Question 1

A community health nurse is meeting with a group of individuals who have been diagnosed with a mental disorder. The nurse interprets this to mean:

Accepted Answer

Mental disorders are those that have compromised both the client's level of function and his or her quality of life. Mental disorders are usually chronic and persistent. Impaired control and dependency are components of addiction. A significant behavior syndrome with present distress characterizes a mental illness.

Question 2

When developing appropriate programs for adult mental health promotion, the nurse incorporates knowledge about the risk for suicide. Which provides the rationale for adding the risk for suicide in the program?

Accepted Answer

When developing a program for adult mental health programs, the nurse should recognize those who are at risk for suicide. These at-risk groups include men and those aged 10 to 34 years. Healthy People 2030 has proposed two objectives related to mental health to reduce the suicide rate and suicide attempts by adolescents. Addressing the risks promotes screening and primary prevention, but it does not plan for identification of methods and location injury.

Question 3

After teaching a group of women in the community about commonly used substances that contribute to substance-related disorders, the community health nurse determines that the teaching has been effective when the group identifies that:

Accepted Answer

C/PHNs should be aware of the prevalence of drug use in the community. Commonly used substances include alcohol, marijuana, cocaine and crack, heroin, hallucinogens, inhalants, methamphetamine, prescription drugs such as opioids, and tobacco. Neither gender is more at risk for substance abuse. Not all instances of substance abuse are accompanied by mental illness. A single screening tool would be used to determine substance abuse.

Question 4

A community health nurse is part of a community discussion group on alcohol. The nurse explains that one standard drink contains about how many grams of alcohol?

Accepted Answer

In the United States, one "standard" drink or one alcoholic drink equivalent contains roughly 14 g of pure alcohol, which is found in 12 oz of regular beer, which is usually about 5% alcohol or 5 oz of wine, which is typically about 12% alcohol or 1.5 oz of distilled spirits, which is about 40% alcohol.

Question 5

A nurse had determined that a group of high school students are using alcohol. What is the next step after the nurse has screened for alcohol use?

Accepted Answer

The C/PHN, after screening, would perform a brief intervention focusing on how alcohol affects their health and wellness. The nurse does not need to administer another screening tool as one tool is sufficient. The students would need parental consent to attend a treatment facility. The nurse does not need to inform the parents of the students who participated in the screening.

Question 6

After teaching a class about commonly used illicit substances, the instructor determines that the teaching was successful when the class identifies which illicit drug as the most frequently reported?

Accepted Answer

Although heroin, methamphetamine, and cocaine are frequently used illicit drugs, marijuana is the most frequently reported illicit drug.

Question 7

A community health nurse is discussing alcohol use disorders and is explaining what is meant by a standard drink. Which would the nurse include as examples? Select all that apply.

Accepted Answer

A standard drink contains about 14 g of alcohol (0.6 fluid ounces or 1.2 tablespoons), which is equivalent to one 12-oz bottle of beer or wine cooler; 8 to 9 oz of malt liquor; one 5-oz glass of table wine; 3 to 4 oz of fortified wine, 2 to 3 oz of cordial, liqueur, or aperitif; 1.5 oz of brandy; or 1.5 oz of 80-proof distilled spirits.

Question 8

A nurse is preparing to seek resources to maintain a prevention program for substance misuse in the community. Which local community partners should be invited to plan for the program? Select all that apply.

Accepted Answer

There are multiple steps in the guide to SAMHSA's strategic prevention framework. After Step 1 assessment, Step 2 is capacity built where local resources are built and mobilized by the community's readiness to address priority substance misuse problems. The stages for building local capacity include engaging in diverse community stakeholders including schools, small business owners, law enforcement, and hospital representatives. Homeowners may not contribute to the building capacity for a prevention program.

Question 9

A nurse is reviewing the SAMHSA program planning document. Which is the correct order of steps in the Strategic Prevention Framework (SPF) for substance misuse program planning?

Accepted Answer

There are five steps for prevention planners to conduct a comprehensive approach to understand and address the substance misuse and related behavioral health problems facing their states and communities. Assess is identifying local needs based on data. Capacity is building local resources and readiness to address needs. Planning is finding out what works to address prevention needs and how to do it well. Implement is to deliver evidence-based programs and practices. Evaluation is examining the process and outcomes of programs and practices. Assessment, intervention, and evaluation are lacking capacity and planning. Repetition is not one of the steps. Review, execution, enforcement, and analysis are missing assessment.

Question 10

The community health nurse is working with a team of community stakeholders to design a prevention program for substance abuse. The group is in the planning stage. What question should lead the group discussion about this stage?

Accepted Answer

There are five steps for prevention planners to conduct a comprehensive approach to understand and address the substance misuse and related behavioral health problems facing their states and communities. Planning is finding out what works to address prevention needs and how to do it well and addresses what they should do and how. Assess is identifying local needs based on data and asks what the problem is. Capacity is building local resources and readiness to address needs and what do we have already in place. Implementation is delivering evidence-based programs and practices and asking how the plan can be put into action. Evaluation is examining the process and outcomes of programs and practices and asks how the plan is succeeding.

Question 11

A community health nurse is providing an in-service program to the agency staff about the Strategic Prevention Framework of SAMHSA, which will be used to develop behavioral intervention programs. The nurse determines that the staff had understood the teaching when they state which of the following?

Accepted Answer

The PSF is guided by tow cross-cutting principles: cultural competence and sustainability. Cultural competence is the ability of an individual or organization to understand and interact effectively with people who have different values, lifestyles, and traditions based on their distinctive heritage and social relationships. Sustainability is the process of building an adaptive and effective system that achieves and maintains desired long-term results. The process of the program is based on five steps, and community stakeholders are imperative but not encompassing. Piloting a program will allow for evaluation, but pilots are not administered over 5 years. Sustainability uses a variety of measures to evaluate the effectiveness and not just subjective evaluations.

Question 12

A community health nurse is applying the Institute of Medicine model based on Gordon's Classification of Disease Prevention model to address prevention of alcohol use during pregnancy and prevention of fetal alcohol syndrome. Which population would the nurse target using indicated prevention strategies?

Accepted Answer

Indicated prevention strategies would be designed to prevent the use of alcohol in pregnant women who had screened positive for alcohol use during pregnancy or already had a child diagnosed with FAS or FASD. Universal prevention strategies would address the entire population of women of childbearing age (national, local community, school, neighborhood), with messages and programs aimed at preventing the use of alcohol if pregnancy is a possibility. Selective prevention strategies would target subsets of women of childbearing age who are deemed to be at risk for alcohol use by virtue of their membership in a particular population segment.

Question 13

A community implements a plan to enforce the underage drinking law. The community health nurse interprets this action as reflecting which public health model?

Accepted Answer

Environmental prevention relies on a societal commitment for the implementation of the interventions and aims to alter the environment by reducing risk (e.g., community-wide decrease in availability of the substance; underage drinking law enforcement). Primary prevention is conducted when no disease is present in the target population with the primary goal being prevention of disease development. Behavioral prevention includes a broad array of strategies aimed at changing lifestyles (e.g., exercise, smoking cessation, balanced nutrition). The goal of the intervention is to change behaviors that put the person at risk for developing the disease or to prevent consequences of the disease. Clinical prevention is based on the medical model for preventive services. It relies on one-to-one, provider-to-client interaction and occurs within the traditional health care delivery system.

Question 14

Which statement about mental health and substance use services is most accurate?

Accepted Answer

For decades, primary care, mental health, and substance use services have been separated, requiring clients to seek services among multiple site and providers to obtain comprehensive care. An integrated model has been established to integrate all the services. These are private organizations that are providing more comprehensive care balancing the complexity of behavioral health needs and the complexity of physical health needs.

Question 15

Healthy People 2030 objectives focus on tobacco, alcohol, and illicit drug use education. Identify the steps in the process to providing this education. Select all that apply.

Accepted Answer

The three steps in the process for providing tobacco, alcohol, and illicit drug use education are in order (1) identifying trends, (2) differentiating legal versus illegal use, and (3) understanding the consequences of substance use. Identifying the impact of substance use on the environment is not one of the steps. There are differences in prevention programs-if the target population is young adults, the prevention of binge drinking might be a top concern; if homeless adults, the focus will be on chronic alcohol, cocaine, and heroin use; cultural and ethnic differences in alcohol and SUDs are noted in American Indians with increased rates of fetal alcohol syndrome and increased prevalence in prison and jail populations.

Question 16

A community health nurse is involved in a screening program for alcohol use with an ethnically diverse population. Which instrument would be the best to use?

Accepted Answer

For alcohol use, the screening instrument recommended by the NIAAA is the AUDIT. The WHO developed this instrument for use across populations, and it has established high reliability and validity across ethnic groups. Other tests that can be used include the CAGE questionnaire and MAST. The DAST would be appropriate to screen for drug use.

Question 17

Which would the community health nurse associate as a major limitation for the development of safe consumption sites for those to overuse drugs?

Accepted Answer

Safe drug consumption sites create some tensions between harm reduction and public safety that the community health nurse be aware. Harm reduction occurs as the sites may reduce drug overdose deaths and encourage people who use to seek help and treatment. Safety concerns focus on if the sites create social problems in the neighborhoods and if the sites encourage more people to use drugs.

Question 18

Which statements about Healthy People 2030 and reducing substance use and addressing mental health needs are most accurate? Select all that apply.

Accepted Answer

Reducing substance abuse and addressing mental health needs are priorities with Healthy People 2030. After a diagnosis is established, the intervention can address the specific public health issue identified using the Healthy People 2030 objectives. Target benchmarks and data derivation for each Healthy People 2030 objective can be used to guide program development. Three of the top 10 health indicators within Healthy People 2030 relate to substance use and mental health. In addition, its goals include improving mental health through prevention and reducing substance abuse to protect the health, safety, and quality of life for all.

Question 19

A community health nurse has completed a community assessment. Which action would be taken next?

Accepted Answer

After completing a community assessment, the nurse then establishes a community diagnosis. Once this is done, the next step is to decide on an intervention that can address the specific public health issue identified in the diagnosis. A good starting point in the development of community/public health intervention is to begin with the Healthy People 2020 objectives, locating the specific focus area that matches the community diagnosis. Once the nurse identifies the focus of the intervention, the next step is to determine the level of prevention.

Question 20

A community health nurse is working with a political group to lobby to develop safe consumption sites. The nurse is functioning in which role?

Accepted Answer

The advocacy role requires being politically involved by serving on decision-making boards and committees, lobbying for legislative changes, and helping to influence mental health policy development that will better serve this population. In the educator role, the community mental health nurse teaches clients individually and in groups about their mental health conditions, their treatment protocols, ways to function more independently in the community, prevention and health-promoting strategies, and much more. In the collaborator role, the nurse works with others, pooling the groups professional expertise to enhance the quality and effectiveness of services. In the case manager role, the nurse is involved with screening, assessment, care planning, arranging for service delivery, monitoring, reassessment, evaluation, and discharge, often within the context of a community mental health center (CMHC). Case management helps the person with an SMI to access services and live as independently as possible.

Quiz 25: Behavioral Health in the Community