Download N340 Exam 2 Questions and Answers and more Exams Human Physiology in PDF only on Docsity!
N340 Exam 2 Questions and Answers Which of the following is the primary cause of vulnerability to health problems? a.Breakdown of family structures b.Poverty c.Prejudice d.Social isolation ✔✔B Which of the following terms is used to describe aggregates who are at high risk for having poor health outcomes because of limited resources? a.Disadvantaged families b.Multi-problem families c.Resilient populations d.Vulnerable populations ✔✔D A community health nurse would like to implement an intervention to increase lasting resilience among new immigrants. Which of the following actions should be taken by the nurse? a.Direct clients to English-as-second-language courses. b.Give immigrant clients money to help them get settled. c.Identify areas in the city where housing is less expensive. d.Solicit donations for food, clothing, and other needs. ✔✔A Which of the following factors predisposes many migrant farmworkers to disenfranchisement? a.Being a minority group member b.Inability to attend religious services because of work requirements c.Previous experiences of physical abuse d.Short length of time in the community ✔✔D A large financial grant was being offered to whichever health facility wanted to accept the responsibility for giving care to local vulnerable populations. Which of the following actions would most likely be taken by the local medical centers? a.Agree to collaboratively apply for the funds in a cooperative proposal. b.Individually compete eagerly for the additional funds now available. c.Reach out enthusiastically to this previously underserved population group. d.Strongly consider not applying, because this population will be expensive to treat. ✔✔D Which of the following statements best describes an outcome of the Balanced Budget Act of 1997?
a.Additional funding was provided to the State Children's Health Insurance Program (SCHIP). b.Individuals were able to keep their health insurance when moving from one place to another. c.Patient privacy and security of health information was enhanced. d.A prospective payment system for home health services was created. ✔✔D A homeless family brought their father to the public health clinic after he reported bleeding when he went to the bathroom. Which of the following nursing actions would be most appropriate? a.Begin tests to determine the cause of the bleeding while asking about other family concerns from nutrition to shelter for the night. b.Refer the man to a urologist to address the urinary bleeding. c.Suggest that the family take him to an urgent care center immediately. d.Treat the urinary infection and give the man medication to take to prevent the return of infection. ✔✔A Nursing students have been assigned to set up a health fair for the homeless population in a large urban setting. Without any funds to pay for space, where should the health fair be located, assuming that all of the following sites are available at no cost? a.At the city's homeless shelter, which is, by policy, vacant during the day b.At a large medical center, where the students could get permission to use an empty clinic in the evening c.At the largest inner-city police station, where there was a large empty space available d.At the local community college, where there are plenty of tables and chairs ✔✔A Which of the following bills would the nurse lobbyist, who believes strongly in social justice, encourage legislators to support? a.A bill that establishes policies requiring all persons to pay the same cost for services regardless of income b.A bill that promotes universal health insurance coverage c.A bill that requires all health care providers to give care to uninsured persons without charge d.A bill that requires health care workers to report undocumented immigrants who present for treatment ✔✔B A nurse who is providing diabetes screening at a community clinic discovers that a new client has type 2 diabetes mellitus. The nurse provides counseling, refers the client to an endocrinologist for initial assessment and treatment, arranges for the client to see someone regarding financial assistance, contacts the mobile van to arrange transportation, and sets up a follow-up appointment. Which of the following types of service do these actions represent? a.Case management b.Client advocacy
a.Be willing to enter into a long-term relationship with families. b.Direct and control the client's care because the nurse knows what is most needed. c.Encourage families to become self-sufficient and less dependent on nursing personnel for advice and referrals. d.Rotate assignments periodically to prevent attachment and codependency. ✔✔A Which statements by a nurse demonstrate understanding of the unique needs of vulnerable groups? (Select all that apply.) a."I always address the problem that the client believes is the most important." b."I avoid asking clients for income or financial information, because this is an invasion of privacy." c."I try to observe the client's cultural traditions as I probe for signs of abuse." d."I make sure to do a complete assessment, since we often don't know when the person will return to the clinic." ✔✔A,C A resident in a rural community has been diagnosed with asthma. Which of the following providers will most likely provide care to this client? a.Advanced nurse practitioner b.Allergist c.Pediatrician d.Pulmonologist ✔✔A Which of the following best describes a health professional shortage area (HPSA)? a.An area with inadequate health care facilities for residents b.An isolated area of underserved populations within an urban region c.A region with insufficient numbers of health care providers d.A rural region of the United States with a population density of less than 10,000 ✔✔C A migrant farmworker has been injured while working on the farm. Which of the following would provide assistance to care for this injury? a.Emergency department for immediate care b.Migrant Health Act clinics c.OSHA, because the man was injured by farm machinery d.Workers' Compensation, because injury was at work ✔✔A A nurse is caring for a migrant farm worker who has been working in the agricultural industry for the past 10 years. When questioned about environmental hazards, the client reports regular exposure to pesticides. Which of the following disorders is the client most at risk to develop? a.Cancer
b.Memory loss c.Skin rashes d.Headaches ✔✔A A migrant farmworker presents to the clinic reporting an acute onset of severe abdominal pain, nausea, vomiting, diarrhea, and headache with difficulty concentrating. Which of the following conditions would cause such symptoms? a.Appendicitis b.Bacterial gastroenteritis c.Pesticide poisoning d.Viral illness ✔✔C In addition to those barriers faced by many residents in rural areas, what additional barrier to health care is a Hispanic migrant farmworker likely to encounter? a.Absence of culturally competent care b.Availability of specialists c.Distance of health care facilities from the place of residence d.High cost of health care ✔✔A Which of the following is the most accurate description of a migrant farmworker? a.A person who does farm work as the primary means of employment, although other work may be done when the seasonal work ends b.A person who immigrates to the United States to "follow the crops" in performing seasonal farm work c.A person who moves from place to place to earn money performing seasonal agricultural work d.A person who specializes in the development of rural land for the purpose of farming ✔✔C An employer provides a migrant farm family the day off to visit the health clinic in a nearby community and tells them to take all of the time they need. However, the family arrives at the clinic appearing very stressed. In addition to the health issue, which of the following would most likely be a fear experienced by the family? a.Their personal belongings may be stolen while they are at the clinic. b.Immigration officials will send them back to their home country. c.The clinic personnel will look down on them and be biased against them. d.They weren't getting paid for that day, and continued employment is never certain. ✔✔D A migrant farmworker brings his daughter into the clinic with severe heat stroke from being out in the sun. The nurse explains the danger signs and stresses staying cool and drinking lots of water. The man seems to know this already. Which of the following best describes the most likely reason that this happened?
Which of the following best describes why health professionals would be particularly concerned about the health needs of residents in rural areas? (Select all that apply.) a.About 25% of all U.S. residents live in rural settings. b.People in rural areas are especially susceptible to acute illnesses rather than chronic diseases. c.Diagnoses in rural areas are usually for physical injuries, not mental health concerns. d.A high prevalence of poverty exists among rural families. ✔✔A,D A nurse is caring for Mexican migrant farmworkers. Which of the following conditions are of greatest importance for the nurse to assess? (Select all that apply.) a.Cholera b.Hepatitis c.High blood level of lead d.Malaria ✔✔B,C A nurse tells her nursing supervisor that her family is moving from the urban area where they both live to a rural area to be near her spouse's parents, who are becoming less independent. Which of the following suggestions would the nursing supervisor provide to the nurse? (Select all that apply.) a."Community members will probably hold you in higher regard and will look up to you." b."Expect to have less autonomy in a small town than you have working as a nurse in a medical center." c."You may feel like an isolated outsider, because the community may not immediately accept you." d."You will have to be very sensitive about the differences in the rural lifestyle." ✔✔A,C,D nurse's family has moved to a rural area to be near her spouse's aging parents. Which of the following would the nurse most likely notice about the family's new environment? (Select all that apply.) a.It is very difficult to obtain continuing education, except for online programs. b.Neighbors seem to expect the nurse to know everything about all health care and illness conditions. c.Neighbors ask questions about health concerns any time they see the nurse, regardless of where they are. d.People come to the health clinic before their situation becomes relatively serious. ✔✔A,B,C A nurse was shocked when late one night she saw a former high school friend going through a trash bin outside a fast-food restaurant and pulling out half-eaten food. Which of the following is the most likely explanation for a healthy young adult engaging in such behavior? a.He ate his meal but wanted more and had no more money. b.He had full-time employment, but with such a low salary it was inadequate to meet basic expenses. c.A friend had thrown his meal away, and he thought he could find his friend's untouched food. d.He was doing this to fulfill an obligation of fraternity initiation at the college. ✔✔B
Which of the following racial groups experiences the highest incidence of poverty? a.Non-Hispanic Whites b.Blacks c.Hispanics d.Asians ✔✔B A school nurse was caring for an 8-year-old child who had been hurt on the school playground. During the nurse's assessment, the child admitted that her mother was working but didn't make much money so the girl and her mother were living in their car. Based on this information, which of the following would the nurse most likely suspect? a.The child is accident-prone and clumsy. b.The child is being bullied and pushed around by other children. c.The child is more likely to have school absences. d.The child is in need of a vision screening. ✔✔C A school nurse was talking to the teacher of an 8-year-old child who was living with her mother in their car. Which of the following concerns would lead the nurse to talk to the teacher about the child? a.Concern that the child is being mistreated by other children b.Concern that the child has developmental delays c.Concern that the child is given adequate food during lunch d.Concern that the child may need to sit in the front in order to be able to see well ✔✔B Which of the following is the most rapidly growing group of homeless? a.Adolescents b.Families with children c.Persons in crisis d.Single men ✔✔B Which of the following statements best describes why health care of the homeless is so expensive to the community? a.Health conditions of the homeless require increased preventive services. b.Homeless clients typically make more clinic visits for multiple health problems. c.Homeless people spread contagious diseases to those they pass on the street. d.Most care to homeless people takes place in hospital emergency departments. ✔✔D The nurse who works at a homeless clinic wants to improve healing of chronic wounds in clients living on the streets. Which of the following would be the best action to take to improve client outcomes?
b.Assessing for mother's knowledge about normal infant growth and development c.Assessing how much the teenage mother's own mother is helping her cope with child care d.Assessing whether the baby's father is being helpful to the mother ✔✔B A mother and her son are in the emergency department. The mother is extremely upset. Earlier, the son had become so angry that he put his hand through a glass window and had to have stitches. The physician suggested a psychiatric consult. Now the mother asks, "Do you think my son is crazy?" Which of the following is the most appropriate response by the nurse? a."Absolutely not. But a psychiatrist can help your son realize more appropriate ways of displaying anger." b."Have you had other reasons to think your son is crazy? Perhaps the psychiatrist can reassure you that your son is just an adolescent coping with hormones." c."Your son is having problems coping with anger. And naturally you're upset. Let the psychiatrist determine whether your son is crazy or not." d."Your son is having problems with behavior, which is distressing all of you. A psychiatrist may be able to help your son cope with life in a more acceptab ✔✔D Which of the following is the leading cause of disability for Americans 15 to 44 years of age? a.Accidents b.Arthritis c.Major depressive disorder d.Workplace injuries ✔✔C A community mental health nurse is working within the community to help prevent youth violence. Which of the following interventions would most likely be implemented by the nurse? a.Distributing literature that associates violence with a lack of intelligence b.Explaining to youth why youth violence is detrimental to society c.Partnering with associations to provide alternative activities that improve social skills d.Recommending increased funding to prosecute and jail teens associated with violent activity ✔✔C Which of the following groups is most at risk for suicide? a.Adolescents under age 20 b.Men over age 85 c.Females 25 to 45 years of age d.Women over age 65 ✔✔B A nurse is trying to decrease the risk for depression among older adults. Which of the following interventions should the nurse implement?
a.Encourage moving to a nursing home where others of the same age reside. b.Monitor for signs and symptoms of depression. c.Organize an exercise and health promotion program at the local senior citizen center. d.Teach older clients to focus on their strengths rather than their weaknesses. ✔✔C A nurse is concerned about stress related to the heavy caregiving burden assumed by adult children of older clients. Which of the following actions by the nurse demonstrates the use of secondary prevention to limit caregiver stress? a.Asking caregivers how they are doing and suggesting coping strategies b.Encouraging caregivers to periodically leave the house for a couple of hours c.Establishing support groups for caregivers of older parents d.Referring some activities to neighbors and friends ✔✔A A nurse would like to increase the accessibility to health care services for mentally ill homeless clients in the community. Which of the following actions should be taken by the nurse? a.Apply for a grant to fund a mobile clinic to take health care to the clients. b.Distribute flyers to the homeless that detail the location of various types of health care services. c.Refer homeless clients to areas that provide temporary housing. d. Solicit donations for food and clothing to be distributed to the homeless. ✔✔A A nurse is working to improve her self-awareness in order to provide better client-centered care to clients living in poverty. Which of the following questions should the nurse ask herself? a.What would I do if I lived in poverty? b.What can be done to get poor people motivated to work? c.How have the media images of poor persons shaped my image of poverty? d.How can community resources assist those living in poverty? ✔✔C A teenager who has just come in for her prenatal visit appears to be about 6 months pregnant. Which of the following best describe why the teenage girl has waited so long to come in for prenatal care? (Select all that apply.) a.Her friends were suggesting ways to make the problem go away. b.She knew she could not be pregnant because her boyfriend said he used a condom. c.She was afraid her parents would pressure her to terminate the pregnancy. d.She kept hoping the pregnancy would just go away. ✔✔C,D A nurse is concerned about a teenage mother who does not seem to know how to play with an infant. Which of the following behaviors would the nurse want to role-model as good parenting behaviors? (Select all that apply.)
A nurse inspects an inpatient psychiatric unit and finds that exits are free of obstructions, no one is smoking, and the janitor's closet is locked. These observations relate to a.coordinating care of patients. b.management of milieu safety. c.management of the interpersonal climate. d.use of therapeutic intervention strategies. ✔✔B The patients below were evaluated in the emergency department. The psychiatric unit has one bed available. Which patient should be admitted? The patient a.feeling anxiety and a sad mood after separation from a spouse of 10 years. b.who self-inflicted a superficial cut on the forearm after a family argument. c.experiencing dry mouth and tremor related to taking antipsychotic medication. d.who is a new parent and hears voices saying, "Smother your baby." ✔✔D A suspicious, socially isolated patient lives alone, eats one meal a day at a local shelter, and spends the remaining daily food allowance on cigarettes. Select a community psychiatric nurse's best initial action. a.Explore ways to help the patient stop smoking. b.Report the situation to the manager of the shelter. c.Assess the patient's weight; determine foods and amounts eaten. d.Arrange hospitalization for the patient in order to formulate a new treatment plan. ✔✔C A nurse surveys medical records. Which finding signals a violation of patients' rights? a.A patient was not allowed to have visitors. b.A patient's belongings were searched at admission. c.A patient with suicidal ideation was placed on continuous observation. d.Physical restraint was used after a patient was assaultive toward a staff member. ✔✔A Which principle has the highest priority when addressing a behavioral crisis in an inpatient setting? a.Resolve the crisis with the least restrictive intervention possible. b.Swift intervention is justified to maintain the integrity of a therapeutic milieu. c.Rights of an individual patient are superseded by the rights of the majority of patients. d.Patients should have opportunities to regain control without intervention if the safety of others is not compromised. ✔✔A Clinical pathways are used in managed care settings to a.stabilize aggressive patients. b.identify obstacles to effective care.
c.relieve nurses of planning responsibilities. d.streamline the care process and reduce costs. ✔✔D A nurse receives these three phone calls regarding a newly admitted patient.
- The psychiatrist wants to complete an initial assessment.
- An internist wants to perform a physical examination.
- The patient's attorney wants an appointment with the patient. The nurse schedules the activities for the patient. Which role has the nurse fulfilled? a.Advocate b.Case manager c.Milieu manager d.Provider of care ✔✔B Which aspect of direct care is an experienced, inpatient psychiatric nurse most likely to provide for a patient? a.Hygiene assistance b.Diversional activities c.Assistance with job hunting d.Building assertiveness skills ✔✔D Which characteristic would be more applicable to a community mental health nurse than to a nurse working in an operating room? a.Kindness b.Autonomy c.Compassion d.Professionalism ✔✔B Which patient would be most appropriate to refer for assertive community treatment (ACT)? A patient diagnosed with a.a phobic fear of crowded places. b.a single episode of major depressive disorder. c.a catastrophic reaction to a tornado in the community. d.schizophrenia and four hospitalizations in the past year. ✔✔D The unit secretary receives a phone call from the health insurer for a hospitalized patient. The caller seeks information about the patient's projected length of stay. How should the nurse instruct the unit secretary to handle the request? a.Obtain the information from the patient's medical record and relay it to the caller.
A patient usually watches television all day, seldom going out in the community or socializing with others. The patient says, "I don't know what to do with my free time." Which member of the treatment team would be most helpful to this patient? a.Psychologist b.Social worker c.Recreational therapist d.Occupational therapist ✔✔C A patient diagnosed with schizophrenia has been stable for 2 months. Today the patient's spouse calls the nurse to report the patient has not taken prescribed medication and is having disorganized thinking. The patient forgot to refill the prescription. The nurse arranges a refill. Select the best outcome to add to the plan of care. a.The patient's spouse will mark dates for prescription refills on the family calendar. b.The nurse will obtain prescription refills every 90 days and deliver to the patient. c.The patient will call the nurse weekly to discuss medication-related issues. d.The patient will report to the clinic for medication follow-up every week. ✔✔A A community mental health nurse has worked for months to establish a relationship with a delusional, suspicious patient. The patient recently lost employment and could no longer afford prescribed medications. The patient says, "Only a traitor would make me go to the hospital." Select the nurse's best initial intervention. a.With the patient's consent, contact resources to provide medications without charge temporarily. b.Arrange a bed in a local homeless shelter with nightly on-site supervision. c.Hospitalize the patient until the symptoms have stabilized. d.Ask the patient, "Do you feel like I am a traitor?" ✔✔A Which activity is appropriate for a nurse engaged exclusively in community-based primary prevention? a.Medication follow-up b.Teaching parenting skills c.Substance abuse counseling d.Making a referral for family therapy ✔✔B A health care provider prescribed long acting antipsychotic medication injections every 3 weeks at the clinic for a patient with a history of medication nonadherence. For this plan to be successful, which factor will be of critical importance? a.The attitude of significant others toward the patient b.Nutrition services in the patient's neighborhood c.The level of trust between the patient and nurse
d.The availability of transportation to the clinic ✔✔D hich assessment finding for a patient diagnosed with serious and persistent mental illness and living in the community merits priority intervention by the psychiatric nurse? The patient a.receives social security disability income plus a small check from a trust fund every month. b.was absent from two of six planned Alcoholics Anonymous meetings in the past 2 weeks. c.lives in an apartment with two patients who attend partial hospitalization programs. d.has a sibling who was recently diagnosed with a mental illness. ✔✔B The nurse should refer which of the following patients to a partial hospitalization program? A patient who a.has a therapeutic lithium level and reports regularly for blood tests and clinic follow-up. b.needs psychoeducation for relaxation therapy related to agoraphobia and panic episodes. c.spent yesterday in a supervised crisis care center and continues to have active suicidal ideation. d.states, "I'm not sure I can avoid using alcohol when my spouse goes to work every morning." ✔✔D After a Category 5 tornado hits a community and destroys many homes and businesses, a community mental health nurse encourages victims to describe their memories and feelings about the event. This action by the nurse best demonstrates a.triage. b.primary prevention. c.psychosocial rehabilitation. d.psychiatric case management. ✔✔B A nurse makes an initial visit to a homebound patient diagnosed with a serious mental illness. A family member offers the nurse a cup of coffee. Select the nurse's best response. a."Thank you. I would enjoy having a cup of coffee with you." b."Thank you, but I would prefer to proceed with the assessment." c."No, but thank you. I never accept drinks from patients or families." d."Our agency policy prohibits me from eating or drinking in patients' homes." ✔✔A A nurse performed these actions while caring for patients in an inpatient psychiatric setting. Which action violated patients' rights? a.Prohibited a patient from using the telephone b.In patient's presence, opened a package mailed to patient c.Remained within arm's length of patient with homicidal ideation d.Permitted a patient with psychosis to refuse oral psychotropic medication ✔✔A
During a group therapy session, a newly admitted patient suddenly says to the nurse, "How old are you? You seem too young to be leading a group." Select the nurse's most appropriate response. a."I am wondering what leads you to ask. Please tell me more." b."I am old enough to be a nurse, which qualifies me to lead this group." c."My age is not pertinent to why we are here and should not concern you." d."You are wondering whether I have enough experience to lead this group?" ✔✔D A patient in a group therapy session listens to others and then remarks, "I used to think I was the only one who felt afraid. I guess I'm not as alone as I thought." This comment is an example of a.altruism. b.ventilation. c.universality. d.group cohesiveness. ✔✔C
- A nurse at the well child clinic realizes that many parents have misconceptions about effective ways of disciplining their children. The nurse decides to form a group to address this problem. What should be the focus of the group? a.Support b.Socialization c.Health education d.Symptom management ✔✔C Which outcome would be most appropriate for a symptom-management group for persons diagnosed with schizophrenia? Group members will a.state the names of their medications. b.resolve conflicts within their families. c.rate anxiety at least two points lower. d.describe ways to cope with their illness. ✔✔D A patient has talked constantly throughout the group therapy session, often repeating the same comments. Other members were initially attentive then became bored, inattentive, and finally sullen. Which comment by the nurse leader would be most effective? a.Say to everyone, "Most of you have become quiet. I wonder if it might be related to concerns you may have about how the group is progressing today." b.Say to everyone, "One person has done most of the talking. I think it would be helpful for everyone to say how that has affected your experience of the group."
c.Say to everyone, "I noticed that as our group progressed, most members became quiet, then disinterested, and now seem almost angry. What is going on?" d.Say to the talkative patient, "You have been doing most of the talking, and others have not had a chance to speak as a result. Could you please yield to others now?" ✔✔A Guidelines followed by the leader of a therapeutic group include focusing on recognizing dysfunctional behavior and thinking patterns, followed by identifying and practicing more adaptive alternate behaviors and thinking. Which theory is evident by this approach? a.Behavioral b.Interpersonal c.Psychodynamic d.Cognitive-behavioral ✔✔D The nurse is planning a new sexuality group for patients. Which location would best enhance the effectiveness of this group? a.The hospital auditorium b.A small conference room c.A common area, such as a day room d.The corner of the music therapy room ✔✔B Which remark by a group participant would the nurse expect during the working stage of group therapy? a."My problems are very personal and private. How do I know people in this group will not tell others what you hear?" b."I have enjoyed this group. It's hard to believe that a few weeks ago I couldn't even bring myself to talk here." c."One thing everyone seems to have in common is that sometimes it's hard to be honest with those you love most." d."I don't think I agree with your action. It might help you, but it seems like it would upset your family." ✔✔D Three members of a therapy group share covert glances as other members of the group describe problems. When one makes a statement that subtly criticizes another speaker, the others nod in agreement. Which group dynamic should the leader suspect? a.Some members are acting as a subgroup instead of as members of the main group. b.Some of the members have become bored and are disregarding others. c.Three members are showing their frustration with slower members. d.The leadership of the group has been ineffective. ✔✔A A therapy group adds new members as others leave. What type of group is evident?
