Question

A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?

Answer 1

Correct Answers:

The provider is paid a fixed sum for the client on a monthly or yearly basis.

Rationale :

💳 In a Health Maintenance Organization (HMO), providers are typically reimbursed through a capitation model, meaning they receive a fixed payment per member per month or year, regardless of how many services that client actually uses.

💳 This prepaid payment structure incentivizes providers to focus on preventive care and cost-efficiency, since their reimbursement is not tied to the volume of services rendered.

💳 The model allows for budget predictability and encourages coordination of care, especially through primary care providers who serve as gatekeepers to specialized services.

💳 This system contrasts sharply with fee-for-service models, where providers are paid for each individual service or procedure, often leading to increased healthcare costs and fragmented care.

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Answer 2

Correct Answers:

Ask the client to sign an informed consent form.

Rationale :

📝 Informed consent is necessary when a competent adult chooses to refuse or withdraw from a medical treatment, including enteral nutrition, even if that refusal may hasten death in terminal illness.

📝 The nurse's role is to ensure the client is making an informed and voluntary decision, understands the consequences of refusing treatment, and then properly documents that decision by obtaining informed consent.

📝 Terminally ill patients have the legal and ethical right to decline life-sustaining interventions, and informed consent confirms that the choice was made knowingly and without coercion.

📝 This action promotes autonomy and self-determination, which are core principles of ethical nursing practice and end-of-life care, especially in the home health setting.

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Answer 3

Correct Answers:

"You should limit your use of extension cords."

Rationale :

⚡ Limiting the use of extension cords is a key safety measure to reduce the risk of electrical fires, tripping hazards, and overloads, especially in home settings where older wiring may be inadequate.

⚡ Overreliance on extension cords can lead to overloaded circuits, especially when multiple high-wattage appliances are connected, increasing the risk of electrical shorts or fires.

⚡ In home health environments, clients—especially those with mobility or cognitive impairments—are at increased risk of falls or injury from exposed or tangled cords.

⚡ Teaching clients to minimize extension cord use promotes a safer, clutter-free, and fire-preventive environment, in line with recommendations from the U.S. Consumer Product Safety Commission (CPSC).

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Answer 4

Correct Answers:

Teaching a class about the risks of cigarette smoking
Organizing a program to promote skateboard safety
Lobbying for funding for health promotion efforts

Rationale :

🩺 Teaching a class about the risks of cigarette smoking

✨ This is a classic example of primary prevention, which aims to prevent the onset of disease or injury before it occurs. ✨ By educating students about the dangers of smoking, the nurse is helping them make informed decisions that reduce their risk of developing chronic illnesses like cancer, heart disease, or COPD in the future. ✨ This activity supports long-term health promotion and risk avoidance.

🛹 Organizing a program to promote skateboard safety

✨ This intervention focuses on preventing injuries before they happen, a key goal of primary prevention. ✨ Teaching children to use protective gear (helmets, knee pads, etc.) and promoting safe practices helps avoid fractures, head injuries, and other trauma. ✨ This is especially relevant in school-aged populations who engage in physical activity and recreation.

📢 Lobbying for funding for health promotion efforts

✨ Advocating for public health resources and education is a system-level approach to primary prevention. ✨ By securing funding, the nurse supports programs that address health risks before they arise—such as nutrition, physical activity, and mental wellness initiatives. ✨ This aligns with the broader goals of community-based primary prevention.

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Answer 5

Correct Answers:

Developing resources for victims of abuse

Rationale :

🛠 Tertiary prevention focuses on minimizing the long-term effects of violence or trauma, restoring function, and preventing further harm after abuse or violence has occurred.

🛠 Developing resources for victims—such as shelters, counseling services, legal aid, trauma-informed care programs, or rehabilitation services—is a classic tertiary strategy because it helps victims recover physically, emotionally, and socially.

🛠 This level of prevention supports healing and reintegration, and addresses issues such as chronic PTSD, homelessness, or re-victimization, which often follow unaddressed abuse.

🛠 While primary and secondary prevention aim to prevent violence or identify it early, tertiary prevention is about intervention and support after the event, emphasizing long-term safety and well-being.

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Answer 6

Correct Answers:

Perform a needs assessment

Rationale :

🔍 A needs assessment is always the first step in community health program planning because it helps the nurse gather objective data about the target population’s specific needs, resources, barriers, and preferences.

🔍 In this case, assessing the nutritional needs, mobility limitations, and support systems of older adults who are no longer driving ensures that the program is designed based on actual community conditions, not assumptions.

🔍 This step allows the nurse to prioritize services, tailor interventions, and build a strong foundation for effective planning, implementation, and evaluation.

🔍 Skipping this step could result in ineffective resource use or a program that doesn’t truly meet the intended population's needs.

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Answer 7

Correct Answers:

Perform a needs assessment

Rationale :

Assessing needs is the first step in program planning.

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Answer 8

Correct Answers:

The children

Rationale :

🧒 In the epidemiological triangle, the host refers to the person or population at risk of developing the disease—in this case, the school-age children who are susceptible to contracting mumps.

🧒 The host’s characteristics—such as age, immunity, vaccination status, and general health—influence their vulnerability to infection, making them a central element in understanding disease transmission.

🧒 In this outbreak scenario, children are the target population affected by the mumps virus, fulfilling the host role within the triangle model (Host–Agent–Environment).

🧒 Identifying the host is crucial for guiding public health interventions, such as targeted vaccination campaigns, isolation practices, or health education efforts aimed at preventing further spread.

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Answer 9

Correct Answers:

Don personal protective equipment.

Rationale :

🛡 Donning personal protective equipment (PPE) is the nurse’s first and most critical action to ensure self-protection and prevent the spread of a potentially infectious or hazardous agent when encountering a suspected bioterrorism-related illness.

🛡 PPE may include gloves, gown, mask, eye protection, and respirators, depending on the suspected biological agent and its mode of transmission (e.g., airborne, contact, droplet).

🛡 In a bioterrorism event, healthcare professionals must first protect themselves before assessing, treating, or transporting the patient to prevent secondary transmission and maintain healthcare system functioning.

🛡 While reporting and quarantine may follow, standard precautions and immediate protective measures are the priority per CDC and emergency response protocols.

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Answer 10

Correct Answers:

"l will use a toilet that is not used by others in my family."

Rationale :

☢ Radioactive iodine (I-131) therapy can cause the patient to emit low levels of radiation for several days post-treatment, especially through body fluids like urine, saliva, and sweat.

☢ Using a separate toilet minimizes the risk of radiation exposure to household members, as residual radioactive iodine may be present in the patient's urine.

☢ Patients are typically advised to flush the toilet twice after each use, maintain distance from others—especially pregnant women and children, and follow other hygiene precautions for a period determined by the provider (often 3 to 7 days).

☢ This practice is part of standard radiation safety guidelines to reduce secondary exposure to others, especially in shared living environments.

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RN Community Health~2019 Exam 1

No.

1 :
A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?

2 :
A home health nurse is caring for a client who has terminal cancer and no longer wants to receive enteral tube feedings. Which of the following actions should the nurse take?

3 :
A home health nurse is discussing electrical hazards with a client. Which of the following statements should the nurse include?

4 :
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.)

5 :
A nurse is working with a community health care team to devise strategies for preventing violence in the community. Which of the following interventions is an example of tertiary prevention?

6 :
A faith-based organization asks a community health nurse to develop a mobile meal program for older adults who are no longer driving. Which of the following actions should the nurse plan to take first?

7 : A faith-based organization asks a community health nurse to develop a mobile meal program for older adults who are no longer driving. Which of the following actions should the nurse plan to take first?

8 :
A nurse is assessing an outbreak of mumps among school-age children. Using the epidemiological triangle, the nurse should recognize that which of the following is the host?

9 :
A community health nurse encounters a client who has a suspected bioterrorism-related illness. Which of the following actions should the nurse take?

10 :
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?

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RN Community Health~2019 Exam 1

No.

1 : A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?

2 : A home health nurse is caring for a client who has terminal cancer and no longer wants to receive enteral tube feedings. Which of the following actions should the nurse take?

3 : A home health nurse is discussing electrical hazards with a client. Which of the following statements should the nurse include?

4 : 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.)

5 : A nurse is working with a community health care team to devise strategies for preventing violence in the community. Which of the following interventions is an example of tertiary prevention?

6 : A faith-based organization asks a community health nurse to develop a mobile meal program for older adults who are no longer driving. Which of the following actions should the nurse plan to take first?

7 : A faith-based organization asks a community health nurse to develop a mobile meal program for older adults who are no longer driving. Which of the following actions should the nurse plan to take first?

8 : A nurse is assessing an outbreak of mumps among school-age children. Using the epidemiological triangle, the nurse should recognize that which of the following is the host?

9 : A community health nurse encounters a client who has a suspected bioterrorism-related illness. Which of the following actions should the nurse take?

10 : 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?

1 :
A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?

2 :
A home health nurse is caring for a client who has terminal cancer and no longer wants to receive enteral tube feedings. Which of the following actions should the nurse take?

3 :
A home health nurse is discussing electrical hazards with a client. Which of the following statements should the nurse include?

4 :
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.)

5 :
A nurse is working with a community health care team to devise strategies for preventing violence in the community. Which of the following interventions is an example of tertiary prevention?

6 :
A faith-based organization asks a community health nurse to develop a mobile meal program for older adults who are no longer driving. Which of the following actions should the nurse plan to take first?

8 :
A nurse is assessing an outbreak of mumps among school-age children. Using the epidemiological triangle, the nurse should recognize that which of the following is the host?

9 :
A community health nurse encounters a client who has a suspected bioterrorism-related illness. Which of the following actions should the nurse take?

10 :
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?