community: chapter 26, 27, 28, 29

Katie, a 2-year-old child, is brought to the doctor's office after 2 days of vomiting and diarrhea. Upon completion of the medical history, the mother tells the nurse that several of the other children at the daycare who played with the same toys as Katie have the same symptoms. The mode of transmission for the pathogen more likely was:
A. vector.
B. direct.
C. indirect.
D. airborne
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Katie, a 2-year-old child, is brought to the doctor's office after 2 days of vomiting and diarrhea. Upon completion of the medical history, the mother tells the nurse that several of the other children at the daycare who played with the same toys as Katie have the same symptoms. The mode of transmission for the pathogen more likely was:
A. vector.
B. direct.
C. indirect.
D. airborne
C. Indirect
The stem of the question indicates that the children played with the same toys. This would indicate the indirect mode of transmission. The other modes of transmission do occur through the sharing of toys.
Four-month-old Lucy is in for immunizations at the local health department. The Vaccine Information Sheet is given to Lucy's mother, and informed consent is obtained. However, the mother then states, "Lucy did have a temperature around 99.1 degrees the night of her last immunizations." After this statement, the nurse should
A. consult the child's pediatrician.
B. delay the immunizations.
C. do not give the immunizations because of the contraindication.
D. give the immunizations.
D. give the immunizations.
A low-grade fever is not a contraindication to immunizations. The nurse should give the immunizations. It is not necessary to contact the child's pediatrician. Vaccination should be postponed in cases of moderate or severe febrile illness to avoid any confusion between a vaccine side effect and an unknown underlying cause.
Which statement regarding sexually transmitted diseases (STDs) is correct?
A. The rate of STDs is decreasing because of effective medication therapies.
B. Women are less likely to use protection methods against STDs.
C. Half of the STD rate in the United States falls within the 15 to 24 age range.
D. Treatment for STDs in women is usually ineffective.
C. Half of the STD rate in the United States falls within the 15 to 24 age range.
An estimated 20 million cases of STDs occur each year in the United States, almost half of them in persons aged 15 to 24 years. The other statements are not true.
Investigating all contacts of a person infected with a sexually transmitted disease is an example of what?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Initial prevention
B. Secondary prevention
Secondary prevention includes the investigation of contacts to sexually transmitted disease cases. Secondary prevention includes activities to ensure early detection of infection and effective treatment of persons who are infected. Not only does this prevent progression of the infectious disease, but it also prevents transmission of the pathogen to others. Primary prevention of communicable diseases involves measures to prevent transmission of an infectious agent and to prevent pathology in the person exposed to an infection. Tertiary prevention includes activities involved in caring for persons with an infectious disease to ensure that they are cured or that their quality of life is maintained.
Which statement indicates that further teaching is needed for a patient involved in family planning?
A. "I can't get human papilloma virus (HPV) from my boyfriend because we're not having intercourse."
B. "I need to use condoms to prevent transmission of sexually transmitted diseases."
C. "Even though I have no signs or symptoms, I still may have Chlamydia."
D. "I can give my unborn baby warts during childbirth."
A. "I can't get human papilloma virus (HPV) from my boyfriend because we're not having intercourse."
Option A indicates the patient needs more teaching. HPV can be transmitted via sexual intercourse, as well as any other means of direct contact. The other statements are true.
Transmission of an infectious disease can be efficiently controlled by
A. breaking all links in the transmission chain.
B. destroying all reservoirs of infectious agents.
C. breaking only one link in the transmission chain.
D. maintaining high levels of herd immunity.
C. breaking only one link in the transmission chain.
Breaking just one link of the chain can control transmission of an infectious agent. Destroying all reservoirs of infectious agents and maintaining high levels of herd immunity are two of several ways to break a link in the chain of transmission.
Which is classified as a vector of disease?
A. Humans
B. Door handles
C. Water and food
D. Mosquitoes
D. Mosquitoes
Vectors can be animals or arthropods and can transmit disease through biological and mechanical routes. The other options are not vectors.
A pathogen lives and multiplies in a __________ and transfers from one host to another by a __________.
A. host, susceptible portal of entry
B. reservoir, mode of transmission
C. infectious agent, portal of exit
D. mode of transmission, reservoir
B. reservoir, mode of transmission
A pathogen lives and multiplies in the reservoir and transfers from one host to another by a mode of transmission.
Seven cases of hepatitis A are diagnosed in a community over a period of 2 weeks. An investigation results in a determination that all of the infected individuals ate at a local restaurant. Which statement explains the possible connection between hepatitis A and a restaurant?
A. The route of transmission for hepatitis A is fecal-oral.
B. A food worker likely coughed on the customers.
C. A food worker may have a bleeding wound.
D. Hepatitis A is transmitted where people congregate.
A. The route of transmission for hepatitis A is fecal-oral.
Hepatitis A is transmitted by fecal-oral route. Coughing or bleeding would not transmit hepatitis A. Option D does not have enough information to form a conclusion about hepatitis A transmission.
Which factors cause primary vaccine failure? (Select all that apply.)
A. Inefficient storage
B. An intramuscular vaccine injection given subcutaneously
C. Waning immunity in immunocompromised patients
D. Light-sensitive vaccines exposed to light
E. Seroconversion
A. Inefficient storage
B. An intramuscular vaccine injection given subcutaneously
D. Light-sensitive vaccines exposed to light
E. Seroconversion
Primary vaccine failure is the failure of a vaccine to stimulate any immune response. It can be caused by improper storage that renders the vaccines ineffective, an improper administration route, or light-sensitive vaccines exposed to light. Additionally, some immunized persons never seroconvert, either because of failure of their own immune system or for some other unknown reason. Secondary vaccine failure is the waning of immunity after an initial immune response.
On discharge after treatment for alcoholism, a client plans to take disulfiram (Antabuse) as prescribed. When teaching the client about this drug, the nurse emphasizes the need to A. avoid all products containing alcohol. B. adhere to concomitant vitamin B therapy. C. return for monthly blood drug level monitoring. D. limit alcohol consumption to a moderate level.A. avoid all products containing alcohol. Disulfiram, when combined with any alcohol, produces the classic disulfiram-ethanol reaction of flushing, tachycardia, nausea, headache, chest tightness, and chest pain. Adhering to concomitant vitamin B therapy and returning for monthly blood drug level monitoring are not necessary when taking Antabuse.A high school student is referred to the school nurse for suspected substance abuse. After the nurse's assessment and interventions, what would be the most desirable outcome? A. The student discusses conflicts over drug use. B. The student accepts a referral to a substance abuse counselor. C. The student agrees to inform his parents of the problem. D. The student reports increased comfort with making choices.B. The student accepts a referral to a substance abuse counselor. Having a substance abuse problem does not mean that problems are always attributable to the addiction. An evaluation for other problems such as mental illness and depression should be conducted, with specialized attention involving a case management approach. Research demonstrates that treatment for substance abuse can be more effective than no treatment. The other goals may be appropriate but not the most desirable.The community health nurse is trying to encourage a client to attend Alcoholics Anonymous meetings. When the client asks the nurse what he must do to become a member, the nurse should respond A. "You must first stop drinking." B. "Your physician must refer you to this program." C. "Admit you are powerless over alcohol and that you need help." D. "You must bring along a friend who will support you."C. "Admit you are powerless over alcohol and that you need help." As a nonprofessional ongoing source of assistance, Alcoholics Anonymous is viewed as an invaluable resource to the community. The first step of the 12-step program is the admission of defeat and surrender to a higher power. The other options are false.When a client regularly takes a drug that is a central nervous system (CNS) stimulant, such as cocaine, what symptoms would the nurse expect to see when the client abstains from this substance? A. The client will have symptoms of CNS stimulation. B. The client will experience anxiety, insomnia, and tremors. C. Common symptoms include hallucinations and seizures. D. The client will feel depressed, apathetic, and lethargic.D. The client will feel depressed, apathetic, and lethargic. Symptoms of withdrawal from CNS stimulants are depression, apathy, lethargy, and sleepiness. The client may experience signs of CNS stimulation while high on the CNS stimulant. The client withdrawing from opioids may experience anxiety and tremors. The client withdrawing from alcohol may experience hallucinations and seizures.The wife of an alcoholic client is considering joining a support group to help her respond to her husband's condition in a healthy way. Where should the nurse refer this client? A. A psychiatrist for a referral to a suitable group B. Spouses Anonymous C. Al-Anon D. Alcoholics AnonymousC. Al-Anon Substance abuse has been called a family disease because it affects the entire family system and holds potential adverse psychological and physical consequences for the family members in addition to the abuser. Al-Anon and Alateen are support groups for family members of substance abusers. A psychiatrist's referral is not necessary. Alcoholics Anonymous is focused more on the substance abuser than their families.All outcomes may contribute to the diagnosis of substance abuse except A. the substance use has placed someone in danger. B. the individual uses the substance despite negative consequences. C. the substance use interferes with the ability to function at work or at home. D. the client is without a job.D. the client is without a job. The diagnosis of substance abuse includes the continued use of a substance despite the consequences; putting oneself or others in danger because of substance use; or substance use interfering with one's major role obligations, such as family, work, and friends.A survey done by The National Institute on Drug Abuse (NIDA) found that the most commonly abused prescription drug among high-school seniors is A. OxyContin. B. Vicodin. C. Xanax. D. codeine.B. Vicodin. As of 2015, 4.4% high school seniors reported past-year nonmedical use of the prescription pain reliever hydrocodone (Vicodin), 3.7% reported abusing oxycodone (OxyContin), 7.7% reported use of amphetamines, and 7.5% reported misuse of Adderall—making these medications among the drugs most commonly abused by adolescents.The community health nurse is visiting the home of a known substance abuser. The client is talking excessively and is excited and aggressive. The nurse notes that the patient's heart rate is 158 beats/min. The nurse recognizes the client is most likely high on which substance? A. PCP B. Alcohol C. Methamphetamine D. InhalantsC. Methamphetamine Short-term effects of methamphetamine are increased heart rate, insomnia, excessive talking, excitation, and aggressive behavior. PCP is known for its violent dissociative and anesthetic effect. Alcohol intoxication causes euphoria, disinhibition, and sedation. Inhalants cause euphoria.Which statement about adolescent substance abuse is false? A. Teen use of cigarettes and smokeless tobacco is increasing. B. Alcohol use among youth declined increased between 2010 and 2015. C. Most of the movement in teen substance abuse has been in the downward direction. D. Marijuana use among teens is decreasing.A. Teen use of cigarettes and smokeless tobacco is increasing. Teen use of cigarettes and smokeless tobacco has declined. Youth (ages 12 to 20) binge and heavy drinking rates in 2015 (13.4% and 3.3%, respectively) were higher than rates in 2010 (7.8% and 1.7%, respectively). The percentage aged 12 to 17 years who perceived great risk in smoking marijuana once or twice a week decreased from 47.5% in 2010 to 40.6% in 2015. Teen substance abuse, overall, is increasing.Personality traits associated with an increased risk of alcohol abuse include (Select all that apply.) A. impulsive. B. shy. C. withdrawn. D. disinhibited. E. aggressive.A. impulsive. D. disinhibited. Two broad personality dimensions are also associated with an increased risk for alcohol abuse. Impulsivity and ease of disinhibition add to the risks for substance abuse. Being prone to anxiety and depression is also a risk, and these comorbidities are not well understood. The other options are not associated with a risk for alcohol abuse.As a school nurse, you know the leading reason cited as the cause of school violence is A. use of violence to handle disputes. B. an unhappy home life. C. overly protective parental situations. D. poor communication with authority figures.A. use of violence to handle disputes. Adolescents and children increasingly use violence to settle disputes. Children are often not taught peaceful ways of resolving differences and learn by what they observe at home, on television, in video games, and in movies. Consequently, schools have become a common site for violence. The reasons for violence are complicated and multilayered, but the most common reason cited is use of violence to handle disputes.Chronic stress characterizes the lives of people living with domestic violence. As the community health nurse, you recognize which as a long-term effect of violence? A. Spontaneous disclosure of abuse to health care provider B. Not complaining of physical symptoms C. Having disturbed eating patterns, but sleeping well D. Suffering chronic fatigue and tensionD. Suffering chronic fatigue and tension When subject to repeated abuse, the victim experiences a variety of responses, including shock, denial, confusion, withdrawal, psychological numbing, and fear. He or she lives in anticipatory terror and experiences chronic fatigue and tension, disturbed sleeping and eating patterns, and vague gastrointestinal and genitourinary complaints. The other options are not symptoms of chronic violence.Child maltreatment that allows the child to use drugs and alcohol is an example of A. sexual abuse. B. physical abuse. C. psychological abuse. D. neglect.D. neglect. Neglect is the failure of the responsible person to provide basic needs such as shelter, food, clothing, education, and access to medical care; permitting the child to use drugs/alcohol; and inattention to the child's emotional needs. The other options are types of abuse.Which client is at highest risk for elder abuse? A. A 75-year-old nursing home client who is alert and has osteoporosis B. A 70-year-old client with dementia who is cared for at home C. A 65-year-old client who has just had a hip replacement D. A 72-year-old client on a rehabilitation unit with bilateral above-the-knee amputationsB. A 70-year-old client with dementia who is cared for at home The most likely victims of elder abuse are individuals who are in poor physical or mental health and dependent on others for physical or financial support; these clients are often confused and depressed.As a visiting community health nurse, you must take precautions to avoid unsafe situations. To avoid putting yourself in danger, you would A. enter a house where a violent act is occurring and call 911. B. expect the client to control angry family members. C. always carry a concealed weapon. D. remain outside if you hear sounds of fighting in a home.D. remain outside if you hear sounds of fighting in a home When approaching a home, as a community health nurse, you should notice the environment, animals, fences, activities, possible indicators of crime, and places you could go for assistance if necessary. Walk with confidence and maintain a professional attitude. Listen for signs of fighting before knocking. If you hear sounds of fighting, leave. Do not enter a home if you suspect an unsafe situation.Which statement about homicide in the United States is false? A. Most homicides are caused by stabbings. B. Homicide is the third leading cause of death for 1- to 4-year-old children. C. Blacks are more likely to be the victims of homicide than whites. D. Over 50% of homicide victims are killed by someone they knew.A. Most homicides are caused by stabbings. Most homicides are caused by firearms. The other statements are true.Nurses, including public health nurses, are at increased risk for workplace violence. Risk factors for violence in the workplace include all except A. working in pairs. B. access to medications. C. increased number of mentally ill patients. D. inadequate security.A. working in pairs. Risk factors for violence in the workplace include increasing number of acute and chronically mentally ill patients, working alone, availability of drugs at worksite, low staffing levels, poorly lit parking areas and corridors, long waits for service, inadequate security, increasing number of substance abusers, and access to firearms.Which statement about intimate partner violence (IPV) is true? A. It occurs only in poor, uneducated, minority households. B. It only occurs in heterosexual relationships. C. Victims can change the abusers' behavior. D. Professional intervention is needed to change the abusers' behavior.D. Professional intervention is needed to change the abusers' behavior. Abusers will stop the abuse only after receiving treatment. Abusers do not change behaviors on their own. The other statements are true.Which assessment findings by the community health nurse would suggest that an elderly client may be the survivor of physical abuse by a caregiver? (Select all that apply.) A. The client has a laceration on her forehead that was sutured. B. The client has a flat affect. C. The client has bruises on her forearms in various stages of healing. D. The client withdraws from soft touch. E. The client is not sexually active but has a diagnosis of Chlamydia.A. The client has a laceration on her forehead that was sutured. C. The client has bruises on her forearms in various stages of healing. E. The client is not sexually active but has a diagnosis of Chlamydia. Signs of physical abuse include bruises, lacerations, fractures, dislocations, untreated injuries in various stages of healing, and STDs in sexually inactive clients. The other options are not indications of physical abuse.The school nurse is interviewing a student who has been assaulted by another student. Both students proclaim to be gang members. The nurse understands the reasons most youth give for joining a gang include the following: (Select all that apply.) A. financial gain. B. sense of belonging. C. peer pressure. D. relative is in a gang. E. need for respect.B. sense of belonging. C. peer pressure. E. need for respect. Reasons that young people give for joining gangs include the belief that gangs will protect them, peer pressure, the need for respect, and a sense of belonging.Which describes a NA-TECH (natural technological) type of disaster? A. A flood covering crops and recreational areas of a geographic area B. A terrorism attack causing major interruption of communication technologies C. A tornado resulting in flood and destruction of electrical systems for a community D. A nuclear accident at a power plant causing evacuation of people in an urban communityC. A tornado resulting in flood and destruction of electrical A natech disaster is a natural disaster that creates or results in a widespread technological problem. A flood covering crops and recreational areas of a geographic area does not mention a technological problem, and a terrorism attack and a nuclear accident are not natural disastersA family of five people presented to a hospital after the flooding of their urban home. These family members are classified as A. poverty victims. B. displaced persons. C. indirect victims. D. mass casualties.B. displaced persons. Displaced persons are those who have to evacuate their home, school, or business as a result of a disaster. An indirect victim may be a family member or friend of the victim or a first responder. A mass casualty event is one in which 100 or more individuals are involved. Poverty is not considered a disaster classification.Which agency has a mission to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all? A. American Red Cross (ARC) B. National Institute for Health (NIH) C. Federal Emergency Management Agency (FEMA) D. Centers for Disease Control and Prevention (CDC)C. Federal Emergency Management Agency (FEMA) FEMA's mission is to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all. The other agencies may be peripherally involved in national disasters, but it is not their primary focus.You teach a community disaster preparedness class on how to find shelter during and after a disaster situation. This is an example of what kind of prevention? A. Primary B. Secondary C. Tertiary D. DisasterA. Primary Primary prevention occurs in the nondisaster and predisaster stages. Actions during these stages includes developing local, state, and federal disaster plans; conducting drill tests; training volunteers and health care providers; and providing educational programs. Secondary measures are those taken after the disaster has occurred and tertiary measures are aimed at rehabilitation. Disaster prevention is a broad term covering all types.What element of a community disaster plan investigates the citizen's reliance on telephone systems or cell phones during disasters? A. Authority B. Logistical C. Rescue D. CommunicationD. Communication Communication is one of the biggest problems during a disaster. The reliance on telephone systems or cell phones should not be the only plan for communication during a disaster. Authority focuses on the people in charge, logistical includes focuses on storage of equipment and location of key responders, and search and rescue focuses on the search and rescue of victims.The nurse at the disaster site is using the SMART triage system. What color triage tag would be provided to an ambulatory individual with a superficial cut on the left elbow and bruise to the right hand? A. Red B. Yellow C. Black D. GreenD. Green Green is for the wounded or individuals with minor injuries who are able to walk and to wait several hours before receiving medical treatment. Red is for those with life-threatening injuries but have a high probability of survival, yellow is for those with systemic but non-life-threatening complications, and black is for the deceased or those with nonsurvivable injuries.Which phase of the community response to disaster includes medical personnel contributing long hours of volunteer work helping unfamiliar people after a disaster? A. Honeymoon phase B. Heroic phase C. Reconstruction phase D. Disillusionment phaseB. Heroic phase The heroic phase of a community's reaction to a disaster involves people feeling the need to rush to help people survive the disaster. Medical personnel may volunteer to work long hours without sleep and in dangerous conditions to care for patients. During the honeymoon phase, people who have survived the disaster get together to talk about their experiences. People begin to look to the future during the reconstruction phase and during the disillusionment phase people recognize that many things are different, and much needs to be done to adjust to the current situation.Chemical warfare agents such as pulmonary agents and cyanides are classified as A. weapons of mass destruction. B. computer-based attack weapons. C. recovery agents. D. prevention medications.A. weapons of mass destruction. Weapons of mass destruction refer to any weapon that is designed or intended to cause death or serious bodily injury through release, dissemination, or impact of toxic or poisonous chemicals or their precursors. Chemical warfare agents are classified as nerve agents, vesicants, pulmonary agents, and cyanides.Which is the purpose of the staging area in a disaster plan? A. A triage area outside the hospital, supplying first aid and transport to medical facilities B. A stage for entertainment to cheer up disaster victims C. To provide sheltered area for displaced victims to sleep, eat, and bathe D. To act as command station for disaster responders to report to and get assignmentsD. To act as command station for disaster responders to report to and get assignments The staging area is the onsite command station. Dispatch responders should report to this area and check-in. This allows everyone to be accounted for and to gather assignments. The other options are not appropriate uses for the staging area in a disaster.The community health nurse is working in an emergency shelter with displaced families. Which clients have risk factors for posttraumatic stress disorder (PTSD)? (Select all that apply.) A. An 18-year-old client with a previous gunshot wound B. A 50-year-old client who saw people die in the disaster C. A 23-year-old client experiencing extreme fear D. A 60-year-old client who had little social support before the event E. A 35-year-old client with a history of schizophreniaA. An 18-year-old client with a previous gunshot wound B. A 50-year-old client who saw people die in the disaster C. A 23-year-old client experiencing extreme fear E. A 35-year-old client with a history of schizophrenia Risks for PTSD include living through dangerous events or traumas; having a history of mental illness; getting hurt; seeing people hurt or killed; feeling horror, helplessness, or extreme fear; having little or no social support after the event; and dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.