community exam 2

1. A group of teens develop their own method of texting in a language that they feel is all their own. The change is subtle, but the meanings and the feelings associated with the text are known only to a select few. This behavior is an example of:

A)Culture

B)Cultural competence

C)Cultural safety

D)Ethnocentrism

A)Culture

2.The nurse is caring for a client who refuses the food as served. He states that the food is foreign to him and will make him ill. All food must be blessed. The personal care attendant is upset by this behavior and states that the client should eat the food anyway. The client's behavior is most likely a result of:

A)Psychosocial deficit

B)Cultural belief

C)Allergies

D)Hygiene

B)Cultural belief

3. The nurse is present when a mother begins cupping her child. She states that it will help to heal the child's respiratory tract infection. The nurse understands that the cultural belief that cupping will aid in the healing process is a:

A)Shared instinct

B)Learned behavior

C)Private idiosyncrasy

D)Genetically programmed idea

B)Learned behavior

4. A Mexican-American client arrives at the emergency department. He reports abdominal pain and has been vomiting for 5 days. The nurse notes that he is exhibiting symptoms of dehydration, and his vital signs and labs confirm this. The nurse asks the client why he waited so long to seek medical care. He states that he is being treated by the Curandero and wishes to continue while in the hospital. The nurse recognizes the different cultural assumptions regarding care. This situation is an example of:

A)Cross-cultural nursing

B)Ethnocentrism

C)Cultural safety

D)Transcultural bias

A)Cross-cultural nursing

5. The nurse conducts a well-child clinic in your community. The client population is culturally diverse, and, although the clinic is busy, it runs smoothly because it has an interpreter. In addition to the interpreter, it is important that the nurses treat each client that reflects his or her individual cultural needs. This is cultural:

A)Bias

B)Artwork

C)Competence

D)Beliefs

C)Competence

6.A nurse, new to the community health agency, works in a culturally diverse area of the community. The nurse is responsible for providing holistic care to clients and to be culturally competent. The health agency requires the nurse to demonstrate which competency to exhibit cultural competence? (Select all that apply.)

A)Value diversity

B)Adopt the client's cultural values

C)Acquire cultural knowledge

D)Adapt to diversity

E)Speak the language of the client

A,C,D

7.The nurse is called to make an unscheduled visit to a new client in her home. The purpose of the visit is to admit the client and treat an abdominal wound. The nurse discovers that the client is from a culture unfamiliar to her. In this situation, the nurse should demonstrate cultural competence and awareness by: (Select all that apply.)

A)Being open to the client's ideas and way of life

B)Obtaining objective data when caring for the client

C)Exhibiting respect and patience

D)Being aware of your own culture

E)Assuming that you have enough knowledge to get by

A,C,D

8.The nurse is caring for a client who is a refugee from Haiti. The client's family has been displaced because of an earthquake in their country. The client has healing fractures on his right arm as well as fractured ribs. He tells the nurse that, before care begins, the nurse must consult with his Voodoo healer. Which is the nurse's best response?

A)Teaching the client that he is in the United States and should abide by Western medical practices

B)Informing the physician that the client is noncompliant

C)Consulting with the healer and updating the physician regarding treatment and any herbal medications that may be used

D)Encouraging the client to use a complementary approach to his care

C)Consulting with the healer and updating the physician regarding treatment and any herbal medications that may be used

9.The nurse is caring for a client who is from a culture for which the nurse has a limited knowledge base. The nurse conducts the admission interview using cultural humility. Which should the nurse ask in the interview? (Select all that apply.)

A)Yes or no questions

B)About traditions

C)Open-ended questions

D)How the client has addressed the illness

E)If the cause of the illness is spiritual

B,C,D

10.During a conference after rounds, a nurse states, "They are in the United States now; you would think that they would act like us." This nurse is exhibiting:

A)Cultural humility

B)Ethnocentrism

C)Cultural competence

D)Cross-cultural nursing

B)Ethnocentrism

11.During an ice storm, people in one neighborhood banded together and shared the home of a neighbor who still had power and heat. Other neighbors provided food, water, and bedding. In another neighborhood the neighbors did not know one another and weathered the storm alone. Both neighborhoods are part of the same community. What characteristic did the people in the first neighborhood share that made them a subculture that those in the second neighborhood lacked?

A)Belief in the value of cooperation

B)Religion

C)Socioeconomic status

D)Geography

A)Belief in the value of cooperation

12.The nurse enters a client's home to provide care to a wound and teach the client's wife how to care for the wound. The nurse is comfortable with the client's culture and the fact that it is matriarchal in nature. As teaching begins, the husband interrupts and states that the woman does not change bandages according to his culture. He asks if the nurse is familiar with his culture and then says that all members of his neighborhood follow its principles. The nurse should suspect that the client is a member of:

A)A cult

B)An orthodox religious group

C)A subculture

D)An occupation

C)A subculture

13.To demonstrate true cultural sensitivity and awareness, the nurse must:

A)Travel to other countries on occasion

B)Become bilingual

C)Be competent in his or her own cultural heritage

D)Know the practices of all major cultures in one's region of the country

C)Be competent in his or her own cultural heritage

14.A client, diagnosed with hypertension, is prescribed a no-added-salt, low-fat diet. He agrees and repeats the teaching principles. At the next visit, the nurse notices salted meat on the counter and the client shows the nurse his food diary. The diet in the past week does not reflect the physician's orders. What cultural component may have contributed to the noncompliance with the diet order?

A)Diet may be too lean

B)Wife cooks according to the husband's preferences

C)Diet may not meet the cultural criteria for food choices

D)Food tastes bland and unappetizing

C)Diet may not meet the cultural criteria for food choices

15.A client is admitted to the hospital. On admission, it is noted that the client does not speak English. It will take 20 minutes for the hospital interpreter to arrive. The nurse decides to wait for the interpreter rather than relying on the client's husband. Appropriate rationales for this decision include that the interpreter is: (Select all that apply.)

A)More likely to be fluent in both languages

B)More likely to be familiar with the client's symptoms

C)Trained in ethics and will be better at explaining cultural differences

D)More likely to understand the client's needs

E)More likely familiar with technical healthcare terms

A,C,E

16.The nurse cares for a client in a community health clinic. The nurse is uncomfortable because the client remains very close when communicating. This discomfort makes it difficult to concentrate on the interview. When the nurse backs away, the client stops speaking and leaves. This is an example of:

A)Differing views of personal space

B)Treatment limitation

C)Aggressive behavior

D)Cultural bias

A)Differing views of personal space

17. A new client, who is Latin American, is getting settled in the hospital. She is expecting her family to arrive soon. A physician enters and informs the client that she requires surgery and asks that she sign the necessary documents. The client refuses and becomes agitated. Which is the most likely cultural reason for the client's reluctance to sign the documents?

A)Client is reluctant to have the surgery.

B)Decision of importance is typically made by the family as a group.

C)Client does not feel comfortable with the surgeon.

D)Client is medicated and is having difficulty making a decision.

B)Decision of importance is typically made by the family as a group.

18.The physician approaches the client with a treatment plan for his cancer. The client states that his life is in God's hands and refuses conventional treatment. This is an example of:

A)Fatalistic behavior

B)Denial

C)Anger

D)Bargaining

A)Fatalistic behavior

19. The client is admitted to the hospital for new-onset hypertension and chest pain. During the admission interview you ask the client if she takes over-the-counter medications, and she states no. She adds that she routinely visits a folk healer. The nurse's response should include:

A)Obtaining a list of the herbs and folk medications that are taken and notifying the physician

B)Requesting the client to stop the ingestion of the folk herbs

C)Calling poison control with the list of herbs and folk medications

D)Encouraging the client to continue to take the herbs and folk medications

A)Obtaining a list of the herbs and folk medications that are taken and notifying the physician

20.The nurse educator is responsible for conducting educational seminars for the staff. After the education component of the program, the group engages in discussion. It is important that nurses routinely attend educational programs related to cultural competence because:

A)The information is lost when caring for clients in real life.

B)One can't be competent at all times.

C)Nurses can facilitate social change.

D)Classes are necessary for regulatory compliance.

Ans:

C)Nurses can facilitate social change.

21.The nurse is scheduling a follow-up appointment for a client who recently immigrated from Nicaragua. The client agrees to a 9:00-AM appointment on the following Wednesday. The nurse should anticipate that on the following Wednesday, this client will:

A)Show up half an hour before the scheduled time

B)Not return at all for the follow-up appointment

C)Arrive late for the appointment, after completing whatever tasks the client feels need to be accomplished first

D)Arrive exactly on time

C)Arrive late for the appointment, after completing whatever tasks the client feels need to be accomplished first

1. Which are recommendations made by the World Health Organization's Commission on Social Determinants of Health (CSDH)? (Select all that apply.)

A)Improve conditions under which all people are born, grow, live, work, and age

B)Provide increased funding for research of genetic disorders

C)Ensure more equitable distribution of power, money, and resources

D)Instill a sense of personal responsibility for one's health in each person

E)Expand knowledge of the social determinants of health

Ans:

A,C,E

2. The nurse is in charge of a local community program that uses a logic model as a planning and communication tool. Which key components are included in this model? (Select all that apply.)

A)Milestones for completing a community health clinic

B)Plan to conduct cholesterol screenings

C)Need for a nurse practitioner to manage the clinic

D)Malaria prevention programs for developing nations

E)Possible locations for the health clinic

A,B,C,E

3. Which characterize health inequities? (Select all that apply.)

A)Necessary

B)Unfair

C)Resulting from social injustices

D)Avoidable

E)Natural

B,C,D

4. Which changes in the environment (second level from the bottom of the health impact pyramid) make the choice for a healthy behavior the default or easy choice? (Select all that apply.)

A)Iodization of salt

B)Restrictions on smoking in public places

C)Community immunization programs

D)Changing food manufacturing to eliminate trans fats

E)Treatment of hypertension

A,B,D

5. Which exemplify clinical interventions (the level just above the middle of the health impact pyramid)? (Select all that apply.)

A)Administration of insulin injections for diabetes

B)Restrictions on smoking in public places

C)Community immunization programs

D)Instruction provided by a nurse regarding proper nutrition

E)Treatment of hypertension

A,E

6. The nurse prepares community program objectives that are specific, measurable, achievable, relevant, and time bound (SMART) to help in planning interventions and establishing measurement systems to evaluate programs and outcomes. Which is a measurable objective?

A)Program will reduce teenage obesity.

B)Fewer teens will start smoking.

C)Blood pressure for children aged 12 to 18 years in Marks School will be reduced by 5% after petting the dog for 1 day in March 2019.

D)Number of older minority residents in Legacy Independent facility receiving a flu shot will triple.

C)Blood pressure for children aged 12 to 18 years in Marks School will be reduced by 5% after petting the dog for 1 day in March 2019.

7. Which aspects of Lewin's change theory will help people visualize and create needed change? (Select all that apply.)

A)Unfreezing the status quo

B)Changing or moving to a new state

C)Enforcing the status quo

D)Refreezing to sustain the change or changes made

E)Increasing restraining forces

A,B,D

8. Which most accurately describes the purpose of force field analysis?

A)Unfreezing the status quo

B)Changing or moving to a new state

C)Identifying the forces driving the change and those resisting it

D)Refreezing to sustain the change or changes made

C)Identifying the forces driving the change and those resisting it

9.The nurse researches whether the community would benefit from monthly blood pressure clinics. Which system level would such an intervention address?

A)Upstream

B)Mainstream

C)Sidestream

D)Downstream

D)Downstream

10. As an advocate for leukemia research, the nurse along with many others succeeded in urging the U.S. Congress to debate and vote on a bill that significantly increases federal funding for this research. Which system level would such an intervention address?

A)Upstream

B)Mainstream

C)Sidestream

D)Downstream

A)Upstream

11. Select the examples of social marketing. (Select all that apply.)

A)Ad campaign for a new brand of toothpaste

B)Brochure placed in obstetricians' offices promoting the benefits of breastfeeding

C)Infomercial on television presenting the advantages of a piece of exercise equipment

D)Billboard illustrating the dangers of texting while driving

E)Posters placed in college dormitories encouraging condom use

B,D,E

12. The nurse decided to approach local organizations for financial and in-kind support for a new community health initiative. On which local resources can the nurse draw? (Select all that apply.)

A)Catholic church

B)Branch of Bank of America

C)Car dealership

D)Community Transformation Grant

E)The Bill and Melinda Gates Foundation

A,B,C

13. The nurse researches the role of nurse-managed health centers in the city. Which are common characteristics of these centers? (Select all that apply.)

A)Led by advanced-practice nurses

B)Serve upper-income mothers and children

C)Emphasize health promotion, disease prevention, and health education

D)Provide clinical practice for nursing students and faculty

E)Offer specialized programs to meet the needs of specific population aggregates

A,C,D,E

14. The nurse is reviewing the sources of funding for the local community health intervention program on smoking cessation. In the federal grant proposal, the nurse elaborates on all the various local organizations and private foundations that have pledged to support the program after initial funding from the grant ends. The nurse also explains the plan for ongoing fundraising efforts for the program for years to come. With these comments, the nurse is attempting to establish which essential component of funding?

A)Sustainability

B)Program replication

C)Clinical expertise

D)Accountability

A)Sustainability

15. After successfully implementing and managing a smoking cessation program in an inner-city neighborhood for 5 years, the group expands the efforts to include a nearby rural community. After a challenging first year, the nurse finds that with a few modifications the program is proving successful in the rural setting, as well. Which essential component of program design has been established by success in the rural community?

A)Sustainability

B)Program replication

C)Clinical expertise

D)Accountability

B) Program replication

16. The nurse reviews the job descriptions of the community health workers who work with community health nurses and other members of the program team. These workers are responsible for: (Select all that apply.)

A)Serving as a cultural and language bridge to members of target population

B)Performing minor surgical procedures

C)Providing health education and outreach to community

D)Offering assistance in accessing services

E)Prescribing commonly used medications

A,C,D

17. The nurse reviews the logic model and formal evaluation plan of a grant proposal on a community rabies program. Which requirements should be included in the plan to support accountability? (Select all that apply.)

A)Regular communication about funds that were not used

B)Details of program activities

C)Report of areas where there is no progress toward program goals

D)Proof that the program can be reproduced effectively in other settings

E)Explanation of how the program will be funded after grant funding expires

A,B,C

18. Which best defines program replication?

A)Ability to replicate a successful program in the same community a second time

B)Ability to reproduce a successful program within a different community

C)Ability to replicate a successful program with a new sample aggregate

D)Ability to implement a successful program with the same population aggregate

B)Ability to reproduce a successful program within a different community

19. The nurse is in the process of forming a coalition to support a community flu shot program. Which step should the nurse take as part of this process? (Select all that apply.)

A)Assign members of the coalition to tasks in a random manner.

B)Seek out people with similar opinions and roles in the community.

C)Consider how each member of the coalition and the organization or group represented will benefit from the work of the coalition.

D)Understand group dynamics and members' motives for serving.

E)Form a group that is heterogeneous but able to show mutual respect.

C,D,E

20. Which best illustrates systems theory?

A)School systems in two different counties each setting up their own independent afterschool exercise programs

B)Father being challenged to stop smoking because his daughter learned of the hazards of smoking from a smoke cessation program at her middle school

C)Hospital requiring all of its nurses to wear an identification badge while on duty

D)Physician in one state deciding to stop accepting Medicaid clients, while another physician in another state begins accepting Medicaid clients

B)Father being challenged to stop smoking because his daughter learned of the hazards of smoking from a smoke cessation program at her middle school

21.Which is the first step in developing a plan for evaluating a community-level intervention?

A)Determine indicators or measures to answer evaluation questions

B)Decide what method you will use to collect data

C)Develop evaluation questions

D)Decide how you will communicate your results

C)Develop evaluation questions