Deck 11: Working With Vulnerable Populations

Question 1

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

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.

Answer 1

Apply for a grant to fund a mobile clinic to take health care to the clients.

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?

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

Answer 2

Directing clients to English-as-a-second-language courses

Question 3

By which of the following actions can the CHN best ensure long-term positive health outcomes in pregnant teens from low-income groups and their children?

A)Help teen mothers learn about body changes during pregnancy.
B)Develop programs that enable teen mothers to complete their education.
C)Offer courses in proper care of babies.
D)Monitor pregnant teens for early detection of problems in pregnancy.

Answer 3

Develop programs that enable teen mothers to complete their education.

Question 4

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

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 5

A CHN who works at a clinic for homeless persons wants to institute a more efficient treatment for chronic wounds.Which of the following actions offers the best way to improve outcomes for these clients?

A)Administer antibiotics to all homeless persons with chronic, nonhealing wounds.
B)Facilitate daily access to a room with soap, water, and bandages.
C)Provide free bandaging supplies to clients at each clinic visit.
D)Regularly monitor the wound condition of clients.

Question 6

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?

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 7

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?

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

Question 8

Which of the following is a primary cause of vulnerability?

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

Question 9

Which of the following actions should a CHN take when using the case management approach with vulnerable populations?

A)Be willing to enter into a long-term relationship with families.
B)Direct and control the client's care because the CHN knows what is most needed.
C)Encourage families to become self-sufficient and less dependent on nursing personnel for advice and referrals.
D)Rotate assignments periodically, to prevent attachment and codependency.

Question 10

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?

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

Question 11

What information is most important to keep in mind when caring for a pregnant teen?

A)All teen pregnancies are considered high risk.
B)Limited knowledge can lead to pregnancy complications.
C)Pregnant teens are less likely to focus on proper prenatal nutrition.
D)Pregnant teens who are poor are more likely to have poorer health outcomes.

Question 12

A CHN suspects that an elementary school student is being physically abused.Which action would be the most appropriate one for the CHN to take?

A)Ask the student about the abuse.
B)Document findings in the student's school record.
C)Discuss the suspicions of abuse with the student's teachers or the family's spiritual leader.
D)Notify legal authorities.

Question 13

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

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

Question 14

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

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 15

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

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 16

Which of the following actions is a way in which the CHN can help prevent depression in older adults who are at high risk for it?

A)Encourage them to move to a nursing home where they will have the company of others in the same age group.
B)Monitor for signs and symptoms of depression.
C)Organize a health promotion program for older adults at the local centre.
D)Encourage older adult clients to focus on their strengths rather than their weaknesses.

Question 17

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

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 18

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?

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 19

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?

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 20

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?

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."

Question 21

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?

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 22

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

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 23

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?

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 24

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

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 25

Which one of the following actions is the best example of enabling in a family with an alcoholic father?

A)The father asks the CHN to explain why his continued drinking is dangerous.
B)The son threatens to leave the home because he finds his father's behaviour embarrassing.
C)The teenage daughter turns to a favourite teacher for support.
D)The wife tells her husband's boss that her husband is sick when he is actually inebriated.

Question 26

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?

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

Question 27

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?

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

Question 28

A CHN suspects that a new client may be a drug addict.When getting the health history of the client, the CHN needs to keep in mind that the client may not admit to drug use.Which one of the following is a primary symptom of addiction?

A)Confusion
B)Denial
C)Forgetfulness
D)Mental status changes

Question 29

Which of the following statements made by a parent indicates a need for more education about child abuse?

A)"I have stopped slapping my child, and I am learning to count to 10 before reacting."
B)"I never spank or hit my children; I yell at them to stop being stupid and if they don't, I tell them that the boogeyman will steal them away at night if they don't obey."
C)"I use 'time out' when my child acts out or is naughty.Sometimes, my child doesn't cope well with this, but I am persistent."
D)"When my child misbehaves, I distract him and try to focus his attention on other things.If he throws a tantrum, I just pick him up and leave the store or show or wherever we may be."

Question 30

An intravenous (IV) drug abuser admits to the CHN that he has no desire to give up his addiction, so the CHN counsels him on the importance of sterilizing his needles to prevent infection and transmission of blood-borne diseases.Which level of prevention does this action represent?

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

Question 31

A CHN is asked by a parent group to explain the risk factors for alcoholism.Which of the following statements should the CHN include in the explanation?

A)Alcoholism is determined solely by environment.
B)Alcoholism is determined partly by genes.
C)Alcoholism is higher in women.
D)Persons born with fetal alcohol syndrome are alcoholics from birth.