Community health nursing final exam (exemplify)
Total Questions : 80
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1.What is the nurse's main goal when (s)he encounters a possible trafficking situation?
Explanation
Rationale:
A. While convincing a victim to escape might be a goal, it’s not always feasible or safe to suggest immediate action in such a dangerous situation.
B. Gathering information is important but should be done cautiously, ensuring the victim’s safety and comfort.
C. Being a safe and supportive presence is crucial, as it allows the victim to feel secure and open up at their own pace, which is essential for their safety and trust-building.
D. Providing resources is valuable, but ensuring that the victim feels safe and supported is a priority before sharing resources.
A 17-year-old female presents to the emergency department with bruises, a disheveled appearance, and signs of malnutrition. She is reluctant to provide information about her situation and appears fearful. During the assessment, she reveals that she was brought to the city by someone she referred to as her "employer" who promised her a job but has since taken her identification documents and restricted her freedom. Which of the following actions should the nurse prioritize to ensure the safety and well-being of this patient?
Explanation
Rationale:
A. Contacting the employer could potentially put the patient at further risk if the trafficker becomes aware of her location or intentions.
B. Encouraging the patient to return to her home town might not address immediate safety concerns and could place her at greater risk.
C. Providing job agency information does not address the immediate safety and health needs of the patient.
D. Ensuring the patient's immediate safety and addressing any urgent medical needs is the top priority. This includes assessing for immediate threats and providing necessary medical care.
When discussing resilience and empowerment, which of the following best describes resilience?
Explanation
Rationale:
A. Socioeconomic status can affect stress responses, but resilience specifically refers to the ability to withstand or recover from adversity.
B. Resilience refers to the ability of individuals or groups to withstand or bounce back from adverse conditions or stressors. This describes resistance to risk factors effectively.
C. Increased susceptibility to risk factors describes vulnerability rather than resilience.
D. Sensitivity to risk factors describes vulnerability rather than resilience, which focuses on recovery and resistance.
A public health nurse is involved in a discussion about the challenges faced when assisting victims of human trafficking. The nurse is evaluating various issues that complicate the process of providing effective support and intervention. Among the numerous difficulties encountered, which of the following is considered the most significant problem when it comes to helping victims of human trafficking today?
Explanation
Rationale:
A. Financial constraints are a significant issue but may not be the primary barrier compared to systemic issues.
B. The lack of standardized protocols and resources can lead to significant gaps in care and support for trafficking victims, making this a critical issue for effective intervention.
C. While training costs are a concern, they are part of a broader issue of inadequate protocols and resources.
D. Beliefs about trafficking being only a foreign issue contribute to underreporting but do not directly address the operational challenges faced in victim support.
A new graduate nurse asks the experienced nurse, "Why did you ask about culture when it was obvious that you needed to focus on the battering?" Which of the following would be the best response by the experienced nurse?
Explanation
Rationale:
A. Understanding culture is crucial because it influences how individuals perceive and respond to violence, which can impact their engagement with support services and interventions.
B. While cultural considerations can help with referrals, the primary focus should be on understanding the patient's responses and needs in the context of their cultural background.
C. Asking about culture is not merely a habit; it’s a critical aspect of providing comprehensive care that respects and understands the patient's background.
D. Culture is not directly related to deciding on the scope of physical assessments but is essential for understanding the patient’s context and needs.
A nurse is working in the emergency department, and is conducting an interview with a victim of intimate partner abuse. Which step should the nurse take first?
Explanation
Rationale:
A. Establishing rapport with both the victim and the abuser might not be appropriate in an abusive situation where the victim’s safety is a priority.
B. Requesting a security guard may be necessary but should be considered after ensuring the interview environment is safe and private.
C. Contacting legal services is important but should come after addressing immediate privacy and safety concerns.
D. Ensuring privacy for the interview is crucial to provide the victim with a safe environment where they can speak freely without fear of the abuser’s presence or intervention.
The nurse is considering making a child abuse or neglect report to protective services. To initiate a report on child abuse or neglect, which of the following criteria does the nurse need to meet?
Explanation
Rationale:
A. Nurses are mandated reporters and must report suspicions of abuse or neglect, regardless of concrete evidence or verbal admission.
B. A verbal admission from the victim is not required; suspicions alone are sufficient to make a report.
C. While notifying a supervisor may be part of internal protocols, it is not a legal requirement for making a report.
D. Notifying the parents may not be safe or appropriate in cases of abuse, and it is not a requirement for reporting abuse or neglect.
A client who is physically abused by their partner mentions to the nurse "Someday I'll have to leave him." Which of the following would be the nurse's best response?
Explanation
Rationale:
A. Asking about family reactions may not address the immediate safety needs or emotional support required.
B. Dismissing or questioning the reasons for staying can be judgmental and not supportive.
C. While encouraging safety is important, it is more helpful to collaboratively work on a plan rather than making definitive statements.
D. Discussing a safety plan empowers the client and provides practical steps to ensure their safety, which is crucial for someone in an abusive situation.
A nurse educator is presenting about the long-term effects of witnessing intimate partner violence (IPV) on children. The nurse knows that the material was understood if the staff accurately identify which of the following as adverse childhood events (ACES) impacting children? Select all that apply
Explanation
Rationale:
A. Living in a household with substance abuse and domestic violence is an ACE that can significantly impact a child's development and mental health.
B. Discipline using "time out" is generally considered a less harmful form of discipline and not classified as an ACE.
C. Childhood abuse is a significant ACE that has long-term effects on physical and mental health.
D. Being behind in reading skills is an educational concern but not classified as an ACE.
E. Neglect is an ACE that can severely affect a child's development and well-being.
While assessing a family system, the nurse is aware that which of the following can alter the family dynamic?
Explanation
Rationale:
A. A change in employment status can significantly impact family roles, finances, and emotional dynamics.
B. Coping with a chronic medical condition affects family routines, emotional health, and caregiving responsibilities.
C. Daily activities of living typically do not cause significant alterations in family dynamics unless they are part of a larger issue.
D. The addition of a new family member can alter family roles, dynamics, and relationships significantly.
E. A crisis affecting a family member can dramatically change family dynamics due to emotional stress and shifts in responsibilities.
A novice nurse has identified impaired verbal communication for an older Asian client who recently immigrated to the United States, based on the client's reluctance to maintain eye contact and engage in a conversation with the staff. Which of the following would be an appropriate response by the nurse mentor to ensure that the nursing diagnosis is correct.
Explanation
Rationale:
A. Observing the client's communication with family might provide some insight but does not directly address the cultural influences on the client’s behavior.
B. Understanding the cultural background is crucial as cultural norms and traditions can significantly influence communication behaviors, such as eye contact and engagement.
C. Asking the client directly might be appropriate but does not take into account potential cultural factors that could influence their communication.
D. Misdiagnosing shyness as a communication issue could be a concern, but recognizing cultural influences helps to ensure that the diagnosis is culturally appropriate.
Based on the research data, which of these children being followed by a pediatric nurse has the highest risk of experiencing fatal abuse?
Explanation
Rationale:
A. Appendicitis is a common condition and does not inherently increase the risk of fatal abuse.
B. A fractured humerus may be concerning but is not as high-risk for fatal abuse as younger children with significant disabilities.
C. A child with cerebral palsy, especially at a young age, is at higher risk of fatal abuse due to increased dependency and vulnerability.
D. Varicella (chickenpox) is a contagious disease but does not significantly increase the risk of fatal abuse.
When discussing the topic of human trafficking to a group of high school students, one student asked "what the difference between Intimate Partner Violence and human trafficking? What is the nurse's best response?
Explanation
Rationale:
A. While Intimate Partner Violence can involve various sexual orientations, it does not define the primary difference between it and human trafficking.
B. Sex trafficking involves significant violence and exploitation, contrary to this statement.
C. Victims of sex trafficking are indeed trafficked for profit, with their bodies exploited to generate revenue for the trafficker.
D. Victims of Intimate Partner Violence do experience a loss of control, but the key difference is that sex trafficking involves the commercial exploitation of victims.
14.Which of the following terms best describes a victim feeling loyalty for their controller, and having negative feelings toward those who may harm the controller?
Explanation
Rationale:
A. Stockholm Syndrome is a psychological phenomenon where victims develop positive feelings toward their captors or abusers and negative feelings toward those who oppose them.
B. Extreme stress may occur in victims but does not specifically describe the loyalty and negative feelings toward others as described.
C. Glamorizing exploitation refers to viewing exploitation in a positive light, which does not align with the feelings of loyalty and animosity described.
D. Sexual confusion does not accurately capture the dynamics of loyalty to a controller and hostility toward others.
When talking to a possible victim of trafficking, what is the most crucial thing to remember?
Explanation
Rationale:
A. While contacting the trafficking hotline may be necessary, it is essential first to ensure the client's immediate safety and confidentiality.
B. Knowing available resources is important, but ensuring a safe, private environment for the client is the first priority.
C. Performing a sexual examination without consent violates the client’s rights and may not be appropriate or necessary at the initial contact.
D. Ensuring the conversation occurs alone and privately is crucial for the client’s comfort and safety, allowing them to speak freely about their situation.
Nurses caring for clients need to provide culturally competent care to an increasingly diverse population. Which statements accurately describe a characteristic of cultural diversity that exists in the United States? (Select all that apply)
Explanation
Rationale:
A. Individuals often belong to multiple cultural groups simultaneously, which can influence their behaviors and perspectives in diverse ways.
B. Culture indeed provides guidelines for acceptable behavior within a specific group, shaping norms and practices.
C. Cultural diversity encompasses more than just race and culture; it includes various aspects such as ethnicity, religion, and social background.
D. Cultural diversity impacts health and illness, as different cultural beliefs can influence health practices and perceptions.
E. Cultural practices can change over time due to various factors such as globalization and generational shifts, rather than remaining constant.
To provide culturally competent care, nurses must be alert to factors that express bias against certain traditions. Which examples exemplify cultural imposition? (Select All that Apply)
Explanation
Rationale:
A. Cultural imposition occurs when a nurse enforces their own cultural norms and practices on clients, such as not allowing them to choose whether to bathe daily.
B. Insisting that a client see a priest based on personal beliefs imposes religious practices on the client, not considering their individual preferences or needs.
C. Treating all clients the same without considering cultural differences is not cultural imposition but rather a lack of cultural competence.
D. Dismissing Jewish dietary restrictions as merely a preference reflects a lack of respect for the client's cultural practices, which is an example of cultural imposition.
E. Directing questions to the client's daughter instead of the client shows a lack of respect for the client's autonomy but does not exemplify cultural imposition.
What type of interventions would be used to influence the knowledge, attitudes, values beliefs, behaviors, and practices of a particular population?
Explanation
Rationale:
A. Consultation involves seeking expert advice and is not primarily focused on influencing broad population behaviors or beliefs.
B. Advocacy involves supporting a cause or policy but does not directly focus on changing knowledge, attitudes, or behaviors of a population.
C. Social marketing uses marketing principles to influence behaviors and practices of specific populations by addressing their knowledge, attitudes, and values.
D. Coalition building involves bringing groups together to address issues but is not the primary method for changing individual knowledge or behaviors.
A client admits to having been battered by her live-in partner several times over the past two years. The client states to the nurse, "We plan to get married next June, and I think things will be better after the wedding. He is always so sorry afterward, that I think I can trust him to change." Which intervention should be included in the client's teaching plan?
Explanation
Rationale:
A. Developing an emergency plan is crucial because patterns of violence often continue or escalate, and having a plan can help ensure the client’s safety.
B. While battering patterns often persist, focusing on immediate safety measures like an emergency plan is more practical.
C. Discouraging hope might not be supportive; instead, focusing on practical safety measures is more helpful.
D. Learning self-defense might not address the root issue of the violence and does not ensure safety in abusive situations.
A nurse is assessing the impact of a severe health crisis, such as a chronic illness or major accident, on a family unit. The family is experiencing significant stress due to the health crisis, which has altered their daily routines and responsibilities. Considering the potential effects of such a crisis, which of the following is the major effect on the family structure that the nurse should be aware of?
Explanation
Rationale:
A. A severe health crisis typically increases emotional support needs and can exacerbate family conflict rather than decrease them.
B. While some families may experience strengthened bonds, crises often lead to increased stress and conflict.
C. Crises often disrupt family stability and can lead to more uneven distribution of tasks rather than enhancing stability.
D. A major health crisis usually results in increased financial strain and changes in family roles and responsibilities, reflecting the significant impact on the family structure.
A nurse is conducting an in-service presentation on human trafficking for high school students. Which of the following statements made by the students demonstrates a correct understanding of human trafficking? (Select all that apply.)
Explanation
Rationale:
A. Victims are typically not aware or willingly participating in their exploitation; they are often coerced or manipulated.
B. Human trafficking involves exploiting individuals for purposes such as forced labor or commercial sex, making this a correct statement.
C. Victims of human trafficking can come from any demographic, including varying ages, genders, and socioeconomic backgrounds.
D. Control methods used in human trafficking include threats, manipulation, and violence, making this a valid statement.
E. Human trafficking is indeed often linked with other illegal activities, including drug trafficking and organized crime.
F. Human trafficking occurs both internationally and within the United States, so this statement is incorrect.
When instructing students about human trafficking, the nurse would realize the need for further instruction if students identify which of the following as a risk for human trafficking?
Explanation
Rationale:
A. Disability can be a risk factor for human trafficking due to vulnerabilities, so this does not indicate a misunderstanding.
B. Neglect during formative years can contribute to vulnerability to trafficking, so this is a relevant risk factor.
C. Homelessness is a known risk factor for human trafficking as it increases vulnerability.
D. Minority religion alone is not typically identified as a risk factor for human trafficking, making this statement a sign of misunderstanding.
A nurse is assessing a client who presents with injuries and signs that may suggest intimate partner violence. Which of the following statements by the client would most likely indicate the need for further assessment and intervention?
Explanation
Rationale:
A. Bruises from a sports injury are less likely to indicate intimate partner violence without additional context.
B. Stress from work is a general issue and does not directly suggest intimate partner violence.
C. A fall down the stairs could be an accident; however, further context is needed to assess if this is related to violence.
D. Fear at home and reluctance to discuss it could indicate underlying intimate partner violence, requiring further assessment and intervention.
Which nursing intervention is most likely to help a client in the Emergency Department with extensive soft tissue injuries disclose an incident of domestic violence?
Explanation
Rationale:
A. Waiting for the client to bring up domestic violence may miss the opportunity for timely intervention.
B. Documentation and referral are important, but directly addressing the issue can be more effective in identifying and assisting victims.
C. Directly asking the client about domestic violence in a private and supportive manner facilitates open communication and disclosure.
D. Providing general information may not be as effective as directly addressing the issue with the client.
The nurse working in emergency triage is evaluating a client with injuries frequently associated with physical abuse. Which of the following questions if answered yes by the client would indicate a higher risk of mortality?
Explanation
Rationale:
A. The presence of a gun in the home is associated with a higher risk of severe injury or death in cases of domestic violence.
B. While trying to leave can be risky, it does not directly indicate a higher risk of mortality compared to other factors.
C. Repeated hospitalizations indicate ongoing abuse but are not as directly related to immediate risk of mortality as the presence of a gun.
D. Having a plan could indicate awareness and preparation, which may not directly correlate with immediate risk of mortality.
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