A nurse is reviewing the record of a client who has a new diagnosis of diabetes mellitus and an A1C of 9. The client has attended multiple workshops about diabetes management but reports not using the meal plan to assist with nutrition and feels unmotivated to start an exercise regimen. According to the Theory of Reasoned Action/Planned Behavior, which of the following explains the likelihood of this client having good outcomes in follow-up clinic visits?

There's no way to predict how a client will do on a medical regimen.

There is a high chance of better outcomes with more education.

There is a higher chance of complications due to poor adherence to the plan.

The outcomes will be about the same.

Answer and Explanation

The Correct Answer is C

Choice A reason: There's no way to predict how a client will do on a medical regimen.
This statement is incorrect because the Theory of Reasoned Action/Planned Behavior (TRA/TPB) provides a framework for predicting and understanding behaviors, including adherence to medical regimens. According to this theory, behavioral intentions, influenced by attitudes, subjective norms, and perceived behavioral control, can predict actual behavior. Therefore, it is possible to predict how a client might adhere to a medical regimen based on these factors.

Choice B reason: There is a high chance of better outcomes with more education.
While education is important, it alone may not be sufficient to ensure better outcomes. The TRA/TPB suggests that intentions to perform a behavior are influenced by attitudes towards the behavior, subjective norms, and perceived behavioral control. Without addressing these factors, simply providing more education may not lead to improved adherence or outcomes.

Choice C reason: There is a higher chance of complications due to poor adherence to the plan.
This statement aligns with the TRA/TPB, which posits that poor adherence to a medical regimen can lead to negative health outcomes. In the context of diabetes management, poor adherence to dietary and exercise plans can result in uncontrolled blood glucose levels, leading to complications such as cardiovascular disease, neuropathy, and retinopathy. The client's reported lack of motivation and non-adherence to the meal plan and exercise regimen increases the risk of such complications.

Choice D reason: The outcomes will be about the same.
This statement is incorrect because it overlooks the impact of adherence on health outcomes. According to the TRA/TPB, adherence to recommended behaviors is crucial for achieving positive health outcomes. In diabetes management, adherence to dietary and exercise plans is essential for controlling blood glucose levels and preventing complications. Therefore, outcomes are unlikely to remain the same if the client does not adhere to the recommended regimen.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Choice A: Develop a Team Strategy
Developing a team strategy is an important step in the CHANGE model, but it is not the first step. Before a strategy can be developed, it is essential to have a team in place. The team will collaborate to create a strategy that aligns with the community's needs and goals.

Choice B: Gather Data
Gathering data is a crucial part of the community assessment process. However, it is not the initial step in the CHANGE model. Data collection comes after the team has been assembled and a strategy has been developed. The team needs to be in place to determine what data is needed and how it will be collected.

Choice C: Build the Community Action Plan
Building the community action plan is a later step in the CHANGE model. This step involves using the data collected to develop a plan that addresses the community's health needs. The action plan is created after the team has been assembled, a strategy has been developed, and data has been gathered.

Choice D: Assemble the Team
This is the correct first step in the CHANGE model. Assembling the team involves bringing together a diverse group of stakeholders who will work collaboratively to assess the community and develop an action plan. The team typically includes representatives from various sectors of the community, such as health care, education, business, and local government.

A. Proportionate mortality B. Crude mortality rate C. Cause-specific mortality rate D. Case fatality

Correct Answer is C

Explanation

Choice A: Proportionate Mortality
Proportionate mortality refers to the proportion of deaths in a specified population over a period of time attributable to different causes. It is expressed as a percentage of the total number of deaths. While this measure can provide insight into the relative importance of different causes of death, it does not give the actual mortality rate for each cause. Therefore, it is not the best measure for identifying the top three causes of death in a county.

Choice B: Crude Mortality Rate
The crude mortality rate is the total number of deaths from all causes per 1,000 or 100,000 population in a given year. This measure provides an overall picture of the mortality level in a population but does not specify the causes of death. It is useful for general mortality trends but not for identifying specific causes of death.

Choice C: Cause-Specific Mortality Rate
The cause-specific mortality rate is the number of deaths from a specific cause per 100,000 population in a given year. This measure is the most appropriate for identifying the top three causes of death because it provides detailed information on the mortality rate for each specific cause. By calculating the cause-specific mortality rates, the nurse can determine which causes are the most significant contributors to mortality in the county.

Choice D: Case Fatality
Case fatality refers to the proportion of individuals diagnosed with a particular disease who die from that disease within a specified period. It is usually expressed as a percentage. While case fatality provides information on the severity of a disease, it does not give the overall mortality rate for the population or help identify the top causes of death.

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Naxlex Comprehensive Predictor Exams

A public health nurse plans to assess a community using the CHANGE model. According to this model, which of the following steps should the nurse take first?

Correct Answer is D

Explanation

A community health nurse is calculating the top three causes of death in a county. Which of the following mortality measures should the nurse use to obtain this data?

Correct Answer is C

Explanation

A community health nurse is preparing an in-service for staff to define the conditions of causation in epidemiology studies. Which of the following descriptions should the nurse use to define a cessation of exposure to establish causation?

A public health nurse and a community team are working on a community diagnosis. Which of the following would be considered a community diagnosis?

A community health nurse is planning community initiatives collaboratively and working on assembling a community team. To help overcome barriers, which of the following should the nurse propose?

A school nurse is helping a special needs student with tube feeding during the lunch hour. Which of the following levels of prevention does this fall under?

A nurse is planning a presentation at a local public health conference about the relationship between quality education and health outcomes. Which of the following information should the nurse include in the presentation?

A nurse is completing a summative evaluation of a condom distribution program at a local community college. Which of the following metrics should the nurse include?

According to the Ecological Model, which of the following factors affect healthy behavior at multiple levels of society? (Select all that apply.)

An employee presents to an occupational health nurse with concerns that their hearing is worse on one side. Which of the following actions should the nurse take first to address the employee's concern?