Community Nursing Test 1
A community-level intervention designed to increase the sense of belonging among older community residents at risk for social isolation was implemented by opening a senior center every other Wednesday at a local church that provided lunch and social programs. At the end of 6 months, the attendees were surveyed to determine their experience with the program, barriers to attendance, expansion of their social networks, and involvement in other community activities. This survey allowed the community health nurse to _______ the program and design program improvements. a. evaluate the effectiveness of b. assess the expansion needs of c. identify problems with d. implement the expansion of
a
A nurse is teaching a postpartum mother how to breastfeed her infant. The nurse notes that the mother is alert and agrees that breastfeeding is important to her and beneficial to her baby. The nurse outlines the expectations of breastfeeding for the mother and the baby and presents the material. In terms of the sequencing of instruction, what should the nurse do next? a. Ask the mother about her previous experience with breastfeeding b. Demonstrate how to position the baby for breastfeeding c. Have the mother demonstrate breastfeeding d. Show the mother a video about breastfeeding
a
A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing: a. community-oriented care. b. community-based care. c. secondary care. d. tertiary care.
a
A nurse practitioner is seeking support from a community health and hospital system to open a nurse-managed and nurse-staffed clinic. The nurse provides data demonstrating the role of the clinic in reducing nonurgent emergency department visits and in improving access to services for clients with chronic illness, management of caseloads, and service flow, as well as data showing proposed input and output parameters. This best demonstrates application of the techniques of: a. business cycle modeling. b. cost-effectiveness analysis. c. cost-benefit analysis. d. indirect reimbursement methods.
a
A nursing diagnosis of Increased risk for delayed development, injury, and disease because of inadequate parenting by a primary parent experiencing depression would most likely indicate that the nursing process is being applied at the _______ level of practice and the _______ level of prevention. a. individual/family, secondary b. community, primary c. community, secondary d. individual/family, primary
a
A rural community health nurse has made sure that CHWs are involved in the health department's migrant worker outreach program. The nurse believes this intervention strategy is important because the nurse knows that such individuals can be: a. influential with their insider status to engage community members. b. medical professionals within the migrant community. c. natural healers within their community. d. translators to help overcome language barriers.
a
Community based nursing stresses what? a. Continuity of care b. the big picture c. promoting and preserving the health d. changing demographic data
a
Primary health care (PHC) differs from primary care in which of the following ways? a. PHC encourages community participation. b. PHC focuses on prevention and cure. c. PHC is defined more narrowly. d. PHC is the primary method of health care delivery in the United States.
a
The state public health agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored eldercare programs. The public health core function applied is: a. assurance. b. policy development. c. primary prevention. d. public transportation
a
Virtue ethics is distinctly different from moral justification via theories or principles because the emphasis of virtue ethics is practical reasoning applied to: a. character development. b. consequentialism. c. distributive justice. d. egalitarianism.
a
What is a function of community health nursing? a. plan and participate in an HIV prevention and education program b. gather and analyze government health data r/t migrant farm workers needs/risks c. Organize and educate employers/politicians to develop programs to educate and prevent further injury and illness d. focus on the availability of necessary health services throughout the community
a
When a nurse evaluates the completeness and accuracy of information made available to community residents regarding the impact of rezoning of land parcels for industrial use, the nurse can best be described as: a. advocating for ethical choices. b. communicating risk. c. controlling environmental damage. d. volunteering for service on state boards.
a
contract with a network of providers to provide services to specific groups of patients at a discounted rate a. Preferred Profiler organization b. Point of service c. Health maintenance organization e. Ethical frameworks
a
Factors related to the determinants of health identified in Healthy People 2020 include which of the following? (Select all that apply.) a. Education and literacy b. Genetic endowment c. Gender d. Culture e. Social status
a b c d e
State Public Health Agencies responsibilities include which of the following? Select all that apply: A. Monitoring their states health care financing and administration B. Enforcing health codes C. Monitoring the health status of the public, related to Healthy People 2020 goals. D. Providing expertise that assists local Public Health Departments. E. Responding to public health emergencies.
a b c d e
The factors that are frequently cited as having caused the increases in total and per capita health care spending in the United States are well exemplified by which of the following health care events? (Select all that apply.) a. Development of the drug sildenafil (Viagra) b. Increase in hip and knee replacement surgeries c. Increased incidence of ischemic heart disease d. Mandated two-day maternity hospital stays e. Medicare Part D prescription drug plan
a b c d e
The most important features of the Affordable Health Care for America Act of 2010 that the community-oriented nurse needs to understand to provide resource information to clients are that the Act: (Select all that apply.) a. transforms the health care system from a sick care system to health care system. b. uses piecemeal approach to strengthen the safety net. c. replaces the rational equitable health care system. d. provides insurance reform. e. increases access to affordable health care insurance.
a d e
A nurse integrates a structured exercise into her classroom presentation on effective handwashing that assists students in demonstrating and modeling good handwashing techniques. The principle followed by an effective educator that is best demonstrated by this approach is: a. create the best learning environment. b. encourage participatory learning. c. organize the learning experience. d. select the learning format.
b
A nurse takes the time to read and understand the community's disaster plans and participates in mock disaster drills as a leader of the triage team. The nurse obtained disaster management training through the local Red Cross chapter and registered with the state as a disaster management nurse. The best description of the nurse's activities is: a. American Red Cross disaster training. b. community preparedness. c. personal preparedness. d. professional preparedness.
b
A community-based HIV/AIDS clinic would be concerned about which aspects of the Public Health Code of Ethics? (Select all that apply.) a. Autonomy of the professional b. Confidentiality, when possible c. Funding d. Advocacy for disenfranchised persons e. Respect of only community rights
b d
What is the driver for decisions that impact care for all citizens a. Nurses b. doctors c. Finances d. inflation e. government
c
A nurse is assigned to provide community outreach to a small town that was partially destroyed by a tornado 3 years earlier and has been rebuilt. The first client is a family who lost their home and their best friend in the tornado. The best intervention would include: a. assessment of the family's home environment to rule out safety issues. b. avoidance of discussion of the disaster of 3 years ago. c. consideration that the family will have worked through the emotional aftermath by now. d. support of the family in preparing a personal disaster response plan.
d
The community planning board's evaluation of a community intervention (child immunization campaign) carried out by the health department determined that some progress was made toward the desired outcome (target rate of childhood immunization), but the degree of progress achieved was not sufficient to offset the initial effort in terms of cost and time to launch the campaign. The community determined that the rate gain was not adequate when compared with that achieved through similar initiatives in other communities, which obtained better results by using more efficient strategies. The budget for this program was cut. This community decision best exemplifies which statement about evaluation? a. Evaluation should start in the planning phase of the nursing process. b. Evaluation can have unintended consequences. c. Effectiveness is the only true measure of worthiness. d. The power to design, judge, or institute change is important.
b
The monitoring and public reporting of air quality in a local community to assist individuals with asthma or other respiratory conditions best illustrates the application of: a. compliance and enforcement. b. environmental epidemiology. c. secondary prevention. d. toxicology.
b
There is strong evidence to suggest that poverty can be directly related to poor health outcomes. Poorer health outcomes lead to reduced educational outcomes for children; poor nutrition; low productivity in the adult workforce; and unstable economic growth in the population, community, and nation. These concepts reflect the human capital approach of the branch of economics known as: a. effectiveness and efficiency. b. macroeconomics. c. microeconomics. d. supply and demand.
b
Which objective includes all of the critical elements of an educational objective? a. After attending the diabetic education class, the client will prepare a meal plan. b. At the end of self-management training, the client will prepare a daily food plan that meets the 1800-calorie per day American Diabetes Association (ADA) diet guidelines. c. The diabetic client will prepare a list of the five food groups and the number of servings from each group that are necessary for an 1800-calorie diet following ADA guidelines. d. The client and his wife will attend all of the diabetic education classes to learn to prepare meals consistent with ADA diet guidelines.
b
Who stands ready for disaster prevention or response? a. Federal level health agencies b. State health departments c. International health organizations d. local health departments
b
what is designed to limit medicare spending a. Affordable care act b. Diagnosis related groups c. medicaid d. managed care
b
which one is administered by state a. medicare b. medicaid c. affordable care act d. Reimbursements
b
who provides a broad range of service at the community level including basic health services, clean water supply, family planning, sanitation, immunizations and WIC? a. Primary care b. Primary health care system c. international health organizations d. Federal health agencies
b
Public health nursing specialists are interested in which of the following topic(s)? (Select all that apply.) a. Educational materials for individuals with HIV/AIDS b. Evaluation of an outreach program for at-risk pregnant teenagers c. Community subpopulations with high rates of type 2 diabetes d. New technologies to monitor diabetes e. Prevalence of hypertension among various age, race, and gender groups
b c e
A group's culture is created by the combination of its norms. The nurse supports helpful rules, attitudes, and behaviors in the group because group norms do which of the following? (Select all that apply.) a. Challenge the cohesiveness of the group b. Ensure movement toward the group's purpose and tasks c. Identify message pathways and member participation d. Influence members' perceptions and interpretation of reality e. Maintain the group through various supports to members
b d e
reson for increase in spending on health care in the U.S. (select all that apply) a. self payments b. increased demand c. more babies d. more elderly e. technology
b d e
A nurse has been newly appointed as commissioner of the state health department services. The programs the nurse will oversee will most likely include: a. administration of Medicare reimbursement rates and eligibility determination. b. programs involving citizens in the local community, including sanitation and communicable disease contact tracing. c. disaster response, health care financing and administration of programs such as Medicaid, and establishment of health codes. d. monitoring of drugs and over-the-counter products available for sale and use by consumers.
c
A nurse has worked for years in an intensive care unit and decides to take a position as a community health nurse directing a local public health unit. Her first assignment is to perform an assessment of the community's migrant farmworker population. The nurse's most appropriate next step is to: a. begin the community assessment using a survey tool proven effective in previous public health unit assessments. b. perform a literature review to study assessment data for similar populations. c. enroll in a community health nursing graduate course to learn community research, measurement, and analysis techniques. d. form a relationship with the farmworkers' community leaders and other key informants.
c
A nurse is working with a disaster medical assistance team as it responds to a disaster. A new team member excitedly insists that its personnel can exceed their 12-hour shifts and do not need breaks. The best intervention on the part of the nurse is to: a. arrange for the team member to be transferred to another unit. b. arrange for the team member to leave duty, return home, and talk with his or her pastor. c. educate the rescuer about necessary stress-management techniques and offer to pair up with the individual so that each can monitor the other's stress level. d. help the team member to call home to speak with his or her family.
c
A registered nurse is seeking a position as a public health nurse. In reviewing the job description, the nurse would expect to find a description of a position that focused on functions such as: a. monitoring pregnant teenagers for symptoms of complications of pregnancy. b. offering free hypertension screening and treatment referral at local health fairs to low-income, uninsured, community members. c. partnering with local seasonal farmworkers to design a program aimed at preventing illness and injury, and advocating for this population with local political and community leaders. d. preventing injury among a population of elderly residents in an assisted living facility and treating residents' chronic illnesses.
c
A rural PBH is in the first phase of a community assessment to determine the community health status characteristics of the local county. This initial data gathering should most likely begin with which agency? a. County public health department b. National Centers for Disease Control and Prevention c. State vital statistics bureau d. U.S. Census Bureau
c
A small business employer desires to control company benefit expenditures by turning health care decision making control over to the employees. The insurance reform mechanism that best addresses the shifting of responsibility, knowledge, and decision making involvement to the individual receiving the care is: a. health spending account. b. managed care. c. medical savings account (MSA). d. prospective payment.
c
After consulting with the health department director, a PHN collaborates with a housing advocate service and legal counsel on behalf of the nurse's clients who live in substandard housing under fear of eviction. The nurse is applying the _______ component of the nursing process to a _______ level of practice. a. evaluation, systems b. assessment, community c. implementation, systems d. diagnosis, community
c
Collaboration is an intervention that would be located where in the Intervention Wheel? a. Red wedge at the individual/family level of practice b. Blue wedge at the community level of practice c. Orange wedge at the community level of practice d. Green wedge at the systems level of practice
c
In evaluation of a program to prevent teen pregnancy, analysis of the net direct and indirect costs, the improvements in the community attributable to the program (such as lower high school dropout rates), and the costs that would result if the program were not implemented (such as the cost of care for low-birth-weight infants) is an example of which of the following? a. Cost-benefit analysis b. Cost-efficiency analysis c. Cost-effectiveness analysis d. Economic growth predictions
c
The 1989 changes to Medicaid Title XIX required states to provide care for children younger than age 6 years and pregnant women with incomes less than 133% of the federal poverty level. These changes also ensured adequate access to qualified providers by: a. adding coverage for the medically indigent. b. reimbursing the costs of early periodic screening, diagnosis, and treatment for those younger than age 21 years. c. reimbursing for treatment by pediatric and family nurse practitioners. d. reimbursing for skilled and intermediate nursing home care.
c
The goal of the PHC system is to achieve the objective "Health for All in the 21st Century," set forth by the World Health Organization (WHO). The major barrier to achieving this objective in the United States is that: a. global indicators are not applicable to the United States. b. Healthy People 2020 is not consistent with the Declaration of Alma-Ata. c. PHC is not the primary delivery method for health care in the United States. d. the U.S public health system is not structured to provide PHC.
c
The impact of the baby boomer generation on the future of health care can best be described as: a. decrease in demand because they are a healthier group of older adults. b. decrease in demand because they are less likely to use preventive care. c. increase in demand because of increased life expectancy. d. increase in demand because of rates of acute health problems.
c
The local nurse-managed community health center initiative is providing community-based primary and preventive care as well as specialty care, community screenings, local health assessments, health education, and health care coordination, targeted to medically uninsured individuals regardless of ability to pay. This initiative best describes a system of: a. managed care. b. primary care. c. PHC. d. private health care.
c
The major factor that drives the current discussions about a Medicare shortfall in the middle of the twenty-first century is: a. diversity of the U.S. health care workforce. b. longevity of the U.S. population. c. percentage of elderly in the U.S. population. d. percentage of foreign-born in the U.S. population.
c
The most important aspect of the nursing community assessment phase can best be described as: a. analyzing and synthesizing data. b. collecting and gathering data. c. formulating a community nursing diagnosis. d. identifying problem correlates.
c
The nurse recommends Parents Without Partners to a colleague who is experiencing the challenges of single parenthood in raising a teenager. The nurse is demonstrating an understanding of the group elements of: a. cohesion and task functioning. b. leadership and role structure. c. member interaction and group purpose. d. norms and maintenance.
c
The role and goals of the community health nursing practice can best be described as: a. community-based interventions aimed at promoting, preserving, and maintaining the health of populations residing in institutional facilities such as nursing homes. b. education of nurses and other staff working in community-based and community-oriented settings to improve the overall effectiveness of their programs to meet client needs. c. population-level strategies aimed at promoting, preserving, and maintaining the health of populations through the delivery of personal health care services to individuals, families, and groups in an effort to improve the health of the community as a whole. d. activities targeted at improving the health status of clients served by community-based health service agencies such as hospice and home health agencies.
c
The three components of the Intervention Wheel are: a. communities, systems, and individuals/families. b. interventions, color wedges, and levels of practice. c. population base, levels of practice, and public health interventions. d. populations at risk, populations of interest, and levels of practice.
c
Which action by the community-oriented nurse best illustrates a partnership for health? a. Assisting a school nurse in conducting vision screening of elementary school children b. Developing a volunteer program for teaching parenting skills c. Helping a group of citizens concerned about potential environmental hazards collect relevant health data and develop needed interventions d. Informing a neighborhood council that smoking is its major community health problem
c
an employer responsible for nurse's negligence when he/she is functioning within some of job a. scope of practice b. sovereign immunity c. Respondent superior d. Nurse practice act
c
based on court/jury decisions a. statutory law. b. constitutional law c. judicial law d. federal law
c
from legislative branches of federal state, local government a. judicial law b. federal laws c. statutory law d. constitutional law
c
maximize possible benefits and minimize possible harm a. nonmaleficence b. autonomy c. beneficence d. justice
c
A community-oriented nurse leader is working with community leaders and interested citizens to improve access to services for the underserved by planning an expansion of the local community health clinic. This is an example of which type of community partnership model? a. Coalition b. Democratic c. Passive d. Community member professional
d
A low-vision client with very early dementia takes pride in her independence. The client, who lives alone in an apartment, tells her nurse she has always enjoyed using fragranced candles. The most appropriate intervention for the nurse is to apply the principle of: a. autonomy, in which the nurse leaves the matches and candles accessible to the client. b. beneficence, in which the nurse maintains the client's dignity and reinforces to the client how pleasant it is to use scented candles. c. nonmaleficence, in which the nurse counsels the client regarding the dangers of the use of candles and matches by someone with low vision. d. respect for autonomy, in which the nurse recommends to the client an arrangement whereby the caregiver lights the candles when the caregiver is present in the home and removes the matches and candles from the kitchen cabinet.
d
A nurse identifies higher-than-normal levels of lead when screening a 3-year-old child. The nurse works with the local health department to put together a team to address the environmental issues responsible for the child's abnormal lead level. Team members should include the following specialists: a. epidemiologist, pediatric specialist, and sanitarian. b. laboratory specialist, contractor whose bid for lead reduction work is the lowest, and public health lead reduction specialist. c. public health sanitarian, pediatric generalist, and plumbing inspector. d. specially trained housing inspector, pediatric specialist, lead-based paint intervention team, and laboratory specialists to test the child's home and the surrounding neighborhood.
d
A nurse is working with an established group of parents of children with special needs. Several parents continually express frustration with the health care system and feelings of powerlessness to address their needs. The nurse uses group techniques to validate their experiences and explore options for action. The nurse reacts in this way to conflict within the group because conflict: a. means the group leader must ask the persons causing the conflict to excuse themselves from future meetings. b. means those with the dissenting opinion will change their stand to be more in line with the rest of the group. c. should be avoided. d. supports individual and group growth and change.
d
A nurse wishes to become actively involved in disaster management and is extremely interested in providing first aid and delivering aggregate health promotion, disease prevention, and emotional support. It would be ideal for the nurse to train and volunteer as which of the following? a. Community emergency response team member b. Disaster medical assistance team member c. Member of the Medical Reserve Corps d. Red Cross shelter manager
d
A public health nurse leader is encountering barriers when trying to shift the public health agency's efforts to a population-focused practice. The reasons peers are not supportive of the proposed shift to a population focus are most likely related to: a. agency colleagues' push for nurses to focus on population initiatives. b. costs associated with staff training and revision of documents. c. lack of support from the agency's funding sources. d. opinions that nursing should focus on the provision of direct client care and services.
d
After a mock disaster drill, the nurse participates in a "hot wash" of the exercise in which participants from all units speak about successes, problem solving, failures, and unanticipated challenges or obstacles faced during the mock disaster drill. This activity best addresses the public health workforce competency of: a. describing the agency chain of command. b. identifying the limits of one's own knowledge, skill, and authority. c. recognizing unusual events that might indicate an emergency. d. writing after-action reports, updating implementation plans, and implementing changes.
d
Although nursing has a strong implicit heritage of ethical values and morality, it was not until the 1960s that several seminal events significantly shifted the focus to ethical decision making processes. One of those seminal events was the emergence of the field of bioethics and the other event was: a. adoption of the ANA's Code for Professional Nurses. b. adoption of the American Public Health Association's Public Health Code of Ethics. c. adoption of the International Council of Nurses' Code of Ethics for Nursing. d. issuance of the ANA's position statement on nursing education in institutions of higher education.
d
An occupational health nurse practitioner's physical assessment of a factory worker identifies an acute-onset pruritic dermatitis extending over the face, hands, neck, and forearms. The nurse's priorities should be to: a. contact factory senior management, educate workers about their exposure, and clean the area. b. contact the Occupational Safety and Health Administration immediately and remove the offending chemical in the work environment. c. immediately evacuate the worker's nearby workspace and treat the worker and other exposed workers. d. treat the client and obtain a comprehensive exposure history; if an on-site environmental exposure is suspected as the cause, screen other at-risk workers and ensure that the environmental risk is identified and eliminated.
d
Campaigns to decrease the inequitable burden of environmental risks on the poor and people of color in the United States strive to apply the ethical principle of: a. societal justice. b. nonmaleficence. c. compliance and enforcement of the Environmental Protection Agency Regulatory Act. d. environmental justice.
d
Caring and the ethic of care are core values of community health nursing. This ethical view was developed in the mid-1980s and early 1990s in response to the technical advances in the health care sciences and the desire of nurses to: a. apply gender-related voices to moral judgment. b. apply principles of utilitarianism. c. differentiate distributive justice from beneficence. d. differentiate nursing practice from medical practice.
d
In 1988, the Institute of Medicine (IOM) published a report on the future of public health and its mission that defined public health as: a. what public-private partnerships do to treat vulnerable populations. b. what the government does to ensure that vital programs are in place. c. what the U.S. Public Health Service does to prevent disease, promote health, and deliver services. d. what society does collectively to ensure the conditions in which people can be healthy.
d
Is a population focused approach to planning delivering and evaluation of nursing care is the definition for? a. Public health nursing b. Community Based nursing c. community orientated nursing d. Community health nursing
d
Of the four major factors that affect health—personal behavior/lifestyle, environmental factors (physical, social, and economic), human biology, and the health care system—medical services are said to have the least effect. Yet the U.S. health care system remains reactionary, with high-cost, high-technology, and disease-specific "sickness care." These statements support the public health goal of: a. expanding managed care for the underserved. b. expanding secondary prevention in the schools. c. increasing tertiary prevention in skilled nursing facilities. d. preserving and maximizing human capital.
d
Promotion of the creation of immunization registries that combine immunization information from different sources into a single electronic record to provide official immunization records for schools, daycare centers, health departments, and clinics is a goal of: a. community-level practice. b. family-level practice. c. individual-level practice. d. systems-level practice.
d
The emergency support functions of the National Response Framework (NRF) and the National Incident Management System (NIMS) provide: a. authority to step in and take control of state, local, and voluntary organizations during disasters. b. command and control for American Red Cross and Disaster Medical Assistance teams. c. oversight of federal and state response operations, with minimal interaction with other organizations. d. written approach, protocol, and common language for responders from federal agencies and other voluntary organizations.
d
The highest priority for a nurse who is among the first responders to a disaster is: a. arranging for shelter for disaster providers. b. beginning community assessment as soon as possible to ensure a rapid recovery. c. beginning surveillance and planning needed health education for disaster survivors. d. immediately developing plans for effective triage and client management.
d
The intervention used to influence the knowledge, attitudes, values, beliefs, behaviors, and practices of the population of interest is referred to as: a. advocacy. b. coalition building. c. consultation. d. social marketing.
d
The major factor that has led to sharply increased insurance payouts following disasters in the United States in recent decades has been: a. El Niño. b. geography. c. technology. d. human development.
d
The new director of a local public health unit reviews the personnel records of the unit staff and notes that none of the assigned public health nurses (PHNs) has academic training in community and public health nursing. The director's next step should be to: a. recognize that staff members have learned on the job through years of experience and that they will be able to teach their new director basic community and public health principles. b. make arrangements to hire new staff with appropriate formal training. c. realize that with the current nursing shortage the unit should be grateful to have long-term staff. d. review continuing education records to determine if the nurses have received training in community-oriented nursing and ethics, and plan for any needed training.
d
What is not a role of Public health nursing? a. Prevent epidemics and spread of disease b. promote healthy behaviors c. Work with other agencies and community partners d. work directly with a specific population
d
When applying the nursing process to environmental health, the nurse would: a. conduct an assessment focused on the client's presenting problem. b. coordinate interventions with the primary care provider of record. c. examine criteria that are limited to the client's immediate responses. d. include outcome measures that involve mitigation and elimination of the contributing factors.
d
Which community attribute is an indicator of a community's health status? a. Mean educational level b. Location of health facilities within the community c. Ratio of police to citizens d. Suicide rate
d
A community-oriented nurse conducts home visits to new parents to assess the health status of the infant, the parent-child relationship, the parents' knowledge regarding the care of the infant, and the need for health department and social services referrals to support the needs of the new parents and the infant. This can best be described as an example of: a. clinical community health practice. b. community-based practice. c. population-focused practice. d. public health nursing.
a
A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the core public health function of: a. assessment. b. assurance. c. policy development. d. research.
a
A factor that strongly influences the success of a PHC system is: a. participation of the community members in the design, implementation, and evaluation of the initiative. b. assurance of access to care for every woman and child from pregnancy through childhood. c. each entity's sense of urgency regarding the evaluation of indicators. d. cure orientation of the private sector of health care delivery in the United States.
a
A shift in general approach from a more reactionary, acute care orientation toward a proactive, primary prevention orientation is necessary to achieve not only a more cost-effective but also a more equitable health care system in the United States. From a public health perspective, this strategy is necessary to avoid the need for other less desirable approaches that may compromise access and quality such as: a. rationing of health care. b. secondary prevention. c. managed care expansion. d. regulatory program mandates.
a
If the community is where nurses practice and apply the nursing process, and the community is the client in that practice, then nurses will want to analyze and synthesize information about: a. boundaries, parts, and dynamic processes of the client community. b. community health status and structure. c. community problems and problem correlates. d. role of the nurse and lay advisors in the community partnership.
a
One step in the ethical decision making framework is to place an ethical issue within a meaningful context. The rationale for this step is that: a. multiple factors affect the formulation and justification of ethical issues and dilemmas. b. the nature of ethical issues and dilemmas determine the specific ethical approach used. c. people cannot make sound ethical decisions if they cannot identify ethical issues and dilemmas. d. professionals cannot avoid choice and action in applied ethics.
a
Public health nursing practice is guided by the community's priorities as identified by community: a. assessment. b. diagnosis. c. interventions. d. planning.
a
The community practice nurse is preparing to initiate a community partnership with a neighborhood watch association to address teenager street vandalism. The nurse meets with a local pastor who introduces her to the neighborhood residents she needs to partner with. The role of the pastor in this example is: a. gatekeeper. b. community health worker (CHW). c. professional service provider. d. stakeholder.
a
The community-oriented nurse best exemplifies the application of feminist ethics when the nurse: a. designs health care programs for the underserved that incorporate social justice, treat men and women with respect and equity, and include community interventions that elevate the status of the underserved in the community. b. designs health care programs for women that respect their dignity and autonomy. c. ensures that male providers do not use sexist terms when counseling clients and their spouses and when dealing with female colleagues. d. participates in political action committees that focus on women's rights and status in the community.
a
When confirmed cases of the mumps, a vaccine-preventable disease, emerged on college campuses in fall 2006, public health nurses (PHNs) conducted outreach at campuses and collaborated with student health officials to increase the number of students with full immunization compliance. This is an example of: a. community-level practice. b. family-level practice. c. individual-level practice. d. systems-level practice.
a
nursing interventions aimed at the individual in order to correct an existing problem a. Microscopic approach b. Macroscopic approach c. community frame work d. Health goal
a
prevention of problems before they occur a. primary prevention b. secondary prevention c. tertiary prevention d. no prevention
a
what come from federal and state constitutions and is overall guidance for practice situations a. constitutional law b. statutory law c. judicial law d. legal law
a
Primary health care differs from primary care in which of the following ways? (select all that apply) a. Primary health care encourages community participation. b. Primary health care focuses on prevention. c. Primary health care is the primary method of health care delivery in the United States. d. Primary health care is defined and focused more narrowly.
a b
Benefits of an electronic health record in the public health system include: (Select all that apply.) a. 24-hour availability of health records. b. ease of referral coordination. c. reduction in medication errors. d. increased privacy. e. consistently reliable internet resources.
a b c
Functions of a community (select all that apply) a. Production, distribution, and consumption b. social control c. social participation d. Socialization e. surveillance
a b c d
Which of the following are the best argument(s) for supporting community-as-client nursing? (Select all that apply.) a. Change for the benefit of the community-client must often occur at several levels. b. Changes in the health of individuals will affect the health of their communities. c. The idea of providing health-related care within the community is not new. d. The impact of the environment on health has long been established. e. Direct hands-on nursing care delivered to individuals or families in community settings is important.
a b c d
A group of six nurses is charged by the nurses' manager with evaluating current unit policies. One month later, the manager determines that the group is ineffective because of lack of cohesiveness. Which of the following group concerns or behaviors would be indicative of lack of cohesion? (Select all that apply.) a. Complaints about the degree of member participation b. Dissatisfaction about demands on their schedules c. Complaints about lack of administrative support d. Lack of a work plan for accomplishing the task e. Vying for leadership
a b c d e
The role of the nurse who wants to become more active in environmental health could include which of the following? (Select all that apply.) a. Assessing farmworkers for pesticide exposure and providing pesticide risk education b. Conducting epidemiologic investigations as a public health nurse (PHN) c. Developing corporate policy to protect workers from unsafe levels of toxic agents d. Organizing the local community to encourage landlords to remove lead-based paint e. Working as a skilled risk communicator for a local chemical manufacturer
a b c d e
Disaster-related nursing is an evolving specialty. Nurses have unique skills that can be applied in which of the following aspects of disaster management? (Select all that apply.) a. Completion of the American Red Cross disaster management course and registration as a disaster responder b. Clinical management of blast lung injury c. Engagement of the BioWatch system d. Monitoring of the environment to contain infectious disease e. Planning and organization of mass prophylaxis and vaccine campaigns
a b d e
main governmental health care function (select all that apply) a. Direct service b. Public protection c. Point of service d. Justice e. Policy setting
a b e
The American health care system will continue to evolve and change. Which of the following groupings of health care trends will have the greatest influence on the health care transformation process at the present time? (Select all that apply.) a. Aging of the population and medical technology advances b. Funding levels, political structure, and professional licensure requirements c. Longevity, population diversity, and funding sources d. Managed care, workforce shortages, and level of education of the population
a c
A clinic-based public health nurse (PHN) has launched an aggressive community health education media campaign to increase the number of fully immunized children within the health district. Which evaluation process would best assess the impact of this strategy at the overall community level? a. Analysis of the immunization clinic appointment rate over the next few months b. Analysis of the trend in childhood immunization rates for the health district c. Assessment of the immunization status of each child who visits the clinic d. Determination of the budgetary impact of the media campaign on the clinic's operations
b
A college health nurse is working with students, faculty, and staff to improve environmental air quality. To address the primary cause of air pollution on campus, the nurse plans a precautionary intervention. Which of the following interventions best demonstrates an appropriate approach? a. Encourage the use of electric cars and scooters on campus b. Increase the use of bicycles, foot-powered scooters, rollerblades, and walking as the primary mode of transportation on campus c. Make the entire campus a no-smoking zone d. Establish a policy to reduce electricity consumption in university buildings by raising the thermostat to 78° in the summer and lowering the thermostat to 70°in the winter
b
A community health nurse manager has integrated exposure history elements into the assessment practices of the health department that are relevant to the urban industrial community served. This strategy indicates that the nurse manager is aware of the relationship between: a. community strengths and weaknesses. b. environment and human health/disease. c. toxicology studies conducted by the Environmental Protection Agency and the environment. d. federal and state environmental regulations.
b
A community-oriented nurse understands that the most important use of the principles for effective advocacy is to: a. act as a friend and advocate for the target population served to promote research and data gathering. b. act in the community's best interest, in keeping with community direction, while maintaining diligence, ongoing communication, and confidentiality. c. ensure that public funds are spent only for the priorities stated in the legislation that authorized program funding and promote regulations and legislation. d. give more priority to the opinions and feelings of key community leaders than to data when determining program priorities.
b
A nurse diabetic educator who recently returned from a professional conference decides to present current best practices and research findings at a gathering of newly diagnosed diabetic clients. In adopting this approach, the nurse may fail to provide health education effectively. This failure would relate to which domain of learning? a. Affective b. Cognitive c. Psychomotor d. Practice
b
A nurse helping to form a group to deal with ongoing industrial pollution within a community understands that effective groups: a. are larger and comprised of recognized community leaders. b. can have individuals with diverse interests and yet be influential in changing the larger community. c. must include members of all involved parties, including political, corporate, health, and environmental leaders. d. should be small with informal leadership and relationships within the group.
b
A nurse practitioner is seeking support from a community health and hospital system to open a nurse-managed and nurse-staffed clinic. The nurse provides data demonstrating the role of the clinic in reducing nonurgent emergency department visits and in improving access to services for clients with chronic illness, management of caseloads, and service flow, as well as data showing proposed input and output parameters. This best demonstrates application of the techniques of: a. business cycle modeling. b. cost-effectiveness analysis. c. cost-benefit analysis. d. indirect reimbursement methods.
b
An extensive train derailment occurs in the suburbs of a large metropolitan area. First responders determine that although no fatalities occurred, the derailed cars contain a noxious gas that diffuses readily into the air. The event easily overwhelms the capability of the local responders and hazmat teams are required. The local office of emergency management would coordinate through the emergency operation center to request assistance through which of the following? a. Environmental Protection Agency (EPA) b. Mutual aid agreement c. NIMS d. National Response Plan
b
Nurses should consider opportunities for population-focused practice that result from the rapid transformation of health care delivery from a medical model to a health promotion/disease prevention model. An example of such opportunity is: a. operator of a nurse practitioner-run urgent care center in a major retail location. b. director of clinical services spanning inpatient and community-based settings that provide a wide range of services to the populations seen by the system. c. clinical director of a home health agency. d. school nurse position in the local high school.
b
The Superfund Amendments and Reauthorization Act (SARA) increased the involvement of the states and their citizens in the cleanup of toxic waste sites and stressed the importance of permanent remedies and innovative treatment technologies. Another important aspect of this federal legislation was that it: a. provided for the appointment of state emergency response commissions. b. increased focus on the human health problems related to hazardous waste sites. c. established a new safety standard of reasonable certainty of no harm that is to be applied to all pesticides used on food. d. reduced the amount of pollution by mandating cost-effective changes in production, operation, and raw materials use.
b
The U.S. public health system is operated at three distinct levels with collaboration and interface across all levels. The agency that assumes the responsibility for regulating health care and overseeing the health status of Americans is the: a. Department of Homeland Security. b. U.S. Department of Health and Human Services (USDHHS). c. local health department. d. state department of health.
b