Community Health Quiz 1

Which phase of a community analysis should the nurse complete first? A)Categorization B)Comparison. C)Inference elaboration D)Summarization

Ans:A Feedback:The phases in order that are used to help in the analysis are categorization, summarization, comparison, and inference elaboration,

The nurse is using the community-as-partner model to complete a community health assessment. Which assessment is completed first? A)Community core B)Community subsystems C)Perceptions about community D)Degree of reaction

Ans :A Feedback:The core of a community is its people-their history, characteristics, values, and beliefs. The first stage of assessing a community, then, is to learn about its people.

Community health nurses are tasked with identifying unserved and underserved populations in communities. Which factors should the nurse look for? Select all that apply. A)Sexual violence, stalking, and intimate partner violence against women, men, and children B)Increase in number of Asian, Pacific Islander, and Hispanic Americans C)Increase in number of Americans older than 65 years D)Effects of free trade on government programs E)Lack of continuing education programs for health care community

Ans :A, B, C, D, Nurses can identify unserved and underserved populations in communities by looking for those factors shaping 21st-century health care. These include the effects of sexual violence, stalking, and intimate partner violence against women, men, and children; the growing number of Asian, Pacific Islander, and Hispanic Americans as well as those Americans older than 65 years; and the effects of free trade on govemment programs, especially in resource-poor areas. Although it is important for community health nurses to ensure a competent public health and personal health care workforce, a lack of continuing education programs would not affect the identification of unserved and underserved populations.

When analyzing community assessment data, data can be categorized in a variety of ways. Which of the following would be categorized as socioeconomic characteristics? A)Area boundaries B)Educational attainment C)Public spaces D)Ethnic and racial groupings

Ans :BFeedback:Educational attainment is considered a socioeconomic characteristic. Ethnic and racial groupings are categorized as demographic characteristics. Area boundaries and public spaces are regarded as geographic characteristics.

Although many philosophical approaches are discussed in the literature, when looking at the two approaches in applied ethics, deontology and teleology, how is deontology defined? A)Decisions are made on the basis of the greatest good for the greatest number. B)Actions are morally right when they are in accord with our nature and end as human beings. C)A system that allows social and economic positions to be to everyone's advantage and open to all D)A rule-based approach in which decisions are made by applying a set of rules of good conduct

Ans :D Feedback:Deontology is a rule-based approach in which decisions are made by applying a set of rules of good conduct. Teleology decisions are made on the basis of the greatest good for the greatest number. Natural law is where actions are morally right when they are in accord with our nature and end as human beings. Social equity and justice allows social and economic positions to be to everyone's advantage and open to all.

Which is an example of an action a nurse can take to influence health policy? A)Encourage voter registration. B)Be a passive constituent in the community. C)Know the executive process. D)ldentify government representatives.

Ans :D Feedback:Nurses can influence health policy by learning the legislative process; staying informed on current issues; identifying government representatives; being an active constituent; and speaking out.

The community health nurse will be analyzing community assessment data. Which of the following is an example of demographic characteristics? A)Number and size of neighborhoods B)Occupation and income categories C)Rental or home ownership patterns D)Sex and family size

Ans :D Feedback:Sex and family size are categorized as demographic characteristics. Number and size of neighborhoods is regarded as geographic characteristics. Occupation and income categories as well as rental or home ownership patterns are considered as socioeconomic characteristics.

The community health nurse is asked by a client what the designation of ".com" means? The accurate response by the nurse would be which of the following? A)Organization site B)Government site C)Educational site D)Commercial site

Ans :D Feedback:Uniform resource locator is the term for an internet address, and it is shown on your browser in the locator bar. The URL provides clues about the origin of the website, whether it is a commercial (.com), educational (.edu), government (gov), or organization (.org) site.

Rates enable researchers to compare different populations in terms of health problems or conditions. When preparing a report to support a research project, using which time frame would be most consistent with the majority of report interpretation data? A)Day B)Week C)Month D)Year

Ans :D, The majority of rates are based on data from a calendar year, which may also present some difficulties. Populations may increase or decrease during a calendar year. To adjust for population changes over the year, the midyear population estimate is generally used because the population at risk cannot be determined accurately.

Which of the following represents the best way for a new nurse to complete an in-depth self-examination of cultural competence? A)Acknowledge and be aware of one's own culture and willingness to explore one's own feelings and biases B)Be responsible for having excellent on-the-job motivation and commitment to caring for assigned clients C)Complete a self-examination of superior social, cultural, and biophysical factors in the community D)Become involved on a monthly basis in at least one cross-cultural interaction or workshop

Ans: A Feedback:A major component of cultural competence is an acknowledgment and awareness of one's own culture and a willingness to explore one's own feelings and biases.

Several nursing interventions can be used to decrease environmental influences on health. How can a nurse use primary prevention to decrease pollution? A)Promote routine immunizations to minimize diseases caused by biologic agents. B)Monitor for signs of hazardous environmental conditions, such as blood lead levels. C)Assess for signs of illness related to environmental hazards in the community. D)Treat and monitor disorders caused by environmental conditions

Ans: A Feedback:A nurse can use primary prevention to decrease pollution by promoting routine immunizations to minimize diseases caused by biologic agents. The nurse can use many techniques involving secondary preventions, including monitoring for signs of hazardous environmental conditions, such as blood lead levels; assessing for signs of illness related to environmental hazards in the community; and treating and monitoring disorders caused by environmental conditions.

A community health nurse is working with a home health client who immigrated to this country 15 years ago. The client has changed the country of origin's cultural patterns and has adopted the health care belief system of the United States. The community health nurse recognizes this as which type of change in the individual? A)Acculturation B)Culture C)Diversity D)Ethnicity

Ans: A Feedback:Acculturation is when an individual adapts to or changes cultural patterns to those of the new country. Diversity is the condition of being different or having differences. Ethnicity is one's identification with a group composed of people who share a unique cultural background and social heritage that is passed from one generation to another. Culture is the medium through which a person's beliefs, standards, and norms for health and illness behaviors are structured, learned, shared, practiced, and judged.

What would be a health promotion strategy for school-aged children and their families that could be implemented that would involve the community? A)Have a community parade celebrating being drug free. B)Conduct a survey to assess student opinion and food preferences for school lunches. C)Perform a plate waste study to determine what children are eating in school. D)Stuff payroll envelopes with health promotion material.

Ans: A Feedback:An example of a health promotion strategy involving the community is to involve school-aged children in a community parade celebrating being drug free. Nutrition awareness can occur if a school meal program is not healthy; form an ad hoc committee to study the problem. The committee should consist of students, parents, the public health/school nurse, cafeteria personnel, representatives of the faculty and administration, and a dietitian. It can include conducting a survey to assess student opinion and food preferences and doing a plate waste study to determine what children are actually eating. A health promotion strategy that can be used with groups such as teachers or staff in a school setting is stuffing payroll envelopes with health promotion material.

What is an example of tertiary prevention strategy that the school nurse can do to influence the school climate and reduce bullying? A)Continue school meetings and teacher-student discussion groups about bullying, sexual bullying/harassment, and violence in the school setting. B)Have separate counseling of bullies and victims. C)Involve parents of bullies and victims in monthly discussions. D)Develop individual care plans for students, both bullies and victims, addressing physical, mental, and behavioral health needs.

Ans: A Feedback:An example of tertiary prevention is to continue school meetings and teacher-student discussion groups about bullying, sexual bullying/ harassment, and violence in the school setting. Examples of secondary prevention include separate counseling of bullies and victims; involving parents of bullies and victims in monthly discussions; developing individual care plans for students, both bullies and victims, and addressing physical, mental, and behavioral health needs.

Following a motor vehicle accident, the wife of the victim requests that life support be continued in the absence of any brain function and that the client be allowed to go home on life support. The health care team believes that life support should be discontinued immediately and the client's organs be donated. Which ethical principle applies to this situation? A)Autonomy B)Fidelity C)Justice D)Veracity

Ans: A Feedback:Autonomy is the right of individuals to self-determination. Fidelity is being faithful in making promises and steadfast in keeping them. Justice is the fair distribution of rights and resources. Veracity is the commitment to tell the truth.

A community health nurse is working in a large urban city, situated in a culturally diverse area of the country. What does the nurse need to do to be culturally competent? A)Recognize that people with cultural backgrounds different from our own have unique values, life ways, health practices, and interpersonal styles. B)Understand and address the total context of the client's situation, using knowledge, attitudes, and skills. C)Be aware that people adapt to and borrow traits from another culture and change their own cultural patterns to those of the host society. D)Remember that an individual's own traditional beliefs and practices of their culture must always be observed.

Ans: A Feedback:Being culturally competent means that we understand how cultural beliefs and practices influence our daily lives and recognize that people with cultural backgrounds different from our own have unique values, life ways, health practices, and interpersonal styles. Cultural appropriateness occurs when a nurse understands and addresses the total context of the client's situation, using knowledge, attitudes, and skills. Cultural acculturation is being aware that people adapt to and borrow traits from another culture and change their own cultural patterns to those of the host society. Heritage consistency relates to the observance of beliefs and practices of an individual's traditional cultural system that may be observed.

Working in partnership with communities requires careful consideration of all seven primary ethical principles and the interplay among them. Which three primary ethical principles are most often threatened by the community health nurse's commitment to beneficence? A)Autonomy, respect for people, and nonmaleficence B)Fidelity, justice, veracity C)Autonomy, justice, veracity D)Nonmaleficence, fidelity, respect for people

Ans: A Feedback:Beneficence is acting in the best interest of others. Autonomy, respect for people, and nonmaleficence are the principles most often threatened by the community health nurse's commitment to beneficence. Autonomy, the right to allow the other person to choose, is in direct conflict with beneficence. At times beneficence helps some but may cause potential harm to others (respect for people) if, for example, new industry brings jobs, but the effects of the new industry could cause harm to others, which is also contradictory to nonmalficence. Justice, the fair distribution of rights and resources, and which also involves reward and punishment, is not in direct conflict with beneficence. Fidelity, which is faithfulness, and veracity, which is the commitment to tell the truth, are also not in direct conflict with beneficence.

Toxic substances have received a great deal of attention in governmental regulations and the news media. When determining ways to control the effects of exposure, the nurse consider the anticipated risk. I risk is primarily determined by what characteristic of a substance? A)Toxicity B)Prevalence C)Neurotoxic effect D)Amount in the environment

Ans: A Feedback:Both the toxicity of the substance the expected exposure to the organism must be considered to define the anticipated risk. The prevalence, neurotoxic effect, and the amount in the environment are not considered primary in determining the anticipated risk.

Which electronic resource would be most helpful in locating full-text articles to support informed community health nursing decisions? A)CINAHL B)ERIC C)MEDLARS D)MEDLINE

Ans: A Feedback:CINAHL is a bibliographic electronic database offering some full-text access, usually available through medical or academic libraries. Education Resources Information Center (ERIC) is an electronic database with many publications relating to teaching and education. Medical Literature and Analysis Retrieval Systems or MEDLARS (National Library of Medicine) is computerized to provide access to medical literature. MEDLINE offers access to more than 11 million documents, including articles with publication dates from 1965 to the present. This database is available at no charge and can be accessed online.

When an ethical issue arises for the community health nurse, which is the most important nursing responsibility in managing the client care situation? A)Analyzing the ethical principles at stake at any given decision-making point B)Following the request of the client and family members exactly as they have verbalized C)Ensuring the community health care team takes ultimate responsibility for deciding the solution to the situation D)Remaining neutral and detaching all present beliefs when making ethical decisions

Ans: A Feedback:Conscious awareness of this risk and application of the principles of justice, both retributive and distributive; veracity; and fidelity will assist community health nurses to analyze the ethical principles at stake at any given decision-making point in their work with communities. Their actions, then, will reflect the best possible application of the principle of community as partner and will promote the optimal overall health of a community within its own culture.

To maintain a clear focus on ethics, it is helpful to contrast its domain to that of law, in order to avoid the tendency confuse the two or to simplify the moral struggle to do the right thing by seeking a legal reason for action. Identify which statement best reflects the comparison between ethics and the law. A)Ethics considers people as inherently good; the law considers them to be basically bad. B)Ethics proposes what a person must do; the law proposes what a person should do. C)Ethics imposes individuals to pay penalties; the law has no sanctions. D)Ethics is a way to enforce the current values of society; the law changes the values of society

Ans: A Feedback:Ethics considers people as inherently good; law presumes them to be basically bad. Ethics proposes what a person should do, whereas law specifies what one must do. An individual may be chastised if found in violation of ethical principles, but there are no definite sanctions, whereas law imposes penalties in terms of fines and imprisonment. Law is often seen as a way to enforce the current ethical values of a society because it responds more quickly to changing circumstances.

In seeking ways to alleviate problems associated with health, the nurse must be cognizant of which statement that reflects one of nature's operating principles? A)Everything has to go somewhere. B)Everything is not connected to everything else. C)Everything has the same rate of change. D)Everything that goes up is dispersed in the air.

Ans: A Feedback:Everything has to go somewhere. Everything is connected to everything else, but some things are connected more tightly than others. Everything is constantly changing. Some changes seem irreversible, permanent, or barely detectable from our perspective in time. Other changes are cyclic or transient. Everything that goes up must come down.

What would be a good topic for a health education program that addresses mental health issues affecting children in the United States? A)Recognizing signs and symptoms of depression B)Problem-solving and decision-making skills C)Date rape and acquaintance rape D)Peer harassment

Ans: A Feedback:Examples of mental health issue programming could be self-esteem; attention deficit disorder/hyperactivity disorder; depression; and suicide. Personal safety programs could be "latchkey" kids and problem-solving/decision-making skills. Sexuality programs could be personal hygiene; teenage pregnancy; teen parenting; and sexually transmitted diseases. Psychological environment programs could be grade stress; parent-child discord; parent-teacher and teacher teacher conflicts; and peer harassment.

Based on the population trends in the United States, descendants of European whites are emerging as a new minority. Which is a cause for this new minority? A)Rapid growth rate in the population of racial and ethnic group diversity B)Nurses that provide care to clients and families who represent global communities C)Less-frequent interactions with clients of diverse ethnic and cultural backgrounds whose health beliefs differ from our own D)Development of required partnerships with individuals of different ethnic health

Ans: A Feedback:Growth in racial and ethnic group diversity throughout the 21st century is causing changes in minority groups. Among descendants of European whites, the number of deaths exceeds the number of births. Racial and ethnic minorities now make up 49.9% of the under-five age group.

Which of the following is a human health hazard that can result from ionizing radiation? A)Birth defects B)Fatigue C)Headache D)Hepatic system damage

Ans: A Feedback:Health hazards to humans from ionizing radiation include birth defects; increased rates of cancer, stroke, diabetes, cardiovascular, renal disease; and immune system damage. Nonionizing radiation leaks from microwave ovens that have improperly fitted seals can cause fatigue and headache.

A community health nurse works with a variety of cultures providing health care services that include acute treatment for illness. Which client most likely would believe that sickness is a punishment from God? A)Hispanic client B)Chinese client C)Female client whose culture is controlled by males D)German client

Ans: A Feedback:Hispanics believe that susto results from a traumatic experience or that sickness is a punishment from God. Susto, or fright, is an emotional response to a traumatic experience and is recognized as an illness that involves the loss of one's spirit from the body.

Immunizations are required by state law to be current and on file for all children. Immunization requirements must be strictly supported by the school administration. What information is important for the nurse to keep in mind when evaluating if a child is in compliance with this law? A)Compliance is expected by the first day of school. B)Immunizations must be complete by the end of the first month of ool. C)Children have until 60 days after school starts to complete immunization requirements. D)90 days after school starts is the final date that immunizations must be completed.

Ans: A Feedback:Immunizations are required by state law to be current and on file before or on the first day of school, although a school district can establish a short grace period, usually 30 days. Immunization requirements must be strictly supported by the school administration. Each state sets a standard for immunizations; a school district can increase the requirements but mus meet the minimum standard.

The nurse can help decrease pollution by beginning which of the following interventions? A)Minimize use of pollutants. B)Maximize use of disposable products. C)Incinerate paper products. D)Incinerate after use disposable products

Ans: A Feedback:Interventions to decrease pollution include use of less resources; select products that are less toxic; reuse products; minimize use of disposable products; recycle; and avoid incineration.

Before planning a health promotion program, the school health nurse needs to: A)Observe how the students and teacher interact in the classroom. B)Plan to conduct the program when the classroom teacher is not available. C)Involve just parents planning the program because of limited teacher availability. D)Only verbally market the program a few days prior to implementation.

Ans: A Feedback:It is important for nurse to always visit the classroom and observe how the students and teacher interact. Classroom management skills are essential. It is difficult to manage the classroom successfully when the nurse's contact with the youngsters is only occasional. Relying on the regular classroom teacher for assistance always works best. It is critical to involve key people, including the teachers, counselors, school nurses, and parents, from the very beginning of the planning phase of health programs. Outlining their expectations will contribute to the overall success of the program and help them become vested in the outcomes of the project. Such an approach is usually well received by students, administrators, teachers, and parents. Another consideration is marketing the program. It may be a great idea, but if no one attends or follows through, it will be a waste of time and resources. Use of flyers, bulletin boards, and public address announcements to reach audiences is important and needs to include various strategies to pique interest.

Trust, faith, and hope are significant concepts that relate closely to developing relationships and ultimately empowerment. For empowerment to be successful, people need to utilize which concept? A)Critical thinking B)Maintaining the "status quo" C)Examining the community outside oneself D)Incorporating theoretical concepts

Ans: A Feedback:It is through the process of critically thinking and evaluation that people are ultimately empowered. For empowerment and communication to be successful, people must engage in critical thinking, continually evaluating and reevaluating the premises behind their thoughts.

Which health insurance program would the nurse recommend to a 25-year-old client with end-stage renal disease? A)Medicare B)Medicaid C)Temporary Assistance to Needy Families D)State Children's Health Insurance Program

Ans: A Feedback:Medicare is a health insurance program for people 65 years or older, disabled people younger than 65 years, and individuals with end-stage renal disease or Lou Gehrig disease. Medicaid provides health care; insurance assistance and nursing home coverage for low-income residents and also pregnant women, a parent, or relative caregiver of a dependent child younger than 19 years, the blind, people with a disability or with a family member in their household with a disability, or people aged 65 years or older. Temporary Assistance to Needy Families provides financial and medical assistance to needy dependent children and parents and relatives with whom they are living. State Children's Health Insurance Program is for children younger than 19 years from families who earn too much to qualify for Medicaid.

Which is the best path a community health nurse can take to be an active constituent? A)Write letters, make a visit, or call government representatives. B)Visit websites of local, state, and federal governments. C)ldentify their representative with address and phone number to contact. D)Be an advocate, which involves speaking for those who cannot speak for themselves.

Ans: A Feedback:Nurses can be active members of a constituency by writing letters, making visits, or calling representatives. Reading the local newspaper with attention to local community issues is an excellent way to stay informed. Most government websites have links to enable constituents to identify their representatives and provide addresses and phone numbers for contacting representatives. Nurses as professionals may also choose to provide nursing expertise as policies and programs are being designed and to work with coalitions who have similar interests in the issues. Community health nurses can also be advocates for the people with whom they work. Being an advocate involves speaking for those who cannot speak for themselves.

In moving away from a disease prevention health care system, the focus of nursing has shifted to which type of health care? A)Primary B)Secondary C)Tertiary D)Both primary and secondary

Ans: A Feedback:Our challenge as community health nurses is to transform our health care system into one that reflects the values and needs of our communities based on the concepts of primary health care.

Choose the best description of the health care framework of patermalism. A)The physician holds the role of the father, the nurse is the mother, and the client is the child. B)The client and health care professional share in determining the options and selecting the best choice for that person. C)The balance of authority in decision making shifts away from the provider to the user of health care services, and the client is clearly in control of choices among available options. D)Interventions depend on the ability of the community health nurse to relinquish decision-making control to the community client and to trust its ability to make responsible decisions.

Ans: A Feedback:Paternalism is where the physician holds the role of the father, the nurse is the mother, and the client is the child. Contractualism occurs when the client and health care professional share in determining the options and selecting the best choice for that person. Consumerism occurs when the balance of authority in decision making shifts away from the provider to the user of health care services and the consumer is clearly in control of choices among available options. Community health interventions depend on the ability of the community health nurse to relinquish decision-making control to the community and to trust its ability to make responsible decisions.

There are several environmental hazards affecting human health. What would be one way the nurse could reduce the effects of a physical hazard on humans? A)Encourage the use of ear plugs during NASCAR races. B)Encourage the use of microwave ovens in place of gas ranges. C)Remove standing water to reduce the mosquito population. D)Remove plants destruction of adjacent plants.

Ans: A Feedback:Physical hazards to health include radiation, lead, other heavy metals, and noise. Biologic hazards can be infectious agents, insects, animals, and plants. Use of earplugs will reduce noise and damage to hearing. Encouraging microwave use is counterproductive to reduction of physical hazards. Reducing the mosquito population and removing dead plants are examples of preventing biologic hazards, not physical hazards.

To decrease pollution, one must understand how pollution is produced and how it affects the environment. Which statement will best assist in beginning to understand pollution? A)The rate of pollution is directly related to population size. B)The capacity of the environment t assimilate pollution is unlimited. C)Industrial development can assist with the elimination of pollutants. D)Movement of populations improve pollution.

Ans: A Feedback:Pollution is a rate function involving a quantity of pollutant introduced over a period of time. This rate is directly correlated with population size. The capacity of the environment to assimilate pollution is not unlimited; in fact, pollution of the environmer occurs when pollutants overwhelm the capacity of the environment to assimilate them without being thrown out of balance. Industrial development increases the number of pollutants and environmental insults. If the population moves, both the nature and the intensity of an environmental problem can shift. Thus, one area may improve; another may become more polluted.

Which activity occurs during the first phase of the MAP-IT process? A)A coalition of individuals who care about the faith community's health is formed. B)Areas of greatest need in the faith community are identified. C)Concrete action steps that can be monitored and make difference are planned. D)Progress of the health program over time is mapped.

Ans: A Feedback:The MAP-IT Strategy for creating a health community means M, mobilize; A, assess; P, plan; I, implement; T, track. Activities include mobilize individuals who care about the faith community's health into a coalition. Assess the areas of greatest need in your community and the resources and strengths you can tap into to address those areas of need. Plan the approach by starting with a vision of where the community wants to be; then add strategies and action steps to help achieve that vision. Implement the plan using concrete action steps that can be monitored and will make a difference. Track progress over time.

The community health nurse has to evaluate nursing research articles on community health nursing and diabetes for credibility and reliability. Which is one of the best databases to search for these articles? A)CINAHL B)DIRLINE C)ERIC D)Google

Ans: A Feedback:The most recent nursing and health care literature published is indexed in CINAHL, which is a valid and reliable source of information for community health nurses planning programming for aggregates in their community practice. The National Library of Medicine offers a database called DIRLINE that provides access to organizations focusing on health. Education Resources Information Center (ERIC) is an electronic database with many publications relating to teaching and education. The Google search engine gives a variety of sites, including those related to health and those not, with no restrictions on accuracy with the database.

The diversity and complexity of communities lead inevitably to a plethora of conflicts between and among ethical principles. What potential conflicts are prominent features of many of the Healthy People 2020 National Health Goals? A)Respect for people and beneficence B) Autonomy and justice C)Beneficence and justice D) Respect for people and autonomy

Ans: A Feedback:The potential conflict between autonomy and the public good (beneficence) is a prominent feature of many of the Healthy People 2020 National Health Goals. As delineated by the U.S. Department of Health and Human Services (2000), the health indicators used to measure progress toward reaching these goals include physical activity, overweight and obesity, tobacco use, substance abuse, responsible sexual activity, and immunization. Clearly, with the exception of immunization and substance abuse, these indicators are health behaviors that carry no mandates.

Emancipatory inquiry provides a framework to expand the political consciousness of the disenfranchised in a community. Who identifies the important problems for this inquiry? A)Community members B)Community health nurse C)Community health professionals D)Community medical director

Ans: A Feedback:The problems examined through emancipatory inquiry are those that community members believe are important and not necessarily those identified by health professionals in the community. Nurses are challenged to awaken the spirit of social change among those who are most vulnerable in our communities.

Which of the following reflects the major constructs of the nursing paradigm? A)Health, environment, client, and nurse B)Client, community outreach center, nursing, health, and illness C)Society, medicine, nursing, and interactions among individuals D)Psychosocial development, discipline, nursing, and client

Ans: A Feedback:The process by which nurses develop healing or caring relationships in the community reflects interactions among the four major constructs of the nursing paradigm: health, environment, client, and nurse.

The role of the nurse with faith communities is dictated as always by the needs of the people. Which is common role of the nurse in this setting? A)Advocate B)Leader C)Manager D)Research expert

Ans: A Feedback:The role of the nurse with faith communities includes, but is not limited to, health educator, health counselor, referral agent, advocate, facilitator, and liaison between the dimensions of spirituality and health.

Which statement best represents a core principle of participatory and action research? A)Community members and the researchers should strive to achieve mutual goals. B)The community health nurse for the research project determines the research agenda. C)The process should be laissez faire and empower the participation of a wide range of community members. D)The relationship between health care experts and community members must be kept confidential.

Ans: A Feedback:The six core principles of participatory and action research are as follows: the participants in the research project determine the research agenda; the research project should benefit the community as a whole and allow community members to make informed decisions and act collectively; the relationship between health care experts and community members should be a collaborative effort based on the principles of shared dialogue; community members should have access to all information and knowledge from which they might normally be excluded; the process should be democratic and empower the participation of a wide range of community members; and community members and the researchers should strive to achieve mutual goals.

Which is the second step in the process of policy making? A)Policy formation B)Policy adoption C)Policy evaluation D)Policy recognition

Ans: A Feedback:The steps in order of policy making are problem recognition and definition, policy formation, policy adoption, budgeting and policy implementation, and policy evaluation.

Reaching which target will meet the goals of the Millennium Declaration? Select all that apply. A)Halt and reverse the spread of HIV/ AIDS. B)Reduce the maternal mortality ratio by three-quarters. C)Develop and implement strategies for decent and productive work for youth. D)Continue gender disparity in primary and secondary education. E)Halve the population without sustainable access to safe drinking water and basic sanitation.

Ans: A, B, C, E, The Millennium Development Goals (MDG) Report outlines eight broad goals and specific targets for each goal that are to be achieved by the year 2015. These include halt and reverse the spread of HIV/AIDS; reduce the maternal mortality ratio by three-quarters; develop and implement strategies for decent and productive work for youth; and halve the population without sustainable access to safe drinking water and basic sanitation. Gender disparity in primary and secondary education should be eliminated, not continued.

After assessing the community's educational preferences, the nurse plans intervention programs based on the results. The faith community is interested developing a walking map. Which information should the nurse include? Select all that apply. A)Quarter-mile markers, noted by a community element such as a "no parking" sign B)One-mile loop around the worship center C)Extension trails to shopping malls, a recreational neighborhood school yards D)Places to stop for food and drink E)Safe and accessible walking trails

Ans: A, B, E Feedback:A walking map is a self-directed exercise tool. It should include safe and accessible walking trails with quarter-mile markers, noted by a community element such as a "no parking" sign. It should have a one-mile loop around the worship center, with extension trails to shopping malls, a recreational park, or neighborhood school yards. As an exercise tool, participants should be encouraged to stop for food

The public health nurse in New York City wishes to prepare for potential health outcomes of climate change. For which client should she develop plans? Select all that apply. A)Elderly man with cardiovascular disease on diuretic medication B)Farmer whose crop yield is low C)Relocated family living in temporary housing D)Child with asthma E)Female with a double knee replacement.

Ans: A, C, D, The elderly will be at the greatest risk for exposure to catastrophic weather events such as hurricanes and extreme heat. Climate change will worsen smog and cause plants to produce more pollen pollution, increasing respiratory health threats, particularly for people with allergies and asthma. Increased flooding will result in possible food and water shortages and may lead to mass migration. Persons affected by disasters and economic problems due to ecosystem and climate changes will be vulnerable to mental health stresses. The health care needs of the farmer with a low crop yield and the female with knee replacement should not require specific plans based on climate change.

Which of the following is one of the eight goals of the Millennium Development Goals Report? A)Eradicate poverty and hunger B)Achieve universal secondary education C)Reduce child morbidity D)Improve maternal health morbidity rates

Ans: A, The eight broad goals of the Millennium Development Goals Report are to eradicate extreme poverty and hunger; achieve universal primary education; promote general equality and empower women; reduce child mortality; improve matermal health; combat HIV/AIDS, malaria, and other diseases; ensure environmental sustainability; and develop a global partnership for development.

Which environmental sustainability target area of the Millennium Development Goals was reached 5 years ahead of schedule? A)Halve the proportion of the population without sustainable access to safe drinking water and basic sanitation. B)Improve the lives of at least 200 million slum dwellers. C)Address the special needs of the least developed countries, landlocked countries, and small island developing states. D)Develop further an open, rule-based, predictable, nondiscriminatory trading and financial system.

Ans: A, The goal of halving the proportion of the population without sustainable access to safe drinking water and basic sanitation was achieved in 2010, 5 years ahead of the 2015 goal. The other target areas have not yet been achieved.

Which is an example of a health care policy decision made at the community level? A)Health clinic for low-income families B)Licensure of health care professionals C)Ensured access to public health care D)Focus of client safety in hospitals

Ans: AFeedback:A new health clinic for low-income families is an example of a health care policy decision made on a community level, because it is funded with budget allocations from local city and county governments. The licensure of health care professionals is an example of a policy decision made at the state level, because the state government provides funding. National health policy focuses on issues of concerm to all citizens, such as legislation and regulations that focus on client safety in hospitals and ensure access to public health care.

Florence Nightingale is considered an exemplar of nurses' involvement in public policy. Nurses continue her work by: A)Being a part of the policy process and a participant in a positive process B)Cleaning of hospitals C)Determining a course of action D)Licensing of practicing nurses

Ans: AFeedback:Florence Nightingale believed not only in being a part of the policy process, but also in being a participant in a positive process. She believed that once she determined a course of action to be beneficial to the patients and was active in setting policy regarding hand washing and cleanliness procedures, it was her responsibility to make sure that the policy continued to be followed that exemplifies involvement in public policy. Nightingale was not involved in licensing of practicing nurses.

The American Nurses Association legislative initiatives include issues of access, cost, and quality of care. What is an example of a cost of care initiative? A)Medicare reform B)Advanced practice nurse coverage C)Safe health care reporting D)Safe client handling

Ans: B Feedback:Access to care includes access to health coverage, health plans, and Medicare reform. Cost of care includes advanced practice nurse coverage, health plans, Medicaid cost containment, medical errors, medical malpractice liability/tort reform, and Medicare reform/prescription drugs. Quality of care includes adequate and appropriate nurse staffing, mandatory overtime, safe health care reporting, "whistle-blowing" protection for nurses, and safe client handling.

The school nurse is developing a health education program on domestic violence for parents that addresses the effects on children and sources help for the whole family. What major issue affecting children does this address? A)Mental health issues B)Interpersonal violence C)Sexuality D)Environmental hazards

Ans: B Feedback:An example of interpersonal violence programming could be domestic violence and its effects on children and sources of help for the whole family. Examples of mental health issue programming could be self- esteem; attention deficit disorder/hyperactivity disorder, depression; and suicide. Sexuality programs could be personal hygiene; teenage pregnancy; teen parenting; and sexually transmitted diseases. Psychological environment programs could be grade stress; parent-child discord; parent-teacher and teacher-teacher conflicts; and peer harassment.

Which source for health information, available electronically, will enable the community health nurse to learn about the many characteristics of a community and to identify trends or patterns? A)The Centers for Disease Control and Prevention B)United States Census Bureau C)American Heart Association D)American Cancer Society

Ans: B Feedback:Census Bureau data enable the community health nurse to learn about the many characteristics of a community and to identify trends or patterns. Topics on the CDC website include prevalence of communicable diseases, updates for travelers, and immunization information. American Heart Association and the American Cancer Society are sources that look at heart disease and cancer and do not identify characteristics of a specific community.

Which two ethical principles come into question when community health research projects involve health screening? A)Autonomy and nonmaleficence B)Fidelity and veracity C)Respect for persons and beneficence D)Beneficence and justice

Ans: B Feedback:Community health research raises serious questions of fidelity and veracity in projects that involve health screening. Many communities, particularly those with underrepresented population groups, are frequently visited by teams of researchers who screen residents for any number of health conditions or risk factors, including chronic illness and toxic exposure. Community health nurses, as community advocates, should help ensure that they and other researchers are honest with the community about exactly what is to be provided. All too often, residents do not understand that the only benefit from participation in a research study is the screening itself. Access to the results of health screening raises a separate issue of veracity, as well as issues of beneficence and nonmaleficence. It is of little benefit to know of a serious health condition if there is no access totreatment for it.

Nursing in faith communities is based on which type of nursing? A)Religious B)Holistic C)Compassionate D)Participant

Ans: B Feedback:Congregational nursing, parish nursing, faith-based organizations (FBOS), and faith community nursing are descriptive terms found in the literature and apply equally to the concept of nursing in faith communities. This movement of nursing in faith communities is based on the principles of holistic nursing that recognize the dynamic relationship between spirituality and health of mind and body throughout the life span. Faith community nursing does not require promoting religious teachings. Although faith community nurses should practice compassionate care, compassion is considered a quality of nursing rather than a type of nursing. Participant nursing involves the nurse being an active participant in the social situation being studied.

Cultural beliefs based in shared meanings, values, and norms are key guidelines to consider when a person has a health problem. What is the first step an individual has to take when he or she is ill? A)Examine all possible and probable causes of the illness. B)Agree that the symptoms represent a problem. C)Plan of action is decided upon. D)Appropriate treatment is determined.

Ans: B Feedback:Cultural beliefs based in shared meanings, values, and norms are the basic guidelines people use for recognizing that something is wrong, interpreting what it might be, and organizing a plan of appropriate actions. For example, before action is taken in response to a problem, individuals and family members must first agree that the symptoms represent a problem. Next, there is an examination of all possible and probable causes, which may range from behaviors and foods to violations of cultural norms. Once a cause has been identified, a plan of action is made and appropriate treatment is determined.

What effect would a loss of biodiversity have on the habitats of plants and animals? A)Clearing of forests to create crop lands. B)Extinction of certain species of plants and animals C)Overall, continuous increase in temperatures throughout the world D)Climate changes as a result of soil erosion, climatic conditions, and air pollution

Ans: B Feedback:Deforestation is the clearing of forests to create crop lands. Deforestation contributes to soil erosion, a change in climatic conditions, and air pollution. Climate changes result in increased desertification. A loss of biodiversity results in the extinction of certain species of plants and animals and thus deforestation, desertification, and reproductive changes. There has been an overall increase in temperatures throughout the world. The greenhouse effect is a contributing factor to global warming.

Which of the following best defines diversity? A)Crosses two cultures, lifestyles, and sets of values B)Condition of being different or having differences C)Individuals with distinct identity that are related to a larger cultural group D)Basic knowledge of the different culture's health traditions in the community where the nurse is practicing

Ans: B Feedback:Derived from the Latin word divertere, meaning to turn in opposite directions, diversity is the condition of being different or having differences. Biculture is used to describe an individual who crosses two cultures, lifestyles, and sets of values. Subculture is where individuals with distinct identity are related to a larger cultural group. Cultural sensitivity is having basic knowledge of the different cultures' health traditions in the community where the nurse is practicing.

When analyzing data, what would the nurse look for to identify if data were missing? A)End point B)Gaps C)Qualitative D)Quantitative

Ans: B Feedback:During analysis, any need for further data collection is revealed as gaps and incongruities in the community assessment data. The end point of analysis is the community nursing diagnosis. Analysis is the study and examination of data. These data may be quantitative (numerical) as well as qualitative.

Which of the following best describes ethnocentric views? A)Dual patterns of identification of two cultures, lifestyles, and sets of values B)Belief that one's own culture or ways of life are better than those of others C)Belonging to a specific group of individuals who share a common social and cultural heritage D)Research framework that is used to provide the ability to focus on the culture of the community where the nurse is practicing

Ans: B Feedback:Ethnocentric views come about through believing that one's own culture or way of life is better than that of others. Biculture describes an individual with dual patterms of identification of two cultures, lifestyles, and sets of values. Being an ethnical individual occurs when one belongs to a specific group of individuals who share a common social and cultural heritage. Ethnography is a research that provides a framework to focus on the culture of a group of individuals.

Which has contributed to the movement of nursing in faith communities? A)Dissatisfaction with the disease-focused holistic model B)Access to health care and insurance coverage C)Decrease in lay ministry responsibilities in faith-based communities D)Need for ongoing chronic disease management in faith-based communities

Ans: B Feedback:Factors such as an increasing concern for disparities in health care; access to health care and insurance coverage; dissatisfaction with the disease-focused medical model; recent emphasis on bioethics as evidenced by institutions devoted to the interface of medicine and health; and church-based 12-step and meal programs historically have contributed to the movement. Other influencing components are self-responsibility for health care, increasing autonomous roles in nursing, increasing lay ministry responsibilities in faith-based communities, and limited health care system resources.

A nurse is designing and planning to implement a health promotion program in partnership with local faith communities. Which community planning guide would be helpful? A)Creative Nursing Journal B)Faith Community Nursing: Developing a Quality Practice C)International Journal for Human Caring D)Vournal of Holistic Nursing

Ans: B Feedback:Faith Community Nursing: Developing a Quality Practice is a guide to faith community nursing that provides practical tips for maintaining a quality health ministry program. In Creative Nursing Journal, a quarterly publication based on values, issues, experiences, and collaboration, nurses are encouraged to think creatively and take risks. Journal of Holistic Nursing integrates holistic health concepts of body, mind, emotions, and spirit within the context of a changing environment and is published quarterly. International Journal for Human Caring is published three times a year and focuses on the knowledge of care and caregiving within the discipline of nursing and in collaboration with other disciplines.

Which best describes HTML? A)List often compiled as a help feature on websites or search engines to assist the new user B)Format for creating documents for communication with browser program C)Provider of internet access D)Internet address shown on the browser in the locator bar

Ans: B Feedback:HTML means hypertext markup language, which is a format for creating documents where the text in the document is formatted with specific coding, called tags, for communication with a browser program. FAQ is a list often compiled as a help feature on websites or search engines to assist the new user. An ISP provides access to the internet for a fee using a telephone dial-up service, cable network, or a wireless service provider. URL is the term for an internet address that is shown on the browser in the locator bar and provides cues about the origin of the website.

Which of the following is a major reason that health disparities exist? A)No sensitivity to the needs of the individuals to be served B)Problems experienced in accessing and effectively utilizing health services C)Belief that individual's health is not closely related to community health. D)Common ground exists among clients and communities to encourage culturally competent health care partnerships.

Ans: B Feedback:Health disparities exist and are due, at least in part, to problems experienced in accessing and effectively utilizing health services. Reducing and eventually eliminating disparities depends on building common ground among clients, providers, agencies, and communities so that culturally competent health care partnerships can grow in number and quality of services.

Which is an example of health policy? A)Child labor laws B)Laws to promote health of citizens C)Rules for smoking environments for employees and clients D)State nurses' associations that determine governing rules for membership

Ans: B Feedback:Health policy includes the laws to promote the health of citizens. Child labor laws are an example of a social welfare policy. Rules of smoking environments for employees and clients are institutional policies. An example of organizational policy is a state nurses' association or a specialty nursing organization that determines governing rules for membership.

Which is most influential when determining how an individual acts when he or she is ill? A)Community health nurse B)Ethnic culture C)Individual who is sick D)Primary care provider

Ans: B Feedback:How an individual acts when "ill" is determined by ethnic culture. Some cultures have specific norms for sick role behavior, whereas other cultures suggest that you continue to carry out your everyday role to the best of your abilities.

To derive a community nursing diagnosis, community assessment data are analyzed and inferences are presented. What statement indicates an example of a descriptive, rather than an etiologic, inference? A)Lack of obstetric and family practitioners in Rosemont B)High prevalence of dental caries among children at Temple Elementary School in Rosemont C)Lack of dental assessment and treatment at the Third Street Clinic D)Low median household income in CT 4104 and associated limited economic resources for purchasing dental care

Ans: B Feedback:Inference statements shape nursing diagnoses. Some inference statements form the descriptive part of the nursing diagnosis (i.e., they testify to a potential or actual community health problem or concern). The correct answer describes a problem and is considered a descriptive statement. The others explain the etiologic, or are related to, cause of a descriptive problem.

A program is being developed to collaborate with local law enforcement to conduct a gun safety awareness program that includes handgun issues. This is a health promotion strategy for a partnership at what level? A)School B)Community C)Parents D)Teachers

Ans: B Feedback:Involving the neighboring community in health promotion programs can benefit school-aged children and their families, as well as members of the surrounding community. Health promotion strategies involving the community may include collaboration with local law enforcement to conduct a gun safety awareness program, including handgun issues.

When asked about the beginning of public health nursing, the best response would include which of the following? A)Public health nursing is a term started in the mid-1900s. B)The public health nurse provided care to people in communities as far back as the 1890s. C)Public health nursing began when clinics opened that provided community health assistance. D)The public health nurse was recognized after the term public health nursing was identified.

Ans: B Feedback:Lillian Wald coined the term public health nurse in 1893. Nurses have had a rich practice in the community, transforming both individual and public health for the poor and disenfranchised through political advocacy long before the 20th century. The public health nurse was one who provided health care to people within a community. Public health nursing started before coining the term public health nurse.

When planning interventions within a site-managed care system, the planners need to look closely at which type of health care to meet the current model standards? A)Aggregate community-based health care B)individual medical care C)Family-based health care D)Family- and community-based health care

Ans: B Feedback:Modern health care emphasizes individualized medical care as opposed to providing aggregate community-based health care. Our present "system" of health care has not served our profession well and has resulted in fragmented programs and limited return on improving the overall health in communities.

"Ineffective community therapeutic regimen management related to decreased rate of childhood immunizations as manifested by participation of 20% of the community in preventive health services, with an infant mortality rate of 42% and a morbidity rate of infants of 64%." Which statement within the diagnosis would be considered the etiologic statement? A)Ineffective community therapeutic regimen management B)Decreased rate of childhood immunizations C)Participation of 20% of the community in preventive health services D)Infant mortality rate of 42% and a morbidity rate of infants of 64%

Ans: B Feedback:Most nursing diagnoses have three parts: a description of the problem, response, or state; identification of factors etiologically related to the problem; and signs and symptoms that are characteristic of the problem. Decreased rate of childhood immunizations contains the etiologic statement which describes the cause. Ineffective community therapeutic regimen management is the description of the problem, participation of 20% of the community in preventive health services, anc infant mortality rate of 42% and a morbidity rate of infants of 64% are considered signs and symptoms of the problem.

A nurse has been hired to be the parish nurse in a new church community. Which is the best strategy for identifying the needs of this faith community? A)Distribute an educational needs survey to the women's auxiliary. B)Attend meetings for the representative different groups. C)Form an ad hoc committee with formal leaders to study the health ministry. D)Make decisions with input from the local community.

Ans: B Feedback:Some strategies for identifying faith community needs include attend meetings for the different groups; distribute an educational needs survey to various groups within the faith community, not just one segment; form an ad hoc committee to study the health ministry with both formal and informal leaders; and remember to only make decisions with input from the faith community.

During which stage of the nursing process does the nurse test the completeness and validity of her community nursing diagnosis? A)Assessment B)Planning C)Implementation D)Evaluation

Ans: B Feedback:The completeness and validity of the diagnoses that have been derived will be tested during the next stage process and will form the foundation f that stage the planning of a health program.

Nurses work to empower communities not for domination or control of people, but rather to facilitate the development of others to promote change. Empowerment is gained through critical dialogue. Which characteristic of this dialogue is correct? A)Enables communities to see individuals as the same to impact change for the betterment of humanity B)Enables communities to see their inequities to transform their environment through healing interventions C)Enables communities to envision the key physical characteristics necessary to encourage individual progress of community members D)Enables communities to negotiate with others who have similar viewpoints about the health of the community

Ans: B Feedback:The emergence of a healing consciousness in which communities envision a mind-body-spirit connection with humanity can only occur through dialogue. Dialogue provides the critical mass for community transformations to take place. Dialogue enables communities to see their inequities and transform their environment through healing interventions. This spirit of openness implies people are willing to listen to others and negotiate with an understanding of opposing viewpoints. Empowerme is a process of hope, trust, faith, and critical thinking based on mutual concerns and love for other human beings. Empowerment is a dualistic interactive process involving investment in understanding yourself and others and a willingness to impact change for the betterment of humanity.

Which intervention is appropriate for the community health nurse to advise citizens at risk for the adverse effects of air pollution? A)It is best to exercise in the early evening hours. B)Exercise indoors when pollutants are especially high outdoors. C)It is important to have access to long-acting relief medication when active outdoors. D)Jogging, instead of walking, is best on high-ozone-level days to reduce the amount of pollution inhaled.

Ans: B Feedback:The nurse should advise to exercise indoors when pollutants are especially high outdoors. Other interventions should include exercising in the early morning and away from busy roads or industrial areas and trying a less intense outdoor activity, such as walking instead of jogging, on high-ozone-level days will reduce the amount of pollution inhaled. The community health nurse can stress the importance of access to quick relief medication when active outdoors, especially for those beginning an activity program that is more intense than usual.

Which is the nurse's first step in the process of deriving community nursing diagnoses? A)Associated inferences are identified that explain the derivation of continuation of the problem. B)Assessment data are categorized and studied for inferences that are descriptive of potential or actual health problems amenable to nursing interventions. C)Documentation of the nursing diagnosis using a three-part statement of the problem, etiology, and signs and symptoms. D)Plan community nursing diagnoses on the basis of identification of only community goals and resources as well as the community priorities.

Ans: B Feedback:The process of deriving community nursing diagnoses always remains the same. First, assessment data are categorized and studied for inferences that are descriptive of potential or actual health problems amenable to nursing interventions; second, associated inferences are identified that explain the derivation or continuation of the problem; and third, documentation is presented. Determining the order of priority among community nursing diagnoses is part of program planning and depends on existing community goals and resources as well as the community's priorities.

Which provider is the most suitable to provide health care to school-aged children? A)Parents and guardians B)School nurse or public health nurse C)Pediatric nurse practitioner D)Family nurse practitioner

Ans: B Feedback:The school nurse or the public health nurse, depending on the community, is ideally suitable to provide health care to school-aged children. Nurses with advanced preparation in child health, such as pediatric nurse practitioners and family nurse practicioners, are also well prepared to initiate partnerships with schools. An ideal model is one in which the school nurse or public health nurse collaborates with the advanced practice nurse. In this way, health promotion, disease prevention, and health maintenance are important components included within the delivery of health care. School-aged children are a captive audience, and their parents/guardians are closely connected to the school community. This situation makes the school community an ideal center for health promotion activities for the entire family.

Which is a basis for faith community nursing? A)Economic recovery and easing poverty through education B)Spirituality and health of mind and body throughout the life span C)Supporting responsible motherhood through financially rewarding employment opportunities D)Fostering national interfaith communities

Ans: B Feedback:This movement of nursing in faith communities is based on the principles of holistic nursing that recognize the dynamic relationship between spirituality and health of mind and body throughout the life span. Helping economic recovery and easing poverty through education, supporting responsible motherhood through financially rewarding employment opportunities, and fostering national interfaith communities are all tasks nurses may perform, but they do not make up the basis of faith community nursing.

Which of the following is an extreme poverty and hunger eradication target of the Millennium Development Goals campaign? A)Halve, between 1990 and 2015, the proportion of people whose income is less than $5 a day. B)Halve, between 1990 and 2015, the proportion of people who suffer from hunger. C)Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling. D)Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015.

Ans: B, A target area for the Millennium Development Goals campaign to promote global health is to halve, between 1990 and 2015, the proportion of people who suffer from hunger and halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day. Ensuring that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling is a target area for achieving universal primary education. Eliminating gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015 is a target area to promote gender equality and empower women.

Which of the following represents research that is problem focused and involves all participants? A)Action B)Participatory C)Qualitative D)Quantitative

Ans: B, Feedback:Participatory research is problem-focused or context-specific research centered on a particular problem involving all participants. Participatory research is similar to action research, in which each person or group engaged in the process is committed to improvement through continuous interaction among dialogue, research, action, reflection, and evaluation. Quantitative research refers to a study in which items can be counted or measured and statisties can be used to analyze the result: Qualitative research refers to a study that involves phenomena sthey naturally occur.

Which program provides supplemental foods, nutrition education, and referrals to health care? A)Medicaid B)Women, Infants, and Children C)Temporary Assistance to Needy Families D)State Children's Health Insurance Program

Ans: BFeedback:The Women, Infants, and Children program provides supplemental foods, nutrition education, and referrals to health care. Medicaid provides health care; insurance assistance and nursing home coverage for low-income residents and also pregnant women, a parent, or relative caregiver of a dependent child younger than 19 years, the blind, people with a disability or with a family member in their household with a disability, and people aged 65 years or older. Temporary Assistance to Needy Families provides financial and medical assistance to needy dependent children and parents and relatives with whom they are living. State Children's Health Insurance Program is for children younger than 19 years from families who carn too much to qualify for Medicaid.

The community health nurse has to provide an elderly client with a seasonal influenza immunization. The immunization will cause temporary discomfort at the injection site, but the benefits or protection from getting the flu outweigh any minor discomfort for the client. Which ethical principle applies the situation? A)Autonomy B)Fidelity C)Beneficence D)Nonmaleficence

Ans: C Feedback:Beneficence is the desire to act in the best interest of others. Autonomy is the right of individuals to self-determination. Nonmaleficence is the avoidance of harm. Fidelity is being faithful in making promises and steadfast in keeping them.

Community health nurses must make a commitment to gain knowledge about health beliefs and health practices that can be used in the delivery of culturally competent health care to at-risk populations. This knowledge is associated with which sector of Kleinman's model? A)Cultural health system B)Folk C)Popular D)Professional

Ans: C Feedback:Conflicts, misunderstandings, and barriers to effective health care will be reduced only by commitment to gain knowledge about the popular sector, where health beliefs and health practices are activated and where 70% to 90% of all illness episodes are recognized and treated. The nursing profession's commitment to health and holism and its capacity to understand complex sociocultural responses to real and potential health problems make it the most logical choice for a professional segment to act as a client advocate in facilitating interactions between the sectors.

The principle of justice has two aspects, although most often discussions of health-related justice center on distributive justice. It would be important to remember that distributive justice is defined as: A)The commitment to tell the truth B)The arena of reward and punishment C)The fair distribution of rights and resources D)Faithful in making promises and steadfast in keeping them

Ans: C Feedback:Distributive justice is based on the fair distribution of rights and resources. Retributive justice is the arena of reward and punishment. Veracity is the commitment to tell the truth. Fidelity is being faithful in making promises and steadfast in keeping them.

Which of the following best describes the composition of an ethnic group? A)Associated with minority or majority populations who share the same cultural background B)Associated with minority populations that do not share the traditions of their social heritage C)Composed of individuals who share a unique cultural background and social heritage that is passed from one generation to the next generation D)Composed of individuals that have distinct identity who relate well within the community at large

Ans: C Feedback:Ethnic groups are composed of people who share a unique cultural background and social heritage that is passed from one generation to another. Ethnicity is associated with minority or majority populations who share the same cultural background. An ethnic group is associated with populations who share the traditions of their heritage. Ethnic groups do not always relate well within a community at large but do within their own communities.

The nurse is using the community-as-partner model to complete a community health assessment. Which does the flexible line of defense represent? A)Level of health the community has reached over time B)Internal mechanisms that act to defend against stressors C)Buffer zone representing a dynamic level of health resulting from a temporary response to stress D)Tension-producing stimuli that have the potential of causing disequilibrium in the system

Ans: C Feedback:Flexible line of defense is the buffer zone representing a dynamic level of health resulting from a temporary response to stress. Normal line of defense is the level of health the community has reached over time. Lines of resistance are internal mechanisms that act to defend against stressors. Stressors are tension-producing stimuli that have the potential of causing disequilibrium in the system.

A community health nurse is developing a program on internal and external environmental issues for school nurses. In describing Healthy People 2020, which goal would the community health nurse emphasize for this group? A)Eliminate preventable disease, disability, injury, and premature death. B)Achieve health equity, eliminate disparities, and improve the health of all groups. C)Create social and physical environments that promote good health for all. D)Promote healthy development and healthy behaviors across every stage of life.

Ans: C Feedback:Healthy People 2020 identifies four overarching goals: eliminate preventable disease, disability, injury, and premature death; achieve health equity, eliminate disparities, and improve the health of all groups; create social and physical environments that promote good health for all; and promote healthy development and healthy behaviors across every stage of life. Comprehensive school health programs should focus on delivering health services mandated by state laws and the individual school system as well as on health education. Additionally, both internal and external environmental issues are critical areas of assessment and intervention for school nurses.

What is an example of a secondary prevention strategy that the school nurse can implement to influence the school climate and reduce bullying? A)Conduct a teacher/staff in-service program to educate the members of the school community about the problem of bullying. B)Have a parent meeting to discuss preventing school violence and explain that addressing and stopping bullying is an important component of violence prevention. C)Have teacher-student discussion groups to reinforce antibullying messages and contribute to changing the school culture. D)Formally assess bullying behaviors on an annual basis.

Ans: C Feedback:Implementing secondary prevention includes teacher-student discussion groups to reinforce antibullying messages and contribute to changing the school culture. Implementing primary prevention includes conducting a teacher/staff in-service program to educate the members of the school community about the problem of bullying and having a parent meeting to discuss preventing school violence and explaining that addressing and stopping bullying is an important component of violence prevention. Implementing tertiary prevention includes formally assessing for bullying behaviors on an annual basis.

Which concept best describes the role of the health care professional, particularly applicable to community health nursing, as that of catalyst? A)The concept involves understanding the world view, life circumstances, and priorities of those requesting or receiving care and exploring the possible options with them in light of their preferences. B)The health care professional tries to imagine experiencing the situation of the person seeking care and offers an opinion of the best choice in full consideration of the other party's individuality. C)The community is seen to contain all the necessary qualities and resources for change, and the role of the health care professional is to provide the spark that will initiate change, as desired by the community and on its terms. D)The concept attempts to describe action within political, economic, and social systems on behalf of health interests of communities.

Ans: C Feedback:In the model of catalyst, the community is seen to contain all the necessary qualities and resources for change, and the role of the health care professional is to provide the spark that will initiate change, as desired by the community and on its terms. Advocacy involves understanding the world view, life circumstances, and priorities of those requesting or receiving care and exploring the possible options with them in light of their preferences; the health care professional tries to imagine experiencing the situation of the person seeking care and offers an opinion of the best choice in full consideration of the other party's individuality; and the concept describes action within political, economic, and social systems on behalf of health interests of communities.

"Ineffective airway clearance related to smoke inhalation." What statement could be added to make this a more completely stated community nursing diagnosis? A)A description of the problem, response, or state B)ldentification of factors etiologically related to the problem C)Signs and symptoms characteristic of the problem D)Nothing is missing; it is a complete community nursing diagnosis.

Ans: C Feedback:Most nursing diagnoses have three parts: a description of the problem, response, or state; identification of factors etiologically related to the problem; and signs and symptoms that are characteristic of the problem.

"Ineffective community coping related to deficits in community social support services." What part of the nursing diagnosis would follow the added statement of "as manifested by"? A)A description of the problem, response, or state B)ldentification of factors etiologically related to the problem C)Signs and symptoms characteristic of the problem D)Nothing is missing; it is a complete community nursing diagnosis.

Ans: C Feedback:Most nursing diagnoses have three parts: a description of the problem, response, or state; identification of factors etiologically related to the problem; and signs and symptoms that are characteristic of the problem. "As manifested by" is a statement that precedes the signs and symptoms in a diagnosis.

The community health nurse needs to have an understanding of the environmental factors that affect the health of communities. As practitioners of community health, how does this information aid us? A)Health of any population cannot be affected by its surrounding environment. B)We should support any claims of perfect disposal schemes for pollutants. C)Pollutants can travel long distances because there are no perfect disposal schemes. D)Water treatment systems usually precipitate pollutants to a top sludge.

Ans: C Feedback:Nurses must be aware that the health of any population can be affected by its surrounding environment. Next, nurses must be skeptical of any claims of perfect disposal schemes for pollutants; they do not exist. Remember that pollutants can travel long distances and remain undetected. Water treatment systems usually precipitate pollutants to a bottom sludge.

Partnerships between community members and health care professionals are critical. For these partnerships to be successful promoting awareness and understanding of a community's health needs, the partners must have which type of relationship? A)Independent B)Dependent C)Collaborative D)Autonomous

Ans: C Feedback:Partnerships between community members and health care professionals are critical for collaborative decisions that promote awareness and understanding of a community's health needs. Community health nurses have power to develop healing relationships or capacity-building activities that promote health and to empower others to engage community members in collaborative efforts, partnerships, and coalitions.

When a nurse is making a career choice, which clinical setting would best support the operative framework of consumerism? A)Burn/ trauma unit B)Cardiac critical care unit C)Plastic surgery unit D)Surgical intensive care unit

Ans: C Feedback:Plastic surgery, an elective health care situation, represents the consumerism framework, in which the consumer is clearly in control of choices among available options, and the balance of authority in decision making shifts away from the provider to the user of health care services. Health care professionals working in areas such as trauma, intensive care, and critical care, care for people who are often in acute distress and may not be able to be active participants in making decisions regarding their care. These setting represent the paternalism framework.

The community health nurse understands that politics is which of the following? A)Laws to promote the health of citizens B)Promoting of the welfare of the public C)Process of influencing the allocation of scarce resources D)Applies to all members of a society and includes prescribed sanctions for failure to comply

Ans: C Feedback:Politics is defined as the process of influencing the allocation of scarce resources. Health policy includes the laws to promote the health of citizens. Policy that promotes the welfare of the public is termed social welfare policy. Public policy applies to all members of a society and includes prescribed sanctions for failure to comply.

The community health nurse is planning a health promotion program for school-aged children for Red Ribbon Week. The goal of this type of program would include which of the following? A)How to avoid teen pregnancies B)Healthy cardiovascular promotion measures C)Increase awareness of the dangers associated with alcohol and tobacco D)Review common eating disorders and how to prepare healthy lunches

Ans: C Feedback:Red Ribbon Week occurs in October each year to celebrate being drug-free. The Red Ribbon Campaign was established in 1988 by the U.S. Congress. The goal was to increase the awareness of the dangers associated with the use of tobacco, alcohol, and other drugs.

The community health nurse is trying to locate information about physical therapy among the developmentally disabled. Which would be the best search string to locate this information? A)Physical therapy B)Physical therapy OR developmentally disabled C)Physical therapy AND developmentally disabled D)Physical therapy NOT developmentally disabled

Ans: C Feedback:The Boolean word AND instructs the search engine to return only resources that have both terms in the documents, resulting in more effective searching. The OR word enlarges the search yield by identifying all information focused on both terms searched. The NOT word can be used to limit yields when searching by identifying what you do not want. Limit setting is a tool to increase the precision of searches.

The nurse establishes a Healthy Heart Club. Which the leading indicator of Healthy People 2020 does this program support? A)Access to health care B)Physical activity C)Overweight and obesity D)Mental health

Ans: C Feedback:The Healthy Heart Club combines nutrition and education in a monthly gathering at lunchtime in an attempt to address the national problem of overweight and obesity. This nursing action can be geared to adults, teens, or children. It is designed to teach the basics of eating a balanced diet, how to shop wisely for healthy food, and how to make good choices in restaurants. The Healthy Heart Club does not address access to care issues, physical activity, or mental health needs.

Which activity occurs during the "P" phase of the MAP-IT process? A)A coalition of individuals who care about the faith community's health is formed. B)Areas of greatest need in the faith community are identified. C)Strategies and action steps to achieve community vision are planned. D)A plan of concrete action steps that can be monitored and make a difference is implemented.

Ans: C Feedback:The MAP-IT Strategy for creating a health community means M, mobilize; A, assess; P, plan; I, implement; T, track. During the "P" phase, community starts with a vision of where it wants to be; then adds strategies and action steps to help achieve that vision. Other activities include mobilize individuals who care about the faith community's health into a coalition. Assess the areas of greatest need in your community and the resources and strengths you can tap into to address those areas of need. Implement the plan using concrete action steps that can be monitored and will make a difference. Track progress over time.

Considering Kleinman's model, which sector includes the family? A)Cultural health system B)Folk C)Popular D)Professional

Ans: C Feedback:The popular sector of cultural health care systems is made up of informal healing relationships that occur within one's own social network. Although the family is at the nucleus of this sector, health care can take place between people linked by kinship, friendship, residence, occupation, or religion. The folk sector of cultural health care systems includes the interaction between a client and sacred and secular healers. The professional sector is composed of the licensed health professionals.

Which of the following approaches would be best to implement when trying to modify unhealthy behaviors? A)Focus on medical professionals curing of diseases. B)Mobilize community members to focus on curing diseases. C)Mobilize community members to take an active role in the delivery of services. D)Mobilize community members to involve in the decision-making process to improve health.

Ans: C Feedback:There are three approaches to community participation in health programs commonly used by different countries. One is the medical approach, which is focused on curing diseases and is controlled by the medical profession. The second is a health services approach, which mobilizes people to take an active role in the delivery of services based on modifying unhealthy behaviors. The third is a community development approach, in which people are involved in the decision-making process to improve health. The first two approache: to health care are called "top-down" approaches, in which experts prescribe their values of health care for the public. The third approach is a the grassroots level, in which members within the community determine what health care services should be provided. It is more consistent with the principles of primary health care.

Which best describes how community health nurses can help a community achieve their common goals? A)Maintenance B)Transforming C)Empowerment D)Implementation

Ans: C Feedback:Through community empowerment, nurses can provide a moral voice to inspire change to regain our historical roots as vanguards of the community. Through empowerment, community health nurses can enable people to make decisions and to act on issues they believe are essential to their health or well-being. The other answer choices are not directly related to the empowerment of communities to achieve a set of goals.

Community health nurses must continue to collect data about the policy that has been implemented in a community agency. In what step of the nursing process does the community health nurse continue to collect data? A)Assessment B)Diagnosis C)Evaluation D)Implementation

Ans: C Feedback:When equating the nursing process to the steps of policy making, evaluation equates to policy evaluation, assessment equates to problem recognition and definition, diagnosis equates to policy formation, and implementation equates to budgeting and policy implementation.

The basic building blocks of nursing, the steps of the nursing process, are similar to the process used in policy making. In what step of the nursing process does adoption of a policy by the appropriate agency occur? A)Assessment B)Diagnosis C)Planning D)Implementation

Ans: C Feedback:When equating the nursing process to the steps of policy making, planning equates to policy adoption, assessment equates to problem recognition and definition, diagnosis equates to policy formation, and implementation equates to budgeting and policy implementation.

Knowing that complications of pregnancy account for 15% of deaths in women of reproductive age worldwide, what focus would best help direct the nurse to decreasing that statistic? A)Recruit a midwife to provide additional assistance with delivery. B)Arrange a breastfeeding class for pregnant mothers. C)Set up a prenatal clinic in a local community. D)Provide childcare while women attend childbirth classes.

Ans: C, Complications of pregnancy account for almost 15% of deaths in women of reproductive age worldwide. Setting up a prenatal clinic in the local community would make health care during the pregnancy more convenient, possibly reducing problems associated with no prenatal care and reducing the maternal mortality rate during pregnancy. Prenatal care would be the best way to provide health care and reduce complications that could result in maternal death. Without prenatal care, recruiting a midwife for the delivery would not reduce problems associated with lack of prenatal care. Providing a breastfeeding class and childcare would not provide reduction in pregnancy problems.

Which of the following is one of the essential elements of primary health care in the globalized 21st century? A)Prevention and control of worldwide endemic diseases B)Prevention of worldwide smoking C)Proper food supplies and nutrition D)Immunizations against all major common diseases

Ans: C, In the globalized 21st century, community health nurses committed to primary health care need to focus on eight essential elements of primary health care. The areas are education for the identification and prevention/control of prevailing health problems; proper food supplies and nutrition; adequate supply of safe water and basic sanitation; maternal and child care, including family planning; immunization against the major infectious diseases and prevention and control of locally endemic diseases; appropriate treatment of common diseases using appropriate technology; promotion of mental health; and provision of essential drugs.

A community health nurse has to start an IV on a client. The client has never had an IV. The client asks the community health nurse if this will be a painful procedure. The nurse tells the client the truth: that it will be uncomfortable while the needle is being inserted. What ethical principle is the nurse practicing? A)Autonomy B)Fidelity C)Justice D)Veracity

Ans: D Feedback: Veracity is the commitment to tell the truth. Autonomy is the right of individuals to self-determination. Fidelity is being faithful in making promises and steadfast in keeping them. Justice is the fair distribution of rights and resources.

When developing an agenda in a community to effect change, which person(s) would be primary to engage in the development of this agenda? A)Community medical director B)Academic experts C)Individual client D)Community members

Ans: D Feedback:A basic tenet of community empowerment is that the community defines its own agenda. Community participation is a crucial element in engaging community members to develop agendas that serve as a cohesive force to mobilize the community toward a process of change.

There are differences between a program funded by the government and a policy formed and funded by the govermment. Which best describes a program? A)Process of influencing the allocation of scarce resources B)Set of principles that is frequently formally agreed upon C)Based on the institution's mission and goals D)Set of actions to achieve a goal

Ans: D Feedback:A program is a set of actions achieve a goal. Politics is the process of influencing the allocation of scarce resources. Policy is a set of principles that is frequently formally agreed upon. Institutional policies are based on the institution's mission and goals, and they determine how the institution will function and relate to employees.

The nurse is wondering if the cancer treatments might be more harmful than the progression of the disease because of the dangerous side effects of chemotherapy. What ethical principle is the nurse struggling with in this situation? A)Autonomy B)Beneficence C)Justice D)Nonmaleficence

Ans: D Feedback:Autonomy is the right of individuals to self-determination. Nonmaleficence is the avoidance of harm. Beneficence is the desire to act in the best interest of others. Justice is the fair distribution of rights and resources.

When contrasting philosophical approaches in applied ethics, it would be important to know that an example of teleology is what? A)All nurses need to follow personal moral codes in their personal and professional lives. B)Nurses should subscribe to professional codes of ethics in their daily actions as a nurse. C)All individuals in a research study have a complete understanding and informed consent of the study. D)Preventing communicable disease benefits many more people in the community than does caring for individual illnesses.

Ans: D Feedback:Examples of deontology include all nurses need to follow personal moral codes in their personal and professional lives; nurses should subscribe to professional codes of ethics in their daily actions as a nurse; all individuals in a research study have a complete understanding and informed consent of the study. An example of teleology is preventing communicable disease benefits many more people in the community than does caring for individual illnesses.

Which of the following can be used to set an agenda for community health improvements in today's society? A)American Nurses Association Code of Ethics with Interpretive Statements B)American Nurses Association Social Policy Statement C)Contributions set forth by Lillian Wald D)Healthy People 2020

Ans: D Feedback:Health care providers are encouraged to work with communities to implement health programs to further the health of the community and to use the Healthy People goals to set an agenda for community health improvements. Community health nursing is guided by the American Nurses Association (ANA) Code of Ethics with Interpretive Statements (2005) and the ANA Social Policy Statement (2003). Both of these documents include sections on nurses' responsibility to the public and threats to the health and safety of the community. Florence Nightingale, Lillian Wald, and Margaret Sanger addressed community issues for community health.

Which of the following is an overarching goal of Healthy People 2020? A)Developing partnerships between individuals and community health B)Believing that individual health is closely related to community health C)Decreasing disparities among subgroups of the population D)Increasing the length and improving the quality of healthy life

Ans: D Feedback:Healthy People 2020 initiatives are guided by two overarching goals: to increase the length and improve the quality of healthy life; and to eliminate disparities among subgroups of the population.

"Readiness for enhanced community coping related to community sense of power to manage stressors as manifested by monthly community meetings to identify and talk about stress concems." What should the nurse add to make this a more complete nursing diagnosis? A)A description of the problem, response, or state B)ldentification of factors etiologically related to the problem C)Signs and symptoms characteristic of the problem D)Nothing is missing; it is a complete community nursing diagnosis.

Ans: D Feedback:Most nursing diagnoses have three parts: a description of the problem, response, or state; identification of factors etiologically related to the problem; and signs and symptoms that are characteristic of the problem.

"Risk for suffocation related to discard of refrigerators without doors as manifested by parental concern for safety" is a nursing diagnosis statement. Is there something that could be added to make this statement more complete? A)A description of the problem, response, or state B)ldentification of factors etiologically related to the problem C)Signs and symptoms characteristic of the problem D)Nothing is missing; is a complete community nursing diagnosis.

Ans: D Feedback:Most nursing diagnoses have three parts: a description of the problem, response, or state; identification of factors etiologically related to the problem; and signs and symptoms that are characteristic of the problem.

Which of the following toxic substances are most likely to pose a risk to human health, both in prevalence and severity? A)Cardiotoxins B)Hepatotoxins C)Nephrotoxins D)Neurotoxins

Ans: D Feedback:Neurotoxins are most likely to be the most significant toxic substances in both prevalence and severity that pose a risk to human health.

It is important the community health nurse agree to do no harm to clients in working to heal clients in the least painful and harmful way possible. Which ethical principle applies to the community health nurse? A)Respect for person B)Veracity C)Beneficence. D)Nonmaleficence

Ans: D Feedback:Nonmaleficence is the avoidance of harm. Veracity is the commitment to tell the truth. Beneficence is the desire to act in the best interest of others. Respect for people is the recognition that every person and community has intrinsic value.

When planning the integration of health resources in a community, which of the following people would be the best to lead this effort? A)Physicians B)Nurse practitioners C)Social workers D)Nurses

Ans: D Feedback:Nurses have long been at the forefront of integrating health resources by forming partnerships with clients, families, and communities. Community health nurses have the power to develop healing relationships or capacity-building activities that promote health and to empower others to engage community members in collaborative efforts, partnerships, and coalitions. Physicians, nurse practitioners, and social workers serve a specific purpose once the nurse identifies the needs of the individuals within a community.

Empowerment through participation has three essential components to which nurses must be sensitive in order for community transformations to occur. Which statement best describes one of the essential components? A)Shared awareness by members of the health care community B)Mechanisms to mobilize the community to recognize its needs C)Suggest ways to develop a culture of community participation. D)People have the right to choose.

Ans: D Feedback:Participation is an active process, not a process in which one group or organization imposes its values on the community, but a process of mutuality, in which all have voice. Participation involves choice, implying people have the right and the power to make decisions that affect their lives. Decisions made through participation must have the potential to be effective, and there must be social systems to allow decisions to be implemented.

Poisoning occurs through cumulative exposure to insecticides, herbicides, fungicides, and rodenticides. What can happen to the human body as a result of poisoning? A)Alopecia B)Developmental disabilities C)Heart disease D)Respiratory cancer

Ans: D Feedback:Poisons cause sarcomas, lymphomas, myelomas, and respiratory and prostate cancers. Air pollution can cause heart disease. Water pollution can cause developmental disabilities and alopecia.

Pollution of the environment occurs when these pollutants overwhelm the capacity of the environment to assimilate them without being thrown out of balance. Which statement is correct about pollution? A)Pollution is an indirect rate function that is correlated to population size. B)Pollution is a direct rate function that is correlated to the quantity of pollutant. C)Pollution is a rate function involving the quality of pollutant introduced over a period of time. D)Pollution is a rate function involving a quantity of pollutant introduced over a period of time.

Ans: D Feedback:Pollution is a rate function involving a quantity of pollutant introduced over a period time. This rate is directly correlated to population size.

Which is one step a community health nurse can take to stay informed on current issues? A)ldentify government representatives about issues. B)Provide nursing expertise as policies are being designed. C)Be an advocate by speaking out for those who cannot speak for themselves. D)Read the local newspaper with attention to local community issues.

Ans: D Feedback:Reading the local newspaper with attention to local community issues is an excellent way to stay informed. Most government websites have links to enable constituents to identify their representatives and provide addresses and phone numbers for contacting representatives. Nurses as professionals also may choose to provide nursing expertise as policies and programs are being designed and to work with coalitions who have similar interests in the issues. Community health nurses can also be advocates for the people with whom they work. Being an advocate involves speaking for those who cannot speak for themselves.

Which nurses would be ideal for faith community nursing, if the work is less physically demanding and provides flexibility in the work schedule? A)Ambulatory care B)Critical care C)Nurse practitioner D)Retired

Ans: D Feedback:Retired professional nurses are ideally suited to work as faith community nurses. As the nursing workforce ages, creative ways to maintain an adequate cadre of nurses to meet the health needs of the population are needed. Older nurses are likely to want or need more flexibility in their schedules and work situations that are less physically demanding.

Partnerships between local health departments and faith-based organizations potentially can do much to deliver services and reduce health disparities experienced by vulnerable groups. Which Healthy People 2020 goal is consistent with this philosophy of faith communities? A)Individual health is closely related to community health. B)Increase quality and years of life with elimination of preventable disease. C)Develop partnerships between individual and community health. D)Achieve health equity, eliminate disparities, and improve the health of all groups.

Ans: D Feedback:The Healthy People 2020 goals are to eliminate preventable disease, disability, injury, and premature death; to achieve health equity, eliminate disparities, and improve the health of all groups; to create social and physical environments that promote good health for all; and to promote healthy development and healthy behaviors across every stage of life.

After the planning phase of the MAP-IT process, which would the nurse do next? A)Form a coalition of individuals who care about the faith community's health. B)Identify areas of greatest need in the faith community. C)Plan strategies and action steps to achieve the community vision. D)Implement a plan of concrete action steps that can be monitored and make a difference.

Ans: D Feedback:The MAP-IT Strategy for creating a health community means M, mobilize; A, assess; P, plan; I, implement; T, track. After planning, implementation begins. Mobilization and assessment occur before the planning phase, and tracking occurs after the implementation phase.

When using the MAP-IT process, which activity will the nurse perform last? A)A coalition of individuals in the faith community is provided with a progress report. B)Progress in all areas of greatest need in the faith community is reviewed. C)Concrete action steps that can be monitored and make a difference are implemented. D)Progress of the individual health program over time is mapped.

Ans: D Feedback:The activities of the MAP-IT Strategy for creating a health community are performed in the following order: M, mobilize; A, assess; P, plan; I, implement; T, track.

A client tells the community health nurse that he looked up information about his respiratory inhaler on the internet. Which would be the community health nurse's best response? A)"That is excellent that you reviewed information on the internet about the medication." B)"The internet does not provide credible information about medications. You must check with the pharmacist about the side effects of any medication." C) You should only check with your primary care provider about the uses and adverse effects of the medication." D)"I would like to review the information with you. On what specific website did you locate the information?"

Ans: D Feedback:The community health nurse always needs to evaluate the information retrieved electronically according to the following criteria: author; credibility and accuracy currency; objectivity versus bias; and navigation.

The community health nurse is involved in a creative program that promotes health and generates a more social school atmosphere. What would be the most appropriate program that can be implemented with groups such as teachers or staff in a school setting? A)Late breakfast meetings; "second cup of coffee meeting" B)Grandparents' day C)Monthly health bulletin board D)Monthly blood pressure assessments

Ans: D Feedback:The following are ideas for health promotion strategies that can be used with groups such as teachers or staff in the school setting: blood pressure screening on the same day each month; cancer awareness programs; stuffing payroll envelopes with health promotion material; healthy heart lunches, such as salad day once a week; referral and resource information; and TB skin testing.

There are several nursing interventions that can be used to decrease environmental influences on health. How can a nurse use tertiary prevention to keep the environment clean? A)Decrease environmental pollution. B)Educate the community on how to keep the environment clean. C)Involvement with political actions that provide strategies to minimize environmental exposure in populations. D)Help communities to manage the long-term effects of conditions that are caused by environmental hazards.

Ans: D Feedback:The nurse can use tertiary prevention to keep the environment clean by helping communities manage the long-term effects of conditions that are caused by environmental hazards. The nurse can use secondary prevention to keep the environment clean by decreasing environmental pollution. The nurse can use primary prevention to keep the environment clean by educating the community on how to keep the environment clean and involvement with political actions that provide strategies to minimize environmental exposure in populations.

Each cultural health care system has several recognized sectors. Select the answer that best represents Kleinman's model. A)Cultural health care system B)Popular and cultural health care system C)Folk, personal, professional D)Folk, popular, professional

Ans: D Feedback:The three sectors Kleinman's model of the health care system addresses are referred to as popular, folk, and professional.

Which sector of Kleinman's model differs in their social and cultural values, beliefs, and assumptions? A)Cultural health system B)Folk C)Popular D)Professional

Ans: D Feedback:Unlike in the popular and folk sectors, the clients and the providers in the professional sector typically differ in their social and cultural values, beliefs, and assumptions.

Humans are hosts to a number of disease-causing pathogens and parasites. Which is an example of a vector? A)Dressings B)Food C)Handkerchiefs D)Insects

Ans: D Feedback:Vectors are animals or flying or crawling insects or other arthropods that serve as an intermediate means of transporting the infectious agent. Vehicles, such as dressings, food, and handkerchiefs, are substances that serve as an intermediate means to transport and introduce an infectious agent into a susceptible host.

The basic building blocks of nursing, the steps of the nursing process, are similar to the process used in policy making. In what step of the nursing process would the budget be established for a policy that is being developed? A)Assessment B)Diagnosis C)Planning D)Implementation

Ans: D Feedback:When equating the nursing process to the steps of policy making, implementation equates to budgeting and policy implementation, assessment equates to problem recognition and definition, diagnosis equates to policy formation, and planning equates to policy adoption.

Which of the following is a negative effect of globalization on health? A)Diffusion of ideas B)Expansion of trade C)Global stewardship D)Brain drain

Ans: D, A negative effect of globalization is the "brain drain" that results when educated society members migrate from lower-resource countries to higher-resource countries. Thus, many groups who could most benefit from increased access to information and communication technology are unable to enjoy the benefits these technologies bring to health care because of challenges with untrained personnel and lack of infrastructure and resources. Diffusion of ideas, expansion of trade, and global stewardship are among the positive effects of globalization.

Which is a true statement regarding the global burden of disease? A)Approximately 5 million children younger than 5 years die every year. B)HIV/AIDS is the leading cause of child death in Africa. C)Lung cancer is contributing to the rise in cancer and heart disease. D)Mental disorders such as depression are among the 20 leading causes of disability.

Ans: D, Mental disorders such as depression are among the 20 leading causes of disability worldwide. Approximately 10 million children younger than 5 years die every year. HIV/AIDS is the leading cause of adult deaths in Africa. Population aging is contributing to the rise in cancer and heart disease. Lung cancer is the most common cause of death from cancer in the world.

Which two sectors of Kleinman's model are associated with belief systems that are nonscientific or subjective? A)Folk and professional. B)Popular and cultural health system C)Popular and professional D)Popular and folk

Ans: D. Feedback:Belief systems in the popular and folk sectors have often been termed as unorthodox, lay, subjective, or nonscientific, and have been associated with non-Western societies. A client's preference for such healing practices may have been dismissed by some professional health care professionals.

Which is the name for the part of the internet that supports the use of information exchange, including pictures, sounds, and movies, using graphical user interface? A)Boolean searching B)Directory C)Home page D)World Wide Web

Ans: D. Feedback:The World Wide Web is part internet supporting use of information exchange, including pictures, sounds, and movies, using what is known as graphical user interface. Boolean searching uses the terms AND, OR, and NOT in the search string. These terms assist the user in increasing the precision of the search. Directory is a list of websites found on the internet that have been organized by a hierarchy determined by the author of the directory. Home page is the first screen or view of a website.

If the community experiences 2,000 motorcycle fatalities, of which 1,900 are male and 100 are female, what would be the proportion of males killed in motorcycle accidents? ______%

Ans:95%, A proportion is one number divided by another in which the numerator is a subset of the denominator (i.e., is included in the denominator) and is expressed as a percentage. In this example, the percentage of males to females would be 1,900/2,000 multiplied by 100, which equals 95%.

The community health nurse recommends a blog on diabetes to a client. Which is the definition of a blog? A)Online diary that offers chronological sharing opportunities B)Worldwide collection of networks in communication using special protocols C)Words and commands entered into a search box to identify desired information D)List of websites found on the internet that have been organized by a hierarchy determined by the author of the directory

Ans:A Feedback:A blog is an online diary that offers chronological sharing opportunities. The internet is a worldwide collection of networks in communication using special protocols. Search strings are words and commands entered into a search box to identify desired information. A directory is a list of websites found on the internet that have been organized by a hierarchy determined by the author of the directory.

The nurse plans to use a mashup when demonstrating data. Which is the definition of a mashup? A)When two or more sources of data are combined to create an online tool, often using mapping features B)Tool that uses computer programs to search the internet for websites and indexes those sites by keywords C)Single word and command that are entered into a search box to identify desired information D)A descriptive term that can be used to search documents that is useful to identify large amounts of information on a topic

Ans:A Feedback:A mashup is when two or more sources of data are combined to create an online tool, often using mapping features. A search engine is a tool that uses computer programs to search the internet for websites and indexes those sites by keywords. Keyword searching is the use of a single word and command that are entered into a search box to identify desired information. Keyword is a descriptive term that can be used to search documents that is useful to identify large amounts of information on a topic.

The school nurse is implementing a muscle mover club in the elementary school. What goal would the nurse document when requesting the implementation of this program? A)Encourage physical activity B)Reward anaerobic exercise C)Importance of pet exercise responsibilities D)Educate on methods to promote cardiovascular function

Ans:A Feedback:A muscle mover club encourages physical activity by rewarding aerobic exercise, such as walking, running, swimming, and biking.

What information is found on the American Cancer Society (ACS) website that would be useful to the community health nurse when teaching a health class for those recovering from cancer? A)Smoking cessation B)Location of ACS offices C)Research projects D)Volunteer opportunities

Ans:A Feedback:A person recovering from cancer would need education on healthy living when attending a health class. Smoking cessation is one topic that could be useful to someone teaching a health class. The location of ACS offices, research projects, and volunteer opportunities would not be part of a health class.

The American Nurses Association legislative initiatives include issues of access, cost, and quality of care. What is an example of an access of care initiative? A)Health coverage B)Mandatory overtime C)Medicare reform of prescription drugs D)Whistle-blowing protection for nurses

Ans:A Feedback:Access to care includes access to health coverage, health plans, and Medicare reform. Cost of care includes advancev practice nurse coverage, health plans, Medicaid cost containment, medical errors, medical malpractice liability/tort reform, and Medicare reform/prescription drugs. Quality of care includes adequate and appropriate nurse staffing, mandatory overtime, safe health care reporting "whistle-blowing" protection for nurses, and safe client handling.

Involving nursing volunteers from the community ensures that the diversity of the community can be mirrored in the faith community nursing team. Other than cultural factors, what other factor is an essential concem of program problem identification and solution? A)Economic B)Emotional C)Physical D)Social

Ans:A Feedback:Economic factors as well as cultural factors are essential concerns of problem identification and solution. Services should be accessible to all members of the faith community as appropriate. The affluence of the community will affect the type of programs that can be implemented. It is an accepted fact that families with more discretionary income are better able to engage in health promotion activities. Economics also influences how members of the community access health services. Emotional, physical, and social factors are important aspect of faith community nursing, but they are considered basic human needs rather than community factors.

Where can the community health nurse locate educational status information, including years of school completed, school enrollment by type of school, and language spoken? A)Census data B)Teachers and staff C)School administrator D)Local board of education

Ans:A Feedback:Educational status information, including years of school completed, school enrollment by type of school, and language spoken, can be located in the social characteristics section of the census data. Teachers and staff can provide information about geographic distribution and demographic profile for educational sources. The local board of education can provide information about the intracommunity and extracommunity for each educational facility. The school administrator and school nurse can provide information about educational, recreational, communication, and health services.

What is an example of a primary prevention strategy that the school nurse can implement to influence the school climate and reduce bullying? A)Determine whether bullying/sexual harassment policies are in place in the school system. B)Assess for bullying behaviors using a student questionnaire, such as the Peer Relations Questionnaire. C)Have a school conference day to disseminate the results of the survey and launch a multicomponent plan to tackle the problem. D)Implement effective adult supervision during recess, lunchtime, and classroom/ bathroom breaks.

Ans:A Feedback:Implementing primary prevention can involve the determination of whether bullying/sexual harassment policies are in place in the school system. Secondary preventions strategies include assessing for bullying behaviors using a student questionnaire, such as the Peer Relations Questionnaire; having a school conference day to disseminate the results of the survey and launch a multicomponent plan to tackle the problem; and implementing effective adult supervision during recess, lunchtime, and classroom/bathroom breaks.

What does high rate of immunity represent in the community-as-partner model? A)Normal line of defense B)Flexible line of defense C)Lines of resistance D)Degree of reaction

Ans:A Feedback:Normal line of defense is the level of health the community has reached over time. Immunity increases the level of health and is considered a normal line of defense. Flexible line of defense is the buffer zone representing a dynamic level of health resulting from a temporary response to stress. Lines of resistance are internal mechanisms that act to defend against stressors. The degree of reaction is the amount of disequilibrium or disruption that results from stressors impinging on the community's lines of defense.

When using the community-as-partner model, which of the following would represent the concept of person? A)Population or an aggregate B)A network of people and their surroundings C)Resource for everyday life, not the objective of living D)Based on definitions the other three concepts, it is prevention.

Ans:A Feedback:Person is a population or an aggregate. Environment is a network of people and their surroundings. Health is a resource for everyday life, not the objective of living. Nursing is based on definitions of the other three concepts; it is prevention.

When completing a community assessment, which source of information would be best to find the marital status of people in a community? A)The census B)The State Department of Health C)The Chamber of Commerce D)The library

Ans:A Feedback:The census collects data on marital status and would be the best source to find this information. The State Department of Health would have health- specific information related to diseases. The Chamber of Commerce would have demographic information such as racial diversity and ethnic distribution. The library would have historical data on the community.

Which is the best source for identifying useful search engines? A)Search Engine Watch B)Directory on the Internet C)Librarians Internet Index D)National Institute of Medicine

Ans:A Feedback:The internet site Search Engine Watch monitors the development of search engines, organizes information using technical descriptions of search engine programming, and provides a list and descriptions of current search engines. General search engines also create their own directories and often allow open browsing in their subject-headed directories. One directory available on the internet is the Librarians Intermet Index. Librarians regularly update and maintain this directory of websites.

Physical examination components are used in assessing individuals and communities. What information is obtained during a systems review of a community? A)Housing, businesses, churches, and hangouts B)Climate, terrain, natural boundaries, and resources C)Listening to community sounds and residents D)Walk through community

Ans:A Feedback:The systems review of the community reveals information about social systems, including housing, businesses, churches, and hangouts. Vital signs provide information about climate, terrain, natural boundaries, and resources. Auscultation involves listening to community sounds and residents. Inspection is used when walking through the community.

The community health nurse is asked by a client about internet addresses. When responding, the nurse needs to understand that an internet address, also called the URL, provides: A)Clues about the origin of the website B)Programs needed to view websites on the internet C)A tool that uses computer programs to search the internet for websites by keywords D)A pull-down menu with commands to navigate the computer, internet, or a website

Ans:A Feedback:Uniform resource locator is the term for an internet address and is shown on your browser in the locator bar. The URL provides clues about the origin of the website, whether it is a commercial (.com) or an educational (.edu) site. A web browser is a specific program that allows you to view websites on the internet. A search engine is a tool that uses computer programs to search the internet for websites and indexes those sites by keywords. The menu bar is located at the top of your computer screen when you access your browser; the menu bar has a series of pull-down menus with commands to allow you to navigate your computer, the internet, or a website.

The school nurse has observed many overweight children, children easily fatigued while running around the playground, and children choosing nonnutritious snacks. Which is the highest priority area of Healthy People 2020 that the school nurse should emphasize in a health promotion program?Select all that apply A)Inadequate physical activity B)Unhealthy dietary patterns C)Tobacco use and addiction D)Unintentional injury E)Proper backpack posture

Ans:A, B Feedback:Casual observations at the school have revealed a high percentage of overweight children, youngsters easily fatigued while running around the playground, and children choosing nonnutritious snacks. These children are at risk for overweight and obesity. Therefore, the health promotion program should emphasize nutritious snacks and physical activity. Children are at risk for tobacco use, addiction, unintentional injury, and back pain from improper backpack posture; however, those topics would be best addressed in other community education programs.

Which question(s) can be helpful are examining one's ethnic culture? Select all that apply. A)What are the common bonds? B)What cultural rituals celebrated and with whom? C)What types of things are shared when people get together? D)What sexual orientations are celebrated when people get together? E)What types of foods are prepared when people get together for an event?

Ans:A, B, C, E Feedback:Questions to think about one's own ethnic culture include the following: With what group(s) do you identify, and why? What are your common bonds? What cultural rituals do you celebrate, and with whom? What are the purposes and meanings of your gatherings and celebrations? What types of things are shared and learned when people get together? What types of foods are prepared for the event? Are there dances, special rites, or ceremonies? Foods, languages, and other bonds of common ancestry are the cultural aspects of ethnicity that serve offer consistency and structure to life and provide individuals with abilities to interpret life events as significant and meaningful. Sexual orientation is individual state, not one determined by culture.

Based on the "10 Tips to a Great Plate," what might the nurse suggest to a group of parents that would help them try to get their children to eat healthier? Select all that apply. A)Make half your grains whole grains. B)Switch to fat-free or low-fat (1%) milk. C)Eat larger portions but less frequently. D)Make a list of foods to eat less often. E)Drink water instead of sugary drinks.

Ans:A, B, D, E Feedback:Some tips for a great plate include making half your grains whole grains, switching to fat-free or low-fat milk, making a list of foods to eat less often, and drinking water instead of sugary drinks. Children should be encouraged to enjoy their food, but eat less as well as to avoid oversized portions. Eating larger portions less frequently is not recommended.

Based on Lillian Wald's work living among the residents of the Henry Street Settlement House in New York City, community health nurses can effect change in a community's health by: select all that apply A)advocating for better housing B)working to change labor practices, wages C)analyzing risks and benefits of care decisions D)teaching preventive practices E)accessing and using emerging research evidence

Ans:A, B, D, Lillian Wald's contributions include establishing nursing schools, advocating for better housing, working to change child labor laws, teaching preventive practices, advocating occupational health nursing, and improving the education of public health nurses. Today's nurses can continue this work. Analyzing risks and benefits of care decisions as well as accessing and using emerging research evidence are important nursing actions for individual clients.

When using medical and hospital records for community health research, Berkson's bias refers to what concept? A)Creating the likelihood of finding a false association between the two or more illnesses B)Autopsy records have an inherent bias because the client's illness was fatal. C)National Electronic Disease Surveillance System provides an integrated surveillance system that transmits public health laboratory and clinical data via the internet. D)Health records provide a representative or valid picture of community health.

Ans:A, Berkson's bias creates the likelihood of finding a false association between the two illnesses. Although medical and hospital records contain comprehensive information about patients seeking services, they do not provide a completely representative or valid picture of community health. Not all clients with health problems receive medical attention; so medical records are biased by including only those that do. Also, medical documentation is not always complete. Hospitalized patients are also more likely to have coexistent illnesses. The National Electronic Disease Surveillance System is a conduit to exchange information health information to public health departments; however, it is only voluntary.

Which of the following represent nursing activities for the essential public health service? Select all that apply A)Participate in community assessment and identify potential environmental hazards. B)Manage chronic conditions in daily life to maximize function. C)Understand and identify determinants of health and disease. D)Develop and implement community-based health education. E)Participate in continuing education and preparation to ensure competence.

Ans:A, C, D, E, Nurses can work toward public health by participating in community assessment and identifying potential environmental hazards; understanding and identifying determinants of health and disease; developing and implementing community-based health education; and participating in continuing education and preparation to ensure competence. Although important, managing chronic conditions in daily life to maximize function is a one-on-one nursing action.

Select the best term for professional nurses who have been educated in the processes of population-based nursing and whose principal client is the aggregate community. A)Community health nursing B)Community-based practice nursing C)Community psychology nursing D)Home care nursing

Ans:A, Community health nursing is the practice of nursing by professional nurses who have been educated in the processes of population-based nursing and whose principal client is the aggregate community. Community-based practice is the provision of skilled therapy services within a client's own home or community. Community psychology is the application psychology to community programs. Home health nursing provides intravenous therapy and wound care.

Community partnerships develop through a process of empowerment. Which characteristic would indicate a community displays empowerment? Select all that apply. A)Faith in all people of the community B)Hope that dialogue will be established within the health care community C)Mandate positive transformations benefiting the community as a whole D)Discussion grounded in critical thinking without fear of repercussion E)Power differences between and within communities

Ans:A, D, Feedback:Four characteristics of an empowered community are faith in people; trust established through dialogue; hope in positive transformations benefiting the community as a whole; and discussions grounded in critical thinking without fear of repercussions by those who are in power.

Which defines demography? A)Statistical study of human populations with reference to size and density, distribution, and vital statistics B)Information about significant characteristics of a population that influence community needs and the delivery of health care services C)Descriptions and comparisons of populations according to the characteristics of age; race; sex; socioeconomic status; geographic distribution; and birth, death, marriage, and divorce patterns D)Health implications that may or may not be addressed by the investigators

Ans:A, Demography is the statistical study of human populations with reference to size and density, distribution, and vital statistics. Demographic statistics provide information about significant characteristics of a population that influence community needs and the delivery of health care services. Demographic studies provide descriptions and comparisons of populations according to the characteristics of age; race; sex; socioeconomic status; geographic distribution; and birth, death, marriage, and divorce patterns. These studies often have health implications that may or may not be addressed by the investigators.

Which is true of descriptive epidemiology? A)lt focuses on the distribution of frequencies and patterns of health events with groups in a population. B)It is the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to improve health. C)It is people with a common characteristic, such as gender, age, and place of residence. D)It seeks to identify associations between a particular disease or health problem and its etiology.

Ans:A, Descriptive epidemiology focuses on the distribution of frequencies and patterns of health events with groups in a population. Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to improve health. Population is defined as people with a common characteristic, such as gender, age, and place of residence. Analytic epidemiology seeks to identify associations between a particular disease or health problem and its etiology.

Which statement best defines health disparities? A)Gaps between rich and poor, including poverty and health insurance, plus geographic, racial, ethnic disparities B)Social, economic, and political issues where inequality, poverty, exploitation, violence, and injustice are at the root of ill health and the death of the poor and marginalized people C)The increased economic, political, social, technological, and intellectual interconnectedness of the world D)The health issues that transcend national boundaries and may best be addressed by cooperative actions

Ans:A, Health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States. Globalization is a term used to refer to the increasing economic, political, social, technological, and intellectual interconnectedness of the world. Health is a social, economic, and political issue where inequality, poverty, exploitation, violence, and injustice are at the root of ill health and the death of poor and marginalized people. Global health is health issues that transcend national boundaries and may best be addressed by cooperative actions.

When doing a lecture on the epidemiologiç triangle, it is important to differentiate each component. When asked a question about what causes a disease, it is important to understand that this organism is called what? A)Agent B)Environment C)Factor D)Host

Ans:A, In the epidemiologic triangle model, the agent is an organism capable of causing disease. The host is the population at risk for developing the disease. The environment is a combination of physical, biologic, and social factors that surround and influence both the agent and the host.

How is the proportionate mortality rate calculated? A)(Number of deaths due to a specific cause/Total number from all cases) x 100 B)(Number of deaths of infants aged <1 year during time interval/Total live births during time interval) x 1,000C)(Number of deaths from puerperal cases during 1 year/Number of live births during same year) x 100,000D)(Number of live births during a time interval/ Estimated midinterval population) x 1,000

Ans:A, Proportionate mortality rate is calculated as (Number of deaths due to a specific cause/Total number of deaths from all cases) x 100. Infant mortality rate is calculated as (Number of deaths of infants aged <1 year during time interval/Total live births during time interval) x 1,000. Maternal mortality rate is calculated as (Number of deaths from puerperal cases during 1 year/Number of live births during same year) 100,000. Crude (Number of live births during a time interval/Estimated midinterval population) x 1,000.

In the 1990s, which was the major concern of policy makers in the United States? A)High cost of health care B)Treatment of communicable diseases C)High-tech medicine to increase life span D)Fluoridation of drinking water

Ans:A, The 1990s can be characterized as the era in which the high cost of health care in the United States became a major concern of policy makers.

Which is likely the most comprehensive source of health-related data for the United States? A)Census data B)Notifiable disease reports C)Surveillance data D)Vital statistics

Ans:A, The census is probably the most comprehensive source of health-related data for the United States. The CDC/U.S. Public Health Service reports data collected by state and local health departments on legally reportable diseases and periodically requests voluntary reporting of nonnotifiable health conditions of special interest. Notifiable diseases are frequentl referred to as "reportable diseases." Surveillance data pertain to the occurrence of specific diseases, the analysis and interpretation of these data, and the dissemination of information about the data. Vital statistics are legal data; however, legality does not guarantee validity. The major deficiency of this category of data for epidemiologic research purposes is the possible incompleteness of population coverage.

Which describes relative risk? A)Incidence among those exposed/incidence rate among those not exposed B)Odds of having the condition when the suspected factor is present/odds of having the condition when not exposed to the factor C)Measures the difference between the incidence rates for those exposed and those not exposed to the risk factor D)ldentifies whether those in the exposed group will develop the disease or condition when compared with those not exposed

Ans:A, The relative risk expresses the risk ratio of the incidence rate of those exposed and those not exposed to the suspected factor. Odds ratio is a simple mathematical ratio of the odds in favor of having a specific health condition when the suspected factor is present and the odds in favor of having the condition when the factor is absent. Attributable risk measures the difference between the incidence rates for those exposed and those not exposed to the risk factor. Relative risks and odds ratios provide a point estimate (a number) that identifies whether those in the exposed group will develop the disease or condition when compared with those not exposed.

Which of the following contributes to the critical shortage of nurses inlow-resource countries? Select all that apply. A)Challenges related to HIV/AIDS B)High-stress work environments C)Gender-based discrimination and violence D)International migration of nurses E)High infant and maternal mortality rates

Ans:A. B, C, D, Factors that contribute to the shortage in low-resource countries include challenges related to HIV/AIDS, high-stress work environments, gender-based discrimination and violence, and international migration of nurses. Many high-resource countries, faced with their own nursing shortages, contribute to this problem by recruiting nurses from lower-resource countries, further compounding the problem. Although many low-resource countries have high infant and maternal mortality rates, this is an outcome of the nursing shortage rather than a cause.

What do the mortality and morbidity rates represent in the community-as-partner model? A)Degree of reaction B)People C)Flexible line of defense D)Normal line of defense

Ans:A. Feedback:The degree of reaction is dependent on stressors and the lines of resistance. Whether the stressor (a disease process) is present and the lines of resistance (how well the person or community can resist the disease) will determine how widespread and how dangerous a disease could become (the degree of reaction). The core of the assessment wheel represents the people who make up the community. The flexible line of defense is a dynamic level of health resulting from the temporary response o stress. Normal line of defense is the level of health the community has reached over time.

A community health nurse is completing a community assessment and needs to identify extracommunity and intracommunity health services. Which is the best source for this information? A)Chamber of commerce B)County health planning board C)County health department D)City health planning board

Ans:AFeedback:Extracommunity or intracommunity facilities are identified best through the chamber of commerce. Once these facilities are identified and grouped into categories, the city and county planning boards can provide specific information. To monitor, maintain, and promote the public's health, each state has a state health department and accompanying regional, county, and sometimes city health departments. The county and city health planning boards have information about health needs and practices.

Which best describes bioaccumulation? A)Generally accomplished by the way of wind patterns or aquatic system B)Introduction of substances into ecologic food webs C)When the accumulation of a pollutant greatly exceeds the rate at which an organism eliminates it D)Simultaneous action of separate substances or agencies that together produce a greater total effect than the sum of individual effects

Ans:B Feedback:Bioaccumulation is the introduction of substances into ecologic food webs. Transport is generally accomplished by the way of wind patterms or aquatic system. Biomagnification is when the accumulation of a pollutant greatly exceeds the rate at which an organism eliminates it. Synergism is when a simultaneous action of separate substances or agencies together produces a greater total effect than the sum of individual effects.

The community health nurse is looking for local information about geographic location of city services. Which electronic resource would most likely provide this information? A)State government website B)City government website C)Nonprofit organization website D)Community agency website

Ans:B Feedback:City websites provide local information, including geographic locations of city services, such as fire departments, animal control services, and city planning. State websites have health information, such as vital statistics, mental health services, and housing assistance. City and community agency websites may also compile information about the community, including the history of the community.

In which phase of a community analysis does the nurse examine data for gaps? A)Categorization B)Comparison C)Inference elaboration D)Summarization

Ans:B Feedback:During the comparison phase, additional tasks of data analysis include the identification of data gaps, incongruencies, and omissions. Frequently, comparative data are needed to determine whether a pattern or trend exists or whether data do not seem correct and whether revalidation of original information is required.

When writing a proposal as to the importance of implementing a program aimed at decreasing childhood obesity, the nurse emphasizes which statistic? A)One of two children is obese as children. B)One of eight preschoolers is overweight. C)Twenty-five percent of school-aged children experience obesity. D)One of five children is considered obese.

Ans:B Feedback:For instance: according to the Centers for Disease Control and Prevention (2014), one out of every eight preschool-aged children is considered overweight.

A community health nurse is developing a workshop on health promotion and development for a group of school-aged children. The nurse would incorporate which goal into the development of this workshop? A)Achieve health equity, eliminate disparities, and improve the health of all groups. B)Promote healthy development and healthy behaviors across every stage of life. C)Increase quality and years of a healthy life. D)Eliminate health disparities.

Ans:B Feedback:Healthy People 2010 identified two broad goals: eliminate health disparities and increase quality and years of healthy life. Healthy People 2020 identifies four overarching goals: eliminate preventable disease, disability, injury, and premature death; achieve health equity, eliminate disparities, and improve the health of all groups; create social and physical environments that promote good health for all; and promote healthy development and healthy behaviors across every stage of life. Promoting healthy development and healthy behaviors across every stage of life apply to the development and focus of the workshop on health promotion. The school community is an ideal center for health promotion activities.

Human ecology is influenced by other factors. To more fully understand human ecology, one must study which links? A)Pollution and space B)Human activities and the environment C)All external conditions and influences affecting life D)Complete physical, mental, and social well-being interacting within the environment

Ans:B Feedback:No one person or community is an independent entity. Each is intimately linked to the environment, frequently in ways never imagined. Thus, the environment influences health, directly and indirectly, through subtle, indirect pathways. Conversely, human activities affect the health of the environmental system. One aspect of human ecology is the study of these linkages.

The community health nurse is reviewing services provided at a county clinic. Which best describes the types of services that could occur as part of a well-child examination? A)Physical assessment, education, and prescriptions filled B)Physical assessment, referral for illness, immunizations, and screening C)Physical assessment and monitoring for ongoing medical issues D)Treatment and care instructions for chronic pediatric health conditions

Ans:B Feedback:Physical assessment, education, and prescriptions filled occur with family planning. Well-child examinations involve physical assessment, referral for illness, immunizations, and screening. Antepartum and postpartum services include physical assessment and monitoring for ongoing medical issues. Chronic disease counseling and treatment services provide treatment and care instructions for chronic pediatric health conditions.

What do the demographics of the population represent in the community-as-partner model? A)Degree of reaction B)People C)Flexible line of defense D)Normal line of defense

Ans:B Feedback:The core of the assessment wheel represents the people who make up the community. The people in this core represent one aspect of demographics. The degree of reaction is the amount of disequilibrium or disruption that results from stressors impinging on the community's lines of defense. Flexible line of defense is the buffer zone representing a dynamic level of health resulting from a temporary response to stress. Normal line of defense is the level of health the community has reached over time.

In the last step of data analysis, what would the nurse develop? A)Community health needs B)Community nursing diagnosis C)Patterns of health responses D)Trends in health care use

Ans:B Feedback:The end point of analysis is the community nursing diagnosis. Analysis is necessary to determine community health needs and community strengths, as well as to identify pattems of health responses and trends in health care use.

The community health nurse is trying to locate information about sanitation in the community. Which is the best source for this information? A)Planning office B)Waste and water treatment plants C)Air control board D)Census data

Ans:B Feedback:Waste and water treatment plants are the best source of information about sanitation the community. The planning office provides information about protection services. The air control board provides information about air quality. Census data provide information about population and housing characteristics.

Arthur Kleinman studied members of many diverse ethnic groups. His findings showed that cultural beliefs are the basic guidelines people use to: select all that apply A)Establish cultural models of health B)Recognize something is wrong C)Interpret what might be wrong D)Organize a plan of appropriate actions E)Understand the link between cultural beliefs and health and illness

Ans:B, C, D Feedback:Arthur Kleinman found that cultural beliefs based in shared meanings, values, and norms are the basic guidelines people use for recognizing that something is wrong, interpreting what it might be, and organizing a plan of appropriate actions. The goal of his research was to study members of many diverse ethnic groups to gain an understanding of the links between cultural beliefs and health and illness behaviors and actions. From his findings, community health nurses established cultural models of health.

Select the best definition of global health? A)Differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups B)Health issues that transcend national boundaries and may best be addressed by cooperative actions C)Increasing economic, political, social, technological, and intellectual interconnectedness of the world D)International and global exchanges leading to growing recognition of common threats, as well as opportunities, and a sense of growing solidarity and commitment to collaboration to promote global social justice and equity

Ans:B, Global health is health issues that transcend national boundaries and may best be addressed by cooperative actions. Health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States. Globalization is a term used to refer to the increasing economic, political, social, technological, and intellectual interconnectedness of the world. Global stewardship is influenced by international and global exchanges, leading to growing recognition of common threats, as well as opportunities, and a sense of growing solidarity and commitment to collaboration to promote global social justice and equity.

To enforce laws and regulations that protect health and ensure safety, the nurse can implement which action? A)Develop programs and services to meet the needs of high-risk populations as well as members of the broader community. B)Regulate and support safe care and treatment for dependent populations such as children and the frail elderly. C)Participate in continuing education and preparation to ensure competence. D)Participate in early identification of factors detrimental to the community's health.

Ans:B, Nurses can enforce laws and regulations that protect health and ensure safety by regulating and supporting safe care and treatment for dependent populations such as children and the frail elderly. Nurses can develop policies and plans that support individual and community health efforts by developing programs and services to meet the needs of high-risk populations as well as members of the broader community. Nurses can ensure a competent public health and personal health care workforce by participating in continuing education and preparation to ensure competence. Nurses can research new insights and innovative solutions to health problems by participating in early identification of factors detrimental to the community's health.

How can the community health nurse mobilize community partnerships to identify and solve health problems? A)Develop programs and services to meet the needs of high-risk populations as well as members of the broader community. B)Explain the significance of health issues to the public and participate in developing plans of action. C)Establish programs and services t meet special needs. D)Participate in early identification of factors detrimental to the community's health.

Ans:B, Nurses can mobilize community partnerships to identify and solve health problems by explaining the significance of health issues to the public and participate in developing plans of action. Nurses can develop policies and plans that support individual and community health efforts by developing programs and services to meet the needs of high-risk populations as well as members of the broader community. Nurses can link people to needed personal health services and ensure the provision of health care when otherwise unavailable by establishing programs and services to meet special needs. Nurses can research new insights and innovations solutions to health problems by participating in early identification of factors detrimental to the community's health.

Building on a success of the Millennium Development Goals, the community health nurse can work for health status improvement in sub- Saharan Africa by lobbying: A)Aid foundations for more food supplies B)US banks to offer more microloans to women C)Agricultural corporations to farm the land D)Local communities to fight for democracy

Ans:B, One strategy that has shown much promise in reducing poverty, and thereby contributing to improvements in health status, has been the use of microfinance programs to provide the poor with access to financial services, including savings plans and opportunities for low-interest loans to stimulate income-generating businesses.

The concept of prevention is a key component of modern community health practice. Which of the following is an example of secondary prevention? A)Wearing of protective devices to prevent injury B)Phenylalanine testing for phenylketonuria in infancy C)Physical therapy for stroke victims D)Exercise programs for heart attack victims

Ans:B, Phenylalanine testing for phenylketonuria in infancy is an example of secondary prevention. Wearing of protective devices to prevent injury is an example of the specific health promotion component of primary prevention. Physical therapy for stroke victims and exercise programs for heart attack victims are examples of tertiary prevention.

When applying epidemiology and demography to the practice of community health, how is the prevalence rate calculated? A)(Number of new cases of specified health condition during time interval/Estimated midinterval population at risk) x 1,000 B)(Number of current cases of a specified health condition at a given point in time/Estimated population at risk at same point) x 1,000C)(Number of deaths of infants aged <1 year during time interval/Total live births during time interval) x 1,000D)(Number of deaths from puerperal cases during 1 year/Number of live births during same year) x 100,000.

Ans:B, Prevalence rate is calculated as (Number of current cases of a specified health condition at a given point in time/Estimated population at risk at same point) x 1,000. Incidence rate is calculated as (Number of new cases of specified health condition during time interval/Estimated midinterval population at risk) x 1,000. Infant mortality rate is calculated as (Number of deaths of infants aged<1 year during time interval/Total live births during time interval) x 1,000. Maternal mortality rate is calculated as (Number of deaths from puerperal cases during 1 year/Number of live births during same year) x 100,000.

The 2008 WHO Primary Health Care: Now More Than Ever Report reflected the ongoing commitment to the Alma-Ata Declaration and identified four reforms necessary to achieving the "health for all" goal. Which reform would meet this commitment? A)Universal access to physical health protection B)Service delivery reforms to reorganize health services around people's needs and expectations C)Universal health care insurance reforms D)Leadership reforms to promote more inclusive and autocratic leadership

Ans:B, The 2008 WHO report reflected the ongoing commitment to the Alma-Ata Declaration and identified four reforms necessary to achieving the "health for all" goal: universal access o social health protection; service delivery reforms to reorganize health services around people's needs and expectations; public policy reforms; and leadership reforms to promote more inclusive and participatory leadership. for global to

Which statement is most relevant to population? A)World population B)Clients living in Chicago with diabetes C)Immunization clinics held annually in California D)Poverty in four continents

Ans:B, The American Nurses Association defines a population as those living in a specific geographic area (e.g., neighborhood, community, city, or county) or those in a particular group (e.g., racial, ethnic, age, disease) who experience a disproportionate burden of poor health outcomes. Using this definition, clients living in Chicago with diabetes represent a population. Diabetes is an example of a particular group in a particular geographic area. The world is not a specific geographic area. Neither immunization clinics in California nor poverty in four continents reflects a specific set of clients.

Which is a goal of the Nightingale Initiative for Global Health (NIGH) for using information and communication technology for global networking? A)Globally unite 5 million nurses through the internet by 2020. B)Demonstrate the significance of nursing's contribution to global health. C)Provide educational and collaborative learning programs. D)Deliver nursing care using telenursing or telehealth services.

Ans:B, The NIGH was established in 2003 and has two goals: to globally unite 10 million nurses through the internet and through developing regional groups around the world to promote a healthier world by 2020; and to demonstrate the significance of nursing's contribution to global health. Opportunities for using information and communication technology include providing educational and collaborative learning programs and delivering nursing and health care using telenursing or telehealth services.

How can the nurse implement the environmental concept emphasized by Florence Nightingale? A)Use antibiotics to help cure diseases. B)Use climate control devices for comfort. C)Keep the client and environment clean. D)Keep insects away through use of insecticides.

Ans:C Feedback:Florence Nightingale emphasized the importance of clean and safe environments for proper recovery to health. Her emphasis was on pure air, pure water, efficient drainage, cleanliness, and light. Keeping the client and environment clean uses the concepts she emphasized.

The community health nurse is synthesizing what is known about the community into succinct phrases. In which phase of a community analysis does the nurse develop phrases? A)Categorization B)Comparison C)Inference elaboration D)Summarization

Ans:C Feedback:Having categorized, summarized, and compared the data, the next phase is to draw logical conclusions from the evidence; that is, during the inference elaboration phase, the nurse will draw inferences that will lead to the statement of a community nursing diagnosis. These conclusions or inferences will identify the community's stressors and strengths in succinct phrases.

Which is the last phase of a community analysis that has to be completed by the community health nurse? A)Categorization B)Comparison C)Inference elaboration D)Summarization

Ans:C Feedback:The phases in order that are used to help in the analysis are categorization, summarization, comparison, and inference elaboration.

A community health nurse is completing a community assessment and needs to identify the monitoring, maintenance, and promotion of public health in the community. Which is the best source for this information? A)Law enforcement department B)County health planning board C)County health department D)State vital statistics office

Ans:C Feedback:To monitor, maintain, and promote the public's health, each state has a state health department and accompanying regional, county, and sometimes city health departments. Law enforcement departments have statistics regarding incidence of crime, vandalism, and drugs. The county health planning board has information about health needs and practices.

Using the community-as-partner model to complete a community health assessment, the nurse gathers birth and death statistics for the community. What does this represent in the community core? A)History of the community B)Demographics and ethnicity C)Vital statistics D)Values, beliefs, and religion

Ans:C Feedback:Vital statistics include birth and death statistics. Demographics and ethnicity includ age, sex, race, and ethnicity data. All ethnic and racial groups have values and beliefs that interact with each community system to influence the people's health.

Although it is true that many of us have improved our standard of living, globally how many people will still live in extreme poverty by 2015? A)750 thousand B)1 million C)1 billion D)4 billion

Ans:C, Although it is true that many of us have improved our standard of living, it is estimated that 1 billion people worldwide will still live in extreme poverty by 2015.

As communicable disease declined in the 1960s, which key public health issue became more prominent? A)Immunizations B)Workplace safety C)Cigarette smoking D)Family planning

Ans:C, Beginning in the 1960s, as communicable diseases declined, attention turned to prevention of chronic diseases and related risk factors, such as cigarette smoking and dietary fat.

The historical focus of nursing in the community has been replaced by site-managed care systems in the United States. Where is the primary base when planning interventions for this system? Select all that apply. A)Community B)Home C)Primary care clinic D)Hospital E)Long-term care facility

Ans:C, D, Feedback:Our historical focus of nursing in the community has been replaced by "site- managed care systems," such as hospitals and primary care clinics, that require the client t come to a facility, rather than the nurse providing care within the community.

Identify one of the common causes of disability worldwide. A)Cardiovascular disease B)Cancer C)Vision problems D)Multiple injuries from road accidents

Ans:C, Hearing loss, vision problems, and mental disorders are the most common causes of disability, according to the World Health Organization.

The person-place time model examines the characteristics of the people affected, place or location, and the time period involved. In studying infant mortality, what is considered an example of the person in the model? A)Rural community B)Urban community C)Infant and maternal factors D)Trends in mortality

Ans:C, In studying infant mortality according to this model, infant and maternal factors are considered traits of "person." Aspects of "place" are such factors as whether the community is rural or urban and affluent or poor. Aspects of "time" include seasonal or age-specific patterns or trends in mortality.

An association may meet all the criteria for causation and later be shown to be false or factitious because of factors that were not known at the time the study was done. Investigators must interpret results with great caution; they rarely consider a cause "proven." Which is a widely used criterion for evaluating causation? A)Association is not strong. B)Association is not specific. C)Association is temporally correct. D)Association is the result of a confounding variable.

Ans:C, Six widely used criteria for evaluating causation are the association is strong; the association is consistent; the association is temporally correct; the association is specific; the association is not the result of a confounding variable; and the association is plausible and consistent with current knowledge.

When doing a presentation on public health nursing, the nurse should include which of the following as a great public health achievement of the 20th century? A)Environmental sanitation B)Abolishment of child labor C)Control of infectious diseases D)Decline in deaths from pulmonary disease

Ans:C, The 10 great public health achievements in the 20th century are immunizations; improvements in motor vehicle safety; workplace safety; control of infectious diseases; decline in deaths from heart disease and stroke; safer and healthier foods; healthier mothers and babies; family planning; fluoridation of drinking water; and recognition of tobacco as a health hazard.

The nurse is comparing populations with different distributions of obesity. Which rate will be helpful in making a comparison of heart disease mortality? A)Crude rate B)Specific rate C)Adjusted rate D)Incidence rate

Ans:C, The adjusted rate is a summary measure in which statistical procedures remove the effect of differences in the composition of the various populations. Rates computed for a population as a whole are crude rates. Rates calculated for subgroups are specific rates. Incidence rates measure those exposed and not exposed to a suspected factor.

Which defines a dependent variable? A)Constant characteristic or phenomenon and the health conditions being studied B)Control group and comparison group of the research study C)Outcome or result that the investigator is studying which can change D)Presumed cause of or contributor to variation in the variable

Ans:C, The dependent variable is the outcome or result that the investigator is studying. The dependent variable can change (e.g., health status, knowledge, behavior). Characteristics or phenomena and the health conditions being studied are the variables. Control groups and comparison groups are essential to ensure that associations between variables can be examined. The presumed "cause" of or contributor to variation in the dependent variable is the independent variable.

Which definition best represents applied ethics? A)When one considers only his/her individual good or self-interest B)A branch of ethics that views everything as universally valid or where true moral principles apply C)A systematic, logical framework for analysis, discourse, and decision making that assists in ensuring decisions are grounded in "good" actions D)A system that focuses on those traits valued personal relationships, such as compassion, love, sympathy, and trust

Ans:C. Feedback:The function of applied ethics is to provide a systematic, logical framework for analysis, discourse, and decision making that helps ensure that decisions are grounded in the philosophy of "good" actions. Ethical/moral egoism occurs when one considers only his/her own good or self-interest. Ethical/moral objectivism is a branch of ethics that views everything as universally valid or where true moral principles apply. Ethics of care focuses on traits valued in personal relationships, such as compassion, love, sympathy, and trust.

The nurse is using the community-as-partner model to complete a community health assessment. Which model would best be used for the community health assessment? A)Disease oriented B)Medical C)Organ focused D)Systems

Ans:D Feedback:Neuman's total-person approach and, subsequently, the community-as-partner model are considered systems models.

The community health nurse needs to get a formal announcement about an upcoming health promotion program. Which is the best example of a formal communication method that can be used in the community? A)Word of mouth B)Posters C)Hand-delivered flyers D)Newspaper

Ans:D Feedback:Newspaper is a formal method of communication. Word of mouth, posters, and hand-delivered flyers are informal forms of communication.

Which program would the community health nurse recommend for a 6-year-old child whose family earms too much to qualify for Medicaid but needs financial reimbursement for doctors' visits, immunizations, and a possible emergency room visit for a suspected broken bone? A)Medicare B)Women, Infants, and Children C)Temporary Assistance to Needy Families D)State Children's Health Insurance Program

Ans:D Feedback:State Children's Health Insurance Program is for children younger than 19 years from families who earn too much to qualify for Medicaid. The Women, Infants, and Children program provides supplemental foods, nutrition education, and referrals to health care. Temporary Assistance to Needy Families provides financial and medical assistance to needy dependent children and parents and relatives with whom they are living. Medicare is a health insurance program for people 65 years or older, disabled people younger than 65 years, and individuals with end-stage renal disease or Lou Gehrig disease.

What are stressors in the community-as-partner model? A)Level of health the community has reached over time B)Internal mechanisms that act to defend against stressors C)Buffer zone representing a dynamic level of health resulting from a temporary response to stress D)Tension- producing stimuli that have the potential of causing disequilibrium in the system

Ans:D Feedback:Stressors are tension-producing stimuli that have the potential of causing disequilibrium in the system. Flexible line of defense is the buffer zone representing a dynamic level of health resulting from a temporary response to stress. Normal line of defense is the level of health the community has reached over time. Lines of resistance are internal mechanisms that act to defend against stressors.

The community health nurse needs to locate information about end-stage renal disease, including vital statistics and health insurance facts. Which electronic resource will be most helpful in locating the information? A)National Library of Medicine B)United States Census Bureau C)March of Dimes D)National Center for Health Statistics

Ans:D Feedback:The National Center for Health Statistics (NCHS) offers information titled "FastStats A to Z," which contains disease information, vital statistics, and health insurance facts. The National Library of Medicine offers a database called DIRLINE that provides access to organizations focusing on health. Census Bureau data enable the community health nurse to learn about the many characteristics of a community and to identify trends or patterns. The March of Dimes website provides information about preventing premature birth and birth defects.

Where can the community health nurse locate information about private transportation sources and the number of individuals with a transportation disability who use these sources? A)Local airport B)State highway department C)Local and city transportation authorities D)Census data

Ans:D Feedback:The population and housing characteristics section of census data provides information about private transportation sources and the number of persons with a transportation disability. The local airport provides information privat and publicly-owned air service. The state highway department and local and city transportation authorities have information about roads, interstate highways, and the freeway system.

The community health nurse is evaluating the credibility of the information retrieved electronically about end-stage renal disease. What is the best question to ask about credibility? A)Who wrote the information? B)When was the information last updated? C)Does the website show institutional affiliation? D)Is the information true, and can it be confirmed with at least two other sources?

Ans:D Feedback:When checking for credibility and accuracy, the best question to ask is: Is the information true, and can you confirm it with at least two other sources? Asking who wrote the information and whether the website shows institutional affiliation can help in evaluating the author. When checking for currency, the question to ask is: When was this information last updated?

According to Quinn, which is the most complete definition of a right-relationship? A)One pattern of organization within the system that supports and encourages actualization at any level. B)Two patterns of organization within the system that support, encourage, and allow actualization and self-transcendence at any level. C)Any pattern of organization within the system that supports, encourages, allows, or generates self-transcendence- at any and all levels. D)Any pattern of organization within the system that supports, encourages, allows, or generates actualization and self-transcendence-at any and all levels.

Ans:D, Feedback:Quinn (1997) defined right-relationship as "any pattern of organization within the system that supports, encourages, allows, or generates actualization and self-transcendence-at any and all levels."

The concept of prevention is a key component of modern community health practice. What is the goal of tertiary prevention? A)General health promotion, such as nutrition, hygiene, exercise, and environmental protection B)Specific health promotion, such as immunizations and the wearing of protective devices to prevent injuries C)Detect and treat a problem at the earliest possible stage when disease or impairment already exists D)Limit disability and rehabilitate or restore affected people to their maximum possible capacities

Ans:D, The goal of tertiary prevention is to limit disability and rehabilitate or restore affected people to their maximum possible capacities. General health promotion, such as nutrition, hygiene, exercise, and environmental protection, as well as specific health promotion, such as immunizations and the wearing of protective devices to prevent injuries, are the goals of primary prevention. Detecting and treating a problem at the earliest possible stage when disease or impairment already exists is the goal of secondary prevention.

Which principle provides the umbrella concept of the community-as-partner model? A)Autonomy B)Fidelity C)Justice D)Veracity

Ans: A Feedback:Autonomy is the umbrella concept of the community-as-partner model. Many health care professionals will come and go, and any outside program, no matter how worthy, will endure only as long as those professionals remain active in the community, unless the community makes an autonomous investment to endorse and adopt the idea behind the program.

Cardiopulmonary resuscitation (CPR) training and emergency cardiovascular care classes for the faith community are examples of which level of prevention activity? A)Primary B)Secondary C)Tertiary D)Illness

Ans: A Feedback:CPR training and emergency cardiovascular care classes are primary prevention activities. Faith-based organizations are a logical place to conduct community training programs.

There are three essential components for community participation in health programs. Select the answer that best reflects one of the essential components. A)Framework to define the community B)Participation is a passive, ongoing process. C)Decisions made through participation must be effective. D)People have the right and power to make decisions that affect their lives.

Ans: A Feedback:Essential components for community participation include the following: a framework to define the community; shared awareness by members of the community; and mechanisms to mobilize the community to recognize its needs and develop a culture of participation.

Which statement would make the following nursing diagnosis complete? "Lack of support groups and programs for single parents, the elderly, and person with STDS as manifested by high percentage of deaths in these age groups in 6 months of sexually transmitted diseases. "A)There is a high mortality rate from sexually transmitted diseases. B)Adolescents have a high death rate. C)The elderly have a high death rate. D)Support groups will decrease the mortality rate from STD..

Ans: A Feedback:Most nursing diagnoses have three parts: a description of the problem, response, or state; identification of factors etiologically related to the problem; and signs and symptoms that are characteristic of the problem. "Adolescents have a high death rate" is a descriptive statement related to the statement diagnosis. The other statements are more specific and are not considered a general descriptive statement that pulls the remainder of the stated diagnosis together.

Building a healthy community takes time, careful planning, and a great deal of organization. Shaping the future of decision making for health care delivery is a primary role of the faith-based nursing ministry. This ministry also may assist with: A)Maintaining cost- effectiveness B)Deciding where best to build community clinics C)Implementing the Affordable Care Act D)Helping to integrate faith into the health care

Ans: A Feedback:Nurses must participate in and help shape future decision making for health care delivery. The faith-based nursing ministry, whether volunteer or reimbursed service, is a cost-effective enhancement of health care delivery systems. Nursing partnerships with faith communities are part of the solution.

The American Nurses Association legislative initiatives include issues of access, cost, and quality of care. Which is an example of a quality initiative? A)Access to health coverage B)Appropriate nursing staffing C)Advanced practice nursing coverage D)Medical malpractice liability and tort reform

Ans: B Feedback:Adequate and appropriate nurse staffing is an example of a quality of care initiative. Access to health coverage is an example of an access to care initiative. Advanced practice nurse coverage and medical malpractice liability/ tort reform are examples of cost of care initiatives.

To promote the health of the community, health policy development is required. Which statement describes public policy? A)Policy that promotes the welfare of the public B)Policy that applies to all members of a society and includes prescribed sanctions for failure to comply C)Policy that applies to groups who have similar interests or special interests, such as professional organizations D)Policy based on the institution's mission and goals and that determines how the institution will function and relate to employees

Ans: B Feedback:Public policy applies to all members of a society and includes prescribed sanctions for failure to comply. Policy that promotes the welfare of the public is termed social welfare policy. Organizational policy is formed and applies to groups who have similar interests or special interests, such as professional associations. Institutional policy governs work sites. Institutional policies are based on the institution's mission and goals, and they determine how the institution will function and relate to employees.

According to Kleinman's model, lay practitioners and healers are part of which sector? A)Cultural health system B)Folk C)Popular D)Professional

Ans: B Feedback:The folk sector of cultural health care systems includes the interaction between a client and sacred and secular healers. The popular sector is composed of ordinary people, families, groups, social networks, and communities. The professional sector is composed of the licensed health professionals.

The community's core and subsystems, its lines of defense and resistance, its stressors, and its degree of reaction comprise assessment parameters for the community nurse who views the community as partner. To what does analyzing data on these parameters with the community lead? A)Statement that synthesizes assessment data B)Describes a situation and implies an etiology C)Diagnoses that represent human responses to actual or potential health problems that nurses are licensed to treat D)Diagnosis of the community group, population, or cluster of people with at least one common characteristic

Ans: C Feedback:A diagnosis is a statement that synthesizes assessment data. A diagnosis is a label that both describes a situation (or state) and implies an etiology (reason). A nursing diagnosis limits the diagnostic process to those diagnoses that represent human responses to actual or potential health problems that nurses are licensed to treat. A community nursing diagnosis focuses the diagnosis on a community-usually defined as a group, population, or cluster of people with at least one common characteristic.

Which definition identifies the core value of European and American health care law and ethics? A)The avoidance of harm B)The desire to act in the best interest of others C)The right self-determination D)The recognition that every person and community has intrinsic value

Ans: C Feedback:Autonomy is the right of individuals to self-determination and is the core value of European and American law and ethics. Nonmaleficence is the avoidance of harm. Beneficence is the desire to act in the best interest of others. Respect for people is the recognition that every person and community has intrinsic value.

Which approach to health care is applied through participatory research as a pathway to community empowerment? A)Medical B)Health services C)Community development D)Medical and health services

Ans: C Feedback:The community development approach is at the grassroots level, in which members within the community determine what health care services should be provided. The medical and health services approaches to health care are called "top-down" approaches, in which experts prescribe their values of health care for the public.

The faith community nurse is organizing a health fair for a faith community. How many weeks should the nurse allow for the preparation phase? A)3 B)4 C)5 D)6

Ans: D Fedback:The nurse should try to allow at least 6 to 8 weeks in preparing a health fair for the faith community to allow for appropriate planning time.

The school nurse is developing a program on breast self-examination and testicular self-examination. At which grade level should implementation of this program begin? A)Third grade B)Fifth grade C)Seventh grade D)Ninth grade

Ans: D Feedback:Programs for children and adolescents in the school setting must be age appropriate. Breast self-examination and testicular self-examination are not appropriate material for elementary school children. Breast self-examination/testicular self-examination is appropriate for teen groups in upper grades such as ninth grade. It is critical to assess the developmental and maturity level of the children before deciding on the educational content of a program or a strategy.

As the cost of health care increases, so does the population of uninsured and underinsured. Combined with the cost of litigation and extravagant settlements, open access to care is coming into question. What specific ethical quandaries apply to this situation? A)Autonomy, beneficence, fidelity B)Respect for people, nonmaleficence, veracity C)Veracity, justice, nonmaleficence D)Autonomy, beneficence, justice

Ans: D Feedback:This scenario raises the ethical issues of autonomy, beneficence, and justice with regard to access to care.

Which of the following would the community health nurse use for an online collaborative writing opportunity that allows multiple community health nurses to add to a growing document? A)Favorites B)Hyperlink C)Web browser D)Wiki

Ans: D Feedback:Wiki is an online collaborative writing opportunity often used to allow multiple users to add to a growing document or site. Favorites are similar to bookmarking in Netscape; this is a feature used in Internet Explorer to create a list of websites that can be returned to later for further review. Hyperlink is also known as link, which is a word or phrase or even an icon or picture that the browser reads and uses to access another resource. Web browser is a specific program that is needed to view websites on the internet.

Which of the following is a key strategy to improving maternal health? A)Decreasing access to skilled birth attendants B)Preventing pregnancies in women older than 40 years C)Preventing multiple birth pregnancies D)Increasing access to prenatal çare

Ans: D, Key strategies to improving maternal health include increasing access to prenatal care and skilled birth attendants, as well as preventing teen and unplanned pregnancies.

To plan prevention interventions, the nurse should know that which of the following is one of the greatest challenges to global health that leads to health disparities? A) Access to adequate food B) Health care C) Shelter D) Poverty

Ans: D, One of the greatest challenges to global health that leads to health disparities is poverty. Lack of access to adequate food, water, shelter, and health care are outcomes associated with poverty.

The community health nurse is trying to locate information about median household income, specifically the percentage of households below poverty level in the community. Which is the best source for these data? A)Census records B)Chamber of commerce C)Department of Labor D)Local union office

Ans:A Feedback:Census records are the best source of information about financial characteristics, including the percentage of households below poverty level in the community. Chamber of Commerce, Department of Labor, and local union office provide information about labor force characteristics.

The community health nurse is synthesizing what is known about the community into succinct phrases. These phrases form the basis for which of the following in the community assessment? A)Community nursing diagnoses B)Plan for the community health program C)Steps to take in implementation of the community health program D)Goals to evaluate the effectiveness of the community health program

Ans:A Feedback:These conclusions or inferences will identify the community's stressors and strengths in succinct phrases. These phrases, then, form the basis for a community nursing diagnosis.

Local water supplies are threatened by organic and synthetic contaminants. Which of the following would be beneficial to Americans to study as the source of threats to water supply? (Select all that apply.) A)Lakes B)Rivers C)Groundwater D)Ponds

Ans:A, B, C Feedback:Half of all Americans obtain their drinking water from surface water sources, which include lakes, rivers, and streams. The other half of all Americans obtain their drinking water from groundwater.

Who is considered to make up the school community? Select all that apply. A)School-aged children and adolescents B)Parents and guardians C)School personnel D)Neighborhood residents, business owners, and service providers E)Facebook friends

Ans:A, B, C, D Feedback:Health-education approaches must be comprehensive and include the children as well as all groups of individuals involved in their care and nurturing. These key adults, together with the children and adolescents they serve, are referred to as the school community. The school community encompasses school-aged children and adolescents, parents and guardians, school personnel (faculty, staff, and administrators), and neighborhood residents, business owners, and service providers. Facebook friends are not considered part of the school community.

The concept of prevention is a key component of modern community health practice. Which of the following is an example of primary prevention? A)Immunization clinic for seasonal influenza B)Blood pressure screening for hypertension C)Audiometric testing for hearing impairment D)Skin test for tuberculosis

Ans:A, Providing an immunization clinic for seasonal influenza is an example of the specific health promotion component of primary prevention. Blood pressure screening for hypertension, audiometric testing for hearing impairment, and skin testing for tuberculosis are examples of secondary prevention.

Which is likely the most comprehensive source of health-related data for the United States? A)Census data B)Notifiable disease reports C)Surveillance data D) Vital statistics

Ans:A, The census is probably the most comprehensive source of health-related data for the United States. The CDC/U.S. Public Health Service reports data collected by state and local health departments on legally reportable diseases and periodically requests voluntary reporting of nonnotifiable health conditions of special interest. Notifiable diseases are frequently referred to as "reportable diseases." Surveillance data pertain to the occurrence of specific diseases, the analysis and interpretation of these data, and the dissemination of information about the data. Vital statistics are legal data; however, legality does not guarantee validity. The major deficiency of this category of data for epidemiologic research purposes is the possible incompleteness of population coverage.

Which electronic resource would be most helpful in locating current immunization information? A)The Centers for Disease Control and Prevention B)United States Census Bureau C)March of Dimes D)American Cancer Society

Ans:A. Feedback:The Centers for Disease Control Prevention website include prevalence of communicable diseases and immunization information. Immunization requirements for all age groups are also listed. Census Bureau data enable the community health nurse to lean about the many characteristics of a community and to identify trends or patterns. The March of Dimes and the American Cancer Society provide information on preventing premature births/birth defects and about cancer statistics.

If you could only study the effects of pollutants on one ecosystem, the one that would potentially generate the greatest result would be which ecosystem? A)Air B)Aquatic C)Plants D)Terrestrial

Ans:B Feedback:Pollutants generally exert greater influence on aquatic ecosystems than on terrestrial environments. Air pollutants can be carried by the winds; but once they fall to earth, they continue their transport along the waterways.

Three nursing students are trying to locate source information about the adequacy, accessibility, and acceptability of education. Which is the best source for this information? A)Teachers and staff B)Students and staff C)School administrator D)Local board of education

Ans:B Feedback:Students and staff can address the issues related to adequacy, accessibility, and acceptability of education to students and staff. Teachers and staff can provide information about geographic distribution and demographic profiles for educational sources. The local board of education can provide information about the intracommunity and extracommunity for each educational facility. The school administrator and school nurse can provide information about educational, recreational, communication, and health services.

Models are used by community health nurses in an organization for analysis of community health data. Which is the core in the community assessment wheel model? A)Lines of resistance B)Major focus for analysis C)Strengths of the analysis D)Stressors for the subsystem of the analysis

Ans:B Feedback:The core is the major focus for analysis, with the subsystems representing the context. Stressors and strengths (lines of resistance) may be contributed by the core, the subsystems, or both.

Explain the focus of community health nursing. A)Direct clinical care B)Prevention rather than one-on-one care C)Family-focused roles D)Community-focused roles and functions

Ans:B, Community health practice is changing its focus to prevention of illness, health promotion, and assurance that care provided, rather than one-on-one care. Official agencies are more involved in direct clinical care, assigning less importance to family- and community-focused roles and functions.

How is the specificity of a screening test calculated? A)True positives/Total diseased B)True negatives/Total not diseased C)False negatives/ Total diseased or 1- Sensitivity D)False positives/Total not diseased or 1- Specificity

Ans:B, Specificity (true-negative rate) is calculated as True negatives/Total not diseased. Sensitivity (true-positive rate) is calculated as True positives/Total diseased. False-negative rate is calculated as False negatives/Total diseased or 1- Sensitivity. False-positive rate is calculated as False positives/Total not diseased or 1- Specificity.

Which is an example of an external relative risk factor? A)Age B)Exercise C)Gender D)Race

Ans:B, The concept of relative risk applies when one group of people clearly is exposed and another is not exposed to an external factor such as cigarette smoke, exercise, or foods high in saturated fat. However, it may be confusing to see relative risks applied to internal factors such as age, race, or gender.

Select the number that according to the Centers for Disease Control and Prevention (CDC) best represents the number of years added to the life expectancy because of public health. A)15 B)20 C)25 D)30

Ans:C, According to the Centers for Disease Control and Prevention (CDC), public health is credited with adding 25 years to the life expectancy of people in the United States.

Following the decline of communicable diseases and the prevention of chronic diseases related to such things as cigarette smoking and obesity, the World Health Organization began to focus on health promotion in which decade? A)1960s B)1970s C)1980s D)1990s

Ans:C, In the 1980s the focus of health shifted somewhat to health promotion, prompted by the Health for All era established by the World Health Organization (WHO, 1978).

Each state mandates certain requirements to maintain the health of school-aged children. Vision and hearing screening programs are required. When planning new student hearing and vision dates, the nurse understands that if school starts September 1, the screening should be scheduled no later than what time? A)By the end of September B)By the end of the school year C)By the end of October D)By the end-of- the-year break

Ans:D Feedback:All new students must be screened for hearing and vision within 120 days of enrollment. If the school year starts September 1, the screening would need to be completed before the end-of-the-year break.

Which of the following factors is shaping 21st-century health? A)Communicable diseases B)Tertiary health care C)Family planning clinics D)Health care reformAns:

Ans:D, The factors that are shaping 21st-century health are health care reform, demographics, globalization, poverty and growing disparities, violence, injuries, and social disintegration.

How does the web of causation view a health condition? A)The result of individual factors B)As an indirect cause of a condition C)Interrelated variables are rarely involved in the cause of a particular outcome. D)Complex interrelationships of numerous factors interacting to increase or decrease the risk of disease

Ans:D, The web of causation views a health condition as the result not of individual factors but of complex interrelationships of numerous factors interacting to increase or decrease the risk of disease. The web identifies a disease as a direct, not indirect, result of a condition and almost always as a result of interrelated variables.

Choose the demographic factor that is helping to shaping the future of community health nursing. A)Decline in smoking B)Social integration C)Shift in medical care from chronic to acute illness D)Increasing ethnic diversity

Ans:D, Two significant demographic factors shaping the future of community health nursing are the increasing age and ethnic diversity of the American population.

A community health nurse is searching for information about heart disease in Chicago, Illinois. What is the best search string to enter to locate this information? A)Heart disease B)Heart disease, Illinois C)Heart disease, Dade County D)Heart disease AND Chicago, Illinois

Ans:D. Feedback:The search string "heart disease AND Chicago, Illinois" would return all information indexed on that search engine pertaining to heart disease as indexed in Chicago, Illinois. The Boolean word AND instructs the search engine to return only resources that have both terms in the documents, resulting in more effective searching. Searching heart disease alone would return volumes of information on heart disease everywhere. Although less information would be returned, simply adding the state or county would still provide a high number of websites.