Identifying that numerous factors influence chronic illnesses such as hypertension, which of the following would be an upstream factor to enhance health outcomes for adults with hypertension in the community?
- A. Nutritional classes featuring low-fat and low-carb choices.
- B. Motivational interviewing sessions for smoking cessation.
- C. Working with the public health department to restrict smoking in public.
- D. Initiating chair yoga classes for seniors in the community.
Correct Answer: C
Rationale: The correct answer is C because working with the public health department to restrict smoking in public is an upstream factor that addresses the root cause of hypertension by reducing exposure to a risk factor (smoking). This approach focuses on population-level interventions to prevent the development of chronic illnesses.
A is incorrect as nutritional classes address individual behaviors, not population-level factors. B focuses on individual behavior change related to smoking, which is downstream from the root cause of hypertension. D is also incorrect as chair yoga classes, while beneficial for seniors, do not address the underlying factors contributing to hypertension in the community.
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When working with moms and babies from diverse backgrounds in the community, what is a necessary competence for a public health nurse to have self-awareness and humility?
- A. I am confident in my ability to teach the new mom about all the necessary aspects of evidence-based newborn care before the baby is born.
- B. I often notice that newly expectant moms underestimate the challenges of caring for a new baby, and I emphasize this to them.
- C. Sometimes, young moms lack knowledge about self-care, and I try to correct their behavior promptly.
- D. I understand that I may not always be perfect with my patients, but I acknowledge this openly and listen to their feedback.
Correct Answer: D
Rationale: The correct answer is D because self-awareness and humility are crucial competencies for a public health nurse working with diverse populations. By acknowledging imperfections openly and listening to patient feedback, the nurse demonstrates an understanding of their own limitations and a willingness to learn and improve. This approach fosters trust and communication with clients, leading to better outcomes.
A is incorrect because it focuses on the nurse's confidence rather than self-awareness and humility. B is incorrect as it highlights a judgmental attitude towards expectant moms instead of promoting understanding and support. C is incorrect as it emphasizes correcting behavior rather than listening and understanding the individual's needs.
In a community with competencies, what characteristic demonstrates their ability effectively?
- A. Identify their needs, achieve consensus, and plan and implement goals
- B. Delegate community processes to an outside expert
- C. Conduct their own cross-sectional epidemiological studies
- D. Predict morbidity and mortality rates
Correct Answer: A
Rationale: The correct answer is A because it demonstrates a comprehensive approach to community competency. Identifying needs shows awareness, achieving consensus promotes unity, and planning and implementing goals indicate organizational skills. B is incorrect as it lacks community involvement. C is incorrect as it focuses on a specific research method rather than overall competencies. D is incorrect as it pertains to forecasting health outcomes rather than community effectiveness. Therefore, A is the most appropriate choice for showcasing the ability to effectively address community needs.
Which best describes an example of primary prevention in maternal newborn care?
- A. Providing prenatal education classes
- B. Screening for gestational diabetes
- C. Providing postpartum support groups
- D. Offering breastfeeding support
Correct Answer: A
Rationale: Primary prevention aims to prevent the occurrence of a disease or health condition before it happens. Providing prenatal education classes falls under primary prevention as it educates expecting mothers on healthy behaviors during pregnancy to prevent complications. This empowers them with knowledge and skills to promote their own and their baby's wellbeing. Screening for gestational diabetes (B) is a form of secondary prevention, as it detects a condition early to prevent its progression. Providing postpartum support groups (C) and offering breastfeeding support (D) are important interventions for promoting maternal and newborn health, but they are considered more as supportive or tertiary prevention measures rather than primary prevention.
The public health nurse is working with a client who desires to move away from eating take-out and fatty foods to maintain a healthier lifestyle. The client mentions eliminating processed foods from her diet most days of the week but still struggles to consistently add fruits and vegetables to her meals. According to the Transtheoretical Model of health behavior change, this client is in which stage:
- A. Pre-contemplation
- B. Contemplation
- C. Preparation
- D. Action
Correct Answer: C
Rationale: The correct answer is C: Preparation. In the Transtheoretical Model of health behavior change, the Preparation stage signifies that the individual is actively preparing to make a change within the next month. In this case, the client has already taken steps to eliminate processed foods most days of the week, indicating a readiness to change. However, the struggle to consistently add fruits and vegetables shows that the change is not fully implemented yet, placing the client in the Preparation stage.
Choice A: Pre-contemplation is incorrect because the client is already taking action to change her eating habits.
Choice B: Contemplation is incorrect as the client has moved past just thinking about changing her behavior.
Choice D: Action is incorrect because the client has not fully implemented the desired change yet, but is actively preparing for it.
The RN working within the NFP model of care uses the Minnesota Health Wheel to describe what she does in her role to her own family. Which intervention is the RN likely to describe that is consistent with the public health nurse role of delegation:
- A. I administered IV antibiotics every 6 hours when the physician or nurse practitioner prescribed them.
- B. I conducted a full respiratory exam on a mother who might need asthma follow-up.
- C. I collaborated with the social work services team when I noted that my patient was unhoused.
- D. I taught the newly pregnant mom about necessary vaccinations to have at this time.
Correct Answer: C
Rationale: The correct answer is C because public health nurses in the NFP model focus on collaborating with other healthcare professionals and community resources to address the social determinants of health. By collaborating with the social work services team when recognizing that a patient is unhoused, the nurse is delegating the appropriate intervention to address the patient's social needs, which is a key aspect of the public health nurse role.
Choices A, B, and D are incorrect because they all involve direct patient care interventions that are typically within the scope of practice of the nurse themselves, rather than delegating to other professionals or resources. Option A involves administering IV antibiotics, which is a nursing task. Option B involves conducting a respiratory exam, which is also a nursing task. Option D involves teaching a patient about necessary vaccinations, which is an educational intervention within the nurse's scope of practice.