Nokea
The community health nurse is involved in public health work. Which of these statements by the nurse reflects an understanding of upstream interventions?
- A. I will engage in policy initiatives in my urban area.
- B. I will administer the flu shot to interested seniors.
- C. I will help manage a senior's diabetes needs at home.
- D. I will work with a local school to provide asthma education.
Correct Answer: A
Rationale: Rationale: Option A is correct as it involves engaging in policy initiatives which are considered upstream interventions in public health. Upstream interventions target the root causes of health issues at a population level. Policy initiatives can lead to systemic changes that impact the health of entire communities. Options B, C, and D are more focused on individual or downstream interventions, which address health issues after they have already occurred and do not target the underlying causes on a larger scale.
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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.
What is the MOST COMMON cause of vaginal bleeding immediately after birth?
- A. Uterine atony
- B. Genital lacerations
- C. Abnormal clotting mechanisms
- D. Endometritis
Correct Answer: A
Rationale: The correct answer is A: Uterine atony. After birth, the uterus may not contract properly, leading to excessive bleeding known as postpartum hemorrhage. Uterine atony is the most common cause, as the uterus fails to remain contracted after delivery. This results in inadequate compression of blood vessels, leading to bleeding. Genital lacerations can cause bleeding but are less common than uterine atony. Abnormal clotting mechanisms and endometritis are less likely causes of immediate postpartum bleeding compared to uterine atony.
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.
How should a healthcare provider determine a client's reading level?
- A. Ask the client how they would rate their ability to read.
- B. Have the client assess their own health literacy and provide examples.
- C. Determine the client's completed years of formal education.
- D. Utilize literacy assessment tools available in the literature.
Correct Answer: A
Rationale: The correct answer is A because directly asking the client about their reading level allows for self-assessment, which is crucial in understanding their actual ability. This approach respects client autonomy and provides an opportunity for open communication.
Option B is incorrect as it focuses on health literacy rather than overall reading level. Option C is incorrect because completed years of education may not necessarily reflect reading ability accurately. Option D is incorrect as it assumes a standardized literacy tool can accurately capture an individual's reading level without considering personal context.
How can health professionals address social determinants of health?
- A. Providing direct care to underserved populations
- B. Advocating for policy changes
- C. Conducting health screenings
- D. Educating about healthy lifestyle behaviors
Correct Answer: B
Rationale: The correct answer is B because advocating for policy changes can address systemic issues that impact social determinants of health on a larger scale. Health professionals have the potential to influence policies that can improve access to healthcare, housing, education, and other social factors that impact health outcomes. Providing direct care (A) addresses immediate needs but does not address root causes. Health screenings (C) focus on early detection but do not tackle underlying social determinants. Educating about healthy lifestyle behaviors (D) is important but may not address the broader social context that influences health.