COMMUNITY CHAPTER 16

The state public health department in a large northern state has convened a task force to help optimize the health of the populations living in the state's rural communities by addressing major barriers to promoting optimal health in those rural communities. Which of the following is a major barrier? (Select all that apply.) 1. Decreased access health care 2. Lack of funding for safety net programs 3. Difficulty recruiting physicians, physician assistants, and nurse practitioners 4. Migration of people from other areas

1, 2, 3

A nurse is looking to develop a coalition of women's health providers and experts in the community. Which of the following strategies would be effective in helping to build a coalition? (Select all that apply.) 1. Create detailed objectives and activities 2. Address diversity among the membership 3. Map assets 4. Convene the coalition prior to drafting a mission statement and structure 5. Maintain and evaluate the vitality of the coalition

1, 2, 3, 5

For the PHN working in a large urban public health department, what are possible health issues facing the population as a whole? (Select all that apply.) 1. Higher crime rates 2. Higher levels of air pollution 3. Lower socioeconomic status 4. Higher incidence of sexually transmitted infection

1,2

A nurse is speaking with members of a community center about using community organization as a process for change. The nurse explains that there are several specific principles for creating change within the community. Which of the following are examples of these principles? (Select all that apply.) 1. Use nonviolence as a tool. 2. Apply downstream assessment principles. 3. The nurse will provide solutions for the community to follow. 4. Increase the community's decision-making ability. 5. Aim to minimize social and economic disparities.

1,4,5

A nurse has been volunteering at a free clinic located at a community center in a rural area twice a month for several years. Over the last few months, the nurse has noticed that the patient load has increased substantially as the population of this community has aged. It is not feasible for the nurse to spend more time at this center. What might be the most feasible action she could take to continue to serve the needs of the community? 1. Try to hire a nurse to work at the free clinic. 2. Set up a telehealth arrangement so the nurse can answer simple questions from home or while on the road. 3. Set up a scheduling and triage system so the nurse only sees the neediest patients. 4. Consider closing the free clinic and opening a fee-for-service center.

2

A nurse is looking to address teen gang violence in a nearby community using the principles of community organizing. The nurse has spent a great deal of time in the community performing a community assessment and getting to know residents and key stakeholders. What is the next step? 1. Identify core leaders to organize the community around the main issue. 2. Identify clear goals that relate to the overarching goal of reducing teen gang violence. 3. Identify available resources. 4. Create a plan to evaluate their actions.

1

A nurse is working in a family planning clinic that provides treatment for sexually transmitted infections (STIs). The nurse has noticed a significant increase in the incidence rate of STIs in the young women being seen at the clinic and wonders if this is a community-wide problem. Which of the following techniques would be a helpful first step in answering her question? 1.Develop collaborative relationships with other health-care providers in the area concerned with STIs. 2. Perform a comprehensive community assessment. 3. Interview several key stakeholders in the community. 4. Create a federally qualified health center (FQHC).

1

A nurse is working with several community members in an inner-city environment to help address broken windows and damaged buildings in their community. They've had several residents volunteer to form a group that will repair the damages and keep the community looking well cared for. This is an example of: 1. Community organization. 2. Community empowerment. 3. Community partnerships. 4. None of the above.

1

A student nurse is reviewing important global communities for ideas about a final research project. The student nurse discovers a movement in Europe that focuses on reducing health disparities and involving the local community in program design and implementation. What program does this describe? 1. Healthy Cities 2. Healthy People 3. Medical Homes 4. Racial and Ethnic Approaches to Community Health

1

A nurse is considering entering the specialty of parish nursing. Nurses working in this field perform which of the following activities specific to that of a parish nurse? 1. Advocating for individuals within the parish. 2. Improving spiritual health through practices such as grief counseling. 3. Providing health education. 4. Performing health screenings of parish members as needed.

2

Jacob has worked as a PHN in urban areas and has just now moved to a rural area and taken a job in the public health department in charge of county outreach programs. Based on data he recently reviewed from the Federal Office of Rural Health Policy, the following might be programs he should consider except: 1. An oral health program. 2. A chronic disease self-management program. 3. An internet-based health education program. 4. A mobile pharmacy program.

2

Nurses at a large urban medical center have noticed that the number of patients with type 2 diabetes being seen at the diabetes clinic with uncontrolled A1C has increased. They have decided to conduct a focused assessment. Which factors specific to the urban environment might be an issue for their population? (Select all that apply.) 1. Not enough pharmacies that carry needed mediations 2. Lack of grocery stores with healthy food choices 3. Increased numbers of patients with different cultural perspectives on food and health 4. Limited access to safe areas for exercise

2,3,4

A nurse is working on his or her first community-based participatory research (CBPR) study. An essential factor specific to CBPR research that the nurse should be careful to address is: 1. The ethical protection of human participants. 2. Making sure that community members aren't directly involved in the research. 3. Ensuring there is a benefit to the community related to the study. 4. Choosing a topic that is neutral to the community.

3

A public health nurse (PHN) has been tasked with addressing the rise in teen pregnancies in her communities. She wishes to create linkages among agencies that provide care to teens and/or obstetrical care generally. Which would be her first step based on the six-step guide created by The Center on Education and Training for Employment at The Ohio State University? 1. State the key challenges, articulate why they are better addressed by multiple agencies, and name potential key players. 2. Create a harmonious planning environment among agencies. 3. Assess the need to work in partnership with other agencies. 4. Make sure the members of the partnership are equally representative of the community-at-large in terms of culture, race, and perspective.

3

A young college student in a rural community has called the health department to get a recommendation for a health center where she could be seen for a chronic health problem. She is uninsured and can't afford the private clinic in town. The PHN recommends that the student: 1. Visit the local health department for management and treatment of her care. 2. Proceed to the local emergency department. 3. Visit the community health center run by an advanced practice registered nurse (APRN). 4. None of the above.

3

A nurse is moving to a rural area and beginning work at a health clinic there. The nurse is performing a basic community assessment to prepare for working with this new community. The nurse knows that which of the following is not characteristic of the needs of the rural population? 1.More likely to smoke tobacco and drink alcohol 2. Have less education and higher rate of poverty 3. More likely to have increased dental problems 4. More likely to have a higher life expectancy

4

A nurse is performing an assessment of a community where the population totals 55,542 persons and has a population density of 1,000 persons per square mile. How does the nurse classify the area? 1. Rural 2. Suburban 3. Urban cluster 4. Urbanized area

4

A nurse is reviewing top 10 priorities from Rural Healthy People 2020 National Survey. Which of the following is not one of the top 10 priorities? 1. Access to quality health services 2. Diabetes 3. Mental health and mental disorders 4. Cancer

4

A nursing professor is looking to give students clinical experience in relation to health program planning with a focus on implementation. The professor proposes which of the following projects to the curriculum committee? 1. A community assessment of three different neighborhoods 2. A mock community assessment and health policy development for a hypothetical community 3. A requirement that each student complete a paper about the history of health policy in the United States 4. Placement of students in a local community center that has requested the school partner with them on population-level health interventions they would like to put in place

4