Community Health NR442 exam 1
Why are health care providers concerned over such social issues as mass transit, clean power, and the farming industry? a. Because air pollutants are contributors to asthma and other health problems. b. Clean power would reduce the pollution that results from burning of high-sulfur coal. c. Manure runoff from industrial farming is polluting water and killing fish throughout the United States. d. Mass transit would remove the problem of so many Americans being killed or injured by drunken or impaired drivers.
ANS: A All three (mass transit, clean power, and industry) emit air pollutants, which result in smog, the most common outdoor air pollutant in the United States. Atmospheric pollutants cause or contribute to asthma, allergic reactions, bronchitis, lung cancer, chronic respiratory disease, and death. They also harm animals and plants. The most inclusive answer refers to air pollutants, although certainly, the others are true in society today. DIF: Cognitive Level: Understand (Comprehension) REF: pp. 256-257
The local stream was full of trash. The Boy Scouts had a cleanup day so they could again canoe on the stream. Which of the following actions should be taken by nurses in the local community? a. Hold a dialogue with community members about the problem and its effects b. Fight for stronger "do not trash" laws and harsher penalties c. Lecture community organizations about the value of safe water for recreation d. Put all personal trash in appropriate trash receptacles
ANS: A An important nursing goal is to help people learn from their own experiences and analyze the world with an intention to change it. It is essential that those affected participate in the process of identifying and working to solve environmental problems. The nurse's role is to ask critical questions and help groups reflect on the environmental realities of their lives. The only way for the nurse to promote this involvement is through a dialogue with the community members. DIF: Cognitive Level: Apply (Application) REF: p. 265
When using an environmental perspective, which of the following would be the most important question for a nurse to ask when assessing potential health problems? a. "Can you tell me how you have been feeling?" b. "Can you tell me what you do at work?" c. "What brings you here today?" d. "What problems have you been having?"
ANS: B Because 25% of worldwide preventable illnesses are caused by poor environmental quality, nurses need to ask critical questions about their clients' work and home environments to help discern the contributions of specific hazards to their health. This can be accomplished by an environmental health history. The other responses do not address a question that would be addressed during an environmental health history. DIF: Cognitive Level: Understand (Comprehension) REF: p. 250
In a community presentation about asthma, a nurse explained the causes of asthma in children, how to observe for "triggers" that lead to an attack, and how to use an inhaler. Which of the following statements best identifies what was omitted from this presentation? a. The nurse did not ask the attendees to disclose if any of them smoke around children. b. The nurse did not address actions that should be taken to improve air quality and only focused on the treatment of asthma. c. The nurse did not address the need to avoid exposure to others who may have a communicable disease. d. The nurse did not review the genetic components related to asthma in families.
ANS: B By placing responsibility for the cause and cure of health problems exclusively on the individuals, the belief is reinforced that all individuals are free to control their lives. Such a perspective absolves society, government, industry, and business from accountability. Research suggests that changing individual behaviors does not lead to significant reductions in overall morbidity and morality in the absence of basic social, economic, and political changes. Thus, the nurse must include information in the presentation that addresses the need to improve air quality. DIF: Cognitive Level: Apply (Application) REF: pp. 263-264
How does critical theory differ from other nursing theories such as the health belief model or Orem's self-care deficit theory? a. Critical theory can be used by professionals other than nurses. b. Critical theory focuses on oppression and facilitates group action. c. Critical theory is not directly related to health promotion. d. Critical theory confronts changing an individual's beliefs.
ANS: B Critical theory is an approach that raises questions about oppressive situations, involves community members in the definition and solution of problems, and facilitates group interventions. The other two theories focus more on individual beliefs and choice of action. DIF: Cognitive Level: Understand (Comprehension) REF: p. 250
Which of the following conclusions can be drawn concerning efforts to decrease environmental pollution? a. The Environmental Protection Agency (EPA) sets priorities for environmental problems and funds action. b. Federal policies have been weakened, and enforcement lacks funding. c. Federal recycling mandates have decreased waste products. d. Legislation is increasingly being passed to force companies to lower toxic waste emissions.
ANS: B Legislation in the 1970s was aimed toward a comprehensive national environmental policy. The momentum slowed in the 1980s, with policies being reversed and regulation losing its funding. This trend has continued. The EPA sets rules but lacks resources to accomplish the goals. There are no federal mandates for recycling, but local communities have made great strides in this area. DIF: Cognitive Level: Understand (Comprehension) REF: p. 262
What conclusion can be drawn from examining where nurses are employed? a. There is a trend toward consolidation of health care into large central medical centers. b. There is an increased emphasis on community-based health care. c. There is an obvious need to decrease health care costs by cutting positions. d. Managed care organizations (MCOs) are employing nurses to improve customer relations.
ANS: B MCOs are employing nurses in many capacities. Although hospitals are closing and acute care is increasingly found in central medical centers, the same trend may be seen in an increase in neighborhood-based practice centers. While positions are cut in most industries, health care is recognized as an area where growth in employment is expected. However, nurses are increasingly employed in community settings as opposed to hospitals. This change reflects the move toward community-based care rather than hospital-based tertiary care. To help decrease the continued rise in health care costs, the increased emphasis is on disease prevention rather than high-cost treatment. DIF: Cognitive Level: Understand (Comprehension) REF: p. 2
It has been learned that a particular industry has vastly polluted the surrounding neighborhood. Which of the following actions would most likely be taken by those living in the neighborhood? a. Band together to shut the industry down b. Nothing, because of family ties and cost of relocation c. Immediately move to a different neighborhood d. Seek legal reimbursement for the hazard exposure
ANS: B Residents may be unwilling to disrupt family ties and cultural roots to start over elsewhere, or they may be unable to afford to move. Residents are revictimized by the difficulty in obtaining compensation. Attempting to shut the industry down, seeking reimbursement for the hazard exposure, and immediately moving to a different neighborhood are all costly interventions and in most cases cannot be easily accomplished by most residents. DIF: Cognitive Level: Apply (Application) REF: p. 254
What would be an appropriate term for intoxicated drivers, secondhand smoke, urban crowding, noise, and mechanization? a. Risks of living style b. Risks in the built environment c. Personal health risks d. Modern day health risks
ANS: B The built environment is the connection between people, communities, and their surrounding environments that affect health habits and behaviors, interpersonal relationships, cultural values, and customs. Most people live within areas that require almost daily contact with potential health risks and threats, such as intoxicated or impaired drivers, secondhand smoke, urban crowding, noise exposure, unabated traffic, and the stress of increased mechanization. DIF: Cognitive Level: Understand (Comprehension) REF: p. 253
Which of the following describe a problem with the U.S. water quality today? (Select all that apply.) a. Companies demand high reimbursement when asked to stop dumping heavy metals into local water sources. b. Many aquifers are contaminated with pesticides and fertilizers. c. More than 45 million Americans drink untreated water. d. Sediment from construction, agriculture, and deforestation is often present. e. Underground water, if contaminated, cannot be cleansed. f. Water-related diseases (cholera, typhoid, dysentery) frequently occur.
ANS: B, C, D, E More than 45 million Americans obtain water from private wells, which have no treatment or monitoring guidelines. Water quality problems include dosing reservoirs with chemicals to reduce algae, contaminating aquifers with pesticides and fertilizers, and leaching lead from water pipes. Underground water cannot be cleansed. Companies demand high reimbursement when asked to stop dumping heavy metals into local water sources and the frequent occurrence of water-related diseases (cholera, typhoid, dysentery) are not current problems with the water quality in the United States.
Which of the following have been identified as part of the core environmental health competencies? (Select all that apply.) a. Assurance b. Assessment c. Policy development d. Management e. Advocacy f. Communication
ANS: B, D, F The National Center for Environmental Health, the Centers for Disease Control and Prevention, and the American Public Health Association have established three core competencies for Environmental Health professionals: (1) assessment, (2) management, and (3) communication. Assurance, policy development, and advocacy are not part of the core environmental health competencies. DIF: Cognitive Level: Understand (Comprehension) REF: p. 264 | p. 265
Which of the following best describes a food desert? a. The inability to store foods at an acceptable temperature b. The inability to have healthy foods at home c. A neighborhood with little to no access to healthy foods d. A neighborhood that has experienced a recent food-borne illness
ANS: C A food desert is a neighborhood with little or no access to healthy foods. There are significant disparities in access to healthy and fresh food supplies, with poor minority families being more likely to live in a food desert. The other responses are not the correct definition of a food desert. DIF: Cognitive Level: Understand (Comprehension) REF: p. 259
A nurse has begun to lobby with politicians for changes to the health care system. Why is this involvement important? a. Nurses, as central characters in several popular TV series, are currently very visible in American media. b. Nurses are primarily responsible for managing the various units in our health care system. c. Nurses are the largest group of health care providers. d. Nurses are the only group that is employed both inside and outside of hospitals.
ANS: C As the largest group of health care providers, nurses are informed about the current health care system and all the problems that result from people not seeking care until they are desperately ill. Nurses, as the American Nurses Association (ANA) emphasize, usually believe that health care is a right, not a privilege. Therefore, nurses, whose work is central to our current health care delivery system, can also be instrumental in working politically to create a health care delivery system that will meet health needs. While nurses are in several current TV series and are employed both inside and outside of hospitals, physicians and other health care providers are as well. Nurses are often managers, but managers often have other backgrounds, such as business administration. DIF: Cognitive Level: Understand (Comprehension) REF: p. 2
What is meant by discriminatory land use? a. Backlash against companies that do not protect the environment b. Daily insults to people who live in a particular community c. Locating industrial hazards in low-income communities d. Political recognition that companies support a safe environment
ANS: C Discriminatory land use ensures that many impoverished and marginalized groups, especially people of color, live in close proximity to industrial contamination. Members of these communities are at risk for illness and injury. The other responses do not correctly define discriminatory land use. DIF: Cognitive Level: Understand (Comprehension) REF: p. 253
Which of the following best explains why it is difficult to get others interested in environmental health? a. Environmental problems just are not interesting or dramatic. b. It's difficult to get media interested. c. People respond more to an acute crisis than chronic environmental problems. d. People respond more to an individual asking for help than a community asking for help.
ANS: C People respond to acute crises with dramatic media coverage (such as hurricanes or earthquakes), but ongoing consistent pressure is needed to ensure day-to-day environmental integrity. Chronic environmental problems are rarely addressed effectively. DIF: Cognitive Level: Understand (Comprehension) REF: pp. 251-252
Which of the following statements supports why it is believed that the risks of various employment positions are inaccurate? a. Companies refuse to share employee injury information. b. Because factories reimburse employees directly, the injury is not reported. c. Individuals assume it is a personal problem, not an employment issue. d. Most employment positions do not have known risks.
ANS: C Statistics do not reflect unreported health problems. Collective problems related to employment or occupation are often perceived as individualized injuries, and no one "connects the dots." Companies are willing to share employee injury information and recognize the risks of employment, but the information may be inaccurate because of the perception of individualized injuries. DIF: Cognitive Level: Understand (Comprehension) REF: p. 254 | p. 256
Which of the following best describes the primary reason that Americans are concerned about health care? a. Politicians are discussing how to improve health care. b. The media has provided mixed messages about the health care system. c. Our national health care costs keep increasing. d. The new health care system offers free services to Americans.
ANS: C The primary reason for the focus on health care is the constantly increasing costs, which cannot be sustained. The costs of caring for the sick accounted for the majority of escalating health care dollars, which increased from 5.7% of the gross domestic product in 1965 to 17.6% in 2009. Politicians and the media both influence Americans' perceptions about health care; however, they are not the primary reason why Americans are concerned. The new health care system will change the health care access and availablity, but will not necessarily be offering any free services to Americans. DIF: Cognitive Level: Understand (Comprehension) REF: p. 2
Which of the following statements best describes what has happened to air quality since the United States outlawed the use of chlorofluorocarbons, halons, and carbon tetrachloride? a. Air quality immediately improved. b. Air quality is slowly improving. c. Little change occurred because these chemicals remain in the atmosphere. d. Nothing has happened because other countries worldwide continue to extensively use these products.
ANS: C These chemicals, which were in widespread use, remain in the atmosphere. Thus, air quality has not improved. This is a global concern and is being addressed worldwide by the World Health Organization. DIF: Cognitive Level: Understand (Comprehension) REF: p. 257
Which of the following statements best describes the relationship between the environment and health? a. Because of the large number of variables involved, the relationship between environment and health cannot be researched. b. Because the environment has such long-term effects on health, research findings are not yet available. c. Research shows that a healthy environment has limited impact on one's health. d. Research shows that a healthy environment increases quality of life and years of healthy living.
ANS: D A healthy environment increases quality of life and years of healthy living. Accumulated evidence shows that the environmental changes of the past few decades have profoundly influenced the status of public health. Globally, environmental factors contribute to nearly 25% of all deaths and increase disease burden (World Health Organization, 2006). The safety, beauty, and life-sustaining capacity of the physical environment are unquestionably of global consequence. DIF: Cognitive Level: Understand (Comprehension) REF: p. 250
Which of the following is a direct result of global warming? a. Decreased prevalence of infectious diseases b. Increased water pollution from soil erosion c. Decreased protection from the ozone layer d. Increased number of parasites and insects
ANS: D Global warming is the gradual increase in the average temperature of Earth's near-surface air and oceans since the mid-twentieth century and its projected continuation (Easterling, 2011). Rising global temperatures may enhance the quantity and distribution of parasites, insects, and other disease vectors, potentially increasing the prevalence of a variety of infectious diseases. DIF: Cognitive Level: Understand (Comprehension) REF: p. 262
Which of the following statements best describe why environmental health is more challenging than other variables related to an individual's health? a. Environmental health affects susceptible individuals more than groups. b. Environmental health demands that individuals be willing to change their beliefs. c. Environmental health is dependent on social neighborhoods, as well as geography. d. Environmental health requires social, economic, and political changes to improve.
ANS: D Intervening to improve environmental conditions requires basic social, economic, and political changes. Aggregates must work together to create such change. The other responses do not address the multiple dimensions that must be impacted in order to impact change within environmental health. DIF: Cognitive Level: Understand (Comprehension) REF: p. 250
How does participatory action research differ from other research methods? a. Participatory action research does not use a control group. b. Participatory action research does not require randomization. c. Participatory action research is not based on a predetermined hypothesis. d. Participatory action research poses solutions to the problem.
ANS: D Participatory action research calls for nurses, community members, and other resource people to work together in identifying health problems, designing the studies, collecting and analyzing the data, disseminating the results, and posing solutions to the problems. The research process (use of control groups, randomization, and using a predetermined hypothesis) is part of participatory action research. DIF: Cognitive Level: Understand (Comprehension) REF: p. 266
Which of the following is the leading cause of lung cancer among nonsmokers? a. Secondhand smoke b. Living near a nuclear power plant c. Exposure to pesticides d. Radon gas
ANS: D Radon exposure is the leading cause of lung cancer among nonsmokers in the United States. It is estimated that radon causes an estimated 21,000 lung cancer deaths every year. DIF: Cognitive Level: Understand (Comprehension) REF: p. 258
Which of the following strategies should a nurse use to remember what should be included in a health history? a. Always use a preprinted form b. Depend on education to learn this c. Depend on experience to know what to ask d. Memorize the I PREPARE mnemonic e. Memorize the I HEALTH mnemonic
ANS: D The I PREPARE environmental exposure history mnemonic is a quick reference for primary care providers. I—Investigate Potential Exposures P—Present Work R—Residence E—Environmental Concerns P—Past Work A—Activities R—Referrals and Resources E—Educate This tool will help the nurse remember what to ask to determine environmental factors relevant to health. DIF: Cognitive Level: Understand (Comprehension) REF: p. 262
Which of the following nursing actions would be the most helpful to the community's long-term health? a. Careful assessment, diagnosis, planning, and giving care to individual patients and their families b. Dialogue with community members concerning what health issues are of importance in that community c. Focusing on family health through school-based neighborhood clinics d. Helping the community create political change through organization, use of media, legislative lobbying, and mass demonstrations
ANS: D The ultimate goal is liberating people from health-damaging environmental conditions by using collective actions. Mechanisms have included strategic organization, litigation, public hearing testimony, letter-writing campaigns, legislative lobbying, and mass demonstrations. Helping the community create political change through organization, use of media, legislative lobbying, and mass demonstrations shows how collective action can be applied. The other interventions do not demonstrate the use of collective action. DIF: Cognitive Level: Understand (Comprehension) REF: p. 251
A community health nurse is overwhelmed with all that needs to be done in one day. Which task could most easily be postponed? a. Reviewing the most recent hospital patient data collected by the local college of nursing b. Deciding which of several possible new clinic options would be most effective in better meeting the needs of the local community c. Evaluating the results of the most recent community-wide screening program before planning for the next community health program d. Giving testimony to the state legislature on a new health and safety bill
a
A nurse decided that a high-risk aggregate most needed education about diabetes. Which of the following would be the best approach when teaching the group? a. Involve participants in small group activities applying the information. b. Organize the information into a visual presentation such as a PowerPoint presentation. c. Share the nurse's expertise directly with the group at a meeting for that purpose. d. Use handouts and pamphlets with pictures consistent with the local cultural groups throughout.
a
A nurse is using the theory of reasoned action when working with a client to exercise on a regular basis. Which of the following would be the easiest way for the nurse to determine if the client will engage in this activity? a. The client's intention to exercise regularly b. The client's perception of the threat of illness if he doesn't exercise regularly c. Society's emphasis on the importance of regular exercise d. The pros and cons of regular exercise
a
A nurse works hard to develop alliances among various community organizations toward improving health in the community. What are actions such as this called? a. Building coalitions b. Collaboration c. Communication d. Community cooperation
a
What factors are most responsible for the increasing length of life of Americans over the past 100 years? a. Better nutrition and family planning options b. Education concerning the need to reduce salt and fat in the diet c. Improved medical care, including exciting new technologies d. More efficient cancer screenings and early intervention
a
Which of the following actions must a nurse take to be successful in addition to the typical assessment, diagnosing, and planning directly related to the intervention project? a. Advocate for community empowerment throughout the process. b. Choose superb people to implement the plan. c. Confirm administrative support throughout the project. d. Continue to assess both barriers and resources throughout the project.
a
Which of the following best describes how John Snow was able to decrease deaths from cholera? a. Removed a source of contaminated water b. Created the world's first antibiotic c. Encouraged the new process of vaccination d. Helped pass laws that required home quarantine
a
Which of the following best describes the district nursing service created in the United States by Lillian Wald and Mary Brewster? a. House on Henry Street b. Visiting Nurses Association c. New York City District Nursing Service d. Wald and Brewster Nursing Service
a
Which of the following best describes the first measures used by large communities to ensure community health? a. Building safe sewage disposal systems b. Healthy food choices and exercise c. Praying to the gods for preservation d. Use of medicine and other herbal remedies
a
Which of the following is the best definition of health? a. A goal and a resource for living b. A lack of disease or illness c. Complete state of well-being d. Freedom from pain or discomfort
a
Which variable has a major influence on a community's health? a. Behavior choices made by persons in the community b. Number of health care providers and hospitals in the community c. Quality of the public safety officers (police officers, firefighters, etc.) d. The number and credentials of public health officials in the community
a
A nurse was becoming frustrated. It had been 2 weeks, and although the client had verbalized that the best time of day to take a 15-minute walk was early in the morning, the client had not begun to exercise. Which of the following principles of the Transtheoretical Model had the nurse forgotten? (Select all that apply.) a. A decision to act always occurs before action begins. b. Behavior change is difficult and takes time. c. Continuing to stress to the client how important exercise is will help the client decide to exercise. d. Discussing with the client why he or she is not yet exercising may help the client recognize his or her own resistance. e. The nurse should offer some reward if the person exercises for at least a week. f. Verbalizing compassion for how difficult it is to change is a crucial intervention.
a,b
What current emphases are focusing attention on public health? (Select all that apply.) a. Cost containment and managed care models b. Focus on disease prevention and health promotion c. Increased funding for care of chronic diseases d. Liberal politicians encouraging public health as part of a national health reform e. Movies showing national disasters and government lack of preparedness f. Shortage of the H1N1 flu vaccine
a,b
Which of the following factors have a profound, if sometimes unrecognized, impact on one's health? (Select all that apply.) a. Adequate resources to allow easy access to health services b. Interpersonal relationships with family and friends c. Local, state, and national policies d. Number and quality of health care providers within transportation range e. Physical neighborhood where one works and lives f. Understanding the need for healthy lifestyle choices
a,b,c,e
A nurse is using Pender's model to explain what influences individuals to pursue health promotion activities. Which of the following factors would be examined? (Select all that apply.) a. A belief that one can change one's behaviors b. Environmental choices possible c. Fear of negative consequences if action is not taken d. The rewards one believes will result if action is taken e. The threat of an early death if behavior is not changed f. What one's family and peers believe should be done
a,b,d,f
Which of the following best describes why folk healers are used by many people? (Select all that apply.) a. Folk healers are often effective. b. Folk healers do not charge for their efforts. c. Folk healers integrate religion and medicine. d. Folk healers use media very effectively. e. Folk healers may involve the whole family. f. Many physicians recommend folk healers.
a,c,e
As in Healthy People 2010, what are the two primary goals of Healthy People 2020? (Select all that apply.) a. Eliminate health disparities b. Expand health promotion activities in every community c. Improve funding, including diverting funds from other priorities to health care d. Improve health outcomes measures to be more consistent with other developed nations' outcomes e. Increase quality and years of healthy life f. Reduce mortality and morbidity figures nationwide
a,e
26. Which factor is most responsible for differences in an individual's health? a. Culture of the majority of the community's citizens b. Individual's education and income c. Number of physicians and other health care providers in the community d. Quality of the community health agency and hospital in the community
b
A nurse assessed carefully and created a comprehensive intervention plan including primary, secondary, and tertiary care for individuals and families. Which of the following factors may the nurse have overlooked? a. Are other staff members interested in such a project? b. Are there adequate resources for such a project? c. Is there support from the administration for the project? d. Does the nurse have adequate energy and time for such a project?
b
A nurse found that several professionals resented time spent interacting with and teaching clients. Which of the following describes the most likely underlying motivation for resisting client involvement? a. Believing that people could change their lives if they really wanted to do so. b. Empowering others shifts power from the experts to the community. c. It is more efficient to plan appropriate care without listening to client ideas. d. Longtime experience with community members has led to disillusionment.
b
A nurse has determined that there is always a consistent level of people in the population who experience pneumonia. Which of the following best describes the prevalence of this disease? a. Prevalent b. Endemic c. Epidemic d. Pandemic
b
A nurse is using a systems framework when caring for individuals, families, and aggregates in the community. Which of the following best describes an aspect that would be more challenging when caring for an aggregate as opposed to caring for an individual? a. Ability to communicate clearly with the client b. Analyzing power and decision making within the system c. Defining the system's structure and functions d. Recognizing the system's goals
b
A nurse reviewed information before meeting with the community residents who were attending a program on healthful living. Which of the following best describes the action by the nurse? a. Disease prevention b. Health promotion c. Health improvement d. Specific protection
b
A nurse was becoming frustrated. She had given her client extensive information on his health problem, but the client continued to be noncompliant in making needed changes. Which of the following principles had the nurse forgotten? a. A person may have a higher priority than improving his or her health. b. Information, while necessary, will not motivate people to change. c. People need repetition over time to be able to absorb information. d. Physicians, not nurses, are perceived as experts in health.
b
A nurse who works on the surgical unit at the local hospital was asked by the home health unit to make a home visit to a patient who had been discharged the previous day and to give follow-up care (for overload pay). What kind of nursing would this nurse be doing? a. Acute care hospital nursing b. Community-based nursing c. Community health nursing d. Public health nursing
b
How does community health nursing define community? a. A group of persons living within specific geographic boundaries b. A group of persons who share a common identity and environment c. A group of persons who work together to meet common goals d. Persons who form a group to resolve a common concern
b
It is rumored that there is something in the workplace that is causing persons employed there to feel ill. Which of the following actions would be most appropriate for the nurse to take? a. Ask researchers to set up a study to confirm the health hazard in the environment b. Assess the risk, including identifying any toxic substance c. Confirm the extent to which the illness resulted from intergroup agreement on the illness and cause d. Insist that the media not further spread stories of possible sick buildings until the truth of the situation can be studied
b
Which of the following best describes how Nightingale responded to challenges about her suggestions for reform of health care? a. She influenced male friends as political leaders to publicize her ideas. b. She conveyed her statistical data in more detail and depth, and shared it with political leaders. c. She encouraged those who challenged her to come up with more acceptable approaches to lowering the death rate. d. She understood their concerns and tried to word her suggestions in a more politically acceptable way.
b
Which of the following best describes how the Health Planning Model for care of aggregates differs from the customary nursing process applied to the care of an individual? a. The nurse must be aware of age, gender, race, ethnic group, religion, educational background, occupation, and marital status of the aggregate. b. The nurse must first decide on and define the aggregate to receive care. c. The nurse must determine how best to ensure that each participant receives an equal number of services. d. The nurse must choose which health care need should have first priority.
b
Which of the following best describes the primary focus of health care efforts in the United States? a. Acute illnesses and trauma b. Chronic diseases c. Diarrhea and starvation d. Infectious diseases
b
Which of the following best describes the reason why so many Americans are obese? a. Culture requires eating at celebrations and holidays. b. For many people, caloric intake is more than needed for their physical activity. c. Physical education is no longer a required subject in most elementary and secondary schools. d. The expected portion size in restaurants has vastly increased over time.
b
Which of the following nursing interventions would have most likely been used by Florence Nightingale when treating wounded soldiers? a. Establishing private visits with spouses b. Improving food, clothing, and cleanliness c. Administering intravenous medications d. Completing a community assessment of the army hospital
b
Which of the following risk factors are least subject to modification? a. Choice of lifestyle behaviors b. Environmental exposure c. Nutritional options d. Recreational activities
b
Which of the following statements best describes the increase in life expectancy among Americans during the twentieth century? a. Life expectancy increased by 30 years; the majority can be attributed to advances in medical technology. b. Life expectancy increased by 30 years; the majority can be attributed to public health efforts. c. Life expectancy increased by 30 years; the majority can be attributed to improved physician education. d. Life expectancy increased by 30 years; the majority can be attributed to increased access to care.
b
Which of the following statements best explains the continued incidence of infectious disease in the United States today? a. Illness theory explains that there are many causes of illness resulting from environmental conditions. b. No single theory adequately explains why a particular person gets a particular illness at a particular time. c. The germ theory explains that a specific infection is caused solely by the invasion of particular bacteria. d. The theory of susceptibility states that an individual only gets ill when there is extensive stress in his or her life.
b
Which of the following statements best summarizes Wald and Brewster's approach to home nursing? a. "All services all the time" b. "Helping people to help themselves" c. "One person, one family, at a time" d. "Your home or ours"
b
Which primary prevention would the school nurse choose to address the school's number of unwed pregnancies? a. Create a class on parenting for both the moms-to-be and the dads-to-be b. Convince the school board to allow sex education classes to include birth control measures c. Employ the moms-to-be as 1-hour-a-day employees in the school day care center for children born to school students d. Establish a class where all the unwed moms-to-be can learn infant care
b
Which task will be most helpful in meeting the public health agency's goals? a. Complete staff evaluations in preparation for individual meetings to plan their agency and individual goals for the next year b. Actively participate in community agencies' collaborative action plan to meet the community's health goals for the year c. Meet with the college of nursing faculty to finalize student objectives and schedules for the next semester d. Teach a free course in healthful living for community residents
b
Why would a public health nurse want to know about morbidity and mortality statistics on the local, state, and national level? a. To be able to share current trends in health problems with the community b. To be able to observe the community's statistics over time and compare the community with other communities c. To justify local budgets and the need for increased income from citizens d. To publicize current health issues and suggest appropriate actions to citizens
b
Which of the following actions have been effective in reducing problems related to alcohol use? (Select all that apply.) a. Abstinence education programs in elementary schools b. Enforcement of ban on sales of alcohol to minors c. Increased taxes on alcoholic beverages d. Media campaigns that show unpleasant behaviors such as vomiting after drinking e. Stringent laws on accurate labeling of alcoholic content in beverages f. Suggesting children be taught appropriate use of alcohol in the home
b,c
What are the leading health indicators found in Healthy People 2020? (Select all that apply.) a. Financial issues b. Health system issues c. Individual behaviors d. Issues related to legal and illegal immigration e. Legislative issues f. Physical and social environmental factors
b,c,f
What historically have been public health nurses' two most important priorities? (Select all that apply.) a. Establishing school nursing to improve care of children b. Engaging in political activity to improve living conditions c. Giving superb clinical bedside care in the home d. Increasing funding to public health efforts e. Teaching family members how to care for their family f. Working with the community to confront health issues and poverty
b,f
Which of the following of Nightingale's ideas were forgotten until recently? (Select all that apply.) a. The need for education for women b. The influence of environment on health c. The importance of clinical practice for expertise to develop d. The need to recognize gender role limitations e. The problem-solving (nursing) process f. The use of statistics and a sound research base
b,f
A 50-year-old woman comes to the clinic for her first mammogram. Which of the following best describes the action of this client? a. Disease prevention b. Health improvement c. Health protection d. Primary health promotion
c
A community health nurse has determined that the number one priority is to help families in which one member has diabetes. Which of the following actions would be most appropriate to maximize services to persons with diabetes? a. Ask friends with diabetes about what services they want improved. b. Duplicate the diabetic organization's services, because not all patients with diabetes have yet received services. c. Meet with the diabetic organization to see how the public health department can augment what it is offering. d. Submit a request for funding so that the public health department can also offer services to patients with diabetes.
c
A new public health nurse carefully assessed all the local mortality and morbidity data in preparation for making appropriate planning suggestions at a meeting next week. What other action is crucial before the nurse can feel prepared? a. Ask other nursing staff their perceptions of the community's needs b. Assess the nurse's own assets, strengths, and ability to contribute c. Meet members of the community to determine their culture and values d. Review discussions and decisions from previous meetings
c
A nurse has assessed an aggregate, determined the priority health needs, and decided on what intervention to offer. Which of the following will best determine if the intervention will be successful? a. Accuracy of the nurse's assessment b. Careful planning and implementation of the intervention c. Determination of the aggregate's perspective of the need for the intervention d. Selection of appropriate evaluation measures both in process and on completion
c
A nurse is caring for an aggregate as his or her client. Which of the following tasks would the nurse complete first? a. Determine the setting of the aggregate b. Gain access into the aggregate c. Identify the nurse's own strengths and preferences d. Review the resources available to use in the community
c
A nurse is determining the needs of a selected aggregate. Eight percent of the aggregate has diabetes. Which of the following best describes the action that should be taken next to determine if this should be a priority? a. Ask the American Diabetes Association if 8% is a worrisome rate. b. Discuss the findings with the head of the public health department. c. Review the literature to determine the national and state diabetic rate. d. Determine what the aggregate's diabetic rate has been in the past.
c
A scholar during the Sanitary Revolution created medical topographies. What was the advantage of these surveys? a. Citizens knew which wells were safe to use for drinking water. b. People knew what housing areas to avoid. c. Results demonstrated environmental factors related to regional disease. d. The king could isolate areas of disease from safe areas.
c
A young couple is searching for a home in a new neighborhood. Which of the following neighborhoods would most likely promote a healthy lifestyle? a. One near a large active military base b. One with excellent health facilities nearby c. One with high walkability d. One with superb recreational facilities
c
During a health history, the client looked confused and said, "But everybody drinks, like at parties and such. How much drinking do you think is too much?" Which of the following would be most appropriate response by the nurse? a. "Alcohol should be used only in moderation." b. "It's okay as long as you don't binge, and you eat food with your drinks." c. "Per day, no more than one drink for women and two drinks for men." d. "Total abstinence is the only healthy choice."
c
How did Edwin Chadwick's ideas help decrease disease in the nineteenth century? a. The minimum wage was increased leading to improved quality of life. b. Parish workhouses where poverty-level children labored for their room and board were closed. c. Social reform legislation resulted in changes such as sidewalks. d. The new emphasis on individual responsibility encouraged people to act to protect their own health.
c
What is the health issue causing the most concern in the United States today? a. Diabetes epidemic b. Increase in cardiac disease c. Increase in obesity d. Rise in cancer rates
c
What responsibility does the American Nurses Association (ANA) Code of Ethics require of the nurse beyond giving excellent care to patients? a. Accept longer work schedules to ensure that professional care is always available to clients b. Recognize the need for experienced nurses to mentor new graduates to help increase and expand the number of professionals available c. Support health legislation to improve accessibility and cost of health care d. Volunteer to work overtime as needed to ensure maximum quality of care
c
What would be the proper term for the action of the school health nurse arranging for all the students in the elementary school to receive H1N1 immunizations? a. Health education b. Secondary prevention c. Specific protection d. Tertiary prevention
c
Which ethical belief would be most helpful in the current health care crisis? a. Emphasis should be on individual and corporation freedom in the marketplace. b. Emphasis should be on individual autonomy and freedom of choice. c. Emphasis should be on social justice and collective responsibility. d. Emphasis should be on the effectiveness of technology in resolving problems.
c
Which of the following best describes a modern public health practice that was originally developed as a means of self-protection from the Black Death (bubonic plague)? a. Care in a hospital b. Chemical intervention c. Isolation and quarantine d. Herbal remedies
c
Which of the following best describes what Lillian Wald suggested in regards to providing care to individuals and families? a. Public health nurses should encourage clients to join the Henry Street settlement for mutual growth and support among the families. b. Public health nurses should focus on providing care in the client's home. c. Public health nurses should recognize the larger social and economic forces that the family cannot control. d. Public health nurses should try to understand that educating clients on how to stay healthy is the nurse's primary responsibility.
c
Which of the following best describes why risk reduction is of such importance in the United States today? a. Families suffer when family members die from avoidable causes. b. Risk reduction activities will decrease insurance costs to individuals and their employers. c. The leading causes of death are all related to lifestyle choices. d. Risk reduction can decrease the ongoing rise in national health care expenditures.
c
Which of the following tool(s) were used by Florence Nightingale to create change? (Select all that apply.) a. Her incredible beauty and personality b. Influence of all the nurses Nightingale trained c. Political advocacy d. Publication of treated soldiers' death rate changed from 42% to 2% e. Use of statistics to demonstrate the effectiveness of her interventions f. Wealth of her family and relatives
c,d,e
A nurse is using the health belief model to help a client improve lifestyle choices. Which of the following interventions would the nurse most likely implement? (Select all that apply.) a. Conduct an ongoing public information campaign to motivate people to take action b. Emphasize how important it is to change behavior immediately c. Examine the individual's perceptions of his or her health in relation to current lifestyle behavior choices d. Review how lifestyle changes can reduce risk and improve the client's life e. Share statistics regarding the probability of health problems and their seriousness if action is not taken f. Use communication channels to send reminders of action currently needed
c,d,e,f
A nurse is completing a health history with a client. Which of the following questions would be most important to include? a. How many alcoholic drinks do you have in a day? b. How many sexual partners have you had in the past month? c. What nonprescription drugs do you take on a routine basis? d. What kinds of tobacco do you use daily?
d
After completing a master's degree, a nurse took a course in marketing. Should the agency reimburse the nurse's tuition costs? a. No, courses taken for personal enjoyment are not eligible. b. No, courses taken outside the professional's responsibilities are not eligible. c. Yes, the nurse is demonstrating professional commitment by continuing education. d. Yes, the nurse could use such information in social marketing for the agency.
d
How do public health efforts differ from medical efforts in improving the health of our citizens? a. Medical care providers autonomously choose appropriate interventions, whereas public health care providers must engage in whatever actions legislation requires. b. Medical care providers are self-employed or agency employed, whereas public health care providers are employed by and paid through the government. c. Medical care providers focus only on individuals, whereas public health care providers focus only on aggregates. d. Medical care providers focus on disease diagnosis and management, whereas public health care providers focus on health promotion and disease prevention.
d
The nurse working with a client to change behavior to maximize health asked the client to bring his family to the next visit. Which of the following best describes why the nurse wants the family to come with the client? a. To analyze the family's beliefs about health b. To determine the family's support of the client c. To establish the family's communication patterns d. To evaluate the family's approval of the proposed changes
d
What change could most effectively lead to a longer life span in Americans? a. Parenting and sexual behavior classes in all public school systems b. Legislation restricting alcohol and drug use c. Notably reducing speed limits on all state and federal highways, and changing the age limit for driving to 21 years of age d. The belief that smoking is shameful and disgusting, as well as expensive, becoming the social norm
d
What is the community health nursing definition of health? a. Health is a person's goal-directed purposeful process toward well-being or wholeness. b. Health is an individual's physical, mental, and social well-being, not merely the absence of disease or infirmity. c. Health is the mutual adaptation between a person and his or her environment in meeting daily existence. d. Health is families and aggregates choosing actions to ensure safety and well-being.
d
What is the primary problem seen in Healthy People 2020's emphasis on choosing healthy lifestyle behaviors, such as daily exercise or healthy food choices? a. Emphasis on other lifestyle choices, such as not smoking and minimal use of alcohol or drugs, is also needed. b. All of us must work together to make unhealthy behaviors socially unacceptable. c. It costs more to make healthy choices, such as buying and eating fresh fruits and vegetables as opposed to quick and cheap fast-food choices. d. Public policy emphasizes personal responsibility but ignores social and environmental changes needed for well-being.
d
Which action would probably result in the largest change in health care outcomes for Americans? a. Establish large numbers of scholarships for education of nurses, physicians, and other health care providers b. Fund a one-time extremely large stimulus to allow all health care providers and agencies to create and integrate computer network systems for client health care records c. Increase funding for hospitals and medical centers to expand their neighborhood clinics d. Redirect a large portion of federal funding from acute care to health promotion activities
d
Which of the following best describes why it is important for the nurse to be knowledgeable about the community when providing care to individuals? a. As nurses travel to meet with clients, they must know the community to find the client's residence. b. On the basis of information from community assessment, community health nurses can be visible and vocal advocates for health care reform. c. Community health nurses are expected to have information about the community to share with individual clients. d. Individuals and families are strongly influenced by the community and environment around them.
d
Which of the following did Lillian Wald help establish? a. Child employment centers with shortened work days b. Daycare centers for preschool-aged children c. Nurseries for infants of working mothers d. School health nursing for school-aged children
d
Which of the following groups was primarily responsible for the establishment of the first school of public health? a. The American Medical Association b. The Association of State Departments of Public Health c. The federal government d. The Rockefeller Foundation
d
Which of the following is a major challenge for health care provider education today? a. Ensuring that research findings related to families and groups are included in the curriculum b. Expanding the curriculum to allow additional experiences in community health settings outside the hospital c. Increasing course emphasis on environmental influences on health d. Refocusing the curriculum from care of the individual to needs of aggregates
d
Which task is most crucial for the community health nurse to do well? a. Review the most recent morbidity and mortality data b. Create a new clinic to better meet local health needs c. Evaluate the results of the recent screening program d. Give testimony regarding proposed state health legislation
d
