NR-436 Community, Public, and Population Health Nursing - Set 2 - Part 1

Correct Answer: Parent's plan until twenty six and subsidised coverage

Current law lets young adults stay on a parent's plan until age twenty six and offers sliding scale premium help in the Marketplace. Coverage cannot be denied or priced up for a pre existing condition. Option a is incorrect because lifetime dollar caps on essential benefits were abolished, which matters enormously for someone facing years of kidney care. Waiting periods before coverage begins were also curtailed rather than preserved. Option b is incorrect because insurers may no longer charge more on the basis of health status, which was one of the central changes in the law. Her kidney disease cannot lawfully raise her premium. Option d is incorrect because temporary exclusion of a known diagnosis is exactly the practice the reform ended. A plan must cover her kidney condition from the day her enrollment takes effect, with no holding period.

Correct Answer: Dual eligibility for Medicare and Medicaid

People with low income who also meet Medicare rules can hold both programmes at once. Medicaid then fills Medicare's gaps and pays for the long term nursing home care Medicare will not cover. Option b is incorrect because a private Advantage plan simply delivers hospital and medical benefits in one package, sometimes adding dental or vision. Extras of that sort never stretch to custodial nursing home charges. Option c is incorrect because supplemental insurance covers deductibles and coinsurance for someone who kept Original Medicare. Filling cost sharing is not the same as funding a facility stay, and such policies are bought with private premiums. Option d is incorrect because veterans benefits flow from military service rather than from low income, and this widow has none described. Service based eligibility is a separate route into care with its own enrollment rules.

Correct Answer: Repair the leak and dry the area

Mold needs moisture, so the water problem is fixed first and wet materials dried within a day or two. Cleaning the growth without stopping the leak guarantees it returns to the same wall. Option a is incorrect because a surface kill treats what is visible while the dampness feeding it continues underneath. Growth reappears within weeks, and the spray itself irritates airways that are already reacting. Option b is incorrect because added humidity feeds the very growth the family is trying to remove. Indoor humidity belongs roughly between thirty and fifty percent, and bathrooms need ventilation rather than more moisture. Option d is incorrect because paint hides a problem it cannot solve. Coating damp wallboard seals moisture in, the material keeps degrading behind the new finish, and the household keeps breathing the same spores.

Correct Answer: "We will treat only what local partners can follow up."

Continuity is the test of an ethical short term trip. Starting treatment that nobody can continue after the team flies home harms people, so care is designed around what local partners can sustain. Option b is incorrect because counting patients seen measures activity, not benefit. Ethical global work is judged by capacity left behind, meaning clinicians trained and services that keep running once the visiting team has gone. Option c is incorrect because distance never expands competence or licensure. Practising beyond scope abroad exposes people to harm they would never be asked to accept at home, and it is indefensible however great the need. Option d is incorrect because leftover supplies often arrive expired, unusable or labelled in a language staff cannot read. Donations should match what the receiving partner actually requested, in date and ready to use.

Correct Answer: The work restrictions and fitness for duty

The employer is entitled to know what the worker can and cannot safely do and for how long. Clinical detail stays in the health record, which is the boundary that keeps workers using the clinic. Option a is incorrect because the diagnosis is protected clinical information that a supervisor has no need to hold in order to assign safe work. Releasing it invites discrimination and destroys trust in the service. Option b is incorrect because a medication list reveals the underlying condition just as plainly as naming it would. Disclosing treatment through the back door breaches the same confidentiality the nurse is obliged to hold. Option d is incorrect because laboratory values belong to the worker and the clinician managing care. A supervisor cannot act on them anyway, since scheduling decisions turn on capability rather than on numbers from a specimen.

Correct Answer: Let local partners set the priorities

Cultural humility means an ongoing self reflective stance rather than a list of facts about a place, and it commits the visiting team to working with a community whose own leaders name the priorities. Option b is incorrect because withholding the plan removes any chance for the community to shape it. Partnership requires transparency from the start, and a programme revealed on arrival is a programme imposed. Option c is incorrect because donors fund the work but do not live with its consequences. Letting an outside funder define the objectives reproduces exactly the top down pattern that undermines sustainability in global projects. Option d is incorrect because a programme that worked elsewhere may fail here for reasons of food supply, kinship structure or belief about feeding infants. Transplanting a design without local input ignores every one of those differences.

Correct Answer: Install mechanical lift equipment on the unit

Mechanical lifts are an engineering control that takes the load off the worker entirely, and safe patient handling programmes built on them outperform body mechanics teaching, which depends on technique under time pressure. Option a is incorrect because more classroom time repeats an approach the injury log already shows is failing on this unit. Training is administrative and cannot change the weight of a client who suddenly slides. Option b is incorrect because reminders in a break room reach people who are not lifting at that moment and vanish from mind during a transfer. Signage never carries any of the physical load. Option c is incorrect because sorting assignments by strength shifts the same hazardous load onto fewer backs and singles out staff for repeated overexertion. Body size was never the reason these injuries keep happening.

Correct Answer: A physical hazard from energy exposure

Noise is classified with vibration, temperature extremes, radiation and machinery as a physical hazard, because the harm comes from a form of energy acting on the body rather than a substance. Option b is incorrect because chemical hazards involve solvents, metals, dusts and fumes that enter the body and act on tissue. Sound waves carry no substance into the worker, so the label misses what is actually damaging the ear. Option c is incorrect because ergonomic problems arise from lifting, repetition, force and awkward posture, and they show up as musculoskeletal injury. A press operator standing beside a loud machine is losing hearing, not straining a joint. Option d is incorrect because psychosocial hazards come from workload, shift schedules, harassment and violence, which stress the worker rather than the ear. Naming job strain here would send the team looking for the wrong control entirely.

Correct Answer: A physical hazard from temperature extremes

Temperature extremes sit with noise, vibration, radiation and machinery in the physical group, because heat is a form of energy acting on the body. Controls include shade, scheduling and acclimatization over the first weeks. Option a is incorrect because ultraviolet light is radiation, which also falls in the physical group rather than the chemical one. Chemical hazards are substances entering the body, such as solvent vapor or roofing tar fume. Option b is incorrect because ergonomic strain would show up as shoulder, wrist or low back injury from posture and load. These roofers collapsed from thermal stress, not from how they were bending. Option c is incorrect because psychosocial hazards work through stress, workload and violence rather than through core temperature. Long afternoons matter here only because they extend the time spent in the heat itself.

Correct Answer: Substitution with a less hazardous material

Substitution swaps a hazardous material for a safer one and sits second in the hierarchy, just below elimination, because the risk is reduced at the source rather than at the worker. Option a is incorrect because engineering means designing a barrier between people and a hazard that remains present, such as local exhaust ventilation or machine guarding. The shop removed the hazardous solvent instead of enclosing it. Option b is incorrect because administrative measures alter schedules, rotation, training and procedures while the dangerous chemical stays in the building. Nothing about this change touches how long or how often anyone works. Option d is incorrect because gloves, respirators and goggles guard only the person wearing them and leave the original agent in use. Buying a safer product protects everyone in the shop, including visitors who wear nothing.

Correct Answer: An engineering control built into design

Safety engineered sharps isolate the worker from the hazard through the design of the device itself, which places them alongside ventilation and machine guarding in the engineering tier of the hierarchy. Option a is incorrect because substitution means trading one material for a less harmful material, such as a safer sterilant. A retracting needle is still a needle, redesigned rather than replaced by a different substance. Option c is incorrect because administrative approaches govern how staff work, through policies, training and prohibitions on recapping, and they depend on people following the rule. This shield activates whether or not anyone remembers. Option d is incorrect because gloves are worn on the body and blunt very little of a sharp injury, since a hollow needle passes straight through them. The protection here is engineered into the syringe.

Correct Answer: Analyze the actual tasks of his assignment

Restrictions only mean something when matched against real job demands, so a job task analysis shows which duties fit within them. A title alone hides whether the work involves overhead reaching every hour. Option a is incorrect because sending him back to unmodified work ignores the very limits the surgeon wrote and risks a repeat injury within days. Restrictions exist to shape the assignment, not to be filed away. Option b is incorrect because more time at home is the outcome the whole programme tries to avoid, since long absence predicts poorer recovery and a lower chance of ever coming back. Transitional duty exists for this situation. Option c is incorrect because the supervisor needs the limits, not the operation. Handing over a diagnosis breaches confidentiality and adds nothing useful, since knowing the procedure does not tell anyone which shelf he can safely reach.

Correct Answer: State administration of Medicaid eligibility

Medicaid is a joint federal and state programme in which each state runs its own version above a federal floor. Income limits and covered benefits therefore differ, so moving can end eligibility. Option a is incorrect because Medicare eligibility does hold steady across every state, which is the opposite of what this family experienced. A programme that never varies cannot explain a change tied to relocation. Option b is incorrect because Washington sets only minimum standards and pays a share of the cost. Leaving the day to day rules in federal hands would produce identical coverage everywhere, which is plainly not the case. Option d is incorrect because a job based plan follows the worker rather than the address, and nothing here points to an employer benefit. Losing that coverage would track a job change, not a move.

Correct Answer: Psychosocial hazards of the work environment

Violence, shift work, long hours and workload with little control are psychosocial hazards. They act through stress and fatigue, producing burnout, mood disorders, cardiovascular disease and injuries caused by exhaustion. Option b is incorrect because biological exposure would mean contact with infectious agents such as tuberculosis or bloodborne viruses carried by clients. Threats and schedules transmit nothing, however draining the department feels by morning. Option c is incorrect because the physical category covers noise, radiation, temperature extremes, vibration and machinery, not the way work is organized. A hostile visitor is a person, not a form of energy. Option d is incorrect because ergonomic strain arises from lifting, reaching and repetition that load muscles and joints. None of the three exposures described involves how the body is positioned during a task.

Correct Answer: Charges are scaled to household income

Federally qualified health centers must serve an underserved area or population and set charges on a sliding scale tied to income. Nobody is refused care because of an inability to pay the full amount. Option a is incorrect because these centers still bill, drawing on Medicaid, Medicare, private insurance and federal grant funds. Telling her nothing is owed would set up an unpleasant surprise when the statement arrives. Option b is incorrect because uninsured adults are a core part of the population these centers were funded to reach. Restricting them to insured clients would defeat the reason the grant programme exists. Option d is incorrect because demanding money up front is precisely the barrier a sliding scale removes. Health centers arrange payment according to what a household earns, and many let clients settle balances over time.

Correct Answer: Efficiency in managing the whole episode

A prospective payment system sets the price for the episode in advance, so complications and extra days come out of the hospital's own funds. Efficient, well coordinated care of the admission becomes the financial goal. Option b is incorrect because piling on tests raises cost without raising the payment, which was fixed when the diagnosis was assigned. Extra investigations would simply shrink whatever margin the admission leaves behind. Option c is incorrect because a longer stay consumes more staff time, supplies and bed days while the amount paid never moves. Stretching admissions is exactly the behaviour this design was built to discourage. Option d is incorrect because delayed discharge planning lengthens stays and raises readmission risk, both of which cost the hospital under this model. Early planning is what protects the fixed payment from being eaten up.

Correct Answer: Activities and hobbies at home

Soldering stained glass is a hobby, so it falls under activities. Hobbies are a major unrecognized source of lead, solvent and metal exposure, and the question about them often uncovers what no other question reaches. Option a is incorrect because present work covers the client's current job, protective equipment, safety data sheets and whether co-workers share symptoms. Weekend craft done for pleasure is not employment and belongs elsewhere in the history. Option c is incorrect because residence asks about the age of the home, heating, remodeling, chemical storage and water source. The basement location is incidental here, since the hazard comes from what the client does. Option d is incorrect because referrals name where to send a client for answers, such as Poison Control or the local health department. That step comes after the nurse has identified the hobby, never instead of it.

Correct Answer: Securing safe water and sanitation

Safe water and sanitation is the largest single determinant of diarrhoeal burden, so protecting the water supply and managing human waste prevents far more child deaths in a camp than any clinical service added later. Option a is incorrect because hypertension screening addresses a chronic condition whose harm unfolds over years. Nothing about it interrupts the faecal to oral route currently killing children, and the outbreak would continue unchecked while staff take blood pressures. Option b is incorrect because a surgical clinic treats injuries and emergencies one person at a time. Camp mortality from dehydration is driven by contaminated water reaching thousands, and an operating theatre changes none of that exposure. Option c is incorrect because treated nets target mosquito borne malaria transmission at night. They belong in this camp's longer term plan, yet they do nothing about the pathogen moving through drinking water right now.

Correct Answer: Part D prescription drug coverage

Part D is the outpatient prescription drug benefit, sold by private plans that Medicare subsidises. Enrolling in a plan whose formulary includes her cardiac tablets is what brings the cost down. Option a is incorrect because hospital insurance pays for admissions, post acute skilled nursing, hospice and home health. Medications given during an inpatient stay ride along with that admission, but tablets bought at a pharmacy do not. Option c is incorrect because medical insurance handles provider visits, outpatient services, equipment, laboratory testing and prevention. Drugs administered in a clinic can fall here, yet a prescription filled at the pharmacy counter does not. Option d is incorrect because the yearly prevention visit reviews risk, plans screening and addresses advance care wishes. It is a planning appointment rather than a payment source, so it changes nothing about what she owes for tablets.

Correct Answer: Refer her to the safety data sheets

The hazard communication standard gives every worker a right to know, delivered through container labeling, accessible safety data sheets and training. The sheets state the hazards, exposure controls and first aid measures. Option b is incorrect because informal advice from another employee is not a substitute for documented hazard information, and it is often wrong. Her right to know is met with records the employer must keep available. Option c is incorrect because federal rules require chemical identity and hazard warnings on the container, so secrecy is not a lawful answer here. Telling her otherwise would leave her working blind beside solvents. Option d is incorrect because chasing the manufacturer puts a delay between the worker and information the employer already holds on site. The nurse should point her to what is available in the building today.