Nokea
A committee of health care professionals would like to establish a district-wide program to improve access to culturally competent health care services for Vietnamese immigrants. Who would be the best person to select as a key informant about this community's needs?
- A. The hospital administrator
- B. A Vietnamese community leader
- C. A national expert on cultural competency
- D. A provincial/territorial or municipal government official
Correct Answer: B
Rationale: The correct answer is B: A Vietnamese community leader. This individual is the best choice as a key informant because they have firsthand knowledge and understanding of the needs, preferences, and challenges faced by Vietnamese immigrants in the district. They can provide valuable insights into the cultural nuances, barriers to accessing health care services, and specific needs of the community. The hospital administrator may have general knowledge but lacks specific insights into the Vietnamese immigrant community. The national expert on cultural competency may have theoretical knowledge but may not understand the local context. The government official may have a broader perspective but lacks the community-specific knowledge necessary for this program.
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Which public health service best represents primary prevention?
- A. Developing a health education program about the dangers of smoking
- B. Providing a diabetes clinic for adults in low-income neighbourhoods
- C. Providing an influenza vaccination program in a community retirement village
- D. Teaching school-aged children about the positive effects of exercise
Correct Answer: A
Rationale: The correct answer is A because developing a health education program about the dangers of smoking is an example of primary prevention, which aims to prevent the occurrence of a disease or injury before it occurs. This intervention targets the root cause of the health issue by educating individuals on the harmful effects of smoking and promoting healthy behaviors to reduce the risk of developing smoking-related diseases. Choices B, C, and D represent secondary or tertiary prevention strategies as they focus on providing care or interventions after the disease has already developed or to prevent complications.
A client with tuberculosis (TB) wants to know why directly observed therapy (DOT) is required as part of the treatment. What community health nurse (CHN) response would be the most appropriate one?
- A. "Clients with TB are often nonadherent to their medication regimen; DOT will ensure that you take the medications prescribed to you."
- B. "This therapy is recommended by TB experts as the best way to ensure that you receive the treatment you need and that the infection doesn't become resistant to treatment."
- C. "This ensures that you get your medication even at the late stages of TB, when your memory may be affected by inadequate oxygenation to the brain."
- D. "TB medications are very expensive, and this method ensures that government health care resources are not wasted by those who will not take the medications regularly."
Correct Answer: B
Rationale: The correct answer is B because directly observed therapy (DOT) is recommended by TB experts to ensure treatment adherence and prevent drug resistance. TB treatment requires strict adherence to a regimen to prevent the development of drug-resistant strains. DOT involves a healthcare provider directly observing the client taking their medication to ensure compliance. Choice A addresses nonadherence but does not emphasize the importance of preventing drug resistance. Choices C and D are incorrect as they do not directly relate to the main purpose of DOT in preventing drug resistance and ensuring treatment effectiveness.
What is the most important action to be taken by the community health nurse (CHN) who wishes to decrease childhood obesity?
- A. Lobbying legislators to enact stronger legislation regarding unhealthy lunches and food from snack machines in schools
- B. Increasing availability of nutrition programs in which schoolchildren are taught to make healthy food choices
- C. Involving the entire family in the management of obesity in a child
- D. Providing after-school activities and summer camps that focus on diet and exercise
Correct Answer: C
Rationale: The correct answer is C. Involving the entire family in the management of obesity in a child is the most important action because family support and involvement are crucial for sustainable behavior change in children. The family plays a significant role in shaping a child's habits and lifestyle choices. By engaging the entire family, the community health nurse can create a supportive environment where healthy behaviors are encouraged and reinforced consistently. This approach addresses the root causes of childhood obesity by promoting healthy eating habits and physical activity within the child's daily life, rather than relying solely on external interventions like legislation or programs.
Choice A is less effective because while legislation can create a healthier environment, it may not directly address the underlying family dynamics influencing a child's behavior. Choice B is important but may not be as effective as involving the family since parental influence extends beyond school-based programs. Choice D is valuable but may not address the core issue of family involvement, which is crucial for sustainable behavior change.
What community health nursing action would best ensure long-term positive health outcomes in pregnant adolescents from low-income groups and their children?
- A. Help adolescent mothers learn about body changes during pregnancy.
- B. Develop programs that enable adolescent mothers to complete their education.
- C. Offer courses in proper care of babies.
- D. Monitor pregnant adolescents for early detection of problems in pregnancy.
Correct Answer: B
Rationale: The correct answer is B because completing education can empower adolescent mothers to secure better job opportunities, higher income, and improved living conditions, leading to long-term positive health outcomes for themselves and their children. This choice addresses the root causes of health disparities in low-income groups by promoting education as a key factor in breaking the cycle of poverty and improving overall well-being.
A: Learning about body changes during pregnancy is important but does not address the broader social determinants of health that impact long-term outcomes.
C: Offering courses in proper baby care is beneficial but does not address the underlying issues of education and socioeconomic status.
D: Monitoring for pregnancy problems is crucial for immediate health concerns but does not address the long-term health and well-being of the adolescent mothers and their children.
What is the biggest challenge for community health nurses (CHNs) who are familiar with evidence-informed practice and want to implement it in their care of clients?
- A. Interpreting vast amounts of evidence and integrating it into practice
- B. Advocating for change and convincing others that it is beneficial
- C. Distinguishing evidence-informed practice from practice based on old standards
- D. Showing clients that evidence-informed practice will improve their health outcomes
Correct Answer: A
Rationale: The correct answer is A because interpreting vast amounts of evidence and integrating it into practice is a significant challenge for community health nurses (CHNs) familiar with evidence-informed practice. CHNs need to sift through numerous research studies, guidelines, and data to make informed decisions about client care. By effectively integrating evidence into practice, CHNs can ensure that their interventions are based on the best available evidence, leading to improved client outcomes.
Choice B is incorrect because advocating for change is not the primary challenge related to implementing evidence-informed practice. Choice C is incorrect because distinguishing evidence-informed practice from outdated standards is important but not the biggest challenge. Choice D is incorrect because showing clients the benefits of evidence-informed practice is essential but not the main challenge faced by CHNs in implementing it.