Deck 19: Screening and Referral

Question 1

A community/public health nurse was responsible for setting up a health fair in a very heavily attended inner-city church,with several screenings being given simultaneously.Within the public health agency,what would the nurse call the health fair?

A)Case finding
B)Community service
C)Multiphasic screening
D)Unreimbursed care

Answer 1

Multiphasic screening

Question 2

Why is health screening considered a secondary level of prevention?

A)It distinguishes between populations at high risk for disease from those at low risk for disease.
B)It identifies patients who may need intervention.
C)It diagnoses many easily treated diseases.
D)It promotes health and well-being.

Answer 2

It identifies patients who may need intervention.

Question 3

Sensitivity is the ability of a screening test to accurately identify what aspect of the screening?

A)Persons who do not have the disease
B)Persons who have the disease
C)Persons with symptoms of the disease
D)Persons who now have a diagnosis of the disease

Answer 3

Persons who have the disease

Question 4

A community/public health nurse was planning a prostate cancer screening in cooperation with the local community hospital.Whom should the nurse be sure to invite?

A)Men older than 50 years in the community
B)Anyone who had ever been involved with the local community hospital
C)Anyone who has a family history of cancer
D)Community members from infants to senior citizens

Question 5

Why are results of screening tests referred to as presumptive?

A)If the test result is positive,it may be assumed that the disease is present.
B)The test results lead to recognition of symptoms.
C)The tests detect previously unrecognized signs and symptoms.
D)Because screening test results have less than 100% accuracy,referral for further tests is necessary.

Question 6

The community/public health nurse was asked why a church was chosen as the site for a recent health fair,because not everyone in the community attended this church.What would be the most likely response by the nurse?

A)"It is accessible to most of the residents of the community,it is large and has several restrooms,and it is centrally located."
B)"Most residents of the neighborhood either do or should attend the church."
C)"I am a member of that church and could reserve the site without charge."
D)"The church is community service-oriented,and hosting the screening met its mission."

Question 7

What must be stressed to all participants attending a health fair?

A)A screening program is not a substitute for ongoing health supervision from a health care provider.
B)All test results are only tentative,and so participants who receive negative test results may nonetheless be suffering from a disease.
C)Results are true today,but disease can develop any time,so participants should attend any future health fairs as well.
D)There are many other diseases that may be attacking participants that the health fair did not screen for,and so continued vigilance is necessary.

Question 8

Which of the following is known to be the leading cause of preventable death in the United States?

A)Obesity
B)Smoking
C)Sun exposure
D)Second-hand smoke

Question 9

Which of the following events might help document the importance of a health screening to the neighborhood?

A)Absenteeism caused by illness at the local factory decreased.
B)Morbidity statistics related to heart disease decreased over the next year.
C)The incidence and prevalence of hypertension fell precipitously.
D)The incidence and prevalence of hypertension rose precipitously.

Question 10

A client received positive results on a screening test.What does this result mean for the client?

A)The client does not have the disease.
B)The client has the disease and needs immediate treatment.
C)The client has a laboratory finding confirming disease.
D)The client will need further testing and follow-up.

Question 11

Specificity is the ability of a screening test to accurately identify what aspect of the screening?

A)Persons who do not have the disease
B)Persons who have the disease
C)Persons who need follow-up in relation to the disease
D)Persons who were unaware that they had the disease

Question 12

A community/public health nurse had a referral to visit a grandmother in her apartment to follow up on blood pressure readings because she was on a new medication.While in the apartment,the nurse took the blood pressure readings of all the adults and children there.What is the nurse attempting to do?

A)Perform a case finding.
B)Follow the American Heart Association guidelines.
C)Give care to all members of the family,regardless of reimbursement.
D)Involve the family in the care.

Question 13

A local community hospital offers weekly hypertension screenings at the community center.A community/public health nurse was asked by a community member about when the health department would be offering a hypertension screening at the center.Which of the following would be the best response from the community/public health nurse?

A)"When the public health department receives additional grant funding."
B)"When the residents of the neighborhood request free screenings."
C)"When the community/public health nurse has extra time."
D)"When the community hospital stops offering screenings."

Question 14

What is the relationship between sensitivity and specificity?

A)The higher the sensitivity,the higher the specificity.
B)The higher the sensitivity,the lower the specificity.
C)The higher the specificity,the higher the sensitivity.
D)The more sensitive a test is,the more specific it becomes.

Question 15

A nurse is planning the evaluation of a mental health screening program in the community.What should be included in the process evaluation of this program?

A)Asking whether program goals were adequately met
B)Determining whether more people sought follow-up care after the screening
C)Determining the number of people who attended and were screened
D)Measuring whether the incidence of disease changed

Question 16

As nursing students were setting up a health screening at a local community center,they reviewed the need to screen for heart disease and cancer.One student asked,"But colon cancer is prevalent;why aren't we setting up for sigmoidoscopy?" How would the instructor reply?

A)"A sigmoidoscopy is expensive to perform and invasive."
B)"Can you find adequate privacy for a sigmoidoscopy?"
C)"What a great idea.Would you like to help arrange it?"
D)"Would you like to administer that test for the screening?"

Question 17

Any screening test must absolutely be

A)Accurate in its conclusion.
B)Capable of being administered in a quiet area.
C)Equally effective with both children and adults.
D)Inexpensive and easy to perform.

Question 18

A woman was found to have a blood glucose reading of 320 mg/dL.What should be the nurse's next action?

A)Escort the woman to the next screening station and then prepare to test the blood glucose level of the next client.
B)Explain the blood glucose reading to the woman and ask whether she has a primary care provider.
C)Fill out the form,giving the results accurately for the health department's records.
D)Hand the woman culturally appropriate literature on diabetes and the dangers of lack of treatment.

Question 19

The ability of a screening test to distinguish correctly between persons with and without a disease is known as

A)Sensitivity.
B)Validity
C)Reliability.
D)Specificity.

Question 20

Some nursing students were taking blood pressure measurements at one spot in the large room where many of the health screening stations were set up.A student pulled aside her instructor and said,"This man's blood pressure is 220/160.Whom should I call to get him to treatment immediately?" What should be the instructor's first action?

A)Ask the gentleman if he has health insurance.
B)Call a local ambulance.
C)Follow up with previously determined emergency plans.
D)Check the reliability of the findings.

Question 21

A nurse was trying to determine what resources might be available to support a screening program for middle-aged adults in the local community.The nurse should be sure to assess which variables? (Select all that apply.)

A)Cost and funding sources
B)Equipment and personnel to run the screening tests
C)Free newspaper publicity
D)Local diagnostic and treatment resources
E)Temporary personnel who could be hired to assist
F)Volunteers to help with the screening

Question 22

Which screening tests would be most useful at a health fair at a local YMCA that serves young adults? (Select all that apply.)

A)Measurements of blood pressure,blood glucose level,and cholesterol level
B)Measurements of height and weight
C)Mammography and prostate examination
D)Purified protein-derivative skin test (PPD)and review of immunizations
E)Stool for occult blood and sigmoidoscopy
F)Vision and hearing

Question 23

Which variables must the nurse consider when planning a health fair? (Select all that apply.)

A)Cost and convenience of possible screening tests
B)Community's culture and support for such screening tests
C)Number and type of volunteers available to assist
D)The health risks inherent in the target population
E)The best photos to use in community advertising
F)Needs of the local community-based agencies

Question 24

The nursing students created a media spot to publicize a free screening for undergraduates to be held at the college.What must the students remember to do? (Select all that apply.)

A)Discuss how listeners would benefit by attending.
B)Emphasize the program is being given for everyone's benefit.
C)Keep the message short,at about 30 seconds or 75 words.
D)Require that the ads run late in the evening when most students listen to the radio and watch television.
E)Stress the health risks that students face that may be diagnosed at this screening.
F)Use lots of visual aids to help listeners visualize the experience.

Question 25

Nursing students were setting up a meeting to finalize plans for a health fair.Of the following people,who must be included? (Select all that apply.)

A)All the health care personnel who will be doing the screenings
B)Community leaders who are actively involved in neighborhood activities
C)Local politicians who will enjoy having their pictures in the media
D)Philanthropists who might contribute funds for additional screening tests if their names are publicized
E)Staff from the health department that is sponsoring the fair
F)Volunteers who will help collect the consent forms and other tasks

Question 26

What variables are considered in the decision as to which screening tests are to be performed at a health fair? (Select all that apply.)

A)A national day dedicated to a specific screening
B)Preferences of the local politicians who support such events
C)Preferences of the local church,which donated space to be used for the event
D)The learning needs of the senior nursing students who are going to be helping
E)The sociodemographics of the population that will probably attend
F)What donations the nurse or the clinic has received

Question 27

A nurse is referring a client who needs follow-up care.Which of the following actions should the nurse take? (Select all that apply.)

A)Asking whether the client prefers to have the nurse make all the arrangements
B)Assessing whether the client meets the eligibility requirements for the receiving agency
C)Discussing with the client the payment mechanism for follow-up care
D)Determining whether the client is interested in following up at that particular agency
E)Arranging for the client to have transportation and child care available
F)Contacting several agencies in the area to see whether they are willing to accept a referral

Question 28

A volunteer explained to a nurse that a certain client did not wish to fill out the information/consent form.What should the nurse explain to the client as to why the form was required? (Select all that apply.)

A)"The agency requires such forms to document personnel time."
B)"The information serves as data for duplicating the screening in the future."
C)"You may wish to keep these data so that they are available for needed follow-up."
D)"The form is needed for student education;the data are collated to determine community-wide needs."
E)"Consent is needed before any tests,particularly invasive ones,are administered."
F)"The data are used for program evaluation so that more such screenings may be available."