Chapter 1, The Journey Begins: Introduction PDF

Chapter 1, The Journey Begins: Introduction 1. A nurse has taught a group of nursing students about the similarities and differences between public health and community health. Which statement by one of the nursing students would best describe the similarities and differences between public health and community health? A) s provided in a B) C) D) ty health nursing can shape the quality of community health services ANS: D Feedback: Operating within an environment of rapid change and increasingly complex challenges, this nursing specialty holds the potential to shape the quality of community health services and improve the health of the general public by promoting healthy behaviors such as weight loss and smoking cessation. Community health can encompass both acute and institutional settings. Public health nursing involves focusing not only on the individual as the client but the community as the client as well. PTS: 1 DIF: Moderate REF: Page and Header: 2, Introduction OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 2. A nurse is reviewing the similarities and differences between public health nursing and community health nursing. Which statement would best describe the difference between public health nursing and community health nursing? A) Public health nursing is focused on the private aspects of health, and community health nursing is focused on the public aspects of health. B) Community health practice refers to a focus on specific, designated communities and is a part of the larger public health effort. C) Public health nursing and community health nursing relate to the very same types of services and perspectives. D) Both public health nursing and community health nursing are practiced exclusively within institutions. ANS: B Feedback: In this textbook, community health practice refers to a focus on specific, designated communities. It is a part of the larger public health effort and recognizes the fundamental concepts and principles of public health as its birthright and foundation for practice. Public health nursing is focused on the public aspects of health. Public health nursing and community health nursing have distinctive types of services and perspectives. Neither public health nursing nor community health nursing is practiced exclusively within institutions. PTS: 1 DIF: Difficult REF: Page and Header: 3, Community Health OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 3. Which statement is most accurate about the concept of community? A) A community is a collection of people who share some important features of their lives. B) Community members live in the same geographic location. C) Community members are biologically related. D) A community is made up of people who do not necessarily interact with one another and do not necessarily share a sense of belonging to that group. ANS: A Feedback: The broad definition of a community is a collection of people who share some important features of their lives. Community members may not live in the same geographic location as in a common-interest community or a community of solution. A population is made up of people who do not necessarily interact with one another and do not necessarily share a sense of belonging to that group. PTS: 1 DIF: Moderate REF: Page and Header: 3, Community Health OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 4. A group of students are reviewing material for a test on populations, communities, and aggregates. Which statement indicates that the students understand these concepts? A) Members of a population share a sense of belonging. B) Communities and populations are types of aggregates. C) Individuals of a community are loosely connected. D) Members of an aggregate share a strong bond. ANS: B Feedback: An aggregate refers to a mass of grouping of distinct individuals who are considered as a whole and who are loosely associated with one another. Communities and populations are types of aggregates. A population is made up of people who do not necessarily interact with one another and do not necessarily share a sense of belonging to the group. A community is a collection of people who chose to interact with one another because of common interests, characteristics, or goals, which form the basis for a sense of unity or belonging. PTS: 1 DIF: Moderate REF: Page and Header: 7, Populations and Aggregates OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analyze NOT: Multiple Choice 5. Which would a community health nurse identify as a community of common interest? A) The global community B) Small rural town in a northern state C) National professional organization D) Counties addressing water pollution ANS: C Feedback: A common-interest community shares a common interest or goal that binds the members together. Membership in a national professional organization is one example. The global community and a small rural town in a northern state would be examples of a geographic community. Counties addressing a water pollution problem would be an example of a community of solution. PTS: 1 DIF: Moderate REF: Page and Header: 5, The Concept of Community OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 6. The nurse is working with a community of solution. Which would the nurse expect to find? A) A health problem affecting the group B) Common goal binding members together C) Sharing of a similar goal D) Locational boundaries ANS: A Feedback: A community of solution involves a group of people coming together to solve a health problem that affects them. A common-interest community involves a collection of people widely scattered geographically who have an interest or goal that binds the members together. A geographical community is defined by its geographical or locational boundaries. PTS: 1 DIF: Moderate REF: Page and Header: 6, Community of Solution OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 7. Which statement made by a student would the nurse educator recognize as evidence that a student understands the health continuum? A) The distinction between health and illness is well demarcated. B) Illness refers to a state of being relatively unhealthy. C) D) Treatment of acute conditions reflects the current focus of health care. ANS: B Feedback: Although society typically depicts an absolute line of difference between being either well or ill, health is considered a relative term. Thus, illness is viewed as a state of being relatively unhealthy. Health is typically described as a continuum that involves a range of degrees from optimal health at one end to total disability or death at the other. The line of demarcation is not clear. Health applies to individuals, families, and communities. Traditionally, most health care has focused on the treatment of acute and chronic conditions at the illness end of the continuum, but this emphasis is shifting to focus on the wellness end. PTS: 1 DIF: Moderate REF: Page and Header: 9, The Health Continuum: Wellness Illness OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analyze NOT: Multiple Choice 8. When discussing the concept of the health continuum with a class, the nurse educator would be certain to include which statement in the description? A) Wellness is a relative concept, and illness is a state of being relatively unhealthy. B) s placement on the health continuum is static throughout time. C) Health is best described as cyclic. D) The health continuum can only be applied to individuals. ANS: A Feedback: Wellness is a relative concept, not an absolute, and illness is a state of being relatively unhealthy. The continuum can change. Because health involves a range of degrees from optimal health at one end to total disability or death at the other, it is often described as a continuum and not cyclic. The health continuum applies not only to individuals but also to families and communities. PTS: 1 DIF: Moderate REF: Page and Header: 9, The Health Continuum: Wellness Illness OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 9. The nurse leading a classroom discussion about leading health indicators and asks the students to give an example of one of these indicators. Which condition given as an example by a student would indicate that the class has understood the lesson? A) Cardiac disease B) Mental health C) Sedentary lifestyle D) Respiratory disease ANS: B Feedback: Mental health is a leading health indicator. Other leading health indicators include physical activity, overweight and obesity, tobacco use, substance use, responsible sexual behavior, injury and violence, environmental quality, immunization, and access to health care. Cardiac disease, respiratory disease, and sedentary lifestyle are specific details assessed as part of overall health indicators. PTS: 1 DIF: Moderate REF: Page and Header: 12, Proposed Leading Health Indicators OBJ: Objective: 4 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analyze NOT: Multiple Choice 10. Which statement best describes the difference between health promotion and disease prevention? A) Health promotion and disease prevention include all efforts that seek to move people closer to optimal well-being or higher levels of wellness. B) Disease prevention differs from health promotion in that disease prevention is targeted toward a specific disease or diseases. C) Health promotion can be described in terms of primary, secondary, and tertiary prevention. D) The goal of disease prevention is to raise levels of wellness for individuals, families, populations, and communities. ANS: B Feedback: Health promotion includes all efforts that seek to move people closer to optimal well-being or higher levels of wellness. The goal of health promotion is to raise levels of wellness for individuals, families, populations, and communities. Disease prevention is targeted toward a specific disease or diseases and consists of primary, secondary, and tertiary prevention. PTS: 1 DIF: Easy REF: Page and Header: 14, Promotion of Health OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analyze NOT: Multiple Choice 11. A group of community health nursing students designs a health education program for a group of pregnant teens. During the program, they plan to teach the group about nutrition during example of: A) health promotion. B) treatment of disorders. C) rehabilitation. D) evaluation. ANS: A Feedback: The student nurses are engaged in health promotion activities. Health promotion incorporates all efforts that seek to move people closer to optimal well-being or higher levels of wellness. Treatment of disorders would include direct care for issues involving the group, such as complications that might arise in this population. Rehabilitation would involve activities to minimize disability or restore or preserve function. Evaluation would involve an analysis of the effectiveness of these activities. PTS: 1 DIF: Moderate REF: Page and Header: 14, Promotion of Health OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 12. The community health nurse is developing a plan of primary prevention activities for the community. Which activities might the nurse include? Select all that apply. A) Teaching about safe sex practices to high school students B) Encouraging older adults to install safety devices in the bathroom C) Providing regular immunization programs for communicable diseases D) Participating in cholesterol screening programs at health fairs E) Providing skin testing for tuberculosis for children over 1 year of age F) Working with a group testing water samples for contamination ANS: A, B, C Feedback: Primary prevention activities are those taken to keep illnesses or injuries from occurring. These include teaching about safe sex practices, encouraging older adults to use safety devices in the bathroom, and providing regular immunization programs for communicable diseases. Cholesterol screening programs, skin tests for tuberculosis, and working with a group testing water samples for contamination are examples of secondary prevention activities. PTS: 1 DIF: Moderate REF: Page and Header: 14, Promotion of Health OBJ: Objective: 2 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Selection 13. A community health nurse is preparing a presentation for a group of nursing students about community health nursing. Which description of community health nursing would the nurse most likely include in the presentation? A) Focusing on addressing continuous needs B) Working with the client as an equal partner C) Engaging in tertiary prevention as the priority D) Encouraging clients to reach out to the nurse ANS: B Feedback: The community health nurse works with the client as an equal partner, encouraging autonomy. At any time, the nurse deals with continuous and episodic needs simultaneously. The community health nurse engages in primary, not tertiary, prevention as the priority and is obligated to actively reach out to all who might benefit from a specific activity or service. PTS: 1 DIF: Moderate REF: Page and Header: 19, Clients as Equal Partners OBJ: Objective: 4 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 14. A community health nurse is working with other members of a team that will be implementing a city-wide immunization program. The nurse is coordinating the services and addressing the needs of the population groups to demonstrate: A) involvement of the community. B) client participation. C) continuity of service. D) plan for follow-up. ANS: C Feedback: Working in cooperation with other team members and coordinating services and addressing the needs of population groups are essential to interprofessional collaboration. In doing so, the community health nurse is preventing fragmentation and gaps thereby ensuring continuity of service. The involvement of the community and client participation are important, but both help to ensure that the clients are viewed as equal partners of the health care team. A plan for follow-up is a possible element of such a program, but it is not what the nurse seeks to demonstrate with the program overall. PTS: 1 DIF: Moderate REF: Page and Header: 20, Interprofessional Collaboration OBJ: Objective: 4 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 15. A community health nurse works to ensure the greatest good for the greatest number of people by applying: A) secondary prevention activities. B) autonomy. C) justice. D) utilitarianism. ANS: D Feedback: The ethical theory of utilitarianism promotes the greatest good for the greatest number. Primary prevention activities, not secondary prevention, are the priority. Autonomy refers to the freedom of choice. Justice involves treating people fairly. PTS: 1 DIF: Moderate REF: Page and Header: 19, The Greatest Good for the Greatest Number of People OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 1 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 16. Using Healthy People 2020 as a guide, the community health nurse would include which factor in a teaching plan to demonstrate that the targeted population understands the basic information provided during an educational session? A) Self-care B) Health disparities C) Health literacy D) Episodic needs ANS: C Feedback: Consumers are often intimated by health professionals and are uninformed about health and health care affecting the quality of care. Adopting a teaching plan to ensure that the population understands the basic information addresses health literacy, the ability to read, understand, and use health care information appropriately. Doing so helps to ensure that the teaching plan will be effective. Self- disparities reflect differences in all aspects of health care related to vulnerable populations. Episodic needs are one-time specific negative health events that arise and are not an expected part of life. PTS: 1 DIF: Moderate REF: Page and Header: 9, Figure 1-4 OBJ: Objective: 4 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice 17. Which would be crucial for the community health nurse to address as the priority when dealing with policymakers about the development of community health programs? A) Research-based best practices B) -up C) Amount of services to be provided D) Scarcity of the available resources ANS: A Feedback: Decisions for programs or services are often made based on cost-effectiveness or cost-benefit. Therefore, community health nurses must provide policymakers with information about best -up, amount of services to be provided, and scarcity of the available resources are factors that may need to be considered, the community health nurse must first demonstrate evidence-based practice. PTS: 1 DIF: Easy REF: Page and Header: 9, Figure 1-4 OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 18. After a class that described the differences between acute care nursing and community health nursing, which statement by the class about community health nurses indicates successful teaching? A) Use a reactive approach. B) Seek out potential health problems. C) Concentrate on the illness end of the continuum. D) Emphasize curative care. ANS: B Feedback: Community health nurses, in contrast to acute care nurses, seek out potential health problems by identifying high-risk groups and instituting preventive programs. They use a proactive, rather than reactive, approach and concentrate on the wellness end of the health continuum. They place less emphasis on curative care. PTS: 1 DIF: Moderate REF: Page and Header: 3, Community Health OBJ: Objective: 3 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analyze NOT: Multiple Choice 19. Which activities would be associated with a community health nurse? Select all that apply. A) Examining infants in a city well-baby clinic B) Caring for elderly stroke victims in their homes C) Providing emergency care in an acute care facility D) Carrying out epidemiologic research E) Participating in health policy analyze ANS: A, B, D, E Feedback: Community health nurses work in every conceivable kind of community agency, from a state public health department to a community-based advocacy group. Their duties range from examining infants in a well-baby clinic or teaching elderly stroke victims in their homes to carrying out epidemiologic research or engaging in health policy analysis and decision-making. Providing care in an acute care facility would not be an activity associated with a community health nurse. PTS: 1 DIF: Moderate REF: Page and Header: 3, Community Health OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Selection 20. ifferent ways. How would the community health nurse define health? A) The absence of disease B) The potential to lead a productive life C) An environment free of toxins D) A holistic state of well-being ANS: D Feedback: Community health nurses view health as a holistic state of well-being, which includes soundness of the mind, body, and spirit. Along with this, foundational view is the emphasis on wellness, which includes the definition of health as well as the capacity potential to lead a fulfilling and productive life. Health is more than just the absence of disease or an environment free of toxins. PTS: 1 DIF: Moderate REF: Page and Header: 3, Community Health OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 21. While interviewing a client, which statement would a nurse identify as reflecting an objective dimension of health? A) B) C) D) ANS: C Feedback: s ability to function in daily activities. The better with medication, life being pretty good, and not wanting to face the day are examples of the subjective dimension of health, which involves how people feel. PTS: 1 DIF: Difficult REF: Page and Header: 13, Subjective and Objective Dimensions of Health OBJ: Objective: 4 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 22. When employing a population-oriented focus, which would the community health nurse do? A) B) Consider the members individually for similarities. C) Focus on the geographical area of the population. D) ANS: A Feedback: A population-oriented focus requires the assessment of relationships, considering the groups or communities in relation to the rest of the community to discover common needs or risks for a common health problem. The nurse does not consider the groups or communities separately but rather in context. The population may or may not be delineated by the geographical area. rather than permitting dependency. PTS: 1 DIF: Moderate REF: Page and Header: 18, Population Focused OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 23. A community health nurse is involved in a project to evaluate the health of a city. Which finding would suggest that the city would most likely need additional programs? A) after-school programs. B) The construction of affordable organized housing developments and communities is nearing completion. C) Approximately one-third of the people are recently unemployed due to the closure of the automotive factory. D) Several new recreational facilities for adults and children have been created at several locations. ANS: C Feedback: A healthy city is one in which there is continual creation and improvement in the physical and social environments with the expansion of community resources so that people can mutually people. This would include food, water, shelter, income, safety, and work. Loss of employment of one- recreational facilities are suggestive of a healthy city. PTS: 1 DIF: Moderate REF: Page and Header: 12, Box 1-5 OBJ: Objective: 4 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 24. The community health nurse is developing a plan of secondary prevention activities. Which actions might the nurse include? Select all that apply. A) Participating in skin cancer screening programs at health fairs B) Encouraging parents to install safety devices in electrical outlets C) Providing annual flu vaccinations D) Participating in hypertension screening programs at health fairs E) Providing skin testing for tuberculosis for children over 1 year of age F) Teaching college-age students about the importance of meningococcal vaccinations ANS: A, D, E Feedback: Secondary prevention activities are those used to detect and treat existing health problems at the earliest possible stage, when disease or impairment is already present. Activities may include hypertension and cholesterol screening programs to identify high-risk individuals and encourage early treatment to prevent heart attacks or stroke. Other examples are encouraging breast and testicular self-examination, regular mammograms, and Pap smears for early detection of possible cancers and providing skin testing for tuberculosis (in infants at 1 year of age and periodically throughout life, with increasing frequency for high-risk groups). Secondary prevention attempts to discover a health problem at a point when intervention may lead to its control or eradication. PTS: 1 DIF: Moderate REF: Page and Header: 14, Promotion of Health OBJ: Objective: 2 NAT: Client Needs: Physiological Integrity: Physiological Adaptation TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Selection 25. The community health nurse is developing a plan of secondary prevention activities. Which actions would the nurse incorporate into the plan? Select all that apply. A) Encouraging monthly self- B) Teaching parents to place infants on their backs to sleep C) Providing BMI measurements during a health fair D) Participating in cholesterol screening programs at health fairs E) Educating high-risk community groups about the importance of exercise at a hypertension clinic F) ANS: A, C, D, E Feedback: Secondary prevention activities are those used to detect and treat existing health problems at the earliest possible stage, when disease or impairment is already present. Activities may include hypertension and cholesterol screening programs to identify high-risk individuals and encourage early treatment to prevent heart attacks or stroke. Other examples are encouraging breast and testicular self-examination, regular mammograms, and Pap smears for early detection of possible cancers and providing skin testing for tuberculosis (in infants at 1 year of age and periodically throughout life, with increasing frequency for high-risk groups). Secondary prevention attempts to discover a health problem at a point when intervention may lead to its control or eradication. PTS: 1 DIF: Moderate REF: Page and Header: 14, Promotion of Health OBJ: Objective: 2 NAT: Client Needs: Physiological Integrity: Physiological Adaptation TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Selection 26. The community health nurse is developing a plan of secondary prevention activities. Which actions would the nurse incorporate into the plan? Select all that apply. A) Encouraging monthly testicular self- th fair B) Teaching preschool children the importance of daily activity C) Providing height and weight measurements during a health fair D) Participating in diabetes screening programs at health fairs E) Educating high school students about safe sex practices F) Encouraging women to schedule yearly mammograms ANS: A, C, D, F Feedback: Secondary prevention activities are those used to detect and treat existing health problems at the earliest possible stage, when disease or impairment is already present. Activities may include hypertension and cholesterol screening programs to identify high-risk individuals and encourage early treatment to prevent heart attacks or stroke. Other examples are encouraging breast and testicular self-examination, regular mammograms, and Pap smears for early detection of possible cancers and providing skin testing for tuberculosis (in infants at 1 year of age and periodically throughout life, with increasing frequency for high-risk groups). Secondary prevention attempts to discover a health problem at a point when intervention may lead to its control or eradication. PTS: 1 DIF: Moderate REF: Page and Header: 14, Promotion of Health OBJ: Objective: 2 NAT: Client Needs: Physiological Integrity: Physiological Adaptation TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Selection 27. The community health nurse is developing a plan of tertiary prevention activities. Which actions might the nurse include? Select all that apply. A) Developing a nutritional plan of care for clients with eating disorders B) Developing an exercise plan for COPD clients C) Providing bicycle safety education during a health fair for children D) Participating in hypertension screenings at health fairs E) Participating in bone density screenings at health fairs F) Educating children on swimming safety ANS: A, B Feedback: Tertiary prevention measures attempt to reduce the extent and severity of a health problem to its lowest possible level, in order to minimize disability and restore or preserve function. Examples include treatment and rehabilitation of persons after a stroke to reduce impairment, postmastectomy exercise programs to restore functioning, and early treatment and management of diabetes to reduce problems or slow their progress. PTS: 1 DIF: Moderate REF: Page and Header: 14, Promotion of Health OBJ: Objective: 2 NAT: Client Needs: Physiological Integrity: Physiological Adaptation TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Selection 28. The community health nurse is developing a plan of tertiary prevention activities. Which actions might the nurse incorporate into the plan? Select all that apply. A) Providing a support group for breast cancer survivors B) Encouraging women to schedule yearly Pap smears C) Providing height and weight measurements during a health fair D) Participating in diabetes screening programs at health fairs E) Educating high school students about bullying F) Providing a community-based stroke rehabilitation program ANS: A, F Feedback: Tertiary prevention measures attempt to reduce the extent and severity of a health problem to its lowest possible level, in order to minimize disability and restore or preserve function. Examples include treatment and rehabilitation of persons after a stroke to reduce impairment, postmastectomy exercise programs to restore functioning, and early treatment and management of diabetes to reduce problems or slow their progress. PTS: 1 DIF: Moderate REF: Page and Header: 14, Promotion of Health OBJ: Objective: 2 NAT: Client Needs: Physiological Integrity: Physiological Adaptation TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Selection Chapter 2, Public Health Nursing in the Community 1. A community health nurse is discussing with a student nurse, the importance of engaging in assurance activities. Which statement made by the student nurse would demonstrate an understanding of assurance activities? A) B) provide leadership in facilitating community groups toward meeting their C) D) essing relevant data that enable identification of strengths, ANS: C Feedback: Assurance activities are those activities that make certain that services are provided and include focusing on the availability of necessary health services throughout the community, maintaining the ability of public health agencies and private providers to manage day-to-day operations as well as the capacity to respond to critical situations and emergencies. Assessment involves gathering and analyzing information that will affect the health of those to be served and accessing relevant data to enable the nurse to identify strengths, weaknesses, and needs. Policy development involves providing leadership in facilitating community groups. PTS: 1 DIF: Moderate REF: Page and Header: 25, Assurance OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Analyze NOT: Multiple Choice 2. When fulfilling the function of assessment, which action would be most important for the community health nurse to take? A) Secure the trust of the clients. B) Gather appropriate information. C) Interact with key community leaders. D) Use a variety of assessment tools. ANS: A Feedback: Although securing and maintaining the trust of others is pivotal to all nursing practice, it is even more critical when working in the community. Trust can afford a nurse access to client populations that are difficult to engage, to agencies, and to health care providers. As difficult as it may be for the nurse to gain the trust and respect of the community, if it is ever lost, these attributes can be difficult if not impossible to regain. Gathering information, interacting with key community leaders, and using a variety of assessment tools are important, but they can only occur after trust is established. PTS: 1 DIF: Moderate REF: Page and Header: 24, Assessment OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Analyze NOT: Multiple Choice 3. The community health nurse is engaging in the core function of policy development. With which of the activity would the nurse most likely be involved? A) Monitoring health status to identify community health problems B) Empowering communities about important health issues C) Linking individuals to needed personal health services D) Ensuring a competent health care workforce is available ANS: B Feedback: With policy development, the community health nurse would be involved in informing, educating, and empowering people about health issues. Monitoring health status is associated with the assessment function. Linking individuals to needed personal health services and ensuring a competent public health and personal health care workforce are associated with assurance. PTS: 1 DIF: Moderate REF: Page and Header: 25, Policy Development OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 4. A community health nurse is collaborating with local community leaders to prepare a community disaster plan. Which function is the nurse fulfilling? A) Research B) Assurance C) Policy development D) Assessment ANS: B Feedback: Community health nurses perform the assurance function at the community level when they collaborate with community leaders in the preparation of a community disaster plan. Research is demonstrated by gaining new insights and innovative solutions to health problems. Policy development would involve client information, education and empowerment, mobilization of community partnerships, and the development of plans and policies to support community health efforts. Assessment involves monitoring health status for community health problems and diagnosing and investigating health problems and hazards in the community. PTS: 1 DIF: Moderate REF: Page and Header: 25, Assurance OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Analyze NOT: Multiple Choice 5. A community health nurse has collected data for several months on the birth weights of newborns to mothers who smoked throughout their pregnancy. This nurse is acting in which role? A) Collaborator B) Manager C) Researcher D) Clinician ANS: C Feedback: The nurse is assuming the role of a researcher, that is, engaging in systematic investigation that includes data collection. In the collaborator role, the nurse would work with numerous members of the health team, working jointly with others in a common endeavor. In the manager role, the nurse exercises administrative direction toward the accomplishment of specified goals. In the clinician role, the nurse ensures the provision of health care services to individuals, families, groups, and populations. PTS: 1 DIF: Moderate REF: Page and Header: 33, Researcher Role OBJ: Objective: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 6. A nurse in community health nursing setting works with police officers, social workers, health educators, and other nurses to promote the health of clients. The nurse is acting in which role? A) Clinician B) Educator C) Researcher D) Collaborator ANS: D Feedback: The nurse is assuming the role of collaborator. In this role, the community health nurse works jointly with many individuals to benefit client care. In the clinician role, the nurse ensures the provision of health care services to individuals, families, groups, and populations. As an educator, the nurse is the health teacher and provides information to community clients. In the researcher role, the community health nurse engages in systematic investigation, collection, and analysis of data for solving problems and enhancing community health practice. PTS: 1 DIF: Moderate REF: Page and Header: 32, Collaborator Role OBJ: Objective: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Analyze NOT: Multiple Choice 7. A community health nurse is interviewing for employment. The interviewer describes some of the typical activities that the nurse would be involved in, such as making home visits to families, holding immunization clinics for infants and children, and setting up flu shot clinics for elders. The interviewer is describing which role? A) Educator B) Advocate C) Clinician D) Manager ANS: C Feedback: The interviewer is describing direct care activities associated with the clinician role. As an educator, the nurse is the health teacher and provides information to community clients. In the their behalf. In the manager role, the nurse exercises administrative direction toward the accomplishment of specified goals. PTS: 1 DIF: Moderate REF: Page and Header: 28, Clinician Role OBJ: Objective: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 8. A community health nurse is reviewing his or her schedule for the day. Included in his or her activities are planning client care, leading a staff conference, and supervising a new staff member. This nurse is fulfilling which role? A) Advocate B) Manager C) Collaborator D) Researcher ANS: B Feedback: When functioning in the manager role, the nurse exercises administrative direction toward the accomplishment of specified goals. Overseeing client care as a case manager, supervising ancillary staff, managing caseloads, running clinics, or conducting community health needs assessment projects are examples of activities associated with the manager role. In the role, the nurse would work with numerous members of the health team, working jointly with others in a common endeavor. In the researcher role, the community health nurse engages in systematic investigation, collection, and analysis of data for solving problems and enhancing community health practice. PTS: 1 DIF: Moderate REF: Page and Header: 30, Manager Role OBJ: Objective: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Analyze NOT: Multiple Choice 9. While providing care to a family at a local center, the community health nurse contacts the local department of social services to help the family attain assistance with health insurance coverage and a list of pharmacies to get their prescriptions filled. The nurse is acting in which role? A) Educator B) Leader C) Clinician D) Advocate ANS: D Feedback: The nurse is acting in the role of advocate, by pleading their cause and acting on their behalf. The nurse acts as an advocate by showing clients what services are available, the ones to which they are entitled, and how to obtain them. As an educator, the nurse is the health teacher and provides information to community clients. As a leader, the nurse directs, move them toward a goal. In the clinician role, the nurse ensures the provision of health care services to individuals, families, groups, and populations. PTS: 1 DIF: Easy REF: Page and Header: 29, Advocate Role OBJ: Objective: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Analyze NOT: Multiple Choice 10. Which action best exemplifies the attributes of a community health nurse in the researcher role? A) Gaining the trust and respect of the staff members B) Interpreting abstract ideas so others can understand C) Implementing a staff development program for a technique D) Evaluating the correlation between variables in specific health conditions ANS: D Feedback: Attributes of a researcher include a spirit of inquiry; careful observation; analytic skills, such as evaluating the possible cause and effect of a situation; and tenacity. Gaining the trust and respect of staff, interpreting abstract ideas, and implementing a staff development program are examples of the management skills used in the role of manager. PTS: 1 DIF: Moderate REF: Page and Header: 33, Researcher Role OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 11. Which statement about the role of educator within the framework of public health nursing functions is true? A) The educator role has the potential for finding greater receptivity and providing higher-yield results. B) People are unable to recognize the value of health and are not well motivated to achieve higher levels of wellness. C) It is only possible for a nurse to reach a limited number of persons. D) ANS: A Feedback: The educator role has the potential for finding greater receptivity and providing higher-yield results. People are recognizing the value of health and are increasingly motivated to achieve higher levels of wellness. With an emphasis on populations and aggregates, the educational efforts of community health nursing are appropriately targeted to reach many people. One PTS: 1 DIF: Moderate REF: Page and Header: 29, Educator Role OBJ: Objective: 4 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analyze NOT: Multiple Choice 12. Which statement about the importance of the role of collaborator is true? A) Community health nurses frequently practice in isolation. B) Successful community health practice depends on multidisciplinary collegiality and leadership. C) Community health nurses must assert themselves as the most powerful person on the health care team to ensure each client receives services that are necessary. D) It is best for community health nurses to focus on what they, as nurses, can do for their clients. ANS: B Feedback: Community health nurses seldom practice in isolation. As collaborators, nurses work jointly with others in a common endeavor, cooperating as partners. Successful community health practice depends on multidisciplinary collegiality and leadership. The community health contribution to the team, and in acting assertively as an equal partner. PTS: 1 DIF: Moderate REF: Page and Header: 32, Collaborator Role OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Analyze NOT: Multiple Choice 13. Which statement about the community health true? A) Within a given time, a community health nurse may practice multiple roles. B) The knowledge that vulnerable populations need someone to guide them through the complexities of the health care system and the nurse can serve as an advocate for them. C) The researcher role for community health nurses involves only the use of quantitative statistics. D) The leadership role consists solely of managing staff. ANS: B Feedback: Community health nurses wear many hats while conducting day-to-day practice. At any given time, however, one role is primary. They need someone to guide them through the complexities of the system and assure the satisfaction of their needs. This is particularly true for minorities and disadvantaged groups. Although research technically involves a complex set of activities conducted by persons with highly developed and specialized skills, research also means applying that technical study to real-practice situations. As leaders, community health nurses seek to initiate changes that posit PTS: 1 DIF: Moderate REF: Page and Header: 27, Roles of C/PHNS OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Analyze NOT: Multiple Choice 14. A community health nurse is involved in education, screening, referral, and support for the individuals of a specific religious congregation. The nurse is practicing in which setting? A) Occupational health nursing B) Faith community nursing C) School nursing D) Residential institution nursing ANS: B Feedback: In faith community nursing, the practice focal point is the faith community and the religious belief system provided by the philosophical framework. It may be called church-based health promotion, parish nursing, or primary care parish nursing practice. Occupational health nursing occurs in business and industry settings. School nursing, as the name implies, involves practicing in the school system, including from preschools to colleges and universities. Residential institution nursing occurs in any facility where the clients reside such as a halfway house or continuing care center. PTS: 1 DIF: Moderate REF: Page and Header: 36, Faith Communities OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 15. Which statement is true regarding the differentiation of the home setting for community health nursing from other settings? A) The nurse acts primarily as an educator. B) The client is viewed within his or her environment. C) Technologically advanced care is limited. D) The home is being used less frequently today. ANS: B Feedback: the client is the host, comfortable and secure in familiar surroundings, and the nurse is a guest. Although education may be a major component of care in the home, all community health nursing roles are performed to varying degrees. In addition, technologically advanced care in the home is increasing in demand, with the home being the most frequently used setting for community health nursing. PTS: 1 DIF: Easy REF: Page and Header: 33, Homes OBJ: Objective: 5 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Analyze NOT: Multiple Choice 16. After teaching a group of students about the various settings for community health nursing, the instructor determines that this teaching was successful when the students identify which facility as an example of ambulatory service setting? A) Local preschool B) Halfway house C) Continuing care center D) Family planning clinic ANS: D Feedback: Ambulatory service setting includes a variety of venues for community health nursing in which clients come for day or evening services that do not include overnight stays. One example is a family planning clinic. A local preschool would be an example of a school setting. A halfway house and continuing care center are examples of residential institutions. PTS: 1 DIF: Moderate REF: Page and Header: 34, Ambulatory Service Settings OBJ: Objective: 5 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 17. After teaching a group of students about the changing roles of the community health nurse in the occupational setting, the instructor determines that the students need additional teaching when they state: A) B) C) D) ANS: C Feedback: The clinician role was primary for many years, as nurses continued to care for sick or injured to prevent their illness led to the inclusion of health education in the occupational health nurse role. Occupational health nurses also act as employee advocates, assuring appropriate job assignments for workers and adequate treatment for job-related illness or injury. They collaborate with other health care providers and company management to offer better services to their clients. They act as leaders and managers in developing new health services in the work setting, endorsing programs such as hypertension screening and weight control. PTS: 1 DIF: Moderate REF: Page and Header: 35, Occupational Health Settings OBJ: Objective: 5 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 18. A community health nurse is working as a lobbyist for health legislation for AIDS research at the state capital. This nurse is practicing in which setting? A) Faith community B) Ambulatory service C) Residential institution D) Community at large ANS: D Feedback: The community at large is not confined to a specific philosophy, location, or building. It serves as the setting for practice of a nurse who serves on health care planning committees, lobbies for health legislation at the state capital, runs for a school board position, or assists with flood relief in another state or country. Faith community nursing focuses on activities involving the faith community and religious belief system. Ambulatory service settings include a variety of venues in which clients come for day or evening services that do not include overnight stays. Residential institutions include any facility where clients reside. PTS: 1 DIF: Moderate REF: Page and Header: 36, Community at Large OBJ: Objective: 5 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 19. Which statement is true regarding the description of school nursing? A) B) C) D) ANS: C Feedback: School nurses, whose primary role initially was that of clinician, are widening their practice to include more health education, interprofessional collaboration, and client advocacy. PTS: 1 DIF: Easy REF: Page and Header: 35, Schools OBJ: Objective: 5 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 20. A community health nurse is assuming the role of a manager. Which problem-solving activity would be most important for the nurse to address first when designing a community health fair? A) Planning B) Organizing C) Leading D) Controlling ANS: A Feedback: The management process incorporates a series of problem-solving activities or function: planning, organizing, leading, and controlling and evaluating. Although these activities occur simultaneously, they are sequential with planning being the first activity. PTS: 1 DIF: Easy REF: Page and Header: 30, Manager Role OBJ: Objective: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 21. A nursing student is interviewing a community health nurse about the various roles the nurse assumes and the skills and behaviors necessary to perform each role. Which would the community health nurse identify as being essential to the role of an advocate? Select all that apply. A) Assertiveness B) Ability to plan C) Ability to negotiate D) Risk taking E) Holistic view F) Questioning attitude ANS: A, C, D Feedback: As an advocate, the community health nurse must be assertive, willing to take risks, be able to communicate and negotiate well, and be able to identify resources and obtain results. The ability to plan is associated with the manager role. A holistic view is critical to the community health nurse acting as a clinician. A questioning attitude is necessary for the role as a researcher. PTS: 1 DIF: Moderate REF: Page and Header: 30, Advocacy Actions OBJ: Objective: 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Analyze NOT: Multiple Selection 22. A community health nurse works in a busy community health nursing practice. Today, the nurse is devoting the day to the educator role. With which activities would the nurse be involved? Select all that apply. A) Planning seven home visits today B) Working on a new curriculum for high-risk teens C) Meeting with colleagues to discuss organizational changes in the office D) Ordering pamphlets over the Internet to be used in a parenting class E) Tabulating data from surveys distributed to elders during a flu shot clinic F) Going to social services to speak up for a family in his or her caseload ANS: B, D Feedback: In the educator role, the nurse would work on a new curriculum for high-risk teens and order pamphlets for use in a parenting class. Planning seven home visits would be part of the clinician role. Meeting with colleagues to discuss organizational changes would be part of the manager role. Tabulating data from surveys would be part of the researcher role. Speaking up PTS: 1 DIF: Moderate REF: Page and Header: 29, Educator Role OBJ: Objective: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Selection 23. A community health nurse is devoting the day to being a manager. Which activities would the nurse expect to perform? Which activities are part of this role? Select all that apply. A) Orienting three new community health nurses in the agency B) Attending a strategy meeting for a new service the community will be offering C) Working with a team to direct a smoking cessation program in public areas D) Investigating an outbreak of Salmonella in the community E) Tabulating the findings of exploring immunization practices among teens F) Reviewing the staff evaluations to assist with planning future in-services ANS: A, B, F Feedback: As a manager, a community health nurse would be involved in orienting new nurses in the agency, attending meetings for new services to be offered, and reviewing the staff evaluations. Working with a team to direct a smoking cessation program in public areas exemplifies the leadership role. Investigating an outbreak of Salmonella and tabulating the findings of immunization practices depict the researcher role. PTS: 1 DIF: Difficult REF: Page and Header: 30, Manager Role OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Selection 24. The community health nurse is discussing the roles assumed by community health nurses with a student nurse. Which statement made by the student nurse demonstrates the correct interpretation of which role must be assumed in every situation? A) B) C) D) ANS: B Feedback: The type and number of roles that are practiced vary with each set of clients and each specific situation, but the nurse should be able to successfully function in each of these roles as the particular situation demands. The role of manager is one that the nurse must play in every needs, directing and leading clients to achieve results, and controlling and evaluating the progress to ensure that the goals and clien PTS: 1 DIF: Moderate REF: Page and Header: 30, Manager Role OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 25. Which are core values of professional behavior that are unique to public health nursing? Select all that apply. A) Community/population as client B) Prevention C) Rehabilitation D) Partnership E) Healthy environment F) Diversity ANS: A, B, D, E, F Feedback: Core values of professional behavior emphasize community/population as client, prevention, partnership, healthy environment, and diversity. Rehabilitation is not population centered. PTS: 1 DIF: Easy REF: Page and Header: 26, Standards of Practice OBJ: Objective: 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Selection 26. A community health nurse is serving as a health consultant for the local school board. This nurse is practicing in which setting? A) Community at large B) Residential institution C) Ambulatory service D) Faith community ANS: A Feedback: The community at large is not confined to a specific philosophy, location, or building. It serves as the setting for practice of a nurse who serves on health care planning committees, lobbies for health legislation at the state capital, runs for a school board position, or assists with flood relief in another state or country. Faith community nursing focuses on activities involving the faith community and religious belief system. Ambulatory service settings include a variety of venues in which clients come for day or evening services that do not include overnight stays. Residential institutions include any facility where clients reside. PTS: 1 DIF: Moderate REF: Page and Header: 36, Community at Large OBJ: Objective: 5 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 27. A community health nurse is working as a cardiac rehabilitation nurse. This nurse is practicing in which setting? A) Residential institution B) Faith community C) Community at large D) Ambulatory service ANS: D Feedback: Ambulatory service settings include a variety of venues in which clients come for day or evening services that do not include overnight stays. The community at large is not confined to a specific philosophy, location, or building. It serves as the setting for practice of a nurse who serves on health care planning committees, lobbies for health legislation at the state capital, runs for a school board position, or assists with flood relief in another state or country. Faith community nursing focuses on activities involving the faith community and religious belief system. Residential institutions include any facility where clients reside. PTS: 1 DIF: Moderate REF: Page and Header: 34, Ambulatory Service Settings OBJ: Objective: 5 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 28. A community health nurse is developing a community-wide drug campaign targeting middle school children. The nurse is incorporating information about the dangers of addiction. Which level of prevention would the nurse classify this activity? A) Primary B) Secondary C) Tertiary D) Secondary and tertiary ANS: A Feedback: This activity would be classified as a primary prevention measure that aims to prevent disease or injury before it ever occurs. Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. Tertiary aims to soften the impact of an ongoing illness or injury that has lasting effects. PTS: 1 DIF: Moderate REF: Page and Header: 29, Educator Role OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 29. A community health nurse is working in a clinic on tribal lands. This nurse is practicing in which setting? A) Faith community B) Ambulatory service C) Residential institution D) Community at large ANS: B Feedback: Ambulatory service settings include a variety of venues in which clients come for day or evening services that do not include overnight stays. The community at large is not confined to a specific philosophy, location, or building. It serves as the setting for practice of a nurse who serves on health care planning committees, lobbies for health legislation at the state capital, runs for a school board position, or assists with flood relief in another state or country. Faith community nursing focuses on activities involving the faith community and religious belief system. Residential institutions include any facility where clients reside. PTS: 1 DIF: Moderate REF: Page and Header: 34, Ambulatory Service Settings OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 30. A community health nurse is working at juvenile group home. This nurse is practicing in which setting? A) Faith community B) Ambulatory service C) Residential institution D) Community at large ANS: C Feedback: Residential institutions include any facility where clients reside. Ambulatory service settings include a variety of venues in which clients come for day or evening services that do not include overnight stays. Faith community nursing focuses on activities involving the faith community and religious belief system. The community at large is not confined to a specific philosophy, location, or building. It serves as the setting for practice of a nurse who serves on health care planning committees, lobbies for health legislation at the state capital, runs for a school board position, or assists with flood relief in another state or country. PTS: 1 DIF: Moderate REF: Page and Header: 36, Community at Large OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 31. A nurse is providing health services to groups and populations. What role is the nurse performing? A) Educator role B) Clinician role C) Advocate role D) Manager role ANS: B Feedback: There are various roles in which a community/public health nurse practices. Providing health s role is teaching health to community clients. The advocate role assists clients to gain greater self-determination and facilitate the health care system to be responsive to the needs of clients. The manager role a series of problem-solving activities or functions: planning, organizing, leading, and controlling and evaluating. PTS: 1 DIF: Moderate REF: Page and Header: 28, Clinician Role OBJ: Objective: 3 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 32. A nurse is shadowing the nurse manager of the clinic. Which behavior is consistent with this role? A) The nurse is providing health education to a group of type 2 diabetics. B) The nurse is initiating a new screening process for young children who have experienced trauma in the community. C) The nurse is making a referral to a food pantry for a client who is in need of food. D) The nurse collaborates with other members of the clinic to evaluate the utilization of resources offered by the clinic. ANS: D Feedback: There are a variety of different types of behaviors associated with managers. There are four types of decisional roles or behaviors: entrepreneur, disturbance handler, resource allocator, and negotiator. A manager serves in the entrepreneur role when initiating new projects. In providing health education, this is an educator role. Advocating for clients is making a referral to a food pantry. Collaboration is necessary for the collaboration role but not in the managerial role. PTS: 1 DIF: Moderate REF: Page and Header: 30, Manager Role OBJ: Objective: 3 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 2 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice Chapter 3, History and Evolution of Public Health Nursing 1. A nursing instructor is describing the history related to the development of community health nursing. The nurse recognizes that the students understand the teaching when they identify which contribution had the greatest influence? A) The settings and the nurses delivering health care in the community B) Decisions made by the American Nurses Association C) Choices made by physicians in a variety of community settings D) ANS: A Feedback: The numbers, increasing variety of settings, and many nurses coming to work in the community settings since the 1970s have contributed most significantly to the change. As a result, professional associations supported the broader term of community health nursing. Physician decisions played no role in the change. The term public health nursing remains. PTS: 1 DIF: Easy REF: Page and Header: 40, Introduction OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 3 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 2. A nurse is discussing the growth and changes of community health nursing with a group of student nurses. Which factor will the nurse mention is most notable before 1850? A) Technical advances with the Industrial Revolution making major changes B) Care provided by family members, friends, and religious groups in the home C) Accomplishments stemming from the work of Florence Nightingale D) Formal organization of visiting nursing to provide care to the sick poor ANS: B Feedback: Before the mid-1800s, early home care was characterized by care of the sick in the home by family members, friends, and religious groups. Though the growth of cities during the Industrial Revolution did include the building of hospitals, these institutions mainly served those experiencing poverty rather than the general public, and formalized medical education did not take hold until the early 1900s. Technical advances came after 1850, as did the work of Florence Nightingale and the formal organization of visiting nurses to provide care to the sick poor. PTS: 1 DIF: Easy REF: Page and Header: 41, Early Home Care Nursing (Before Mid-1800s) OBJ: Objective: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 3 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 3. A nurse instructor is preparing to discuss the various forms of community health nursing with the class. Which form of service will the instructor identify as the most recent? A) Voluntary home nursing care for the sick poor via district nursing B) Care provided termed public health nursing C) Lay and religious groups providing care to the sick poor in their homes D) Focus on populations with community health nursing seen as a specialty field ANS: D Feedback: Nurses in this professional specialty have provided care to the sick, taught positive health habits and self-care, advocated on behalf of needy populations, developed and managed health programs, provided leadership, and collaborated with other professionals and consumers to implement changes in health services. Although the practice settings may have differed, the essential goal of the C/PHN has always been a healthier community. The home certainly has been one site for practice, but so too have public health clinics, schools, factories, and other community-based locations. PTS: 1 DIF: Easy REF: Page and Header: 40, Introduction OBJ: Objective: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 3 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 4. Which district nursing role most contributed to the advancement of public health nursing? A) Caring for the sick B) Teaching hygiene and cleanliness C) Preventing illness D) Gathering statistical data ANS: B Feedback: The initiation of district nursing in the late 1800s continued to advance the field of public health nursing. Although district nurses primarily cared for the sick, they also taught cleanliness and wholesome living to their clients. This early emphasis on prevention and health became one of the distinguishing features of district nursing and later of public health nursing. Preventing illness and gathering statistical data were key contributions of Florence Nightingale during the Crimean War of the early 1850s. PTS: 1 DIF: Easy REF: Page and Header: 45, Home Visiting Takes Root OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 3 KEY: Integrated Process: Caring BLM: Cognitive Level: Understand NOT: Multiple Choice 5. A nurse recognizes that each stage of community health nursing has certain emphasis and characteristics. What was a defining characteristic during of the public health nursing stage? A) Voluntary health agencies emphasizing disease prevention B) Family considered as the primary unit of care C) Service provision to the sick poor population D) Primary health care as the key to health for all ANS: B Feedback: The public health nursing stage was characterized by service to the public, with the family targeted as a primary unit of care. Official, not voluntary, health agencies that placed a greater emphasis on disease prevention and health promotion provided the chief institutional base. The early home care stage (before the mid-1800s) emphasized care to the sick poor in their homes by various lay and religious orders. Primary health care as the key to health for all characterizes the community health nursing stage. PTS: 1 DIF: Easy REF: Page and Header: 51, Public Health Nursing Advances OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 6. District nursing continued to evolve over time with its focus eventually including the health and welfare of the general public. The nurse will recognize that this occurred at which stage? A) Beginning of 20th century B) In the late 19th century C) Prior to the 1850s D) By the early 1970s ANS: A Feedback: The focus of district nursing broadened to include the health and welfare of the general public by the beginning of the 20th century or the early 1900s. In the late 19th century, district nurses widespread immigration and filled tenement housing that led to inadequate sanitation, unsafe and unhealthy working condition, and barriers adding to poverty and disease. District nursing did not develop until after 1850. The early 1970s is associated with the emergence of community health nursing. PTS: 1 DIF: Easy REF: Page and Header: 45, Public Health Nursing (1900 1970) OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 3 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 7. An instructor is teaching a group of students about the settings of public health nursing. The instructor recognizes that the teaching is successful when the students identify which focused on the home setting? A) Jessie Sleet B) Lillian Wald C) Lina Rogers D) Margaret Sanger ANS: B Feedback: Lillian Wald, a leading figure in the expansion of district nursing, was the first to deliver public health nursing in the home setting to describe the specialty. Jessie Sleet was credited as being the first Black public health nurse. Lina Rogers was credited with being the first school nurse. Margaret Sanger was the nurse who opened the first birth control clinic in America that eventually resulted in the formation of the International Planned Parenthood Federation. PTS: 1 DIF: Easy REF: Page and Header: 47, Nurses Making a Difference OBJ: Objective: 5 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 3 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 8. Nursing group of student nurses are preparing to create a poster depicting the various contributions to public health nursing by Lillian Wald. Which contributions will the students include? Select all that apply. A) Demonstrating the effectiveness of placing school nurses in public schools to reduce absenteeism and improve follow-up of problems identified in school children B) Promoting the use of birth control C) Convincing the Metropolitan Life Company that nurse intervention could reduce death rates D) to serve mountain families in Kentucky E) Founding the National Organization for Public Health Nursing (NOPHN) ANS: A, C, E Feedback: Lillian Wald contributed to the profession of public health nursing by demonstrating the effectiveness of placing school nurses in public schools to reduce absenteeism and improve follow-up of problems identified in school children, convincing the Metropolitan Life Company that nurse intervention could reduce death rates, and founding the National Organization for Public Health Nursing (NOPHN). Margaret Sanger was responsible for promoting the use of birth control. Mary Breckenridge was responsible for creating the Frontier Nursing Service in Kentucky. PTS: 1 DIF: Easy REF: Page and Header: 45 50, Public Health Nursing (1900 1970) (Table 3-7) OBJ: Objective: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 3 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Selection 9. The nurse recognizes Lillian Wald as an early leader and innovator of community health nursing. Which contribution is attributed to Wald? A) Establishment of family-centered nursing and outreach services in New York City at the turn of the 20th century B) Use of clean and safe nursing care practices to soldiers during the Crimean War in the 1850s C) Assistance to high-risk populations experiencing tropical diseases in Central America and the Caribbean in the late 1800s D) Creation of home nursing services in London, marking the beginning of district nursing in the 1860s ANS: A Feedback: Lillian Wald worked with immigrant families in the Lower East Side of New York City, providing home visits, a neighborhood center, and general sanitation improvement for families and health care services to children in schools. Florence Nightingale was responsible for providing clean and safe nursing care practices to soldiers during the Crimean War. Mary Seacole helped high-risk populations who experienced tropical diseases in Central America and the Caribbean. William Rathbone was responsible for establishing a visiting nurse service for the sick in London. PTS: 1 DIF: Easy REF: Page and Header: 47, Nurses Making a Difference OBJ: Objective: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 3 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 10. A group of student nurses are discussing the many traits necessary to be a public health nurse. Which early leader should the students recognize as an example of advocacy for her patients by defying the laws of her time? A) Lillian Wald B) Florence Nightingale C) Margaret Sanger D) Mary Brewster ANS: C Feedback: Margaret Sanger openly defied a law that she saw as unjust (the Comstock Act that prohibited the provision of any information on contraception to women). This defiance eventually resulted in the formation of The International Planned Parenthood Federation. During the same period that Lillian Wald and her contemporaries were working to alleviate the suffering caused by disease and poverty, Margaret Sanger began a different battle. Florence Nightingale the view that prevention was better than cure. Mary Brewster was a nurse and a friend of Lillian Wald who both together started the Henry Street Settlement. PTS: 1 DIF: Easy REF: Page and Header: 51, Another Nurse Another Problem OBJ: Objective: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 3 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 11. A prospective nursing student is interested in working in community health nursing after graduation. Which level of education would be most appropriate for this student to complete? A) Diploma program B) Associate degree C) Baccalaureate degree D) ANS: C Feedback: Community health nursing is a challenging specialty in nursing. The demands of this type of nursing require additional courses in liberal arts and science, along with courses in community health nursing practice as a student. The minimum preparation for community health nurses in many states is a baccalaureate degree. The diploma and associate degree level prepares students for basic nursing practice. Students can build on this basic knowledge by entering a BSN completion program, which will prepare them to enter the specialty of community health nursing. In order to stay current and to build skills in this specialty, advanced courses or a e is needed. PTS: 1 DIF: Moderate REF: Page and Header: 57, Community Health Nursing (1970 to the present) OBJ: Objective: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 3 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 12. As the field of public health nursing advanced, providing adequate education became vital. Which piece of legislation is recognized as providing federal funds to support advanced training for public health nursing in the 1950s? A) Health Amendment Act B) Public Health Service Act C) Hill-Burton Act D) Public Health Nursing Act ANS: A Feedback: The Health Amendment Act was passed in 1956 and provided funds to support public health nurse advanced training. The Public Health Service Act was passed in 1944 and authorized qualified nurses to be commissioned in the U.S. Public Health Services. The Hill-Burton Act was approved in 1945, and it resulted in federal funding of hospitals and medical centers. There is no Public Health Nursing Act. PTS: 1 DIF: Moderate REF: Page and Header: 48, Table 3-6: Landmarks in Nursing History: 1900 1970 OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 3 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 13. A group of students are reviewing the history of public health nursing and the evolution of the education preparing the nurse to take on this role. Which training will the students recognize from the 1960s that emphasized primary health care to rural areas? A) Nurse practitioners B) Baccalaureate degree in public health nursing C) Postgraduate courses in public health nursing D) Master degree in public health nursing ANS: A Feedback: The nurse practitioner (NP) movement, starting in 1965 at the University of Colorado, was initially a part of public health nursing and emphasized primary health care to rural and underserved populations. A baccalaureate degree prepares the nurse for entry level into public health nursing. Before the NP movement, postgraduate courses were offered for nurses however, the NP is more advanced. PTS: 1 DIF: Moderate REF: Page and Header: 55, The Profession Evolves OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 2 KEY: Integrated Process: Caring BLM: Cognitive Level: Apply NOT: Multiple Choice 14. work is fundamental to nursing today. Which are essential elements learned in nursing? Select all that apply. A) Reduction of airborne pathogens B) Efficient drainage C) Well-organized exercise D) Adequate illumination E) Culturally acceptable diet F) Hand hygiene ANS: A, B, D, F Feedback: s work, particularly her five essential components to optimal health and healing especially hand hygiene, adequate lighting, and three agencies (WHO, UNICEP, and USAID). the development of chronic conditions. PTS: 1 DIF: Moderate REF: Page and Header: 43, The Early Nightingale Years OBJ: Objective: 2 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter: 3 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Selection Chapter 4, Evidence-Based Practice and Ethics 1. A nursing instructor is preparing a teaching plan for a class comparing evidence-based practice and critical thinking. Which concept would the instructor include? A) Evidence-based practice and critical thinking are polar opposites. B) Problem clarification of central concepts is inherent to both. C) Interpretation of accumulated evidence is unique to evidence-based practice. D) Problem exploration is unique to critical thinking. ANS: B Feedback: Evidence-based practice and critical thinking share commonalities including exploring a problem; addressing a purpose or goal; making assumptions; clarifying the problem around central concepts or indicators; accessing data; interpreting accumulated evidence; using reasoning, processing, defining, planning, and documenting; acting on the problem; and evaluating, adjusting, generalizing, and applying to a broader problem set. In addition, critical thinking is an important component of evidence-based practice. PTS: 1 DIF: Moderate REF: Page and Header: 68, Research and Evidence-Based Practice OBJ: Objective: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 4 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 2. do what? Select all that apply. A) Work independently from other health professionals to promote the profession of nursing. B) Work collaboratively with other health professionals to promote health care. C) Attempt to redesign health care. D) Improve practices through evidence-based means. E) Provide the Future of Nursing report that does not express the importance of evidence-based nursing. ANS: B, C, D Feedback: The Future of Nursing highlights the need for nursing to work with other health professionals evidence-based means. PTS: 1 DIF: Moderate REF: Page and Header: 68, Research and Evidence-Based Practice OBJ: Objective: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 4 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Selection 3. Multiple reports such as To Err Is Human: Building a Safer Health System (2000), Crossing the Quality Chasm: A New Health System for the 21st Century (2001), and Priority Areas for National Action: Transforming Health Care Quality (2003) have supported evidence-based practice in the past decade. Which statement best summarizes evidence-based nursing practice? A) B) We have spent billions of dollars each year researching new treatments and have translated that knowledge into clinical practice. C) We are not translating the knowledge that we are gaining into clinical practice. D) We have continued to spend more than a trillion dollars a year providing care and do translate that capacity into improved clinical practice. ANS: C Feedback: To Err Is Human: Building a Safer Health System (2000), Crossing the Quality Chasm: A New Health System for the 21st Century (2001), and Priority Areas for National Action: Transforming Health Care Quality (2003). These reports draw attention to the fact that we spend billions of dollars each year researching new treatments, and more than a trillion dollars PTS: 1 DIF: Moderate REF: Page and Header: 68, Research and Evidence-Based Practice OBJ: Objective: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 4 KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Evaluate NOT: Multiple Choice 4. Which statement about the steps of the EBP process is most accurate? A) One of the last steps of the EBP process is to search for and collect the most relevant best evidence. B) One of the earliest steps in the EBP process is to disseminate the outcomes of the EBP decision or change. C) preferences and values in making a practice decision or change. D) The first step in the EBP process is to cultivate a spirit of inquiry. ANS: D Feedback: The steps of the EBP process in order are cultivating a spirit of inquiry; asking the burning question in PICOT format; searching for and collecting the most relevant best evidence; critically appraising the evidence for its validity, reliability, and applicability and then patient preferences and values in making a practice decision or change; evaluating outcomes of the practice decision or change based on evidence; and disseminating the outcomes of the EBP decision or change. PTS: 1 DIF: Moderate REF: Page and Header: 69, Steps of the EBP Process OBJ: Objective: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 4 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 5. Which statement about cultivating a spirit of inquiry is most accurate? A) It is not very important; research will be performed anyway. B) In order for effective change to occur, current practices must be continually examined, questioned, and challenged. C) D) The agency does not have an important role in cultivating a spirit of inquiry. ANS: B Feedback: In order for effective change to occur, current practices must be continually examined, have a role in cultivating a spirit of inquiry. The organization must be open to a cultural shift from the status quo. The foundations of this spirit of inquiry are ongoing curiosity and a culture that supports it. PTS: 1 DIF: Moderate REF: Page and Header: 69, Cultivating a Spirit of Inquiry OBJ: Objective: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 4 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 6. Which statements about the impact of research on community health nursing are true? Select all that apply. A) It is important to conduct research to affect public policy. B) C) Research will affect the effectiveness of community health nursing practice. D) Research will affect the status and influence of nursing as a profession. E) The impact that research has on community health nursing is negligible. ANS: A, C, D Feedback: Research has the potential to have a significant impact on community health nursing in three health nursing practice, and the status and influence of nursing as a profession. Community health nurses have been involved in research addressing all three of these dimensions. PTS: 1 DIF: Moderate REF: Page and Header: 75, Impact of Research on Community/Public Health and Nursing Practice OBJ: Objective: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 4 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Selection 7. Application of nursing research results to community health nursing practice is essential. Which step must occur before results can be applied? A) Be informed about research findings. B) Demonstrate skill in examining research reports. C) Assess abstracts of relevant research studies. D) Check if the study was funded by a drug company. ANS: A Feedback: Communi research, but a necessary prerequisite is that the nurse must be informed about research findings. Critically examining research reports and assessing abstracts are all part of evaluating relevant research studies. However, the nurse needs to know what the research findings are before he or she can evaluate the research. Checking if the study was funded by a drug company might indicate that the results of the study could be questioned due to a conflict of interest. PTS: 1 DIF: Difficult REF: OBJ: Objective: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter: 4 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 8. After teaching a class on values, which statement by the class indicates the need for additional teaching? A) B) C) D) ANS: B Feedback: Terminal values refer to end states of existence such as spiritual salvation, peace of mind, or world peac

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