mother reports that the child has not be given yearly.
had an appetite and has been fussy c. The varicella vaccine will be given
e. The child has a disorder that caused before 6 months of age.
a severely deficient immune system d. A western blot test needs to be
f. Mother reports that the child has performed and the results evaluated
recently been exposed to an infectious before immunizations.
disease. Immunizations against common childhood
The general contraindications for receiving live illnesses are recommended for all children
virus vaccines include a previous anaphylactic exposed to or infected with HIV. The
reaction to a vaccine or a component of the inactivated influenza vaccine that is given IM
vaccine. Additionally, live virus vaccines will be administered. The hepatitis B vaccine is
generally are not administered to individuals administered according to the recommended
with a severely deficient immune system, immunization schedule. Varicella-zoster
individuals with a severe sensitivity to gelatin, immunoglobulin may be prescribed after
or pregnant woman A vaccine is administered
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 chickenpox exposure. Option 4 is unnecessary b. An emergency is personal, whereas a
and inaccurate. disaster is community-wide.
28. The gold standard of evidence gathering in c. Both emergencies and disasters are
evidence-based practice is: devastating.
a. Clinical knowledge and judgment d. Both emergencies and disasters are
b. Expert opinions failures resulting in extensive insurance
c. Randomized clinical trials claims.
d. Theories of practice A disaster is any event that causes a level of
29. When acting as a mediator, the nurse advocate destruction, death, or injury that affects the
would: abilities of the community to respond to the
a. Choose a new health plan for a client incident using available resources.
with limited funds Emergencies differ from disasters in that the
b. Assist new parents in communicating agency, community, family, or individual can
with their health plan regarding well- manage an emergency using their own
baby coverage resources. However, a disaster event may be
c. Provide health education to teens who beyond the ability of the community to
need knowledge about sexually respond to and recover from the incident using
transmitted diseases its own resources. Disasters frequently require
d. Set up a doctor's appointment for an assistance from outside the immediate
illiterate adult community.
30. Which U.S. agency is responsible for
CHAPTER 19 NCLEX QUESTIONS
overseeing the actions of protecting against,
responding to, recovering from, and 1. During a family nursing assessment, a parent
preventing the effects of disaster? questions whether God is punishing the family,
a. American Red Cross because one of the children has just been
b. Department of National Security diagnosed with leukemia. The most facilitative
c. Federal Emergency Management response by the nurse would be:
Agency a. "God is loving and doesn't punish
d. The National Disaster Relief Agency people."
e. The National Incident Management b. "Tell me more about your family's
System spiritual beliefs."
Because of the recognition of the need to be c. "That is not part of my religious belief
prepared, programs have been created to system, so I don't know."
address the national, state, and local d. "Why do you think your family needed
management of disasters. President G. W. Bush to be punished?"
established the National Incident Management The focus of the Neuman Systems Model
System (NIMS) in 2004. The NIMS provides a would be to assess the family's ability to adapt
systematic, proactive approach for all levels of to this stressful change. Assessment of
government and nongovernmental agencies to spirituality is an important variable in assessing
work seamlessly to prevent, protect against, family strengths and weaknesses. The Neuman
respond to, recover from, and prevent the Systems Model is a wellness-oriented model in
effects of disasters (Federal Emergency which the nurse uses the strengths and
Management Agency, 2009). resources of the family to maintain system
31. How is a disaster the same as or different from stability while adjusting to stress reactions that
an emergency? may lead to health change and affect wellness.
a. A disaster is personal, whereas an In other words, this model focuses on family
emergency is community-wide. wellness in the face of change.

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2. A nurse doing a family assessment asks the neighborhood playground. The nurse's best
client, "Have any of your blood relatives had response would be:
mental illness?" The nurse is asking this a. "Don't worry about it. We are going to
question to: talk about all this anyway."
a. Determine whether the family is stable. b. "It's important to good health to
b. Assess for biological risk factors. have adequate recreation resources."
c. Decide whether this family member c. "We want to be able to report any
needs medication. dangerous playground equipment to
d. Demonstrate open-mindedness about the city."
mental illness. d. "We want to know what kind of
Healthy People 2020 (U.S. Department of neighborhood you're in so we can
Health and Human Services, 2010) identified assess income."
the following major categories as being: The importance of social risks to family health
inherited biological risk, including age-related is gaining increased recognition. A family's
risks, social and physical environmental risks health risk increases if they are living in high-
and behavioral risks as well as health care risks. crime neighborhoods, communities without
Although single risk factors can influence adequate recreation or health resources, in
outcomes, the combined effect of several risks communities with major noise pollution or
has greater influence. chemical pollution, or in other high-stress
3. One member of an older couple has just environments.
retired. This is considered a: 5. A nurse in community health decides to form a
a. Developmental stage that will help the contract with a family. The contract states that
family with stress reduction. the family will designate one night as a family
b. Nonnormative event that will have night. The nurse is most likely using the
psychological impact on the family. contract to:
c. Normative event and can increase the a. Make sure the family does what is
family's risk for illness. expected.
d. Normative event and will have little b. Encourage the family to put plans in
effect on the family' well-being. writing.
Life events can increase the risk for illness. c. Let the family know that this is a legal
Normative events are those that are generally agreement.
expected to occur at a particular stage of d. Shift the responsibility so that it
development or the life span. If the event is becomes a shared effort.
normative, families may be able to identify Contracting involves a shift in responsibility
needed resources, make plans to cope with the and control toward a shared effort by the client
change, learn new skills, and prepare for the and professional as opposed to an effort by the
event and its consequences. This kind of professional alone. The premise of contracting
anticipatory preparation can increase the is family control. It is assumed that when the
family's coping ability and decrease stress and family has legitimate control, its ability to make
negative outcomes. However, when the event healthful choices is increased. Contracting is a
is nonnormative, or unexpected, families have strategy aimed at formally involving the family
little or no time to prepare and the outcome in the nursing process and jointly defining the
can be increased stress, crisis, or even roles of both the family members and the
dysfunction. health professional.
4. A parent with two school-age children has just 6. A nurse in community health is conducting a
finished a family health assessment parenting class for prospective parents that will
questionnaire. The parent asks the nurse why focus on the development of new skills,
one of the questions asks whether there is a identification of needed resources, planning,
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 and other preparations for the arrival of a The first step is to obtain the referral and review
newborn. This intervention is addressing a it to gather information about the possible
potential risk associated with: needs of the family and the reason for the visit.
a. Biology. Once this is done, then the nurse would obtain
b. Behavior. the basic supplies and education materials that
c. Environment. might be needed and contact the family to
d. Transitions. arrange the visit.
Transitions, or the movement from one stage 2. When planning for a home visit, which of the
or condition to another, are times of potential following would be most helpful to ensure a
risk for families. Age-related or life event risks successful home visit?
often occur during transitions from one a. Documentation in a timely manner
developmental stage to another. They require b. Summarizing the main visit points
families to learn new skills; change behaviors, c. Providing incidental teaching
schedules, or patterns of communication; d. Scheduling an appropriate visit time
identify needed resources; and make plans. As part of planning the community health
7. A nurse in community health is conducting an nurse would contact the family to set up an
assessment on a family of four. During the appropriate time for the visit. Documenting in
course of the assessment, the nurse collects a timely manner ensures successful evaluation.
information about previous generations of the Providing incidental teaching and summarizing
family and siblings. The results are used to the main visit points help to ensure successful
create a diagram for the family that displays the implementation.
family unit across generations. Further 3. A community health nurse arrives at a family's
discussions occur regarding the patterns of home. Which of the following would behaviors
health and illness that relate to biological by the nurse would be nontherapeutic?
health risks. The diagram is called: a. Maintaining eye contact with the family
a. An ecomap. members
b. A family plan. b. Paging through paperwork for
c. A genogram. information
d. A risk plot. c. Sitting on the furniture near the family
A genogram is a drawing that shows the family members
unit of immediate interest and includes several d. Placing car keys in the nurse's carryall
generations, using a series of circles, squares, bag
and connecting lines. Basic information about Community health nurses, like all nurses, need
the family, relationships in the family, and to be aware of their own body language.
patterns of health and illness can be obtained Fidgeting with car keys during the entire visit,
by completing the genogram with the family. noisily chewing gum, giving minimal eye
contact, continuously looking at or paging
COMMUNITY HEALTH NSG CH. 19 MC
through paperwork, appearing rushed, and
1. Which of the following would be most refusing to sit on any of the furniture are
appropriate for the community health nurse to behaviors that tell the family a great deal about
do first when planning an initial home visit to a the nurse, including how he or she feels about
family? being in their home. These actions are
a. Obtain the basic supplies that will be nontherapeutic. Sitting on the furniture near
needed family members demonstrates interest in the
b. Gather appropriate educational family. Placing car keys in the carryall bags
materials prevents inadvertent distractions.
c. Contact the family via telephone 4. A community health nurse is about to make the
d. Review the referral information first home visit to a family based on a referral
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 from the hospital where the high-risk infant becomes verbally abusive and increasingly
was born to an adolescent mother about 6 days loud. Which action by the community health
ago. The nurse plans to assess the family and nurse would be best?
home environment and provide anticipatory a. Continue the visit with caution
guidance. On arrival, the mother sleepily b. Suggest the relative go in another room
answers the door after the nurse rings the bell and take a nap
and knocks several times. The mother lets the c. Ask the sober family members to take
nurse in but is not happy to see the nurse. She the visitor home
gets the infant and places him in the nurse's d. Terminate the visit, making plans for
arms, then sits across the room and turns on another visit
the TV. Which response by the nurse would be Terminating the visit is the best choice. It
most appropriate? appears the problem is escalating, and the
a. "You must be very tired caring for a nurse's safety should always come first.
newborn baby." Continuing the visit puts the nurse and possibly
b. "I wasn't planning to hold the baby. You the other family members at risk. Making a
should hold him, you are the mother." suggestion to go into another room and take a
c. "I need to talk to you, so please turn off nap may agitate the relative and make a
the TV." deteriorating situation worse. Making a
d. "How do you feel being a mother at suggestion for a family member to take the
17?" visitor home may agitate the relative and make
It is always best to acknowledge a client's a deteriorating situation worse. Additionally,
feelings, and from the scenario, observations this is the client's home and the suggestion
and referral information, being fatigued 6 days should be the client's.
after having a baby is very possible. The option 6. Which of the following things does a nurse who
about holding the baby is not the best way to is traveling by automobile to make a home visit
respond to the mother or the first comment to need? Select all that apply.
make, but holding the baby gives the nurse an a. A full gas tank and well-operating
opportunity to role model infant interaction vehicle
and caring and assess his or her cleanliness and b. A map that includes the geographic
clothing appropriateness. However, the nurse location where the home visit will be
may want to say that he or she would like to made
wash his or her hands before holding the baby. c. A cellular telephone
This gives the nurse an additional opportunity d. A bus schedule
to teach and assess another room when e. Exact change
washing hands. Asking to turn off the TV might A nurse who is traveling by automobile to make
be appropriate after a few moments of a home visit needs the following: a full gas tank
introductory conversation. It would be best to and well-operating vehicle, a map that includes
ask the mother to turn the TV down because of the geographic location where the home visit
difficulty hearing her. The nurse will win the will be made, and a cellular telephone. If the
mother's favor with this approach better than nurse is not using public transportation, the
by asking her to turn off the TV. Asking how she nurse does not need exact change for each bus
feels being a mother at 17 might be trip or a bus schedule.
information to gather, but asking it directly as 7. Which of the following are specific safety
a first comment sounds like a put-down. There measures the nurse should apply when making
are better ways to obtain this information a bit a home visit? Select all that apply.
later in the visit. a. Plan to reschedule the visit if you
5. While making a family health visit, an older find a large group of people
relative who is visiting has been drinking and
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 assembled between you and the c. Family patterns dictate whether
client's door. members participate in their own
b. Immediately leave the home when health care.
family members begin to physically d. Individuals can obstruct the family's
fight with one another. health and families can obstruct
c. Enter the residence before you individual family members' health.
determine that the family you are A negative influence on family health and
intending to visit does live there and is individual health is that individuals can obstruct
home. the family's health and families can obstruct
d. Travel only in pairs for all home visits. individual family members' health. The level at
e. If someone approaches you and which a family functions significantly affects
indicates that they want your nursing the individual's level of health; that a healthy
bag, throw your bag away from family fosters individual growth and sustains
where you are and run in the members during times of crisis; and the
opposite direction. influence of families that dictate whether
f. Leave an itinerary of your planned members participate in their own health care
travels, the telephone numbers of are all positive influences.
families you will attempt to visit and 9. When assessing a family, which of the following
your cellular phone number at your would lead the nurse to question the health of
base of operation. a family?
It is most important to leave an itinerary of your a. Role relationships are inflexible.
planned travels, the telephone numbers of b. Coping is actively attempted.
families you will attempt to visit, and your c. Family members communicate
cellular phone number at your base of regularly.
operation. Specific safety measures the nurse d. The family lacks regular links with
should apply when making a home visit include the broader community.
planning to reschedule the visit if you find a In a healthy family, role relationships are
large group of people assembled between you structured effectively so that they can change
and the client's door; immediately leaving the with changing family needs. Active coping,
home when family members begin to regular family communication, and regular
physically fight with one another; and if links with the broader community reflect a
someone approaches you and indicates that healthy family.
they want your nursing bag, throw your bag 10. Community health nurse to take his or her
away from where you are and run in the shopping to purchase some of the food items
opposite direction. It is not appropriate for the he or she needs for his or her diet. Which
nurse to enter the residence before response by the nurse would be most
determining that the family that is to be visited appropriate?
does live there and is home. It is not necessary a. "I can't, I'm going in a totally different
to travel only in pairs for all home visits. direction."
8. Which one of the following has a negative b. "You need to find some other way to
influence on family health and individual get to the store."
health? c. "I'll help you find a way to get to the
a. The level at which a family functions store."
significantly affects the individual's d. "Use the foods you have in the house
level of health. and shop next week."
b. A healthy family fosters individual The nurse needs to empower the client and
growth and sustains members during helping the client find a way to get to the store
times of crisis. promotes the skill of planning so that the client
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 can begin to manage her own needs constantly changing. The nurse should
effectively. Telling the client that the nurse is recognize the validity of family structure
going in a different direction, telling him or her variations.
to find some other way to get to the store, and 13. A community health nurse is attempting to
telling him or her to use the foods in the house empower a family to become independent.
are neither therapeutic nor do they promote Which of the following would be most
empowerment. appropriate?
11. A community health nurse, visits an 81-year- a. Focus attention on the problem areas
old newly diagnosed insulin-dependent b. Do for the family what they cannot
diabetic who lives alone. The nurse has visited c. Emphasize the family's strengths
the family three previous times and is visiting d. Reinforce positive traits
early in the morning to observe his client's To help empower families, the community
insulin administration technique. The nurse health nurse needs to emphasize the family's
finds the client depressed over his or her strengths. It is the nurse's job to recognize the
situation one morning. The nurse suggests that strengths in families and to help families
together they list positive points about his or recognize them as well. Focusing on problem
her situation and discuss his or her feelings. areas portrays a negative view and can
This is an example of which of the following? undermine the nurse's efforts. Doing for the
a. Strengthening family what they cannot fosters dependency.
b. Data collection Reinforcing positive traits may be appropriate
c. Goal-directed questioning if those positive traits are strengths. Not all
d. Measuring family functioning positive traits are strengths.
The nurse is demonstrating a communication 14. A community health nurse is applying an
technique called strengthening which is used interactional framework to assess a family's
to assist the family in becoming independent health. Which of the following would the nurse
of the nurse's services. Data collection, goal- do?
directed questioning, and measurement of a. View them in terms of the family's
family function are methods used for internal relationships
assessment. b. Look at them from a life-cycle
12. Which one of the following is a principle that perspective
guides and enhances family nursing practice? c. Evaluate the members' changing roles
a. The nurse should expect that the family and tasks
will be normal and will not change. d. Assess them as a social system relating
b. The nurse should start where the to other social systems
family is at the present time and not An interactional framework describes the
the ideal level of functioning. family as a unit of interacting personalities and
c. The nurse should focus on each family emphasizes communication, roles, conflict,
member individually. coping patterns, and decision-making
d. The nurse should evaluate the family processes. A developmental framework studies
based on consistency with traditional the family from a life-cycle perspective by
family patterns. examining the members' changing roles and
When working with families, community health tasks in each progressive stage. A structural-
nurses begin at the present, not the ideal level functional framework describes the family as a
of functioning. This is accomplished after the social system relating to other social systems in
nurse views the family collectively, not the environment.
individually. The nurse should expect that what 15. A community health nurse constructs an eco-
is normal for one family is not necessarily map for a family based on the understanding
normal for another and that families are that this tool is useful for which reason?
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 a. Family relationships over three or more d. Make several visits and accumulate
generations are depicted. data from all family members
b. The ecological system of a family's Completing a family assessment takes time. It
neighborhood is charted. is better to keep notes from several visits with
c. It was originally devised to depict the the family and observe the family as a group
complexity of the client's story. during some family activity. The nurse should
d. Directions for gathering data about not use obtrusive questionnaire techniques or
neighborhoods are provided. take notes in the family's presence.
An eco-map depicts the complexity of the Quantitative data will give a one-sided view of
client's story. Lines are drawn to indicate family data. It is best to interview all family
connections to other systems with arrows members over time. The nurse should collect
signifying the direction of energy or flow of both quantitative and qualitative data, which
resources, and the absence of lines indicates a will provide a rich family assessment.
lack of connections. The family's neighborhood 18. During a home visit and assessment of an
is one component, but not the central focus of infant and new mother, the nurse determines
the eco-map. A genogram displays family that the infant looks healthy. The mother asks
information about complex family patterns several questions and listens attentively. One
such as family relationships over three or more question she asks is whether the nurse is going
generations, arrows signify the direction of to visit her again. Which response would be
energy or flow of resources, and absence of most appropriate?
lines indicates a lack of connections. a. "Your baby looks healthy. You should
16. A community health nurse is collecting data not have any further questions."
about the family's demographics. Which of the b. "The agency limits the number of visits
following would the nurse include? Select all I can make; I will let you know."
that apply. c. "I plan to visit again. What would
a. Dietary patterns you like to accomplish at the next
b. Housing visit."
c. Climate d. "I can come weekly for the next 16
d. Socioeconomic status weeks, and then a staff nurse will visit."
e. Education of members The response about what the client wants to
f. Ethnicity accomplish together represents a mutual
Family demographics refer to such descriptive approach, giving power to the client and hints
variables as a family's composition, its at accomplishing things together on
socioeconomic status, and the ages, education, subsequent visits. Noting that the infant looks
occupation, ethnicity, and religious affiliations good and that the mother should not have
of members. Dietary patterns, housing, and further questions is closed-ended and nurse-
climate are variables assessed with the physical focused and does not promote open
environment. communication between the client and the
17. When a community health nurse is conducting nurse. The option about limiting visits is
a family assessment on an assigned family, inaccurate; the nurse has more control over the
which of the following would be most number of visits than this response implies,
appropriate? unless the visit is part of a special and very
a. Use quantitative data only to maintain limited program. Even then it would not be
and preserve objectivity phrased this way. The final option about 16
b. Interview one family member to avoid weekly visits followed by a staff nurse sounds
confusion and repeated information overwhelming and unrealistic. Very few clients
c. Use a checklist format, completing the receive this much service from public health
tool in the family's presence agencies.
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19. A community health nurse determines that it is Sometimes, we cannot see our own strengths
time for teaching a family about health or flaws, and evaluations by others are helpful.
promotion activities when they say which of the
following?
a. "Is there a place we can go for the
medicine?"
b. "It's time we do something about
eating right."
c. "When are you coming back to visit?"
d. "Our grandchildren visit every
summer."
Teaching health promotion activities should
begin only after family members express an
interest and recognize a need, such as the
statement about eating right. Asking about
where to get medicine and when the nurse is
coming back do not reflect an interest or need.
The statement about grandchildren reflects
information about the family structure and
demographics.
20. Which of the following would a community
health nurse use when conducting an outcome
evaluation?
a. Organization
b. Family progress
c. Timing
d. Performance
Outcome evaluation involves determining the
change in the family's health status or progress.
Organization and timing are components of
the structure-process evaluation. Performance
is part of self- evaluation.
21. The nurse educator knows that the nursing
student has grasped the concept of self-
evaluation when the nursing student makes
which one of the following statements?
a. It is important for the family to evaluate
itself.
b. It is important for the nurse's growth
and effectiveness as a community
health nurse.
c. Evaluations by others are not helpful.
d. Individuals can always see their own
strengths or flaws.
Self-evaluation is important for the nurse's
growth and effectiveness as a community
health nurse. Self-evaluation is referring to the
nurse's growth and not the family's.
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