Community Health Nursing Chapter 22 MC

When providing safety education for parents of school-age children, the community health nurse would focus interventions on which of the following as the priority?

A)

Motor vehicle safety

B)

Water safety

C)

Fire safety

D)

Poisoning prevention

A

Feedback:

For the 1- to 9-year-old age group, motor vehicle/traffic injury, drowning, and fire/burn injuries were the top three causes of injury death. For the 10- to 19-year-old age group, motor vehicle/traffic injuries, drowning, and poisoning are the three leading causes of injury death. Thus the priority would be to focus interventions on motor vehicle safety. Although water and fire safety and poisoning prevention would be important, motor vehicle safety would be most important.

A community health nurse is presenting a program to a local elementary parent-teacher association on the topic of pediculosis. The nurse determines that the group needs additional teaching when they identify which of the following as a likely mode of transmission?

A)

Coming into contact with an animal

B)

Combing hair with another's comb

C)

Using a towel of an infected child

D)

Sleeping in a friend's bed who had lice

A

Feedback:

Head lice are most often transmitted by direct contact (head-to-head) or may be passed from infected to uninfected children through shared items such as combs and brushes, hats, scarves, sheets, and towels (called fomites). Contrary to some popular myths, lice do not fly or jump, and they cannot be contracted from animals—they live only on humans.

A community health nurse who is participating in a nutritional screening program with school-age children measures their body mass index (BMI). The majority of children fall within the 45th to 65th percentile for their age. The nurse would classify these children as which of the following?

A)

Underweight

B)

Healthy weight

C)

At risk for overweight

D)

Overweight

B

Feedback:

A BMI between the 5th and 95th percentile for age is considered healthy weight. Underweight refers to a BMI below the 5th percentile. At risk for overweight refers to children with a BMI between the 85th and 94th percentile. Overweight refers to children with a BMI equal to or greater than the 95th percentile.

Which of the following measures would be most appropriate for a community health nurse to include when developing programs to address childhood obesity?

A)

Encouraging television watching for about 3 hours per day

B)

Suggesting that families eat less meals together at home

C)

Urging participation in physical activity for 30 minutes per day

D)

Limiting the intake of unsaturated oils in cooking

C

Research has demonstrated an association between poor eating habits and physical inactivity. Low levels of physical activity and more than 2 hours of watching television per day were found to be predictors of overweight status in a large longitudinal study of children. Therefore, interventions should focus on increasing levels of physical activity and encouraging limited television for school- age children, encouraging families to eat more meals together at home, advocating for increased physical education in the school setting, and for more safe recreational opportunities in all neighborhoods. In addition, healthy eating habits such as using unsaturated oils in cooking need to be stressed.

Which of the following programs would be least effective to institute for a community of school-age children who are experiencing dental caries?

A)

Ensuring that the drinking water is fluoridated

B)

Having the school to institute a fluoride rinse program

C)

Encouraging the parents to get their children's teeth sealed

D)

Advising parents to encourage the children to brush once daily

D

Feedback:

Regular brushing and flossing is important for dental hygiene. However, once daily is not enough. Fluoridated drinking water, school- based fluoride rinse or gel, and dental sealant programs are cost-effective, proven methods of reducing dental caries in school-age children.

Which of the following would a community health nurse expect to assess in the adolescent population with an eating disorder?

A)

High levels of peer support

B)

Clear sense of self

C)

Feelings of being in control

D)

Distorted body image

D

Feedback:

Adolescents with eating disorders typically have a disturbed body image, low levels of peer support, distorted self-concept and low self-esteem. In addition, they have issues with control, such that they used eating as a means for control.

A community health nurse is teaching a group of parents about attention deficit hyperactivity disorder. Which statement by the parents would indicate the need for additional teaching?

A)

"We probably will need to give him medication to help him in school."

B)

"We need to keep him away from foods that have additives in them."

C)

"This condition is most likely due to problems with genes and nerve receptors."

D)

"We'll be alert to the possibility of more injuries and accidents."

Ans:

B

Feedback:

While a number of parents feel that sugar and food coloring or additives may worsen ADHD symptoms in their children, research shows no behavioral or learning differences in double- blind studies with sugar and sugar substitutes. Medications are commonly used, with the primary goal of improving academics. New research is focusing on inherited tendencies for problems with dopamine receptors and transporter genes, supporting a neurologic basis for the condition. Children with ADHD are more prone to accidents and injuries.

local community agencies to provide services for children and adolescents with disabilities.

8. Based on the nurse's knowledge of the most common disabilities affecting this group, the nurse would advocate for which of the following to address the largest group?

A)

Special education services

B)

Speech therapy services

C)

Mental health services

D)

Mental retardation services

A

Feedback:

In descending order, the most common disabilities found in school-age children and adolescents are learning disorders; speech or language impairment; mental retardation; serious emotional disturbances and other disabilities, such as autism; deaf-blindness; orthopedic problems; traumatic brain injury; and other health impairments, such as asthma, diabetes, and epilepsy. Thus advocating for special education services would address the most common disability, learning disorders.

Which of the following statements about children's health status and academic achievement are most accurate?

A)

All health problems that can affect learning and achievement in school-age children are preventable.

B)

Physical and emotional health can affect academic achievement in children and adolescents.

C)

Only behavioral health problems can affect learning and achievement in school-age children.

D)

Poverty is one health problem that does not affect learning and achievement in school-age children.

B

Physical and emotional health can affect academic achievement in children and adolescents. Not all health problems that can affect learning and achievement in school-age children are preventable. Behavioral health problems can affect learning and achievement in school-age children, but other types of health problems can also affect learning and achievement in school-age children. Poverty is a health problem that also affects learning and achievement in school-age children.

A community health nurse is providing immunizations to school-age children at a local health department. At which age would the nurse expect to administer the first dose of human papilloma virus (HPV) vaccine?

A)

9

B)

11

C)

13

D)

15

B

Feedback:

The current recommendation is to administer the first dose of HPV vaccine at age 11. However, the earliest age that the vaccine can be given is age 9. The HPV vaccine is administered to females at age 13 to 18 if they have not been previously vaccinated.

A community health nurse is speaking to a group of parents of incoming college freshmen students who will be living in the dormitories. The focus of the program is on the college health program, health issues, and immunizations. Which immunization would the nurse most strongly encourage the students to receive if they have not received it previously?

A)

Varicella virus vaccine

B)

Human papilloma virus vaccine

C)

Meningococcal vaccine

D)

Influenza vaccine

C

Feedback:

The meningococcal vaccine is a catch-up vaccine that is recommended for all previously unvaccinated college freshmen living in dormitories. Adolescents who have not had chickenpox and have not received prior vaccination should receive the varicella vaccines. The HPV vaccine is given to females only. The influenza vaccine should be given only those who are considered high risk.

When preparing a program to address violence among school-age children and adolescents, the community health nurse integrates knowledge of which of the following?

A)

Teen females commit homicide more frequently than teen males.

B)

Homicide is the second highest cause of death for all adolescents.

C)

Adolescents account for less than one half of all firearm injuries treated.

D)

Serious youth violence is unrelated to drugs and guns.

B

Feedback:

Homicide is the second leading cause of death for adolescents (ages 10 to 24) and is more common in males than females. Adolescents between the ages of 15 and 19 years account for almost 85% of all firearm injuries treated in emergency departments or hospitals. Serious youth violence is part of a constellation of risk-taking behaviors that also includes precocious sex, drugs, and guns.

When working with community groups to develop appropriate programs for adolescent health promotion, the nurse integrates knowledge of the Healthy People 2020 objectives, keeping in mind that many of the objectives address which of the following?

A)

Self-esteem improvement

B)

Risk-taking behaviors

C)

Control of disease

D)

Behavioral issues

B

Feedback:

Healthy People 2020 objectives are geared to improve the health of all Americans. Twenty- one specific objectives have been ranked as critical for this population. The objectives focus on issues involving mortality and morbidity in this age group that stems primarily from risk-taking behaviors. Many of the objectives relate to reduction in alcohol- related unintentional injuries, declines in violent behaviors, suicide and mental health issues, as well as more responsible reproductive health behaviors.

When working with school districts, which of the following would the community health nurse encourage as the most effective school- based approach to solve the problem of teenage suicide?

A)

Suicide prevention programs with direct interventions

B)

Teachers assessing suicide risk among students

C)

Promotion of stronger parental control of teens

D)

Punitive treatment of teens by the school administration

A

Programs and interventions by counselors and school nurses that are focused on determining adolescent suicide intentions are the most effective approaches. Teachers do not feel comfortable or prepared to assess suicide risk, and this alone will not prevent teen suicide. Peer pressure is strong, and parent concerns are not as important to the teen. Teens are seeking independence, and stronger parental control is not an effective method of reducing teen suicide. This approach is inappropriate for any school-age child or teen behavior.

A community health nurse is working with local schools to help address teen pregnancy. The nurse would focus interventions on which of the following?

A)

Better use of contraceptives

B)

Decreased sexual activity

C)

Improved parenting skills

D)

Proper nutritional habits

B

Feedback:

Although contraceptives, parenting skills, and nutrition may be areas of focus for teen pregnancy, research has shown that the downward trend for teen pregnancy rates has been attributed largely to better contraceptive use rather than less sexual activity. Therefore, interventions should focus on the area of decreasing sexual activity.

Which of the following would the community health nurse most commonly need to address when planning programs for children with chronic illness?

A)

Asthma control

B)

Autism education

C)

Diabetes regimens

D)

Seizure control

A

Although autism education, diabetic regimens, and seizure control are common issues related to chronic disease in children, asthma is the most common chronic disease. Thus asthma control would be a priority.

A community health nurse is working with a group of school nurses to develop interventions for a 10-year-old girl exhibiting signs and symptoms of school refusal. Which of the following would be most appropriate?

A)

Limiting parent involvement in the school

B)

Exposing the child rapidly to the classroom

C)

Keeping the child at home for a while

D)

Providing relaxation training

D

Feedback:

The most effective interventions for school refusal include early return to school with parental involvement in school, systematic desensitization (gradual exposure to the classroom), relaxation training, and counseling.

A community health nurse is working with the local health department on screening for sexually transmitted infections. Which of the following would the nurse identify as the most common?

A)

Syphilis

B)

Gonorrhea

C)

Chlamydia

D)

Herpes simplex virus

C

Feedback:

Chlamydia is the most common STI in adolescents and should be a major focus of the screening. Syphilis, gonorrhea, and herpes simplex virus also are common among adolescents but less than Chlamydia.

When preparing a program about substance abuse prevention for adolescents, the community health nurse would focus on which substance as the most frequently used?

A)

Marijuana

B)

Alcohol

C)

Ecstasy

D)

Ketamine

B

Feedback:

Alcohol is the most frequently used substance for adolescents in the United States. Marijuana is the most commonly used drug among 14- to 17-year-olds. Ecstasy and ketamine are other drugs used by adolescents and young adults.

A community health nurse is engaged in a community-wide program for promoting nutrition in adolescents. Which of the following would lead the nurse to target the program to adolescent girls?

A)

Girls eat larger quantities of food than boys.

B)

They are more physically active than boys.

C)

They have a tendency to diet inappropriately.

D)

They are more conscious about food nutrients.

C

Feedback:

Girls are more at risk for problems with nutrition for several reasons: They tend to diet inappropriately, to have more finicky eating habits, and to be less physically active than teenage boys. Boys typically eat large quantities of food, which increases the likelihood of obtaining adequate nutrients, and they also tend to be more physically active than girls.

A community health nurse is implementing a family planning program near a local inner city's schools. The nurse is engaging which type of health service?

A)

Preventive program

B)

Health protection

C)

Health promotion

D)

Injury prevention

A

Feedback:

A family planning program is an example of a preventive program that provides birth control information and counseling. Health protection programs focus on safety including injury prevention. Health promotion programs focus on areas such as nutrition and weight control, and drug abuse education.