Community and Public Health Nursing Flashcards

A community nurse is using the PRECEDE-PROCEED model for health program planning. What does the PRECEDE phase involve?

Answer: Assessing needs — identifying factors predisposing, enabling, and reinforcing health behaviors

PRECEDE (Predisposing, Reinforcing, Enabling Constructs in Educational/Ecological Diagnosis and Evaluation) is the assessment phase that identifies why people behave as they do, including predisposing factors (knowledge, beliefs), enabling factors (resources, skills), and reinforcing factors (social support).

The nurse is following up on a patient with latent tuberculosis infection (LTBI) who has a positive tuberculin skin test but no symptoms. What treatment is typically recommended?

Answer: Isoniazid for 9 months (or rifampin for 4 months)

LTBI treatment prevents progression to active TB. Standard regimens include isoniazid (INH) for 9 months, or rifampin for 4 months (shorter, better tolerated). Active TB requires the full 4-drug regimen for 6 months.

The nurse is implementing a cervical cancer screening program in Saudi Arabia. According to WHO guidelines, at what age should regular Pap smear screening begin?

Answer: Age 25

WHO guidelines recommend cervical cancer screening (Pap smear or HPV test) beginning at age 25–30, depending on the country's protocol. Screening before this age is not recommended because of high false-positive rates and overtreatment of lesions that would resolve naturally in younger women.

A community health nurse is implementing a needle exchange program for people who inject drugs. This is an example of which public health approach?

Answer: Harm reduction

Harm reduction minimizes the negative health consequences of risky behaviors without requiring abstinence. Needle exchange programs reduce HIV and hepatitis transmission among people who inject drugs without requiring them to stop using. It is pragmatic and evidence-based.

A nurse is caring for a patient with active pulmonary tuberculosis in the community. How long after initiating effective antibiotic therapy is the patient generally considered non-infectious?

Answer: 2–3 weeks

After 2–3 weeks of effective anti-TB therapy, sputum smears usually become negative and the patient is considered non-infectious. Clinical improvement typically occurs within the first 2 weeks. This guideline governs return to school or work decisions.

A public health nurse is reviewing data showing that cardiovascular disease rates are disproportionately higher in lower-income neighborhoods. This difference is an example of:

Answer: A health disparity related to social determinants of health

Health disparities are preventable differences in disease burden linked to social, economic, and environmental disadvantage. Income, education, neighborhood environment, and access to care are social determinants that drive disparities in cardiovascular disease and other conditions.