Question 1

A CHN is orienting a new recruit to a health clinic that primarily serves vulnerable populations.Which of the following statements by the CHN indicates a need for additional information?

Accepted Answer

A)  "If a client who does not speak English comes in, you must obtain an interpreter right away."
B)  "We try to take care of as many problems as possible in one visit, so when you check the client in, ask about additional concerns."
C)  "You will like working with Filipino immigrants because they have close-knit family structures."
D)  "You will need to assist the client by scheduling any referral or follow-up appointments." C

Question 2

Which one of the following is the best intervention a community health nurse (CHN) can initiate to increase lasting resilience among new immigrants?

Accepted Answer

A)  Directing clients to English-as-a-second-language courses
B)  Giving immigrant clients money to help them get settled
C)  Identifying areas in the city where housing is less expensive
D)  Soliciting donations for food, clothing, and other needs A

Question 3

A client reports that the narcotic she took for pain on a regular basis made her feel bad and that when she tried an alternative analgesic, she experienced withdrawal symptoms.What is this client suffering from?

Accepted Answer

A)  Drug abuse
B)  Drug addiction
C)  Drug dependence
D)  Substance abuse C

Question 4

At a district board meeting, the CHN requests funding for an after-school recreation program that promotes healthy, fun activities in an effort to decrease drug abuse.Which level of prevention does this exemplify?

Accepted Answer

A)  Primary prevention
B)  Secondary prevention
C)  Tertiary prevention
D)  Primary and secondary prevention

Question 5

During a group counselling session for perpetrators of intimate partner violence, which of the following statements made by one of the clients indicates a lack of insight into his violent behaviour?

Accepted Answer

A)  "I have been taking out my frustrations about work on my girlfriend."
B)  "I love my girlfriend and didn't want to hurt her; it was an accident."
C)  "It might be a good idea for me to temporarily leave the house when I feel I am getting angry."
D)  "When I drink alcohol, I become more abusive toward my girlfriend."

Question 6

While screening for diabetes at a community clinic, a CHN found out that a new client had type 2 diabetes.The CHN then provided counselling, referred the client to an endocrinologist for initial assessment and treatment, helped with arrangements for financial assistance, arranged transportation, and booked a follow-up appointment.What role is this type of service most representative of?

Accepted Answer

A)  Case management
B)  Client advocacy
C)  Holistic care
D)  Wrap-around services

Question 7

Which one of the following is the designation given to groups at high risk of having poor health outcomes?

Accepted Answer

A)  Cumulative risk groups
B)  Health disparity groups
C)  Resilient populations
D)  Vulnerable populations

Question 8

CHNs at a clinic for homeless persons are concerned that clients rarely return for follow-up after their TB skin (Mantoux) tests.Which policy would be the most appropriate one for addressing this situation?

Accepted Answer

A)  Call all homeless clients 48 hours after testing to remind them to return to the clinic for follow-up.
B)  Have the homeless persons read the test result themselves and then mail in the results on a postage-paid card coded to protect privacy.
C)  Readminister the test if the client returns later than scheduled for follow-up.
D)  Routinely refer all homeless clients for chest X-rays.

Question 9

Which one of the following characteristics observed in a teenage boy should always alert the CHN to the possibility of suicide?

Accepted Answer

A)  Age between 15 and 19 years
B)  A homosexual orientation and history of depression
C)  Threatening to cause harm to peers
D)  A history of torturing and abusing animals

Question 10

A CHN is concerned about caregiver stress in the children of older clients with health concerns.Which of the following secondary prevention strategies can the CHN implement to limit caregiver stress?

Accepted Answer

A)  Asking caregivers how they are coping with their role
B)  Encouraging caregivers to periodically take a few hours away from their duties
C)  Establishing support groups for caregivers of older adult parents
D)  Referring some caregiving responsibilities to home health nurses (HHNs)  or professional caregivers

Question 11

Which one of the following is the cause of the greatest overall costs to the community for providing health care to the homeless?

Accepted Answer

A)  The need for increased preventive services to address the health conditions of the homeless population
B)  The need for more frequent clinic visits by homeless clients for multiple health problems
C)  The spread of contagious diseases by homeless people to those they pass on the street
D)  The fact that most of the care for homeless people takes place in hospital emergency departments

Question 12

A CHN presents a proposal for a program for preventing teen pregnancy to a group of parents.In the discussion that follows the presentation, which of the following responses by a parent indicates the need for additional teaching by the CHN?

Accepted Answer

A)  "I do not know if my son is sexually active; however, I have decided that I am going to talk to him about birth control, just in case."
B)  "I have found that being very strict and checking on my daughter whenever she is out are the best ways to prevent trouble."
C)  "I plan to sit down with my daughter and have an honest talk about sexuality and potential risks."
D)  "I will start spending more time with my teens when I get home from work."

Question 13

Which of the following actions can a CHN take to potentially increase accessibility to health care services for mentally ill homeless clients?

Accepted Answer

A)  Apply for a grant to fund a mobile clinic to take health care to the clients.
B)  Distribute flyers to homeless persons that detail the location of various healthcare services.
C)  Refer homeless clients to temporary housing facilities.
D)  Solicit donations for food and clothing to be distributed to the homeless.

Question 14

Which of the following actions by a case manager would be classified as primary prevention?

Accepted Answer

A)  Advocating for the client whose values conflict with those of the medical service provider
B)  Collaborating between nursing and occupational health personnel
C)  Educating a group regarding community services that are available if they are ever needed
D)  Resolving conflict between a primary care clinic and a tertiary care facility

Question 15

Which one of the following is an example of tertiary prevention by a CHN?

Accepted Answer

A)  Administering the Mantoux (skin)  test to identify persons with TB
B)  Assessing for signs and symptoms of active TB
C)  Directly observing clients with active TB as they take their antituberculosis medications
D)  Interpreting TB skin test results

Question 16

A mother confides to the CHN that her live-in boyfriend pushed her 2-year-old child because he was crying too much.She begs the CHN not to tell anyone because her boyfriend has agreed to take anger management classes.What should the CHN do?

Accepted Answer

A)  Abide by the mother's wishes because this information was provided in confidence.
B)  Arrange for the earliest available counselling for the boyfriend.
C)  Advise the mother to take the child away from the boyfriend and find alternate housing right away.
D)  Report the incident to the child protection agency.

Question 17

Which of the following interventions by the CHN would best serve a vulnerable population?

Accepted Answer

A)  Addressing multiple health concerns, including preventive education, when clients present for treatment of an illness
B)  Establishing a system of networks so that clients may be referred to different services such as preventive care, acute illness care, and chronic treatment
C)  Providing acute care services that focus on the client's main health concern and setting up appointments at discharge for other concerns
D)  Referring clients to specialists to address specific health concerns

Question 18

Which definition accurately reflects the meaning of the term health inequities?

Accepted Answer

A)  Health inequities are the accumulation of multiple factors that lead to poor health.
B)  Health inequities occur when people are more inclined to become ill and usually do not seek appropriate care.
C)  Health inequities are unfair differences in health that could be avoided with reasonable action.
D)  Health inequities are wide variations in health status and services among certain population groups.

Question 19

Which level of prevention is a CHN practising when she offers homeless clients yearly tuberculosis ( TB ) screening and free treatment for those who test positive?

Accepted Answer

A)  Primary prevention
B)  Secondary prevention
C)  Tertiary prevention
D)  Secondary and tertiary prevention

Question 20

Which of the following is a primary cause of vulnerability?

Accepted Answer

A)  Breakdown of family structures
B)  Poverty
C)  Prejudice
D)  Social isolation

Exam 11: Working With Vulnerable Populations