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1.     A home health nurse is providing teaching to the guardian of a child who has leukemia about methods to prevent complications. Which of the following statements by the guardian indicates and understanding of the teaching?
a)    "I'm sure my child will feel better now that he can ride his bicycle."
b)    "I should take my child's rectal temperature daily."
c)    "I will make sure my child gets a measles, mumps, and rubella vaccine this week."
d)    "I should inspect my child's mouth for sore."
2.     A nurse at a community clinic is preparing an educational guide about cultural variance in expression of pain. which of the following information should the nurse include? 
a)    Native American cultural practices include being outspoken about pain.
b)    Middle Eastern cultural practices include hiding pain from close family members.
c)    Puerto Rican cultural practice include the view that outspoken expression of pain are shameful.
d)    Chinese cultural practices include enduring pain to prevent family dishonor. 
3.      A case manager is completing discharge planning for a client who has alcohol use disorder and cirrhosis of the liver. Which of the following actions should the case manager take first?
a)    Arrange for a home health nurse to visit the client following discharge.
b)    Contact a social worker to assist the client with managing finances.
c)    Provide the client with information on self-help group for alcohol use disorder.
d)    Determine which home safety measure the client needs to implement. 
4.     A home health nurse is assessing a client who has AIDS. Which of the following responses by the client indicates a risk for suicide?
a)    "I don't want to lose control of my ability to make decisions."
b)    "I am afraid of experiencing pain near the end."
c)    "I know that everything will be better soon."
d)    "I am relying more and more on my partner for support."
5.    SKIP
6.     A nurse is caring for a client who has hepatitis A virus. Which of the following reservoirs should the nurse identify for this infection?
a)    Blood
b)    Genitourinary tract
c)    Skin
d)    Feces


7.     A nurse is conducting home visits to postpartum adolescents who participated who prenatal parenting classes. Which of the following statements indicates an understanding of the teaching?
a)    "I warm my baby's bottle in the microwave for 30 seconds at a time."
b)    "I use baby talk when talking to my baby."
c)    "I limit the time her grandparents cuddle my baby to prevent spoiling."
d)    "I carry my baby with me as I move around the house."
8.     A nurse educator is teaching a group of newly licensed nurse about maintaining client confidentially according to HIPPA regulation. which of the following statements by a newly licensed nurse indicates an understanding of the teaching?
a)    "HIPAA rules allow clients to receive a copy of their medical records."
b)    "HIPAA rules vary from state to states."
c)    "What should share our computer passwords with our manager."
d)    "A client's diagnosis can be posted on the communication board inside the client's room."
9.     A nurse is working with a community health care team to devise strategies for preventing violence in the community. Which of the following intervention is an example of tertiary prevention?
a)    Presenting community education programs about stress management
b)    Urging community leaders to make nonviolence a priority
c)    Developing resource for victims of abuse
d)    Assessing for risk factors of intimate partner abuse during health examinations 

-A nurse is teaching a group of clients about ways to prevent skin cancer. Which of the following statement by the nurse demonstrate a priority prevention strategy?a)    "Use acetaminophen as needed for sunburn."
b)    "Apply cool tap water soaks for 20 minutes to relieve sunburn."
c)    "Ensure you have a yearly skin examination with your provider."
d)    "Avoid direct sunlight between 10 and 4pm."
11. A parish nurse is counselling a family following a client's recent diagnosis of the heart disease. Which of the following action should the nurse take first?
a)    Assist the direct and the client's partner with finding an affordable exercise program.
b)    Offer to accompany the client and the client's partner during health care provider visits.
c)    Ask family members about the impact of the disease on relationship within the family.
d)    Discuss the benefits of eating a well-balanced diet with the client's family.
12. A nurse is caring for a child whose parent reports that their partner has been physically maltreating the child. The parent states, "My partner has moved out, so please don't tell anyone, "Which of the following statements should the nurse make?
a)    "I think you should report the abuse to law enforcement."
b)    "I will not report the abuse because I know you will keep your child sale."
c)    "You should let your pediatrician know about the abuse,"
d)    "State law requires health care providers to report suspected abuse."


13. A home health nurse is assessing a client who hepatitis A. which of the following findings should the nurse except?
a)    Malaise
b)    Ankle edema
c)    Petechiae
d)    Weight gain
14.  A school nurse is assessing a child who has a fever and notices several bite marks on the child's arm. The nurse should referral for suspected child maltreatment based on which of the following additional findings? (Select all that apply)
a)    The child is wearing open-toed shoes and the weather is cold outside.
b)    The child is frequently absent from school.
c)    The child's clothes are wrinkled and dry.
d)    The child tells the nurse that they are sick because they are bad.
e)    The child reports coughing all day. 
15. A nurse is reviewing levels of prevention with a newly licensed nurse. Which of the following is an example of tertiary prevention?
a)    Providing STI testing for students on a college camps.
b)    Educating adults about breast cancer screening guidelines 
c)    Teaching about inhaler use to a client who has asthma 
d)    Promoting the use of helmets with children who rides bicycles.
16. A nurse is providing teaching to a newly licensed nurse about case management. The nurse should include that which of the following tasks is the responsibility of a case manager?


A.   evaluate the cost effectiveness of clients treatments
B.   teach a smoking cessation support group
C.    perform employee risk assessments
D.   enforce OSHA standards in the workplace
17. A home health nurse is planning the initial home visit a client who has dementia and lives with his adult son's family. Which of the following actions should the nurse take first during the visit? 
a)    Provide the family with information about respite care
b)    Educate the family regarding the progression if dementia
c)    Engage the family in informal conversion
d)    Encourage the family to join a support group.
18. A nurse in a community health clinic is assessing a client who has two preschoolers was recently divorced and is seeking help for major depression. Which of the following questions should the nurse ask first? 
a)    "Is there anything that makes you feel less depressed?"
b)    "Could you describe how you are feeling today?"
c)    "Are you having any thoughts about hurting yourself?"
d)    "Who is available to help you?"
19. A mental health nurse is scheduling a home health appointment with a client who has recently lost his partner in a motor vehicle crash. Which of the following statements by the client indicates the need for immediate nursing intervention?
a)    "I just feel so angry right now."
b)    "There's no need for anyone to come see me, including you."
c)    "Everything is going to be fine soon."
d)    "I'm not going to talk to you about my problems."
20. A nurse is teaching a client who has a terminal illness about hospice care. Which of the following statement by the client indicate an understanding of the teaching? (select all thar apply)
a)    "I can receive care in the hospital or at home."
b)    "My provider will recommend that I entre hospice care when I have 1 year left to live."
c)    "I can discontinue hospice care whenever I want."
d)    "I will need to have private insurance because Medicare does not cover hospice services."
e)    "I will receive care from a variety of interprofessional team members."
21. A nurse is working with a married couple who each have children from prior relationships living is the home. The nurse should clarify the family as which of the following household structure?
a)    Adoptive family 
b)    Foster family
c)    A commune
d)    Blended family  
22.  A nurse is planning a primary strategy for reducing obesity in a community. Which of the following strategies should the nurse use? 
a)    Educate children at a day care center about nutrients and exercise.
b)    Measure the BMI of older adults at a community senior center.
c)    Distribute health-risk appraisal questionnaires at community functions. 
d)    Encourage enrollment and attendance at weight-reduction programs. 
23. A community health nurse is teaching a group of parents about manifestations of alcohol withdrawal. Which of the following manifestation should the nurse include in the teaching? 
a)    Hyperglycemia
b)    Hypotension
c)    Seizures
d)    Somnolence
24. A parish nurse is planning activities for a faith-based community. Which of the following activities should the nurse include?
a)    Change a negative pressure wound therapy dressing
b)    Teach stress management strategies
c)    Provide case management 
d)    Offer primary care to uninsured members.
25. A home health nurse is caring for a client who a client who has chemotherapy-induced nausea that has been resistant to relief from pharmacological measures. Which of the following interventions should the nurse initiate? (Select all that apply).
a)    Offer 120 mL (4 OZ) of cold 2% milk as a meal replacement.
b)    Use seasoning to enhance the flavor of foods.
c)    Provide sips of room-temperature ginger ale between meals. 
d)    Maintain the head of the client's bed in an elevated position after eating.
e)    Assist the client in using guided imagery. 


26. A home health nurse is caring for a client who has terminal cancer and no longer wants to receive enteral tube feeding. Which of the following actions should the nurse take?
a)    Request the facility chaplain to visit the client.
b)    Ask the client to sign an informed consent form
c)    Compete against medical advice form.
d)    Explain the process for completing a living will.
27. A nurse is providing teaching to a client about directives regarding end-of-life care. Which of the following information should the nurse include in the teaching?
a)    The living will is a legally binding contract between the client and the provider,
b)    The client can choose a non-family member as the designated power of attorney.
c)    The client's family has the authority to revoke the do-not-resuscitate order at any time.
d)    The client can verbally choose a health care proxy if two nurses witness the designation.
28. A nurse is providing teaching to a newly licensed nurse about secondary prevention strategies related to violence and abuse. Which of the following strategies should the nurse include in the teaching?
a)    Teach a parenting skills class at a child development center.
b)    Refer clients to the appropriate community agency if signs of abuse are evident.
c)    Coordinate a personal defense program at a local agency.
d)    Assess clients for withdrawal and passivity during home health visits.
29. A nurse is participating in a qualify improvement committee for home health client. Which of the following topics should the nurse recommend for the committee to review?
a)    An increase in clients reviewing annual flu vaccines.
b)    An increase in client admissions for home health care
c)    An increase in levels of local air pollution 
d)    An increase in client falls at home
30. A school nurse is planning primary prevention activities for the school year. Which of the following action should the nurse plan to take? 
a)    Schedule hearing screening for each grade level.
b)    Provide referrals for students who have asthma
c)    Monitor the immunization states of students.
d)    Provide first aid for injured students.
31. A nurse is caring for a client who asks, "Can I decide not to continue not to continue with chemotherapy?" The nurse responds. "This is your choice and "I'II support whenever decision you make." The nurse's response is an example of which of the following ethical principles?
a)    Nonmaleficence
b)    Autonomy
c)    Beneficence
d)    Veracity
32. A community health nurse is working with a migrant population. The nurse should recognize the which of the following interventions necessary to provide care to this population?
a)    Offering health screenings at a community center
b)    Requiring clients to show a work visa before they receive care.
c)    Providing health services at work sales
d)    Treating clients on a fee-for-service basis.
33.  A case manager in a rehabilitation facility is discussing discharge plans with a client who has a pressure injury and requires a special level at home. Which of the following statements should the nurse make first?
a)    "Eat a balanced diet with high-protein snacks."
b)    "Apply moisture barrier ointment three times a day."
c)    "A social worker can help you with the cost of supplies."
d)    "Describe the place where you are currently living."
34. A nurse is planning an in-service about isolation precautions for her coworkers. For which of the following infections should the nurse identify the need for contact precautions?
a)    Pertussis
b)    Pulmonary tuberculosis  
c)    Herpes Simplex
d)    Diphtheria
35. An occupational health nurse is completing a walk-through of a factory to identify workers at risk for injury. Which of the following workers should the nurse identify as being at risk?
a)    A worker who is 7-week postoperative following rotator cuff surgery and is labelling boxes
b)    A worker standing with a wide base of support when pulling a cart toward himself.
c)    A worker who is wearing a back brace and bends at the waist when picking up a pallet.
d)    A worker who is standing in place for extended periods and rests one foot on a box. 
36. A nurse is serving on a state task force for disaster planning. The nurse is engaging in disaster preparation efforts when performing which of the following actions?
a)    Functioning as a manager at a temporary shelter
b)    Organizing a mass casualty drill for community members
c)     Implementing a disaster triage plan with a local medical facility
d)    Assisting with the identification of a biological agent 
37.  A nurse is an extended care facility enters the room of a client and notices a fire in the trash can. Which of the following actions is the nurse priority?
a)    Activate the alarm
b)    Attempt to extinguish the fire.
c)    Move the client to another location
d)    Shut the doors and windows of the room.
38. A home health nurse is caring for a client who has a clostridium difficile infection. Which of the following actions should the nurse take?
a)    Clean the client's bathroom with a diluted bleach solution.
b)    Use an alcohol-based hand sanitizer following care.
c)    Obtain a surgical mask for the client to wear when away from home.
d)    Instruct the client to avoid the use of probiotics
39. A home health nurse is performing an eye assessment for an older adult client. Which of the following findings is the priority for the nurse to report to the provider?
a)    Conjunctivitis
b)    Decreased near vision
c)    Hemianopsia
d)    Increased sensitivity to glare 
40. A community health nurse encounters a client who has a suspected bioterrorism-related illness. Which of the following actions should the nurse take?
a)    Don personal protective equipment.
b)    Move the client to a quarantine area.
c)    Report the client's conditions to the federal Bureau of investigation.
d)    Disinfect contaminated areas of skin with isopropyl alcohol.
41. A school nurse is developing a plan to address the primary prevention of communicable disease. Which of the following interventions should the nurse include? 
a)    Increase the students' access to the school's health clinic 
b)    Teach proper hand hygiene techniques to students.
c)    Conduct physical assessments of the students.
d)    Start a protocol to isolate contagious students. 
42. A school nurse is planning primary prevention activities for the new school year. Which of the following should the nurse include? (select all that apply.)
a)    Creating a plan of care for children who have a diagnosis of diabetes mellitus. 
b)    Teaching a class about the risks of cigarette smoking
c)    Recommending a seating arrangement for a child in a body cast. 
d)    Lobbying for funding for health promotion efforts
43. A nurse is caring for a group of clients. For which of the following clients should the nurse recommend a referral for palliative care?
a)    A client who has chronic kidney disease and wants to discontinue dialysis
b)    A client who has tuberculosis and requires directly observed therapy
c)    A client who had a total knee arthroplasty and will need assistance with transportation
d)    A client who has their vision and will require assistance in the home with ADLs
44. An occupational health nurse is assessing agricultural workers for acute of pesticide exposure. Which of the following findings should the nurse expect?
a)    Dizziness
b)    Hypoglycemia
c)    Oliguria
d)    Diplopia
45. A nurse is developing health promotion strategies for older adult clients at an assisted living facility. Which of the following strategies is the priority for the nurse to include?
a)    Encouraging the clients to exercise regularly
b)    Immunizing the clients against influence
c)    Scheduling annual dental examination for the clients.
d)    Providing the clients with a low-fat diet.
46. A school nurse is caring for a child who has muscular dystrophy and is having difficulty swallowing at lunch. Which of the following referrals should the nurse initiate? 
a)    Speech-language therapist
b)    Respiratory therapist
c)    Dietitian
d)    Occupational therapist
47. A nurse in a mobile health clinic is caring for a client who requires a tetanus immunization and is accompanied by his daughter. The client does not speak the same language as the nurse. Which of the following actions should the nurse take?
a)    Use professional terminology when providing education prior to the procedure. 
b)    Identify the client's spoken dialect prior to contacting an interpreter
c)    Have the client's daughter communication information about the procedure
d)    Arrange for a member of the client's community to interpret the teaching.
48. A nurse in a community clinic is assessing a client who reports injecting 1 hr ago. Which of the following findings should the nurse except? 
a)    Nystagmus
b)    Tachypnea 
c)    Euphoria
d)    Dilated pupils
49. A community health nurse is working with a task force to decrease community violence. Which of the following planned interventions should the nurse identify as primary prevention strategy?
a)    Developing a protocol for managing victims of violence.
b)    Providing sexual assault nurse examiner training for nurses in the local clinic
c)    Arranging for a local clinic to provide methadone treatment
d)    Providing parenting classes for local parents
50. A home health nurse is caring for a young adult client who has stage a ovarian cancer. The client tells the nurse they do not want to continue treatment. Which of the following statements should the nurse make? 
a)    "Your provider knows what is best for you."
b)    "You have the right to refuse treatment."
c)    "Ovarian cancer has a high cure rate, so you should reconsider."
d)    "You are still young and have a lot to live for."
51. A nurse is triaging clients who were involved in a commuter train crash. Which of the following clients should the nurse choose for transport to the emergency department first?
a)    A client who is exhibiting agonal respirations with fixed and dilated pupils
b)    A client who has a fracture of the humerus with a 2+radial pulse in the affected arm.
c)    An ambulatory client who has a nosebleed and reports feeling dizzy
d)    A client who has full-thickness burn injuries over 30% of his total body surface area.
52. The
53. A nurse in a clinic is reviewing home safety precautions with a client who is to begin radioactive iodine therapy. Which of the following statements by the client indicates an understanding of the teaching?
a)    "I will wait 1 week after treatment to use a laxative."
b)    "I'll will allow my granddaughter to visit for a hours daily."
c)    "I will use cloth handkerchiefs instead of tissues."
d)    "I will use a toilet that is not used by others in my family."
54. A nurse working in an assisted care facility is developing a disaster plan. Which of the following is the first actions the nurse should take?
a)    Identify materials needed for staff and resident education.
b)    Verify dates of the annual community-wide mass casualty drill.
c)    Determine potential environmental health hazards
d)    Develop response strategies specific to older adults.
55. A nurse at a rural clinic is interviewing a family who has different cultural beliefs than the nurse. The family reports seeing a folk healer. Which of the following statements should the nurse make? 
a)    "Many folk medicine treatment work by providing a placebo effect."
b)    "Alternative medicine practices can be dangerous and should be avoided." 
c)    "I can refer you to a medical practitioner for your health care needs."
d)    "Describe how you hope the treatments will affect your health." 
56. A nurse is working for a hospice organization. The nurse should identify that which of the following criteria must be me for a client to qualify for hospice care?
a)    The client's requires inpatient care due to lack of a caregiver.
b)    The client's insurance provides coverage for palliative care.
c)    The client has declined additional life-prolonging treatments.
d)    The client has documentation stating he has less than 12 months to live.
57. Th
58. A home health nurse is discussing electrical hazards with a client. Which of the following statements should the nurse include?
a)    "You should pull on the cord when unplugging items."
b)    "You should cover electrical cords with an area rug."
c)    "You should secure extension cords with clear packing tape."
d)    "You should limit your use of extension cords."
59. A nurse in an antepartum clinic is reviewing the medical records of four clients. Which of following infectious conditions should the nurse report to the Centers for Disease Control and prevention?
a)    Genital herpes simplex virus
b)    Human papillomavirus
c)    Bacterial Vaginosis 
d)    Gonorrhea
60. A community health nurse is teaching a group of guardian of toddlers about toddlers increased risk for accidents and injuries. Which of the following rationales should the nurse provider?
a)    They have a tendency to be influenced by peer pressure.
b)    Their logic abilities are not matured.
c)    They have poor social adjustment.
d)    Their motor skills are underdeveloped.

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