RN Community Health 2023

Question 1

A nurse at a community mental health center is teaching a course for the family and friends of clients who have a gambling disorder. Which of the following statements by a participant indicates an understanding of the information? RN Community Health 2023

• “Gambling behaviors can increase during times of stress.”
• “Family members should provide financial assistance during times of increased gambling.”
• “A person must gamble at least four to six times per month to have a gambling disorder.”
• “There is no genetic link to an increased risk for a gambling disorder.”

Question 2

A school nurse realizes that a student who has asthma visits the health office two to three times every day to use his rescue inhaler. Which of the following interventions should the nurse plan to implement first?

• Determine if the student sees his provider on a regular basis.
• Encourage the student’s parent to identify and reduce environmental triggers.
• Discuss the manifestations of asthma with the student’s teacher.
• Review breathing exercises with the student.

Question 3

A hospice nurse is caring for a client who is terminally ill. Which of the following actions by the client demonstrates that they are effectively coping?

• The client expresses anger frequently.
• The client journals about the experience of dying.
• The client plans a family reunion in 6 months.
• The client says they wish for a miracle cure.

Question 4

A nurse at a county health department is reviewing the newly diagnosed conditions of several clients. Which of the following should the nurse identify as nationally notifiable conditions? (Select all that apply.)

• Streptococcal pharyngitis
• Legionellosis
• Clostridium difficile
• Cutaneous anthrax
• Tuberculosis

Question 5

A school nurse is caring for a child who has muscular dystrophy and is having difficulty swallowing at lunch. Which of the following referrals should the nurse initiate? RN Community Health 2023

• Speech-language therapist
• Occupational therapist
• Respiratory therapist
• Dietitian

Question 6

A nurse is assessing an outbreak of mumps among school-age children. Using the epidemiological triangle, the nurse should recognize that which of the following is the host?

• The virus
• The vaccine
• The school
• The children

Question 7

A nurse at a shelter is assisting with client triage after a tornado destroyed a community. Which of the following clients should receive priority care? RN Community Health 2023

• An adult client who is short of breath
• An infant client who is crying
• An older adult client who has a fractured arm
• A school-age client who has a head abrasion

Question 8

A nurse is performing a community assessment. Which of the following situations should the nurse report to a social worker? RN Community Health 2023

• An increase in birth rates among middle adult clients
• An outbreak of chickenpox at a local daycare
• A family who cannot afford health care
• A neighborhood where the water supply was contaminated

Question 9

A home health nurse is caring for a client who is postoperative following a total hip arthroplasty. Which of the following interventions should the nurse recommend to promote recovery?

• Take baths instead of showers.
• Use an elevated toilet seat.
• Use a walker on the stairs.
• Cross legs at the ankles.

Question 10

A home health nurse is visiting a client who has a terminal illness. Which of the following statements by the client indicates a feeling of loss of control?

• “I should feel more grateful for my family and friends who are coming to visit.”
• “I don’t have much say in what’s happening anymore.”
• “I don’t think I did anything to deserve this. I tried to live a good life.”
• “I hope I have enough money saved to pay for the medications I need.”

Question 11

A home health nurse is teaching a client about the safe use of crutches. Which of the following information should the nurse include in the teaching?

• Wear leather-soled shoes when walking with crutches.
• Wipe the rubber crutch tips to remove moisture.
• Lean forward while walking with crutches.
• Support body weight on the axillae.

Question 12

A home health nurse is visiting a client who has right-sided weakness following a recent stroke. The client states, “I’m not sure how I will buy my groceries since I can’t go back to work.” Which of the following actions should the nurse take?

• Initiate a referral for the client to a social worker.
• Provide the client information about respite care.
• Offer to bring groceries to the client on a regular basis.
• Contact friends and neighbors to shop for the client.

Question 14

A nurse is caring for a client who is grieving. Which of the following questions should the nurse ask to identify the client’s support systems? RN Community Health 2023

• “How long did you know the person who died?”
• “What do others do for you that helps you the most?”
• “What are your hopes and plans for the future?”
• “Have you thought about harming yourself?”

Question 15

A nurse is working in a shelter following a disaster. Which of the following is the priority action for the nurse to take?

• Explore feelings the clients are experiencing.
• Address the physical needs of clients.
• Help clients gather needed supplies.
• Create diversionary activities for children.

Question 16

A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?

• The client is participating in a fee-for-service health care insurance program.
• The provider bills the client directly for a predetermined percentage of the cost of services.
• The client pays the insurer a percentage of the total costs for each service rendered by the provider.
• The provider is paid a fixed sum for the client on a monthly or yearly basis.

Question 17

A home health nurse is caring for a client who is receiving antibiotics via a central venous access device (CVAD). Which of the following actions should the nurse take to prevent infection?

• Instruct the client to change the end caps of the CVAD daily.
• Use clean technique when administering medication.
• Clean blood spills on hard surfaces with isopropyl alcohol.
• Use disposable equipment whenever possible.

Question 18

A nurse is planning an in-service about isolation precautions for her coworkers. For which of the following infections should the nurse identify the need for contact precautions? RN Community Health 2023

• Pulmonary tuberculosis
• Pertussis
• Herpes simplex
• Diphtheria

Question 19

A nurse is participating in an outreach program to combat the rise of encephalitis in the community due to an increased population of mosquitos. Which of the following activities should the nurse perform to implement mosquito control strategies?

• Release a media announcement asking residents to remove areas of standing water.
• Review morbidity rates of encephalitis within the last 6 months.
• Identify the number of cases resulting in disability from encephalitis.
• Research the species of mosquito responsible for the outbreak.

Question 20

A community health nurse is planning several health initiatives within the local area. Which of the following interventions should the nurse implement as a tertiary prevention initiative?

• Performing cancer screening at a local health fair
• Discussing health risks of nicotine with middle school students
• Teaching bicycle safety to school-age children
• Providing dietary guidance for clients who have diabetes

Question 21

A nurse is caring for a client who has hepatitis A virus. Which of the following reservoirs should the nurse identify for this infection?

• Skin
• Genitourinary tract
• Feces
• Blood

Question 22

A school nurse is assessing a child who has a fever and notices several bite marks on the child’s arm. The nurse should submit a referral for suspected child maltreatment based on which of the following additional findings? (Select all that apply.)

• The child’s clothes are wrinkled and dirty.
• The child reports coughing all day.
• The child tells the nurse that they are sick because they are bad.
• The child is wearing open-toed shoes and the weather is cold outside.
• The child is frequently absent from school.

Question 23

A home health nurse is discussing how to meet the needs of a diverse client population with a newly licensed nurse. The nurse should include that which of the following is an example of a nurse incorporating culturally competent care?

• Using a family member as an interpreter when caring for a client who speaks a different language than the nurse
• Instructing a client who is pregnant and has gestational diabetes mellitus that they must avoid the use of herbal teas for insulin replacement
• Integrating a client’s desire to use acupuncture to manage pain into their plan of care
• Informing the guardian of a child that the use of cupping to prevent illness is a form of child maltreatment

Question 24

A community health nurse is developing a disaster-preparedness plan. Which of the following actions should the nurse take first when developing the plan?

• Evaluate the effectiveness of local disaster-preparedness drills.
• Identify the community’s risks and capabilities.
• Provide education about first aid and triage.
• Assemble an emergency disaster response team.

Question 25

A public health nurse is educating caregivers about expected age-related changes seen in toddlers. Which of the following information should the nurse include?

• Toddlers will engage in imaginary play with other children their age.
• Toddlers are able to feed themselves using a spoon.
• Toddlers are able to use safety scissors to cut out simple shapes.
• Toddlers do not require short nap periods during the day.

Question 26

A home health nurse is assessing the health history of a new client. The nurse should identify that which of the following conditions increases the client’s risk for falls?

• Wide-angle glaucoma
• Osteoarthritis
• Chronic obstructive pulmonary disease
• Chronic kidney disease

Question 27

A hospice nurse is caring for a client who is experiencing acute air hunger. Which of the following actions should the nurse take? RN Community Health 2023

• Administer prednisone PO.
• Obtain ABGs.
• Circulate air using a fan.
• Place the client in a prone position.

Question 28

A nurse is planning a program about healthy eating at an elementary school where most students select french fries and pizza at lunch every day. Which of the following actions should the nurse plan to take first?

• Provide students with resources about making wise choices independently.
• Help students recognize the value of making healthy food choices.
• Give positive feedback to students who make appropriate choices.
• Determine students’ motivation to learn about healthy food choices.

Question 29

A nurse is conducting a community assessment. Which of the following information should the nurse include as part of a windshield survey?

• Community stakeholders
• Housing quality
• Mortality rate
• Informant interviews

Question 30

A school nurse is reviewing the family history of a school-age child who has a fractured ulna for the second time. Which of the following findings place the child at risk for child abuse? (Select all that apply.)

• The child’s family has an indoor cat that sleeps with the child.
• One of the child’s parents appears frightened of the other parent.
• One of the child’s parents has a history of alcohol use disorder.
• Neither of the child’s parents are financially stable.
• The child spends the weekends with their grandparents.

Question 31

A community health clinic nurse manager is reviewing the incidence rate of chlamydia in the state. In a given year, 3,144 new cases were reported and the population was estimated at 325,986. Which of the following is the incidence rate in the state for the year?

• About 3 reported cases per 10,000 population
• About 1 reported case per 10,000 population
• About 300 reported cases per 100,000 population
• About 10 reported cases per 1,000 population

Question 32

A home health nurse is caring for a client who has terminal cancer and no longer wants to receive enteral tube feedings. Which of the following actions should the nurse take?

• Complete an against medical advice form.
• Request the facility chaplain to visit the client.
• Ask the client to sign an informed consent form.
• Explain the process for completing a living will.

Question 33

A home health nurse is performing a home safety evaluation for a newly admitted client. Which of the following findings requires action by the nurse? (Select all that apply.)

• An extension cord extends across the floor of the living room.
• A red light is kept on in the bedroom at night.
• A rubber-backed bath mat is on the floor outside the shower.
• The floors of the house are carpeted.
• The water heater is set at 54.4° C (130° F).

Question 34

A nurse is developing community programs for a women’s clinic. Which of the following areas should be included according to Healthy People 2020?

• Educational programs regarding warning signs of heart attack
• Vocational education opportunities to enhance financial independence
• Adult day care programs to provide respite for employed caregivers
• Surgical options for weight reduction in individuals classified as obese

Question 35

A nurse is participating in a quality improvement committee for home health clients. Which of the following topics should the nurse recommend for the committee to review? RN Community Health 2023

• An increase in levels of local air pollution
• An increase in client admissions for home health care
• An increase in client falls at home
• An increase in clients receiving annual influenza vaccines

Question 36

A home health nurse is visiting a client who has recently started treatment for tuberculosis. The client is refusing to continue treatment due to the potential adverse effects. Which of the following statements should the nurse make? RN Community Health 2023

• “You might be legally required to participate in direct observed therapy.”
• “You will be required to wear an N95 mask when around your family members who live with you.”
• “You can discontinue follow-up appointments with your doctor after 6 month’s.”
• “You are only required to take the medications for 12 weeks to eliminate the bacteria.”

Question 37

A nurse is conducting a training session about disease prevention for staff at a community summer camp. When asked to provide an example of a vector-borne illness, which of the following responses indicates the teaching has been effective?

• Escherichia coli
• Pediculosis
• Lyme disease
• Chickenpox

Question 38

During a home health visit, a school-age child who has muscular dystrophy confides in the nurse that he was struck by his parent. Which of the following actions should the nurse take first?

• Report the incident to local authorities.
• Check the child for injuries.
• Refer the parent to a social service agency.
• Enroll the parent in anger management classes.

Question 39

A school nurse is planning teaching for the parent of a school-age child who has pediculosis capitis. Which of the following instructions should the nurse plan to include in the teaching?

• Dry bed linens in a hot dryer for 15 min.
• Soak combs in boiling water for 3 min every day.
• Seal non washable items in plastic bags for 14 days.
• Apply permethrin 1% cream rinse daily for 5 days.

Question 40

Scenario: A public health nurse is caring for clients in an immunization clinic.

Client Records

• Client 1: 65-year-old; No known allergies; Received all childhood vaccinations; Received 3 doses of COVID-19 vaccine; Temp: 36.4C(97.5F).
• Client 2: 2-month-old infant; No known allergies; Received Hepatitis B at birth; Temp: 37.2C(99F).
• Client 3: 12-year-old; Allergy to eggs, shellfish, and penicillin; Received all childhood vaccinations; Received 3 doses of COVID-19 vaccine; Temp: 37C (98.6 F).
• Client 4: 58-year-old; Allergy to milk; History of HIV; Received all childhood vaccinations; Received 3 doses of COVID-19 vaccine; Temp: 37.5 C (99.5 F).

Question: Which of the following immunizations should the nurse provide to the clients? (Select all that apply.)

• Human papillomavirus immunization (HPV) to client 2
• Rotavirus immunization to client 2 (Correct)
• Inactivated influenza immunization to client 4 (Correct)
• Inactivated influenza immunization to client 1 (Correct)
• Human papillomavirus immunization (HPV) to client 3 (Correct)

Question 41

Scenario: A home health nurse is performing a home visit to determine safety needs for a client who is postoperative right knee arthroplasty 3 days ago.

Home Assessment Findings

• Living room with excessive furniture and narrow pathways.
• Nonsecure rugs throughout the house.
• Highly polished wood floors.
• No handrails present in the bathroom.

Question: Which of the following findings by the nurse may present complications for the client? (Select all that apply.)

• Bedroom location
• Inside walking pathway (Correct)
• Rugs (Correct)
• Home assistance
• Flooring (Correct)
• Inside lighting
• Toilet
• Handrails (Correct)
• Home entrance
• Shower

Question 42

Scenario: A school nurse is participating in evaluation and program planning to reduce school violence. Surveys show an increase in students carrying weapons (1% to 3%) and physical fights (15% to 20%) over 6 months.

Question: Which of the following interventions for primary prevention in the proposed plan to reduce school violence should the nurse include? (Select 4 interventions.)

• Encourage student relationships within the school community. (Correct)
• Provide gun safety education for students. (Correct)
• Coordinate trauma response resources.
• Promote parent engagement in the school community. (Correct)
• Provide care for students injured during episodes of school violence.
• Employ a zero tolerance weapon policy. (Correct)

Question 43

Scenario: A nurse in a community clinic is caring for a 4-year-old child with a history of elevated lead levels (38.0g}/dL two years ago).

Question: Which of the following findings should the nurse identify as long-term complications of elevated lead levels? (Select all that apply.)

• Vital signs
• Hearing findings (Correct)
• Eating history
• Attention findings (Correct)
• Speech history (Correct)
• Behavior findings (Correct)

Question 44

A nurse is counseling a client who has a new diagnosis of chlamydia. Which of the following information should the nurse include in the teaching? (Select all that apply.)

• “You should avoid sexual contact until therapy is complete.”
• “Notify anyone with whom you have had sexual contact over the past 2 months.”
• “Once you complete treatment, you will have an acquired immunity against chlamydia.”
• “You might experience painful urination until the infection has resolved.”
• “You will need to take an antiviral medication for 30 days.”