Cqmmunity week 1

1. Realizing that many factors impact chronic illnesses like hypertension which of the following would be an upstream factor to help improve health outcomes for adults with hypertension in the community? a) Nutritional classes featuring low fat and low carb choices. b) Motivational interviewing sessions for smoking cessation. c) Working with the public health department to restrict smoking in public. d) Starting chair yoga classes for seniors in the community.

ANS : C

3. Which of the following 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 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.

6. The nurse is working with a community of solution. Which of the following 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 A community of solution involves a group of people coming together to solve a 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 one defined by its geographical or locational boundaries.

22. When employing a population-oriented focus, the community health nurse would do which of the following? A) Assess the groups' relationships looking for a common need. B) Consider the members individually for similarities. C) Focus on the geographical area of the population. D) Promote the groups' dependency for improving health.

ANS A Feedback: A population-oriented focus requires the assessment of relationships, considering the groups or communities in relationship 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. The community health nurse encourages individuals' participation to promote their autonomy rather than permitting dependency.

4. A group of students are reviewing material for a test on populations, communities, and aggregates. Which of the following 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 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 Btestbanks.com Btetsbanks.com 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.

2. Which of the following statements 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) In our textbook, the term 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 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.

7. Which one of the following statements 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) The term health is limited to reflect an individual's state. D) Treatment of acute conditions reflects the current focus of health care.

ANS B 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.

14. A community health nurse is working with other members of a team that will be implementing a citywide immunization program. The nurse is coordinating the services and addressing the needs of the population groups to ensure which of the following? A) Involvement of the community B) Client participation C) Continuity of service D) Plan for follow-up

ANS C 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. Involvement of the community and client participation are important but these help to ensure that the clients are viewed as equal partners of the health care team. A plan for follow-up may or may not be appropriate. In addition, it is the only aspect that may be addressed with the program.

5. Which of the following 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 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.

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 of the following 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.

3. The community health nurse is involved in public health work. Which of these statements by the nurse reflects an understanding of upstream interventions? a. "I will engage in policy initiatives in my urban area." b. "I will administer the flu shot to interested seniors." c. "I will help manage a senior's diabetes needs at home." d. "I will work with a local school to provide asthma education."

ANS: A

4.The public health nurse is partnering with NYC Department of Health colleagues to provide resources in multiple languages in their community to help smokers quit. Which Core Function of Public Health does this action best represent? a. Assurance at the local level b. Policy Development at the federal level c. Evaluation at the population level d. Assessment at the state level

ANS: A

2. When a client voices concerns about accessing healthy food options, the community health nurse performs a community assessment. The nurse identifies which factors as social determinants of health regarding this concern? (Select All That Apply) a. Lack of fresh fruits and vegetables in local markets b. Lack of transportation to shopping. c. Density of fast food chains near local schools d. Having insurance through a private carrier.

ANS: ABC

5. The C/PHN knows that which of the following statements are true concerning cultural competence? (Select all that apply) a.Patterns of cultural behavior are inherited, not acquired. b. The process of learning one's culture is known as enculturation. c. Culture is the product of individual habit, not aggregate behavior. d. Ethnocentrism blocks effective communication by creating biases. e. The process and results of learning culture are different for each person.

ANS: B D E

8. Which of the following statements is an accurate description of the characteristic shared by all cultures, culture is integrated? A) A person's culture is an interrelated and interdependent web of ideas and practices. B) In order to describe a person's culture, it is necessary to describe each trait independently. C) Aspects of a person's culture are best described as unrelated to other aspects of the person's culture. D) A person's culture is an assortment of various customs and traits.

Ans A Feedback: A person's culture is an integrated web of ideas and practices. To understand culture, single traits should not be described independently. As in any system, all parts of a culture are interrelated and interdependent.

3. Community health nursing has a long history of contributing to the health of populations. Which of the following forms of service would the nurse identify as being 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: The four stages of community health nursing followed from lay and religious groups providing care in the early years before 1850, the more specialized " health nurses" or district nursing after the mid-1800s, concern for the health of the general public from 1900s to 1970, and finally community health nursing as a specialty with a focus on populations since 1970.

1. After teaching a group of nursing students about the similarities and differences between public health and community health, which of the following statements by a nursing student would indicate knowledge of the similarities and differences between public health and community health? A) community health nursing is defined as nursing care that is provided in a community setting, rather than B) Public health nursing is defined as nursing care that is provided in a community setting, rather than an institutional setting." C) Public health nursing is focused on the health of individuals D) Community health nursing can shape the quality of community health services and improve the health of the general public.

Ans D 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.

12. When assessing a community's needs, which of the following would the nurse most likely complete first? A) Familiarization assessment B) Problem-oriented assessment C) Community subsystem assessment D) Comprehensive assessment

Ans: A Feedback: A familiarization assessment is a common starting place in evaluation of a community. It involves studying data already available on a community and then gathering a certain amount of firsthand data in order to gain a working knowledge of the community. A problem-oriented assessment begins with a single problem and assesses the community in terms of that problem. It is commonly used when familiarization is not sufficient and a comprehensive assessment is too expensive. A community subsystem assessment focuses on one dimension of community life. It is a useful way for a team to conduct a more thorough community assessment. A comprehensive assessment seeks to discover all relevant community health information.

2. When fulfilling the function of assessment, which of the following would be most important for the community health nurse to do? 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.

21. A community health nurse is providing care to several cultural groups in the community. When providing transcultural nursing, which of the following would be the priority? A) Examining one's own culture carefully and recognizing that alternative viewpoints are possible B) Recognizing that cultural values, beliefs, and practices influence people's health and lifestyles C) Obtaining health-related information about a cultural group concerning their values, beliefs, and practices D) Actively and attentively listening to demonstrate respect while learning about other cultures

Ans: A Feedback: Btestbanks.com Btetsbanks.com The first step in providing transcultural nursing is to develop cultural self-awareness by examining one's own culture carefully and recognizing that alternative viewpoints are possible. Next, the nurse would need to cultivate cultural sensitivity by recognizing that cultural values, beliefs, and practices influence people's health and lifestyle. Then the nurse would assess the client group's culture by obtaining health-related information and actively and attentively listening to demonstrate respect.

7. by all cultures. Which description of culture being tacit indicates that the teaching was successful? A) Culture is mostly unexpressed. B) Cultures do not remain static. C) Culture is a functional and integrated whole. D) Patterns of cultural behavior are acquired.

Ans: A Feedback: Culture is tacit, that is, mostly unexpressed and at the unconscious level. Culture is dynamic, undergoing change and never entirely static. It is integrated and learned.

17. Which of the following would be crucial for the community health nurse to address as the priority when dealing with policy makers about the development of community health programs? A) Research-based best practices B) Population's make 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 on the basis of cost-effectiveness or cost±benefit. Therefore, community health nurses must provide policy makers with information about best practices, grounded in research. Although population make up, amount of services to be provided, and scarcity of resources are factors that may need to be considered, the community health nurse must demonstrate evidence-based practice.

5. In their early stages, district nursing was sponsored by which of the following? A) Religious organizations B) Private philanthropy C) Contributions D) Public funding

Ans: A Feedback: Early district nursing services were founded by religious organizations that served as their sponsors. Later sponsorship shifted to private philanthropy. Funding came from contributions and fees charged to clients on an ability-to-pay basis. Finally, visiting nursing began to be supported by public money.

3. While providing care to a community group, a community health nurse provides culturally sensitive care by avoiding which of the following? A) Ethnocentrism B) Ethnorelativism C) Enculturation D) Ethnicity

Ans: A Feedback: Ethnocentrism is the belief or feeling that one's own culture is best causing the person to believe that his or her way of doing things is right and to judge others' methods as inferior, ignorant, or irrational. It blocks effective communication by creating biases and misconceptions. Ethnorelativism is seeing all behavior in a cultural context. Enculturation refers to the process of each person learning his or her culture through socialization with the family or significant group. Ethnicity refers to the group of qualities that mark a person's association with a particular ethnic group (collection of people who have common origins and a shared culture and identity).

11. A group of nursing students are studying for an examination on influential nursing leaders involved in the advancement of community health nursing. The students demonstrate that they are prepared for the examination when they identify which person as the first community health nurse in the United States? A) Frances Root B) Mary Robinson C) Mary Seacole D) Reba Thelin

Ans: A Feedback: In the United States, Frances Root was the first community health nurse who was hired by the Women's Branch of the New York Mission in 1877. Mary Robinson was the nurse who cared for William Rathbone's wife and was hired by Rathbone to visit the sick poor in their homes in England. Mary Seacole, the " Black Nightingale" practiced creole or afro- caribbean medicine in Jamaica and helped populations who experienced tropical diseases in Central America, Panama, and the Caribbean. Reba Thelin was a nurse hired by Johns Hopkins Hospital to visit the homes of tuberculosis clients in 1903.

14. A community health nurse is developing health promotion programs for a local community that consists predominantly of African Americans. Which of the following areas would be a priority for health promotion with this group? A) Cardiac health B) Respiratory care C) Mental health D) Skin care

Ans: A Feedback: Leading causes of death for African Americans include heart disease, cancer, and stroke. Heart disease is also a major health problem. Thus programs emphasizing cardiac health would be a priority. African Americans show a lower incidence in suicide and chronic obstructive pulmonary disease. They may experience skin problems such as keloids and melasma. However, all of these conditions would be of lesser importance than cardiac health.

10. After a class discussion about the contributions of Lillian Wald to the advancement of community health nursing, which of the following if stated by the class indicates that the discussion was effective? 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 Btestbanks.com Btetsbanks.com 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.

8. The community health nurse is determining the health of a community by examining status. Which of the following would the nurse examine? A) Leading causes of death and illness B) Adequacy of health services C) Socioeconomic distributions D) Strengths of the community

Ans: A Feedback: Status typically comprises morbidity and mortality data identifying the physical, emotional, and social determinants of health. Physical and social indices include vital statistics, leading causes of death and illness, suicide rates, and rates of drug and alcohol addiction. Social determinants can be identified by crime rates and functional ability level, or by high school dropout rates or average income levels. Adequacy of health services and socioeconomic distributions reflect structure. Strengths of the community involve process.

1. After discussing the meaning of cultural diversity and its significance for community health nursing, the nursing instructor recognizes that some points need to be clarified when a student makes which of the following comments? A) "Dominant values are those held by the male head of the household in most American families" B) " the percentages of White European descent Americans are rising, while the percentages of other ethnicities are declining and this is projected to continue into the year 2050 at least" C) Nurses maintain their original culture as they are socialized throughout the educational process. D) America has become an amalgamation of people who have different values, ideals, and behaviors, rather than the melting pot that was once envisioned".

Ans: A Feedback: The beliefs and sanctions of the dominant or majority culture are called dominant values. The proportion of the population identified as White is projected to continue to fall below other ethnicities between 2010 and 2050. Nurses will still have the same culture as they did before they were socialized in the nursing educational process, but they may be able to see things differently. America is not the ideal melting pot once described, but rather an amalgamation of people who have different values, ideals, and behaviors.

11. Which of the following statements 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) The public's higher level of health consciousness hinders the educator's role.

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 factor that enhances the educator role is the public's higher level of health consciousness.

7. At which time did the focus of district nursing broadened to include the health and welfare of the general public? 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 were ill-prepared to cope with their clients' multiple health and social problems resulting from 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.

20. A community health nurse is assuming the role of a manager. Which function would be most important for the nurse to address first? 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.

1. A group of students are reviewing the various historical events associated with the evolution of community health nursing in preparation for a test. They identify the time from 1970 to the present as the era known as community health nursing based on the understanding that which of the following influences Btestbanks.com Btetsbanks.com contributed most to this change? A) The settings and the nurses delivering health care in the community B) Decisions made by the American Nurses Association C) Decisions made by physicians in a variety of community settings D) The Demand to eliminate the word "public" from health services

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 still remains.

11. A group of community health nursing students design a health education program for a group of pregnant teens that includes teaching nutrition during pregnancy, demonstrating helpful exercises, and discussing their concerns. This is an example of which of the following? A) Health promotion B) Treatment of disorders C) Rehabilitation D) Evaluation

Ans: A Feedback: The student nurses are engaging in health promotion activities. Health promotion incorporates all efforts that seek to move people closer to optimal well-being or to 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.

3. When the nursing student identifies the three dimensions of the health of a community, the nurse educator is aware that the student has grasped which of the following concepts? A) Status/people, structure, and process B) Assessment, policy development, and assurance C) Primary, secondary, and tertiary D) Function, structure, and process

Ans: A Feedback: The three dimensions of the health of the community are status/people, structure, and process. Assessment, policy development, and assurance are the three core public health functions. Primary, secondary, and tertiary are the levels of prevention. Function, structure, and process are the descriptions of Human Anatomy and Physiology.

12. plan of primary prevention activities. Which of the following might the nurse include? Select all that apply. A) Teaching about safe-sex practices to high Btestbanks.com Btetsbanks.com 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 illness 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.

7. Which of the following statements about the structural dimension of the community as client are accurate? Select all that apply. A) Structure of a community refers to its services and resources. B) Community associations, groups, and organizations provide a means for accessing needed services. C) Adequacy and appropriateness of health services can be determined by examining patterns of use, number and types of health and social services, and quality measures. D) Demographic data, such as socioeconomic and racial distribution, age, gender, and educational level, are important indicators of community structure. E) Structure is the most common measure of the health of a community.

Ans: A, B, C, D Feedback: Structure of a community refers to its services and resources. Community associations, groups, and organizations provide a means for accessing needed services. Adequacy and appropriateness of health services can be determined by examining patterns of use, number and types of health and social services, and quality measures. Demographic data, such as socioeconomic and racial distribution, age, gender, and educational level, are important indicators of community structure. Status/people is the most common measure of the health of a community.

2. Which of the following are overarching goals for the health of the nation presented in Healthy People 2020? Select all that apply. A) To attain high-quality, longer lives free of preventable disease, disability, injury, and premature death B) To achieve health equity, eliminate disparities, and improve the health of all groups C) To create social and physical environments that promote good health for all D) To promote quality of life, healthy development, and healthy behaviors across all life stages E) Healthy People 2020 does not address the health of the nation but does address the health of individuals.

Ans: A, B, C, D Feedback: The four overarching goals for the health of the nation are the following: To attain high-quality, longer lives free of preventable disease, disability, injury, and premature death To achieve health equity, eliminate disparities, and improve the health of all groups To create social and physical environments that promote good health for all To promote quality of life, healthy development, and healthy behaviors across all life stages

1. Which of the following statements about competent communities are accurate? Select all that apply. A) A competent community is able to collaborate effectively identifying community needs and problems. B) A competent community is able to achieve a working consensus on goals and priorities. C) A competent community is able to agree on ways and means to implement the agreed- upon goals. D) A competent community has no problems. E) A competent community is able to collaborate effectively to take the required actions.

Ans: A, B, C, E Feedback: A competent community is able to collaborate effectively identifying community needs and problems. A competent community is able to achieve a working consensus on goals and priorities. A competent community is able to agree on ways and means to implement the agreed- upon goals. A competent community is able to collaborate effectively to take the required actions. All communities have problems.

19. Which of the following 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 analysis

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 rang from examining infants in a well- baby clinic or teaching elderly stroke victims in their homes to

25. Which of the following 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.

4. A community health nurse is working as part of a health planning team to determine the needs of pregnant teenagers in the community. Which of the following population variables would be important to assess? Select all that apply. A) Rate of growth or decline among those in need B) Health needs and practices of subculture groups C) Geographic placement of proposed health services D) Functions of community organizations E) Social class of the community F) Level of agreement on community goals

Ans: A, B, E Feedback: Btestbanks.com Btetsbanks.com Population variables include size, density, composition, rate of growth or decline, cultural characteristics, social class structure, and mobility. Pregnant teens are a subculture of teenagers. Cultural differences are population variables along with the numbers, social class, and mobility. Health needs vary among subculture and ethnic populations. Geographic placement reflects location. Functions of community organizations and social class reflect the social system.

23. A community health nurse is devoting the day to being a manager. Which activities would the nurse expect to perform? Which of the following 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 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.

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 of the following 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: Btestbanks.com Btetsbanks.com 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.

9. Which of the following are important contributions made by Lillian Wald to the profession of public health nursing? 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) providing rural " frontier nursing" 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).

13. The community health nurse is preparing a presentation for a group of nursing students about the societal influences on the development of community health nursing. Which factors should the nurse include that have influenced the growth of community health nursing? Select all that apply. A) Advances in the technology B) The recognition that one single agent could be considered a cause of illness C) Access to education being limited to the privileged few D) Continued increase in the number of women entering nursing because it is recognized as a choice career for women and not men E) Consumer demand for quality services coupled with community health nurses provision of holistic care

Ans: A, E Feedback: Many factors have influenced the growth of community health nursing, including advances in technology, progress in causal thinking (relating disease or illness to its cause and recognition that many factors might contribute to a disease or health disorder), and the consumer movement with consumers demanding quality services. Education is now widely available and is considered a basic right and necessity for a vital society. Changing demographics and the role of women have influenced community health nursing; however, the number of women entering nursing has decreased.

2. The population that community health nurses serve in the United States is changing. Because of population shifts, nurses must become sensitive to the cultural differences and language differences among new community members. Which minority group currently represents the largest group? A) African Americans B) Hispanic Americans C) Asian Americans D) American Indians

Ans: B Feedback: Significant minorities include Hispanic Americans, numbering more than 35 million in 2000 and over 42 million in 2005 and currently representing over 14% of the population; African Americans, numbering over 37 million or approximately 12.8% of the population; Asian Americans, numbering more than 12 million or approximately 4.3% of the population; and American Indians and Alaska Natives, numbering 2.8 million or 1% of the population.

4. Which factor was the most significant feature associated with district nursing? A) Caring for the sick B) Teaching hygiene and cleanliness C) Preventing illness D) Gathering statistical data

Ans: B Feedback: 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.

13. When completing a community assets assessment, the community health nurse would gather information about which of the following? A) Key informants B) Strengths of the community C) Specific problem of the community D) Overall life of the community

Ans: B Feedback: An assets assessment focuses on the strengths and capacities of a community rather than its problems. Key informants are important sources of information with a comprehensive assessment. Information about a specific health problem is gathered during a problem- oriented assessment. Information about an overall view of the community and its life is gathered with a familiarization or windshield survey.

19. When applying the principles of transcultural nursing, which of the following must the nurse do first? A) Cultivate cultural sensitivity B) Develop cultural awareness C) Learn the client's group culture D) Demonstrate respect for culture

Ans: B Feedback: Applying the principles of transcultural nursing involves the following: (1) developing cultural self-awareness, (2) cultivating cultural sensitivity, (3) assessing the client group's Btestbanks.com Btetsbanks.com culture, (4) showing respect and patience while learning about other cultures, and (5) examining culturally derived health practices.

10. A community health nurse working a large metropolitan city has a large Asian American client base. Which of the following would the nurse be least likely to assess in this population? A) Belief that illness results from a body imbalance B) Reliance on Western medical practices C) Use of traditional self-care practices D) A focus on patriarchal family structures

Ans: B Feedback: Asian Americans believe illness results from an imbalance of yin and yang forces. They use traditional healers and also exercise traditional self-care practices before using Western medical practices.

2. Before the mid-1800s, early home care nursing was best recognized by which of the following? 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. 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.

4. As a community health nurse, you overhear a colleague say " I don't understand why the Yang's take their young teenage daughters to the Hmong New Year celebration and have them play these match- making games. The girls meet boys every day at the school and they are too young to be looking for husbands." which of the following would be the most appropriate response? A) "The Yang's are very different rom us; maybe in time we can convince them that their practices are not right". B) "Every culture has its differences; I think it is valuable that the Yang's are keeping their cultural practices alive". C) "I Know what you mean, I was thinking the same thing. You wouldn't catch me doing something similar with my teens". D) "I feel sorry for those girls; they must feel funny in those cultural costumes. Lets talk to the parents and tell them how much teens in America feel about such things".

Ans: B Feedback: Community health nurses need to develop cultural sensitivity, becoming aware of own biases and preconceived values and beliefs. This would be evidenced by the statement about every culture having differences. The celebration is a part of the family's culture, and the nurses should not attempt to convince them that it is not right nor should they attempt to impose their views, feelings, or beliefs on the family.

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.

12. Which of the following statements about the importance of the role of collaborator is true? A) Community health nurses frequently practice in isolation. Btestbanks.com Btetsbanks.com 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 nurse's collaborator role requires skills in communicating, in interpreting the nurse's unique contribution to the team, and in acting assertively as an equal partner.

13. Which of the following statements about the community health nurse's selection and practice of each role is 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 positively affect people's health.

8. 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, identifying high-risk groups and instituting preventive programs; use a proactive approach; concentrate on the wellness end of the health continuum; and put less emphasis on curative care.

18. During which stage of the health planning process would the community health nurse create a plan? A) Assessment B) Analysis and design C) Implementation D) Evaluation

Ans: B Feedback: During the health planning process, a community health nurse creates a plan during the analysis and design stage, which correlates to the planning phase of the nursing process. Assessment involves data collection, interpretation, and goal setting. Implementation involves how to operationalize the plan and a design for monitoring progress. Evaluation involves examining the costs and benefits, judging the potential outcomes, modifying the plan, presenting the plan to the sponsoring group or agency, and obtaining acceptance.

15. A community health nurse is providing care to a family in the community who are Muslim. Which of the following would be most important for the nurse to integrate when Btestbanks.com Btetsbanks.com providing care for this family? A) Rules are stricter for boys than for girls. B) Modest dressing is key for both men and women. C) Most Arabic women work outside the home. D) Most adhere to the three tenets of Islam.

Ans: B Feedback: For Muslims, modesty in dress is a core value for both men and women, although it is expressed more evidently by women. Rules are stricter for girls than for boys and most Arabic women stay at home and are not in the workplace. All practicing Muslims adhere to the five tenets of Islam.

10. Which of the following statements about health promotion and disease prevention is the most accurate? 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.

12. The community health nurse is working in the health department of a major city that has a large Hispanic/Latino population. Which of the following would the nurse need to integrate into the plan of care for this population? A) View of the female as superior to the male B) Importance of an extended, cohesive family C) Males as the binding force of the family D) Adherence to strict time schedules

Ans: B Feedback: Hispanic people value extended, cohesive families. Families have been patriarchal, with male members perceived as superior and female members seen as a family-bonding life force. Many Latinos tend to be oriented to the present and are not as concerned as the mainstream culture about keeping time schedules or preparing for the future.

15. Which of the following differentiates 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: IN the home, unlike most other health care setting, clients are on their own " turf", such that 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

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.

18. When developing an in-service program for a group of community health nurses about culture, which of the following would the presenter expect to include? A) All members of a cultural group are alike. B) Intraethnic variations underscore a population's cultural diversity. C) Ethnicity has a major impact on the effectiveness of health care. D) Ethnocentric attitudes are key to working with different cultures.

Ans: B Feedback: Intraethnic variations, differences within microcultures, underscore the range of culturally diverse clients served by community health nurses. Subcultures and microcultures have their own distinctive characteristics even within fairly homogenous cultural groups. Culture, not ethnicity, has a major impact on the effectiveness of health care. Ethnocentric attitudes are to be avoided. All members of a cultural group are not alike. In general, individuals who are members of a specific culture are more alike than unlike but still not totally alike.

8. A student is planning a presentation about the evolution of public health nursing. As part of the presentation, the student would identify which person as being the first one to use the term "public health nursing"? 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 use the term "public health nursing" 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.

9. After discussing the leading health indicators with a class, which condition if stated by the class as one of these indicators suggests that the class has understood the information? A) Cardiac disease B) Mental health C) Sedentary lifestyle D) Maternal health care

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.

16. A community health nurse obtains data about the community from primary sources, including which of the following? A) World Health Organization B) Community members C) State health department D) Other community health nurses

Ans: B Feedback: Primary sources of information include community members, including formal leaders, informal leaders, and community members, and can frequently offer the most accurate insights and comprehensive information. Information gathered by talking to people provides primary data, because the data are obtained directly from the community. The World Health Organization is an international source of information. State health department is a state source of data. Other community health nurses as well as health team members, client records, community health (vital) statistics, census bureau data, reference books, and research reports are secondary sources of information.

9. The community health nurse is assessing the health of a community by reviewing the dimension of process. Which of the following is true of this dimension? A) Process of a community refers to its services and resources. B) Process reflects the community's ability to function effectively. C) It usually consists of morbidity and mortality data. D) It refers to the physical, emotional and social determinants of health.

Ans: B Feedback: Process reflects the community's ability to function effectively. Structure of a community refers to its services and resources. Status/ people dimension usually refers to the morbidity and mortality data and the physical, emotional, and social determinants of health.

13. A community health nurse is preparing a presentation for a group of nursing students about community health nursing. Which of the following descriptions about 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. Primary prevention is the priority for community health nurses. The community health nurse engages in primary prevention as the priority, having the obligation to actively reach out to all who might benefit from a specific activity or service.

15. A community health nurse who is teaching a group of nursing students about the various societal influences on community health nursing is explaining the effects of the consumer movement. Which of the following student responses would lead the community health nurse to determine that the teaching was successful? A) Individuals are considered passive members of the health care team. B) Consumers are demanding more coordinated comprehensive care. C) People are expecting community health nurses to develop new programs. D) Consumers are identifying a greater need for care by a variety of care providers.

Ans: B Feedback: The consumer movement has led to changes in community health nursing. Consumers are demanding more humane, personalized health care, seeking more comprehensive coordinated care. They are viewed as active members of the health care team. The need to develop new programs is a response to the economic forces that have affected the practice of community health nursing. Consumers desire more coordinated care, not care from a variety of care providers.

6. Which of the following would characterize the public health stage of community health nursing? 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 health agencies, which placed a greater emphasis on disease prevention and health promotion, provided the chief institutional base. Primary health care as the key to health for all characterizes the community health nursing stage.

24. Of all the nursing roles assumed by community health nurses, which role must be assumed in every situation? A) Researcher B) Manager C) Leader D) Clinician

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 situation, because it involves assessing clients' needs, planning and organizing to meet those needs, directing and leading clients to achieve results, and controlling and evaluating the progress to ensure that the goals and clients' needs are met.

20. When applying community development theory, which of the following would most likely be considered the agent of change? A) Clients B) Nurse C) Families D) Community leaders

Ans: B Feedback: When applying community development theory, the agent of change is most often the community health nurse who is considered a partner rather than an authority figure responsible for the community's health. Clients, families, and community leaders would be the care recipients.

6. When describing culture as shared, which of the following would be most accurate? A) It is acquired, not inherited. B) It is a product of aggregate behavior. C) It is interrelated and interdependent. D) It undergoes change.

Ans: B Feedback: When describing culture as shared, it means that it is a product of aggregate behavior, not an individual habit. The customs are phenomena shared by all members of the group. Culture is learned; that is, the patterns of cultural behavior are acquired, not inherited. Culture is integrated; that is, it is a functional, integrated whole where all parts are interrelated and interdependent. Culture is dynamic; that is, it is changeable and not entirely static.

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 advocate role, the nurse pleads for the clients' cause or acts on their behalf. 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 researcher role, the community health nurse engages in systematic investigation, collection, and analysis of data for solving problems and enhancing community health practice.

3. The community health nurse is engaging in the core function of policy development. With which of the activities 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.

9. A community health nurse is working with several Native American groups in Arizona. Which of the following would the nurse be most likely to assess? Select all that apply. A) The value of competition B) Respect for advancing age and elders C) Focus of living in the future D) Frequent dialogue and discussion E) Each tribe or nation has its own distinct language, beliefs, customs, and rituals.

Ans: B, C, E Feedback: Although there are differences among Native American tribes, most have respect for advancing age and they live in the present and not the distant future (making primary prevention activities more difficult). Each tribe or nation has its own distinct language, beliefs, customs, and rituals. Competition and frequent dialogue and discussion are not values held by Native Americans.

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 of the following 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 for a family in the nurse's caseload would be an example of the advocate role.

18. A community health nurse desires to attain a tenure-track position at a local university to teach community health nursing. Which of the following would this nurse need? A) Certification B) Master's degree C) Doctoral degree D) Nurse practitioner license

Ans: C Feedback: A doctoral degree would be the required education needed to obtain a tenure-track teaching position at a university. Certification provides additional education for specialization and may result in a promotion or higher salary accompanied by additional responsibilities and opportunities. A master's degree can lead to management positions, private community health ownership, agency teaching, or research positions. Nurse practitioners can run well-child clinics and direct a school-based clinic if a school nurse. Advanced practice can open doors into leadership positions in community health nursing.

23. A community health nurse is involved in a project to evaluate the health of a city. Which of the following findings would suggest that the city would most likely need additional programs? A) Citizens are actively involved in the city's department of recreation and 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 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 the physical and social environments with expansion of community resources so that people can mutually support one another. It is characterized by the meeting of basic needs for all of the city's people. This would include food, water, shelter, income, safety, and work. Loss of employment of one third of the city's workforce would be a threat to the health of the city and necessitate intervention. Active involvement in the city's functioning, affordable housing, and recreational facilities are suggestive of a healthy city.

10. As part of an orientation for a group of newly hired nurses for a community agency, a community health nurse emphasizes which of the following as crucial? A) Cyclic nature B) Client focus C) Interaction D) Flexibility

Ans: C Feedback: Although the nursing process is cyclical, deliberative, flexible (adaptable), client focused, and need oriented, interaction is an essential first consideration for community health nursing. All steps of the nursing process depend on interaction.

1. A community health nurse is engaging in assurance activities. Which of the following would best explain these activities? Btestbanks.com Btetsbanks.com A) Gathering and analyzing information that will affect the health of the people to be served B) Providing leadership in facilitating community groups toward meeting their needs, often involving changes in and additions to existing laws C) Being involved in activities to make certain that necessary services are being provided to the community D) Accessing relevant data that enable identification of strengths, weaknesses, and needs within the community

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.

14. Which of the following actions by the community health nurse exemplifies the societal influence of causality on the practice of community health nursing? A) Using computer-based education programs for client education B) Engaging in video conferencing to share research findings C) Identifying multiple factors associated with promoting wellness D) Developing a plan to address the rapid increase in older adult population

Ans: C Feedback: Causal thinking relates disease or illness to its cause and includes areas such as epidemiology; interactions among an agent, host, and environment; and recognition of multiple factors contributing to a disease, health disorder, or wellness. Using computer- based education programs and engaging in video conferencing are examples reflecting the advancement of technology. Developing a plan to address the rapid increase in the older adult population involves application of the change in demographics affecting community health nursing.

17. A prospective nursing student is interested in working in community health nursing after graduation. Which type of education would be most appropriate for this student to choose? A) Diploma program B) Associate degree C) Baccalaureate degree D) Graduate degree

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 graduate (masters) degree is needed.

16. When working in the community, the community health nurse adopts the teaching plan to ensure that the population understands the basic information provided to address which of the following? 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-care refers to the process of taking responsibility for developing one's own health potential by actively participating in promoting one's own health. Health 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.

16. Which of the following most accurately reflects the response of community health nursing to economic forces? A) Decreased competition with other community health service providers B) Reduction in available programs and services C) Development of new services for generating revenue D) Switch to a more illness-oriented philosophy for service

Ans: C Feedback: Economic forces have led community health nursing to respond by developing new revenue-generating services to augment depleted budgets. Other responses include directly competing with other community health service providers and developing new programs and service emphases. Although some public health agencies have been drawn into more illness- oriented services, community health nursing continues to be resourceful in finding ways to foster the community's optimal health.

12. Which of the following nurses openly defied a law that she saw as unjust and eventually resulted in the formation of The International Planned Parenthood Federation? 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 wrote a series of papers on the need for " home missioners" and "health visitors" and endorsed 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.

13. A group of nursing students are studying for a test about various cultural communities. The students demonstrate that they understand the material when they identify which cultural group as believing in predestination? A) Hispanic/Latinos B) African Americans C) Muslims D) Native Americans

Ans: C Feedback: Muslims believe in predestination, that life is determined beforehand, and they attribute the occurrence of disease to the will of Allah. Hispanic/Latinos believe that illness may be a form of punishment for sins. Some African Americans believe that illness is evidence of disharmony possibly due to evil spirits, punishment of God, or a hex placed on a person. Native Americans believe that health reflects living in total harmony with nature.

19. Which of the following is included in the most accurate description of school nursing? A) This is one community health setting where the role is static. B) The primary role of school nurses is clinician. C) The practice of school nurses is widening. D) School nurses rarely act as advocates.

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.

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 which of the following? A) Occupational health nurses are increasing their role as employee advocates. B) Health education is a key function of the occupational health nurse. C) There is a greater emphasis on the occupational health nurse's role as a clinician. D) Collaboration with other health care providers fosters the offering of better services.

Ans: C Feedback: The clinician role was primary for many years, as nurses continued to care for sick or injured employees at work. However, recognition of the need to protect employees' safety and, later, 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.

6. When the nursing student identifies the concept of community as client as which of the following the instructor knows that the student has grasped this concept? A) The community is comprised of individual clients. B) The community is comprised of families. C) The community is a group or population of people as the focus of nursing service. D) The community cannot be a client. Persons who are hospitalized are patients.

Ans: C Feedback: The concept of community as client refers to a group or population of people as the focus of nursing service.

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 advocate role, the nurse pleads for the clients' cause or acts on their behalf. In the manager role, the nurse exercises administrative direction toward the accomplishment of specified goals.

5. What is the most serious negative effect of a nurse maintaining ethnocentric views but not recognizing or acknowledging this? A) The nurse fails to understand the views of other cultures because of his or her ethnocentrism. B) The nurse does not communicate effectively with members of other cultures because of his or her ethnocentrism. C) The nurse's ethnocentrism causes damage to interpersonal relationships and interferes with the effectiveness of nursing interventions. D) Nurses are immune to the effects of ethnocentrism.

Ans: C Feedback: The most negative effect of nurses maintaining ethnocentric views but not recognizing or acknowledging this is that the nurse's ethnocentrism causes damage to interpersonal relationships and interferes with the effectiveness of nursing interventions. The nurse who is ethnocentric and doesn't realize it will fail to understand the views of other cultures, but this is not the most serious negative effect. If the nurse is ethnocentric, he or she may not communicate effectively because of his or her ethnocentrism, and this can lead to impaired relationships and interference with the effectiveness of nursing interventions. All nurses hold ethnocentric views, but it is important for the nurse to be aware of them and acknowledge them to avoid having it damage relationships and interfere with the effectiveness of nursing interventions.

22. A community health nurse is assessing a family during a home visit. The nurse is examining the mother who is pregnant with her second child. The nurse asks the mother to raise her arms above her head. The mother replies, " I cant do this because it will cause the umbilical cord to strangle the baby ." The nurse interprets this statement as reflective of which of the following? which of the following? A) Home remedy B) Herbalism C) Folk medicine D) Alternative therapy

Ans: C Feedback: The mother's statement reflects folk medicine, a body of preserved treatment practices that has been handed down verbally from generation to generation. One example is not reaching above your head if you are pregnant, because doing so will cause the umbilical cord to strangle the baby. Home remedies are caregiving practices passed down between families, for example, ice on a cold sore, baking soda paste on a bee sting. Herbalism involves the use of medicinal herbs. Alternative therapy or complementary therapy is designed to promote comfort, health, and well- being and includes, for example, aromatherapy, music therapy, acupuncture, and yoga.

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.

15. A community health nurse involved in assessing community health needs is planning to get a group of approximately 10 similar individuals together to obtain information about opinions on first pregnancies. The nurse is using which assessment method? A) Survey B) Community forum C) Focus group D) Descriptive epidemiology

Ans: C Feedback: The nurse is using a focus group, similar to the community forum or town hall meeting in that it is designed to obtain grassroots opinion. Focus groups usually have only a small group of participants, usually 5 to 15 people and the members chosen for the group are homogeneous with respect to specific demographic variables. A survey involves a series of questions, often to provide a broad range of data. Community forum is a qualitative method to obtain community opinions; the members typically represent all segments of the community involved with the issue. Descriptive epidemiologic studies examine the amount and distribution of a disease or health condition in a population by person, place, and time.

11. While visiting an Asian American family in their home, the community health nurse inspects the skin of the 3-year-old child and notices a bruise-like lesion on the child's abdomen. The mother states that the child has been experiencing diarrhea for 2 days. Which of the following would the nurse do next? A) Report the family to the local child abuse agency B) Recognize this as a normal skin variation C) Question the family about the use of cupping D) Obtain a blood test for clotting function

Ans: C Feedback: The nurse needs to gather additional information about the lesion. Practicing transcultural nursing would require the nurse to perform a cultural assessment and question the family about their use of dermabrasive techniques such as cupping that would leave a bruise-like lesion on the skin and be mistaken for physical abuse. The nurse would report the family to the local child abuse agency if further investigation provides additional information to support that decision. The lesion is not a normal skin variation. Obtaining a blood test for clotting function would be warranted only if further assessment reveals additional bruising or other signs of clotting problems.

21. While interviewing a client, which of the following statements would a nurse identify as reflecting an objective dimension of health? A) While interviewing a client, which of the following statements would a nurse identify as reflecting an objective dimension of health? B) Im feeling better since I started taking medication C) Life is pretty food right now, except for an occasional upset stomach D) Sometimes when I wake up, I dont even want to face the day

Ans: C Feedback: The objective dimension of health involves one's ability to function in daily activities. The statement about being able to care for one's self is an example. The statements of feeling 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.

14. Nursing students in a community health nursing course identified toxic waste disposal to be a major problem in their community. The most cost-effective type of community assessment to determine the extent of the problem and the resources available to handle it would be a A) familiarization assessment. B) community subsystem assessment. C) problem-oriented assessment. D) comprehensive community assessment.

Ans: C Feedback: The problem-oriented assessment is commonly used when familiarization is not sufficient and a comprehensive assessment is too expensive and not needed and a subsystem assessment is too narrow to determine the extent of the problem.

24. When working with immigrant groups in community health care, which of the following would be least appropriate for the community health nurse to do? A) Permit ample time for interviewing to allow time to evaluate beliefs B) Develop educational programs to correct misconceptions C) Assume that the client has a basic understanding of health issues D) Ensure an appropriate interpreter for communication if needed

Ans: C Feedback: When working with immigrant groups in the community, do not make assumptions about a client's understanding of health care issues; permit more time for interviewing; allow time to evaluate beliefs and provide appropriate interventions; provide educational programs to correct any misconceptions about health issues; provide an appropriate interpreter to improve communication with immigrants who do not speak English well.

17. What is the most important reason for the nurse to conduct a cultural assessment? A) Because it is often assigned by nursing faculty B) Because usually there is some culturally based reason that causes clients to engage in or avoid certain actions C) To meet the nurse's professional learning needs D) Because understanding the values, beliefs, and practices of a designated cultural group is critical to effective nursing action

Ans: D Feedback: The most important reason for the nurse to conduct a cultural assessment is that because understanding the values, beliefs, and practices of a designated cultural group is critical to effective nursing action. There is usually some culturally based reason that causes clients to engage in or avoid certain actions but that is not the most important reason for the nurse to conduct a cultural assessment. The nurse does not necessarily collect a cultural assessment to meet his or her own needs primarily.

10. Which of the following 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.

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.

17. When developing community diagnoses, which of the following would the community health nurse do? A) Focus primarily on deficits of the community B) Use broad statements to guide a range of interventions C) Employ a revised nursing diagnosis format D) Substitute the terms client, family, group, or aggregate for the word patient

Ans: D Feedback: Community diagnoses should include statements about the strengths of the community and possible sources for community solutions, as well as the community's weaknesses or problem areas. In addition, they should portray a community focus, include the community response, and identify any related factors that have potential for change through community health nursing. These may also include wellness diagnoses, which indicate maintenance or potential change responses (due to growth and development), when no deficit is present. Diagnoses statements should be narrow enough to guide interventions and use the standard nursing diagnosis format.

20. The term health can be described in many different ways. A community health nurse would view health as which of the following? 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 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 to develop a person's potential to lead a fulfilling and productive life. Health is more than just the absence of disease or an environment free of toxins.

16. A community health nurse is providing care to an Asian American family who believes that a member's current illness is due to an excess of yin. The nurse integrates knowledge of this belief, expecting the family to avoid which foods? A) Rice B) Eggs C) Chicken D) Fruits

Ans: D Feedback: If the imbalance is an excess of yin, the "cold" foods, such as vegetables and fruits, are avoided, and "hot" foods such as rice, chicken, eggs, and pork, are offered.

20. A community health nurse implements a plan of care that combines aromatherapy and acupuncture with medication therapy and surgery. The nurse is applying which of the following? A) Holistic health care B) Folk medicine care C) Herbalistic health care D) Integrated health care

Ans: D Feedback: Integrated health care is defined as the combination of complementary therapies such as aromatherapy and acupuncture with biomedical or Western health care such as medication therapy and surgery. Holistic health care vies the world as being in harmonious balance in which all facets of the individual's natures (physical, mental, emotional, and spiritual) must be in balance. Folk medicine involves treatment practices that have been handed down from generation to generation. Herbalism is the use of medicinal herbs.

5. A community health nurse avoids focusing care on illness and health problems, considering clients as which of the following? A) Aggregate B) Agent C) Community D) Total system

Ans: D Feedback: It was proposed by Mundinger and Jauron that the use of nursing diagnoses in the community could be formulated by substituting the terms, client, family, group, or aggregate for the word patient. Community health nurses look for evidence of all kinds of needs that relate to or influence a client's levels of wellness. Needs cover the whole span of the health±illness continuum and the total person, family, group, aggregate, population, or community2the total system. Not all clients are communities. They may be individuals or families. Not all clients are in the category of groups, aggregates, or populations. A client can be an individual or a family. When using the epidemiological triad, there are three components: host, agent, and environment. A client would be considered the host. An agent is a factor that causes or contributes to a health problem or condition.

11. When building a coalition, which of the following would the community health nurse do first? A) Conduct a community assessment B) Identify key players C) Identify potential members D) Define goals and objectives

Ans: D Feedback: Steps to coalition building include defining goals and objectives, conducting a community assessment, identifying key players or leaders, and identifying potential coalition members.

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.

15. A community health nurse works to ensure the greatest good for the greatest number of people by applying which of the following? 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.

. 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. The nurse also gives the family a list of pharmacies where they can 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, influences, or persuades others to effect change that will positively impact people's health and move them toward a goal. In the clinician role, the nurse ensures the provision of health care services to individuals, families, groups, and populations.

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.

23. When working with different cultural groups in the area of health care practices, the nurse acts as an effective advocate for the client. Which of the following must the nurse do first? A) Prepare to teach clients about the limits and benefits of cultural health practices Btestbanks.com Btetsbanks.com B) Assess the client or family adequately to ascertain their belief system and choices C) Individualize caregiving for the client within his or her culture D) Be knowledgeable about health care practices and choices

Ans: D Feedback: When working with different cultural groups in the area of health care practices, the community health nurse can be an effective advocate for the client. First, however, the nurse must be prepared to speak knowledgeably about health care practices and choices. The nurse also must be able to assess the client or family adequately so as to know what belief system motivates their choices. Finally, the nurse must be prepared to teach clients about the limits and benefits of cultural health care practices. The community health nurse should always individualize assessment and caregiving for the client within his or her culture and should not generalize about the client based on cultural group norms.

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, not an absolute, and illness is a state of being relatively unhealthy. B) A client'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.

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. The health continuum applies not only to individuals but also to families and communities.