RN Social Influences Assessment

A nurse is assessing a new parent and their newborn in a community health clinic. The parent reports that they have resumed smoking tobacco and eating fast food more frequently. Which of the following topics would be most important for the nurse to discuss with the parent?

Healthy eating and weight management

Postpartum depression and self-care

Smoking cessation and the effects of secondhand smoke

On-demand feeding and schedules

Smoking cessation and the effects of secondhand smoke

The nurse should identify that the greatest risk to this parent is the effect of secondhand smoking on their newborn. Secondhand smoke is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year. It also causes 430 sudden infant death syndrome (SIDS) deaths in the U.S. annually.

A nurse is making recommendations to the school board regarding necessary improvements at a high school located in a low-income area in order to improve health outcomes. The nurse notes there is a lack of school lunch programs and audio-visual equipment, a gymnasium that cannot be used because it requires repairs, and there are a number of students who are experiencing mental and emotional health issues, such as eating disorders, anxiety, and depression. Which of the following interventions should the nurse recommend as the priority for the school board to address?

Provide more audio-visual equipment for students.

Write a letter to local school board members to address the need for a new snack bar.

Implement repairs to the gymnasium.

Add a counselor to the school faculty.

Add a counselor to the school faculty.

When using the greatest risk priority framework, the nurse should identify that adding a counselor to the school faculty could help to address mental and emotional issues among the student body and improve health outcomes.

An occupational health nurse is assessing the risk for workplace hazards and injuries at a manufacturing center. Which of the following preventative actions is the priority for the nurse to implement?

Limiting indoor smoking

Improving access to and adherence of the use of personal protective equipment

Planning an education program for employees on safety awareness

Updating outdated policies

Improving access to and adherence of the use of personal protective equipment

The nurse should identify that the greatest risk to the employees is injury due to exposure to hazardous chemicals or substances in the workplace. Improved access to and adherence of the use of personal protective equipment, such as masks and gloves, would help to reduce hazards and injuries from this exposure.

An occupational health nurse is presenting information to county government leaders. Which of the following occupations should the nurse include as having higher health hazards and exposures?

Urban design architect

Customer service phone operator

Computer programmer

Outdoor landscaper

Outdoor landscaper

Although there are hazards and exposures with all jobs, manual labor jobs carry risks of higher health hazards and exposures. Outdoor landscaping is a manual labor job. Being an outdoor landscaper requires being subject to variable temperatures outside, loud noises from equipment, and dangerous chemicals.

A nurse is providing teaching to a client who inquired about utilizing private managed care insurance to cover medical expenses. Which of the following statements should the nurse include in the teaching?

"The government provides basic coverage and the client is required to pay for supplemental insurance."

"The government pays for coverage, including insurance policies that typically are considered supplemental."

"Clients pay for health care coverage partially in the form of income tax and partially as a monthly fee to an insurance provider."

"Clients pay a monthly fee to an insurance provider to cover medical expenses, including supplemental policies."

"Clients pay a monthly fee to an insurance provider to cover medical expenses, including supplemental policies."

Under private managed care insurances, health care plans create contracts with providers and health care institutions to provide care for clients per a monthly payment for services. The client chooses from listed providers to oversee their care.

A nurse is reviewing data from a group of clients. Which of the following clients is more likely to experience structural inequity?

A Hispanic client with low income

A client who has three children

A female client with moderate income

A client who is 18 years old

A Hispanic client with low income

People of color with low incomes are more likely to experience structural racism or unequal treatment based on being a member of a particular ethnic group and, therefore, are more susceptible to living in faulty built environments.

A county health nurse is reviewing the morbidity and mortality reports for areas within the county. The nurse should recognize that which of the following findings in the report is an example of a client health outcome that can result from living in a cycle of poverty?

Sickle cell anemia

Schizophrenia

Cystic fibrosis

Sexually transmitted infections (STIs)

Sexually transmitted infections (STIs)

Adolescents from poor socioeconomic homes have a more difficult time lifting their lives out of poverty. Studies have shown that these adolescents are more likely to engage in promiscuous behavior and acquire STIs.

A nurse proposes an evidence-based improvement project in partnership with the Workforce Innovation and Opportunity Act to mitigate the effects of the coronavirus (SARS-CoV-2) lockdown restrictions on physical and mental health. Which of the following factors should the nurse identify as the priority to address with the project?

Constant fear-laden media reports led to an increased incidence of people being unwilling to cooperate with health officials.

The threat of being infected with a deadly virus led to an inability to cope among various parts of the population.

The educational challenges of distance learning contributed to students failing more classes.

The lockdown led to an uncertainty of resources for several families within the community.

The lockdown led to an uncertainty of resources for several families within the community.

When utilizing the greatest risk priority framework, the nurse should recognize that families endured the detrimental effects of not being able to work or make a decent living wage because of the coronavirus (SARS-CoV-2) pandemic lockdown restrictions. People sustained financial losses that had long-lasting negative impacts, even more than fear of the virus itself.

A nurse is performing an evaluation on an older adult couple who have been attending a caregiver support group for individuals taking care of loved ones who have Alzheimer's disease. Which of the following statements by the caregiver shows that the intervention has been successful?

"I don't enjoy socializing with my friends anymore."

"I am just so exhausted. I am always tired and sometimes cannot get my work complete."

"Even though it is a lot of work, I sleep well at night."

"Over the last 6 months I have gained 30 pounds, and now my doctor says I am prediabetic."

"Even though it is a lot of work, I sleep well at night."

The nurse should identify this statement indicates that the intervention is working. Although taking care of the loved one is a lot of work, the caregiver is able to get good rest at night, which indicates they are benefitting from the support. This in turn will prevent burnout and aid the caregiver in meeting their partner's needs.

A nurse is planning a presentation for state legislators about the impact of depression on student health outcomes at a low-performing school. Which of the following information should the nurse include in the presentation?

Students experiencing depression and attending a low-performing school are less likely to become infected with sexually transmitted infections (STIs).

Students experiencing depression and attending a low-performing school are half as likely to become chronically truant.

Students experiencing depression and attending a low-performing school are more likely to suffer congenital defects, such as spina bifida.

Students experiencing depression and attending a low-performing school are more likely to develop a chronic illness.

Students experiencing depression and attending a low-performing school are more likely to develop a chronic illness.

Depression in children and adolescents might foster the development of chronic illnesses, such as diabetes mellitus.

A nurse is counseling a client who is trying to get out of a gang situation. Which of the following referrals should the nurse make to the client?

Occupational Safety Hazard Administration (OSHA)

The Healthy Teen Network

Boys & Girls Club of America

Nurse-Family Partnership

Boys & Girls Club of America

The Boys & Girls Club of America has a long history of successful mentorship for at-risk youth who have had gang-related problems. This intervention would be a good strategy for helping this client overcome their current situation and make plans for social, educational, and career success in life.

A nurse is reviewing the insurance coverage of an adult client who is in a skilled nursing facility following a total hip arthroplasty and is paid for by a private insurance company as well as a government-provided program. Which of the following statements should the nurse identify as describing the client's coverage?

The client has Medicare with supplemental insurance provided by Medigap.

The client has insurance that is solely under the Medicare program.

The client has managed care insurance provided by both Medicare and Medicaid.

The client has insurance from a private provider with a supplemental policy that the client pays for themselves.

The client has Medicare with supplemental insurance provided by Medigap.

The client has Medicare with supplemental insurance provided by Medigap. Private insurance helps to fill certain "gaps" in the coverage provided by Medicare.

A nurse is assessing the needs of a school-age child. Which of the following risk factors should the nurse identify as placing the child at risk for social support issues?

Neighborhood social cohesion

Household with two guardians present

Low-crime neighborhood

Incarcerated family members

Incarcerated family members

When children have family members who are incarcerated, the risk is higher for the child to exhibit dysfunctional behavior. These children often require social support to receive necessary guidance and stability and provide a foundation for healthy growth.

A public health nurse is reviewing the medical records of a group of clients. For which of the following clients should the nurse identify that the client is at high risk for adverse health outcomes?

A family with a toddler who own a single-family home in which one of the partners works in construction for 10 months out of the year

A single working mother who manages hypertension with diet and exercise and utilizes her aunt for childcare for her three children

A client who lives in a rural area who walks 4 miles every day to and from work

An older adult widow who has diabetes mellitus and has been unemployed for the past 6 months

An older adult widow who has diabetes mellitus and has been unemployed for the past 6 months

An older adult who has been unemployed for 6 months and has a chronic condition such as diabetes is at a higher risk of poverty and might not be able to afford essential items and access appropriate health care. The nurse should identify that this client is at risk for adverse health outcomes.

A school nurse is recommending a referral to a mentorship program for an adolescent who reports facing pressure and violence in school and is feeling depressed. Which of the following statements should the nurse include when discussing the reason for the mentorship program?

"A mentorship program will teach self-defense tactics."

"A mentorship program can help with the selection of another school to attend."

"A mentorship program will assess for any special academic needs."

"A mentorship program can help you cope with challenges at school."

"A mentorship program can help you cope with challenges at school."

Adolescents facing school violence often avoid attending school and, therefore, have lower attendance. Mentorship programs can help give this adolescent an outlet to feel safe and seek ways in which to cope with challenges, as well as examples of others who have successfully endured similar situations with positive results.

A public health nurse is speaking with a group of newly hired school nurses about issues facing poorly performing schools. Which of the following statements by a newly hired school nurse demonstrates their understanding of the issues?

"Poorly performing schools have an adequate number of counselors available."

"Schools located in zip code areas that have high homeowner rates receive less money."

"The majority of school funding comes from property taxes."

"School nurses in poorly performing schools will not be able to make a difference in the childrens' health

"The majority of school funding comes from property taxes."

Public schools in the United States are allotted state funding to educate children in a predetermined school zone, with most of the funding coming from property taxes in their school zone district.

A school nurse at a poorly performing high school is planning interventions to address a current outbreak of mononucleosis. Which of the following interventions should the nurse implement to improve the health outcomes of the students?

Set up a patient portal for virtual visits.

Establish a lunch program for the school.

Provide students with preventative tips.

Provide access to Medigap policies.

Provide students with preventative tips.

The school nurse could provide students with preventative tips to help them stay healthy. Screenings performed by nurses also could help prevent the spread of diseases, such as mononucleosis.

A nurse is caring for a client who has a history of socioeconomic issues. Which of the following client statements indicates that the client is experiencing very low food security?

"Although I am home on disability leave and am not working at the moment, my mother-in-law makes dinner for our family every night."

"I am able to pay most of my bills, but sometimes I do have to make payment plans with my creditors."

"Although I do not have steady weekly income, I do budget my bills with the royalties I've earned from a book deal once every 3 months."

"My job is inflexible without consideration for my personal needs. My budget is tight and I often skip meals to save money."

"My job is inflexible without consideration for my personal needs. My budget is tight and I often skip meals to save money."

Adults who have less flexible jobs and are living and working in low-income roles tend to be at higher risk for food insecurity. Very low food security is defined by Healthy People objectives as "multiple indications of disrupted eating patterns and reduced food intake."

A home care nurse is planning to teach a client about their medications. Which of the following is a tool the nurse can use to determine the health literacy of the client?

"Teach Back identifies which expenses were not covered by the client's insurance."

"Teach Back helps to determine which medications should be prescribed to continue the client's care."

"This method makes sure the client understands all of the instructions given."

"This method assesses the care the client has received and identifies possible areas for improvement."

"This method makes sure the client understands all of the instructions given."

The Teach Back Method of educating a client asks the client to tell the provider in their own words what they were taught. At the end of a facility stay, this method would be used to ensure the client understands discharge instructions.

A community health nurse is caring for a 19-year-old unemployed client who is pregnant and has had an uncomplicated pregnancy. The client missed a prenatal appointment for the third time in a row related to the inability to obtain transportation to the visits. Which of the following interventions should the nurse prioritize for this client?

Implementing an alternate prenatal schedule for clients who have low-risk pregnancies

Setting up telemedicine visits

Referring the client to a career counseling group

Educating the client on the importance of prenatal care

Implementing an alternate prenatal schedule for clients who have low-risk pregnancies

Research shows that most pregnant clients receive the regular schedule of frequent prenatal visits. However, clients who have low-risk pregnancies could rightly receive an amended schedule of less frequent visits and still maintain a healthy and successful pregnancy.

A community health nurse is discussing the pathophysiology of disease with a newly licensed nurse. Which of the following conditions, according to a Yale University study published by the Center for Effective Government, should the nurse report are caused by environmental pollutants?

Asthma and arthritis

Cardiovascular disease and lung disease

Dementia and chronic fatigue syndrome

Pulmonary fibrosis and diabetes mellitus

Cardiovascular disease and lung disease

The study confirmed that both cardiovascular disease and lung disease are known conditions resulting from exposure to environmental pollution.

A nurse is interviewing a client who has three small children and has a history of interventions with Child Protective Services. Which of the following client statements should the nurse identify as an indication that family relationships are positive and further interventions are unnecessary?

"Since I started working, I have so many caregivers for my kids that I cannot remember them all."

"My kids and I attend virtual therapy sessions twice each month."

"My partner has unexpectedly moved out of our home."

"I feel overwhelmed because my oldest son just got out of jail last week."

"My kids and I attend virtual therapy sessions twice each month."

This client statement is a positive sign showing that they have taken a step in the right direction to foster good communication between family members and a positive social environment for the children at home. No further intervention is warranted at this time.

A nurse is discussing an older adult client's care plan. The client mentions that both of their grandchildren currently live with them and, as a result, the client is frequently required to choose between paying bills and buying groceries for the household. Which of the following actions should the nurse take?

Offer appropriate resources related to food insecurity.

Question the current living arrangements.

Make a referral to an assisted living facility.

Offer home health aide services.

Offer appropriate resources related to food insecurity.

This client is experiencing food insecurity by having to sacrifice other financial responsibilities for food. This fact alerts the nurse of the need to connect the client with appropriate community resources and programs for assistance, such as Meals on Wheels.

A nurse is creating a poster with examples of health care disparities for a community health care conference. Which of the following statements should the nurse use as an example of a health care disparity?

The implementation of a new treatment has reduced the diabetes mellitus rates among the Latino population of a community so that it is in line with other groups.

Ovarian cancer rates across the various populations of a community are proportional according to the demographics of the area.

African Americans have the highest rates of high blood pressure and hypertension compared to any other population worldwide.

A new health care clinic has opened near a reservation to treat clients from the local indigenous community, which is traditionally an underserved community.

African Americans have the highest rates of high blood pressure and hypertension compared to any other population worldwide.

Health care disparities are health outcomes that are seen at a greater or lesser extent between populations. One example is the fact that African Americans have the highest rates of high blood pressure and hypertension compared to any other population worldwide.

A nurse is explaining health care barriers to a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of a client who is underinsured?

"A client who is underinsured does not have health insurance but is able to pay for medical expenditures on their own."

"A client who is underinsured is not covered by any form of health insurance and cannot pay for medical expenditures."

"A client who is underinsured has health insurance but is likely to assume significant financial risk for medical expenditures."

"A client who is underinsured has more than one form of health insurance, which leads to duplications or discrepancies in covering medical expenditures."

"A client who is underinsured has health insurance but is likely to assume significant financial risk for medical expenditures."

An underinsured client is one who has health insurance but is likely to assume significant financial risk for medical expenditures. The underinsured population is typically unable to use their health insurance due to high deductibles and copays.