Community/Public Health Nursing: Exam
2 LATEST UPDATE 2025
Explain why substance abuse is a public health problem - ANSWER -Leading national
health problem
-Causes more deaths, illnesses, and disabilities than any other health problem
-Family disease
Describe the Harm Reduction Model - ANSWER Recognizes: addiction is a health
problem, any drug can be abused, accurate information can help people make
responsible decisions, people who have substance abuse disorders can be helped
-Emphasize that substance abuse is a health problem, less of a criminal problem= move
away from punishing to treating the illness
-Intervention Examples: to reduce OD deaths among opioid abusers= fentanyl tests
strips and Nalaxone education; to reduce sharing equipment= syringe service programs,
access to safe smoking supplies
Compare and Contrast Psychoactive drugs, including risk factors and preventative
efforts - ANSWER 1. Depressants: reduce CNS activity; lower body's energy level
(alcohol, barbs, benzos, opioids)
2. Stimulants: increase CNS activity; feel alert/energetic, followed by crash (nicotine,
cocaine, caffeine, energy drinks, amphetamines)
3. Alcohol: MOST USED SUBSTANCE: excess in blood affects CNS and brain,
genetics and personal characteristics influence development of use disorder: tolerance
causes increased amount needed
4.Tobacco: most preventable cause of death, tolerance develops within hours= very
hard to quit; youth= e-cigarettes most common; secondhand smoke= higher
concentrations of carcinogens than mainstream smoke, leads to many health problems
5. Opioids: primarily used for pain management; tolerance and physical dependence
develop quickly (need to taper); morphine, heroin, codeine, fentanyl (50x more potent
than heroin, 100x than morphine)
Discuss the role of the nurse in primary, secondary, and tertiary prevention related to
substance abuse - ANSWER 1. Primary: Promote healthy lifestyle/resilience, educate
on drugs and use guidelines (especially adolescents), increase awareness of
hazards/risks of SA
2. Secondary: ID at risk individuals, discuss stress sources with clients, refer to social
workers/services, screen for SAD, work with families to recognize
addiction/codependency
3. Assist client to develop plan to avoid high-risk situations, monitor withdrawal, monitor
pharm. management, refer to addiction treatment facility, refer to support groups,
provide emotional support
, Describe the public health approach to violence prevention - ANSWER -Public Health
Approach: Define the Problem, ID risk factors, Develop and test prevention strategies,
Disseminate and implement strategies *usually public health campaign
Describe the socioecological model in relation to violence prevention - ANSWER -
Socioecological Model:
1. Individual: biological/personal history factors that increase the likelihood of becoming
a victim/perpetrator of violence (younger age, decreased education, decreased income,
SA, History of abuse*****)
2. Relationship: close relationships that may increase risk of experiencing violence as
victim or perpetrator
3. Community: looks at setting where relationships occur (neighborhoods: high
population density, poverty, gangs, transient, diverse; schools: school violence)
4. Societal: Examines societal factors that help crease a climate where violence is
encouraged/inhibited: cultural norms (if accepting of violence) organized religion (if
accepting of violence, don't believe in divorce)
ID factors that increase the risk for abusive patterns - ANSWER 1. Upbringing: previous
exposure to violence****, abusers learn violence is how you manage conflict
2. Living Conditions: young parents, many children, SA, mental health issues, low
income, crowded living conditions, social isolation
3. Increased Stress: unemployment, marital strain, financial stress
Explain the four general types of child abuse: Neglect, physical, emotional, sexual -
ANSWER 1. Neglect: failure to meet basic needs
-Physical: failure to provide food, clothing, shelter, hygiene (associated with poverty)
-Emotional: omission of basic nurturing, acceptance, and caring
2. Physical
3. Emotional: Harm a child's self worth
4. Sexual: usually someone child knows, can have inappropriate knowledge of sexual
behaviors; underreported
Discuss the dynamics/signs of intimate partner violence - ANSWER -Signs:
bruises/lacerations to face, head, trunk (inflicted on areas you don't see); increase in
physical health problems
-Initially situation is minimized, external blame is placed, apologies are given, then
escalates in severity/frequency. Remorsefulness lessens
ID appropriate nursing interventions when working with survivors of violence - ANSWER
-Build trust and confidence with client: MOST IMPORTANT
-Focus on the client not the situation
-Assess for immediate danger
-Provide emergency care if necessary
-Work with client to develop a safety plan
-Make needed referrals for community services/legal options
-Complete mandatory reporting
