Exam 1 Community

What disease that was once isolated and rare is now widespread throughout the world? a. Acquired immunodeficiency syndrome (AIDS) b. Smallpox c. Malaria d. Measles

Acquired immunodeficiency syndrome (AIDS) Smallpox has been eradicated; malaria and measles were not isolated and rare throughout the world. AIDS was once isolated and rare but is now worldwide.

What is evidence-based public health (EBPH)? a. An integration of the best available nursing expertise b. Derived from community principles to fit the area where it is practiced c. A health endeavor that makes informed use of evidence d. Comprised of only public health records

A health endeavor that makes informed use of evidence EBPH is a public health endeavor in which there is an informed, explicit, and judicious use of evidence that has been derived from any of a variety of science and social science research and evaluation methods. EBPH includes more than public health records. EBPH is not an integration of nursing expertise. EBPH is not derived from community principles.

A nurse is faced with a macroeconomics issue. Which situation describes what is happening? a. The evaluation of client access to services b. A health policy that makes the development of a new program possible c. Informing clients and others of the cost of service d. The referral of clients to available services

A health policy that makes the development of a new program possible Macroeconomics focuses on the "big picture," such as a program, whereas microeconomics focuses on the individual or organization.

What is one effect of the use of block grants? a. A reduction of federal expenditures b. A decreased ability of states to spend money on programming c. The guaranteed continuation of programs with demonstrated effectiveness d. The shift from hospital-based to community-based nursing care

A reduction of federal expenditures Block grants enabled financial responsibility to shift from the federal level to the state level, thereby reducing expenditures. Block grants gave additional monies to state and local areas to improve access to care. Block grants have not caused a shift in care from hospital-based to community-based nursing care. Block grants have not guaranteed program continuation.

A nurse would identify which as a point source of air pollution? a. A smoke stack b. The number of cars and trucks c. The amount of fossil fuel consumed in a community d. Ground ozone levels

A smoke stack Point sources of pollution are identifiable sources of air pollution, such as a smoke stack. Nonpoint sources come from more diffuse exposures, such as from cars and trucks. The amount of fossil fuel that is consumed and ground ozone levels do not identify sources of air pollution.

A nurse providing care through the Frontier Nursing Service (FNS), would most likely have addressed the needs of which client? a. An injured soldier b. A homebound, elderly male c. A woman in labor d. A child with measles

A woman in labor The FNS nurses were trained in nursing public health and midwifery and provided care to rural and inaccessible areas, which led to reduced mortality. They would not have seen injured soldiers, males, or a child with measles.

The blueprint or code that is used to construct other components of cells is referred to by what term: a. deoxyribonucleic acid (DNA). b. gene. c. chromosome. d. base.

deoxyribonucleic acid (DNA). The DNA is the chemical inside the nucleus of the cell that has the genetic instructions for making living organisms. This can be compared to a blueprint or code that is used to construct other components of cells. Genes are the DNA segments that carry the genetic information. DNA is organized into long structures called chromosomes within the cells. DNA is comprised of four bases.

A nurse is assisting a family in compiling a family health history. Which of the following statements would be most appropriate for the nurse to make? a. "When you have completed this history, it will not need to be updated." b. "Looking back at two generations of biological relatives will be sufficient." c. "The purpose of completing a family history is to decrease genetic susceptibility." d. "A family history is a useful tool when considering your future health risks."

"A family history is a useful tool when considering your future health risks." A family history is a useful tool to help families know about their health risks and prevent disease in themselves and their close relatives. It is recommended that families develop a three-generation history and update it on a regular basis. Completion of a family history will not decrease genetic susceptibility; rather it will make families more aware of what that susceptibility may be.

An 80-year-old client comes to the community health center with a large bag of medications. The client tells the nurse these medications are unaffordable on just Social Security. Which statement is the best response by the nurse? a. "Let's go through these medications and see which ones we can delete." b. "You can get these medicines at this clinic for free." c. "I will consult with our social worker to see if Medicare will pay for these medications." d. "These medications are important. Do your best to pay for them."

"I will consult with our social worker to see if Medicare will pay for these medications." This elderly patient probably is eligible for benefits through Part C, the Medicare Advantage program, but often a patient needs help negotiating the system. Finding prescriptive coverage through an insurance plan with the help of a social worker is a better choice than eliminating medications, trying to get medications for free (which is only a short-term solution in most cases), and telling the client to find a way to pay for the medications when she does not have the resources.

A nurse is counseling a client who is considering purchasing a genetic testing kit from a vendor advertised on the Internet. Which of the following would be the response by the nurse? a. "It is illegal to purchase genetic testing kits from Internet vendors." b. "It will be important to follow up with a health care provider after receiving your results." c. "Many times, online vendors experience inaccuracies with their results." d. "Internet vendors use the latest technology to perform these tests."

"It will be important to follow up with a health care provider after receiving your results." The most important aspect of genetic testing is the counseling that occurs with the testing. Purchasing genetic testing kits on the Internet makes it easy for the public to access but leaves a health care professional out of the testing process. Meeting with a health care professional is important to counsel a client about the implications and indications for such testing. It is not illegal to purchase genetic testing kits from the Internet. The accuracy and technology used by the Internet vendor may vary depending on the vendor that is used.

A nurse is eliciting information about a client's genetic history. Which of the following questions would be most appropriate for the nurse to ask? a. "Have any of your family members ever completed genetic testing?" b. "Do any of your family members have a genetic disorder?" c. "What medical problems have your parents and grandparents experienced?" d. "What environmental exposures have you had?"

"What medical problems have your parents and grandparents experienced?" A client's family medical history is important to obtain to consider the client's potential risk for genetic diseases and disorders. The best way to obtain this information is to ask an open-ended question about past medical history of parents and grandparents. Asking about completion of genetic testing by others, familial history specific only to genetic disorders, and environmental exposures do not address the importance of obtaining a family history.

A nurse is counseling a client whose genetic test results show a genetic susceptibility for breast cancer. Which of the following would be the most appropriate statement by the nurse? a. "You should discuss hormone replacement therapy with your physician." b. "You are at an increased risk to develop breast cancer." c. "You should have a bilateral mastectomy as soon as possible." d. "You should tell all of your siblings and children to get tested."

"You are at an increased risk to develop breast cancer." Persons with a genetic susceptibility are at increased risk for developing the disease. Although the client may choose to have a bilateral mastectomy and recommend genetic testing to other family members, the most important thing to relay to the client is that having a genetic susceptibility does not mean that one will automatically have the disease.

A community health nurse is assisting clients to access health care. Which individual would most likely experience a barrier when accessing health care? a. A 40-year-old who speaks English b. A 25-year-old with health insurance c. A 50-year-old with hypertension d. A 30-year-old who is unemployed

A 30-year-old who is unemployed Barriers to accessing care include the inability to afford health care, lack of transportation, physical barriers, communication problems, child care needs, lack of time or information, or refusal of services by providers. The unemployed person is most likely to experience a barrier because of not having a job, which may reduce his access to health insurance and limit his income.

A nurse is working with members of the community to assist them with acquiring health insurance. Which individual is most likely to be uninsured? a. An 82-year-old with chronic medical problems b. A 2-year-old whose mother is on welfare c. A 50-year-old business executive who works for a large corporation d. A 32-year-old who works part-time at a small business

A 32-year-old who works part-time at a small business The typical uninsured person is one who works at a low-paying job, part-time or temporary, or at a small business. The elderly person would be eligible for Medicare, and the 2-year-old is probably eligible for Medicaid. The individual who works at the large corporation probably has health insurance, since most large businesses provide it.

Which client is most likely to have enrolled in Medicaid? a. An 85-year-old female who has hypertension. b. A 25-year-old female who is pregnant. c. A 50-year-old male who is blind. d. A 70-year-old male who is hearing impaired.

A 50-year-old male who is blind. Medicaid provides financial assistance to states and counties to pay for medical services for the aged poor, the blind, the disabled, and families with dependent children who are below state poverty income levels. Medicaid does not provide coverage to those who have hypertension, are pregnant, or are hearing impaired unless they meet income guidelines.

A public health nurse (PHN) is developing a measurable outcome health status indicator that can be used at the individual level of practice. Which of the following would the nurse likely use? a. A 50-year-old woman receives annual mammograms. b. School absences in a community decline. c. Teachers have increased awareness of health problems. d. Those in poverty utilize the free mammogram program.

A 50-year-old woman receives annual mammograms. Outcome health status indicators are used to measure the impact of the interventions on population health. In this case, a 50-year-old woman receiving an annual mammogram will have an impact on the population health when considering those who are receiving the screening. The other examples do not look at population health as an outcome or are not occurring at the individual level.

A nurse is reading a systematic review when researching the best practices to promote increased safety among toddlers. Which of the following information would the nurse most likely find? a. Results of randomized controlled trials b. A description of the methods used to search for evidence c. Data compiled on a particular question d. An in-depth review of the literature completed by one person

A description of the methods used to search for evidence A systematic review is usually done by more than one person and describes the methods used to search for the evidence. It is a method of identifying, appraising, and synthesizing research evidence to evaluate and interpret all available research relevant to a particular research question.

A nurse is analyzing one of the components of a unit of disability-adjusted life-years (DALYs). From which individual would the nurse be able to calculate this measurement? a. A woman who lives to be 100 years old. b. A woman who contracts human immunodeficiency virus (HIV) after working as a prostitute. c. A father with five children who dies at the age of 50 from malaria. d. A woman who gives birth to a premature infant.

A father with five children who dies at the age of 50 from malaria. A male who dies from malaria at age 50 would represent 30 DALYs. Measurement is based on the potential limit for life, which has been set at 82.5 years for women and 80 years for men. To calculate this statistic, the nurse must know the client's age and the potential limit for life.

Congress's legal base for actions in health care includes which of the following? (Select all that apply.) a. Providing for the general welfare b. Raising funds to support research c. Regulating commerce among the states d. Providing spending power e. Increasing revenue by raising taxes

A, B, C, D The legal base for actions in health care includes providing for the general welfare, regulating commerce among the states, providing spending power, and raising funds to support the military. Increasing revenue is not part of Congress's legal base for actions for health care.

By what means does the Center for Disease Control (CDC) accomplish its mission? (Select all that apply.) a. Implementing prevention strategies b. Detecting and investigating health problems c. Dictating world health policy d. Fostering safe and healthful environments e. Protecting the population from bioterrorism events

ANS: A, B, D The CDC implements prevention strategies, detects and investigates health problems, and fosters safe and healthful environments. The CDC operates within the United States, not worldwide. The Department of Homeland Security is concerned with protecting the population from bioterrorism, not the CDC.

A nurse is considering joining the American Public Health Association (APHA). What information about this organization should be considered when making this decision? a. APHA focuses on the public health concerns of the medical profession. b. APHA represents concerns of nursing specialty practices. c. APHA provides a forum for nurses to discuss their public health concerns. d. APHA focuses on providing health promotion education to the public.

APHA provides a forum for nurses to discuss their public health concerns. APHA was formed to facilitate interprofessional efforts and promote the "practical application of public hygiene." The Public Health Section within APHA provides nurses with a forum to discuss their concerns and strategies. It also serves as a focus of leadership and policy development for community/public health nursing.

Residents of rural communities report that they must travel for long distances to obtain health care services. As a result, they seek health care only for emergencies and severe illnesses. Which aspect of the health care system in the United States is illustrated in this situation? a. Access to care b. Cost c. Quality d. Advances in technology

Access to care One significant problem is poor access to care. Access can refer to inability to pay for care and inability to access care. Cost refers to the health care expenditures that happen to pay for the services received. Quality refers to the quality of health care that is provided. Advances in technology refer to the medical advancements made to treat diseases.

When researching pesticides, the nurse looks at the "family" of the chemical. What similarities are found among chemicals that have been placed in the same family? a. Route of entry into the body b. Actions and associated risks c. Effects that they have on the body d. Potency and toxicity

Actions and associated risks Chemicals are grouped so it's possible to understand the actions and risks associated with each group. Although some common health risks exist within these families of chemicals, the possible health risks for each chemical should be evaluated individually when a potential human exposure exists.

What is one of the main goals of the Human Genome Project? a. Providing physicians with a national database for information related to genetic disorders b. Developing new medications that can be used in genetics research c. Addressing ethical, legal, and social issues related to this research d. Improving the ability to accurately test for genetic disorders

Addressing ethical, legal, and social issues related to this research The goals of the Human Genome Project were to determine the sequences of the base pairs in human DNA; improve tools for data analysis; transfer-related technologies to the private sector; and address the ethical, legal, and social issues that may arise. The Human Genome Project did not provide physicians with a national database of information for genetic disorders, develop new medications related to genetics research, or improve the ability to accurately test for genetic disorders.

A nurse is working in a community health nursing practice setting. Which intervention is the nurse most likely to implement? a. Administering a flu shot to a client in a physician's office b. Conducting a flu shot clinic at a community center c. Performing a client assessment in a hospital d. Providing supervision of staff in a rehabilitation center

Administering a flu shot to a client in a physician's office Community health nursing practice focuses on the health of individuals, families, and groups and the effect of their health status on the health of the whole community. Administering a flu shot to an individual is the only example that meets this criterion. Performing a client assessment focuses only on individual care, not the community. Providing supervision of staff does not focus on the community. Conducting a flu shot clinic at a community center focuses on protecting the community as a whole and would be considered public health nursing practice.

A nurse is applying the ethical principle of nonmaleficence. Which of the following describes the action that the nurse is taking? a. Administering medications using the "five rights" b. Allowing clients to be active participants in their care c. Providing patient privacy when delivering care d. Referring a client to a physical therapist

Administering medications using the "five rights" Nonmaleficence requires that one do no harm. It requires that health care professionals act according to the standards of due care, always seeking to produce the least amount of harm possible. Providing privacy when delivering care demonstrates the client's right to privacy. Allowing clients to be active participants in their care refers to the ethical principle of the right to autonomy. Referring a client to a physical therapist demonstrates the nursing role of referral agent.

A nurse is working with a community to decrease the occurrence of influenza. Which of the following U.S. Department of Health and Human Services (USDHHS) or simply HHS) goals is being applied? a. Strengthen Health Care. b. Advance the Health, Safety, and Well-being of the American People. c. Increase Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs. d. Advance Scientific Knowledge and Innovation.

Advance the Health, Safety, and Well-being of the American People. One of the objectives of Advance the Health, Safety, and Well-being of the American People is to reduce the occurrence of infectious diseases. The goal of Strengthen Health Care focuses on improving health care services, quality, and coverage. The goal of Increase Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs focuses on improving programming and application of found data. The goal of Advance Scientific Knowledge and Innovation focuses on scientific discovery and application of the new knowledge.

The community leaders in a lesser-developed country decide not to tell the citizens of a small village about a chemical spill at a major industrial facility that could produce harmful effects. Which of the following principles is being violated? a. Morality b. Advocacy c. Caring d. Virtue

Advocacy Advocacy requires that the community be properly informed, and this was violated in the above scenario. Morality is shared and generational societal norms about what constitutes right or wrong conduct. Caring represents the essence of nursing. Virtue demonstrates behavior showing high moral standards.

A nurse is considering seeking employment in a career as a genomic nurse. Which of the following roles would be most important role of the nurse in this setting? a. Direct caregiver b. Educator c. Advocate d. Referral agent

Advocate Although the nurse will use all of these roles when providing genomic nursing care, the most important role will be that of advocate. Nurses will increasingly provide guidance on policy discussions and ethical issues that relate to confidentiality, privacy, and commercialization. This is the nursing role of advocate.

Population-focused practice concentrates on defining the problems or needs of and implementing solutions for whom? a. Individuals b. Aggregates c. Communities d. Geographical regions

Aggregates Aggregates are a defined population made up of individuals in communities of a specific geographical region. Population-focused practice is implemented with defined populations or subpopulations. This is larger than the scope of individual care but may not address the larger needs of the entire community or geographical region.

A public health nurse is examining several issues within daily practice. Which of the following issues would be considered an ethical dilemma? a. Whether or not to establish a community health center in a rural area b. Allocating resources in a natural disaster c. Deciding to withdraw care on a hospice patient d. Applying the principles of Florence Nightingale in Bangladesh

Allocating resources in a natural disaster When resources are scarce, a dilemma may exist as to how to allocate them. Considering establishing a community health center may be a dilemma, but it probably does not involve ethics. Withdrawing care from a hospice patient would most likely not be an issue encountered by a public health nurse, as this represents community health nursing practice, not public health nursing practice. Applying the principles of Florence Nightingale would not be ethical issue.

A nurse concerned about an event of bioterrorism would most likely be focusing on what? a. An outbreak of smallpox b. The bombing of historic buildings c. Exploding land mines d. All threats of war

An outbreak of smallpox Bioterrorism is a term used to describe the deliberate release of viruses, bacteria, or other germs (agents) used to cause illness or death in people, animals, or plants. Bombing historical buildings, explosion of land mines, and threats of war may be part of terrorist attacks, but do not include the component of bioterrorism.

A public health nurse (PHN) utilizes the nursing process at all levels of practice. Which of the following demonstrates how this is accomplished? a. Including specific goals for community health nurses b. Developing an accurate nursing diagnosis c. Analyzing the needs of the community, systems, individuals, and families d. Utilizing primary, secondary, and tertiary prevention

Analyzing the needs of the community, systems, individuals, and families PHNs must customize the nursing process to consider the community, systems, and individual/family levels of practice. The levels of practice are not used for developing nursing diagnoses or goals. The levels of practice are not demonstrated utilizing the levels of prevention.

What is considered a nonpoint source of pollution? a. Hazardous waste site b. Animal waste from wildlife c. Chlorine poured down a well d. Stagnant water

Animal waste from wildlife Nonpoint sources come from more diffuse exposures to pollution. Animal waste is the only diffuse exposure given. The others are considered point sources; point sources are individual, identifiable sources such as smoke stacks.

A public health nurse (PHN) collects data and monitors the health status of the population. Which of the following core public health functions is the nurse addressing? a. Assessment b. Prevention c. Assurance d. Policy development

Assessment Assessment consists of systematic data collection and monitoring health status. Prevention is not a core function, assurance is making sure essential services are available, and policy development is needed to provide leadership in developing policies.

A public health nurse (PHN) is conducting an assessment of the community's health. Which of the following is being accomplished through this activity? a. Define one problem that will be the focus for a year. b. Assess a social network of interacting individuals usually in a defined territory. c. Minimize the effects of health risks and hazards. d. Intervene at the population level by changing laws and regulations.

Assess a social network of interacting individuals usually in a defined territory. A community is defined as a social network of interacting individuals, usually concentrated in a defined territory. The community assessment generally results in a lengthy list of community problems and issues. Intervention and minimization do not take place during the assessment phase.

A public health nurse (PHN) has been prepared at the graduate level. Which activity should the practitioner be able to complete? a. Teaching public and community health nursing b. Assessing and intervening successfully at the aggregate level c. Diagnosing and treating disease while having earned prescriptive authority d. Running for political office as experts in public health policy

Assessing and intervening successfully at the aggregate level According to the Consensus Conference, specialists should have assessment skills that allow them to intervene at the aggregate level. Public health practitioners have a broad range of practice areas within public health and are not limited to only nursing and medicine.

The public health nurse (PHN) compares the rate of teenage pregnancy in various areas of the city. Which of the core functions of public health is the nurse addressing? a. Assurance b. Assessment c. Prevention d. Policy development

Assessment Assessment refers to systematic data collection, which this nurse is doing for teenage pregnancy. Prevention is not a core function, assurance is making sure essential services are available, and policy development is needed to provide leadership in developing policies.

A nurse provides for the availability of essential personal health services for people who would otherwise not receive health care. Which of the public health core functions is the nurse addressing a. Assessment b. Prevention c. Assurance d. Policy development

Assurance Assurance deals with the availability of health services. Prevention is not a core function, assessment refers to systematic data collection, and policy development refers to the need to provide leadership in developing health policies.

A public health department makes sure that the essential community-oriented health services are available in the community. Which of the following core public health functions is being implemented? a. Policy development b. Assessment c. Assurance d. Scientific knowledge-based care

Assurance Assurance focuses on the responsibility of public health agencies to ensure certain activities have been appropriately carried out to meet public health goals and plans. Policy development seeks to build constituencies that can help bring about change in public policy. Assessment includes activities that involve collecting, analyzing, and disseminating information on both the health status and the health- related aspects of a community or a specific population. Public health is based on scientific knowledge but is not a core function.

A nurse believes that all Americans should receive basic health care services. Which of the following core functions supports this belief? a. Assessment b. Assurance c. Policy development d. Advocacy

Assurance Assurance purports that all persons should receive essential personal health services. Assessment refers to systematically collecting data on the population, monitoring the population's health status, and making information available about the health of the community. Policy development refers to the need to provide leadership in developing policies that support the health of the population, including the use of the scientific knowledge base in making decisions about policy. Advocacy embodies an ethical focus grounded in quality of life.

The nurse manager makes sure that the staff members who work in a local clinic are competent in their job responsibilities. Which of the public health core functions is being demonstrated? a. Assurance b. Assessment c. Prevention d. Policy development

Assurance Assurance refers to making sure a competent health care workforce is available. Prevention is not a core function, assessment refers to systematic data collection, and policy development refers to the need to provide leadership in developing health policies.

Public health administrators provide part-time translators to a health department serving indigent immigrants. Which of the following best describes what is being addressed? a. Policy development b. Quality c. Assurance d. Libertarian philosophy

Assurance Assurance refers to the role of public health in making sure that essential community-oriented health services are available, which may include providing essential personal health services for those who would otherwise not receive them. Policy development refers to the need to provide leadership in developing policies that support the health of the population, including the use of the scientific knowledge base in making decisions about policy. Quality refers to providing the best care possible. Libertarian philosophy refers to the view that the right to private property is the most important right.

A nurse is using a population focus when providing public health nursing care. Which statement best describes the care that is being provided? a. Priority is given to the highest risk population. b. Direct caregiving is limited to preventive measures, such as administration of immunizations. c. Attention is given to the population or community, regardless of whether they do or do not access the health care system. d. Only populations outside institutional settings are considered.

Attention is given to the population or community, regardless of whether they do or do not access the health care system. PHNs are concerned with the health of the entire population. Priority is given to the entire population, not just the group at highest risk or those outside of institutional settings. Direct caregiving is not the focus of public health nursing care.

A nurse is working in a public health nursing setting. Which statement best describes why this specialty is appealing to nurses? a. Interactions with wealthy contributors to secure funding b. Autonomy and independence of practice c. Ability to locate the source of diseases and cure patients d. Opportunities to meet a variety of people

Autonomy and independence of practice Community health nurses have a long history of autonomous practice, problem solving, and decision making. Community health care nurses engage in the other activities as well, but overall, they have been best known for autonomy of practice.

Public health economics focuses on what? a. Use of resources. b. Availability and usage of goods and services related to public health. c. Scarcity of resources in the health care industry. d. Management and use of monies to improve the health of populations.

Availability and usage of goods and services related to public health. Public health economics focuses on producing, distributing, and consuming goods and services related to public health. Economics is the science concerned with the use of resources, including the production, distribution, and consumption of goods and services. Health economics is the allocation of scarce resources within the health care sector and the focus on resource allocation issues related to producing and distributing health care. Public health finance involves the acquiring, managing, and use of monies to improve the health of populations through disease prevention and health promotion strategies.

A nurse will be using an interpreter during a client encounter. Which of the following considerations should be made by the nurse? (Select all that apply.) a. It is appropriate to use family members as interpreters. b. Written materials should be available in the client's primary language. c. Observe the interpreter's gestures to assure client understanding. d. The gender, age, and educational level of the interpreter should be evaluated. e. The nurse should face the interpreter when speaking.

B, D Family members should be used with caution. The client's gestures and nonverbal messages should be observed to assure understanding. Written materials should be available in the client's primary language. The gender, age, educational level, socioeconomic status, religion, and dialect should all be considered when selecting the proper interpreter. The nurse should face the client during the dialogue, not the interpreter.

A nurse is writing to a legislator to advocate for funds to support advanced practice nursing education. Which of the following considerations should be made by the nurse? (Select all that apply.) a. Limit the letter to one page in length. b. Identify oneself as a nurse. c. Provide only factual information. d. Share personal knowledge about the issue. e. Arrange a face-to-face meeting as soon as possible.

B, D When writing to a legislator, the letter should be a maximum of two pages in length and opinions should be expressed. Additionally, the nurse should identify oneself as a nurse and share knowledge about the issue.

The necessary basic preparation for public health nursing is what level of nursing education? Associate degree b. Baccalaureate degree c. Master's degree d. Doctor of Nursing Practice

Baccalaureate degree A Bachelor of Science in nursing (BSN) is the necessary basic preparation to function as a beginning staff PHN. An Associate degree is not enough for basic preparation. A Master's degree or Doctor of Nursing Practice degree would be part of preparation for advanced practice.

A nurse is applying the principle of distributive justice. Which of the following describes the benefits that will occur through application of this principle? a. Basic needs, material and social goods, liberties, rights, and entitlements b. Taxes, military service, location of incinerators or power plants c. Entitlement to equal rights and equal treatment d. The right to private property and personal assets

Basic needs, material and social goods, liberties, rights, and entitlements Distributive justice requires that the distribution of benefits and burdens on a society be fair or equal. Entitlement to equal rights and equal treatment refers to egalitarianism. The right to private property and personal assets refers to libertarianism. Taxes, military service, and location of incinerators or power plants are not benefits associated with justice.

A nurse is working with an immigrant population. Which of the following should be the first action taken by the nurse? a. Be aware of one's own culture. b. Become familiar with traditional practices of the immigrants. c. Try to see things from the immigrant's viewpoint. d. Learn to speak the language of the immigrant population.

Be aware of one's own culture. Cultural competence is one of the core attributes of public health nurses. Nurses come from a variety of cultural backgrounds and have their own cultural traditions. Nurses also bring their biomedical beliefs and values to the practice environment that may differ from the client's own beliefs and values. Because nurses recognize their own culture, they are better able to understand that there are differences among cultures. Being aware of one's own culture should be done before completing the other tasks of increasing familiarity with traditional practices, trying to see things from the other's point of view, or learning to speak the language.

A nurse is applying the knowledge and processes of ethics to the examination of ethical problems in health care. Which of the following describes the actions of the nurse? a. Values b. Morality c. Ethics d. Bioethics

Bioethics Bioethics applies the knowledge and processes of ethics to the examination of ethical problems in health care. Values are beliefs about the worth or importance of what is right or esteemed. Morality is shared and generational societal norms about what constitutes right or wrong conduct. Ethics is a branch of philosophy that includes both a body of knowledge about the moral life and a process of reflection for determining what persons ought to do or be regarding this life.

Research has shown that Asian men tend to have a greater sensitivity than white Europeans to codeine, and they experience significantly weaker effects from the drug. Which of the following types of cultural variations is being demonstrated? a. Biological variations b. Personal space c. Social organization d. Perception of time

Biological variations Biological variations are the physical, biological, and physiological differences that exist between racial groups and distinguish one group from another. Personal space is the physical distance between two individuals during an interaction. Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions. Perception of time is the duration or period between successive events, where some cultures assign greater or lesser emphasis to events that occur in the past, present, or future.

What is the primary focus to be addressed concerning the improvement of the health of the American people in the twenty-first century? Bioterrorism and global health threats Delivery of individual care and hygiene The need for increased hospital and acute care Chronic disease and disability management

Bioterrorism and global health threats There are new concerns, and of the most serious are bioterrorism and globally induced infections, such as the avian flu. These threats will divert health care funds and resources from other health care programs to be spent for public safety. The others are not related to public health or are concerns that have been present for many years.

An occupational health nurse maintains a log of injuries from contaminated sharps. Which of the following describes why the nurse must do this? a. Bloodborne Pathogen Standard b. Occupational Safety and Health Administration (OSHA) c. Department of Labor (DOL) d. Department of Defense (DOD)

Bloodborne Pathogen Standard OSHA is part of the DOL. The Bloodborne Pathogen Standard became effective in 2002. This act clarified the responsibility of employers to select safer needle devices as they become available and to involve employees in identifying and choosing the devices. The updated standard also required employers to maintain a log of injuries from contaminated sharps. The DOD is not involved in these activities.

The nurse is investigating environmental health problems caused by contaminated ground water. Which type of nursing practice is being implemented? a. Community-oriented b. Community-based c. Policy development d. Tertiary care

Community-oriented Community-oriented nursing emphasizes the prevention of disease and disability. Community-based nursing practice is a setting-specific practice whereby care is provided for clients and families where they live, work, and attend school. Policy development seeks to build constituencies that can help bring about change in public policy. Tertiary care focuses on highly specialized medical care.

In what country was the term evidence-based first used? a. Canada b. Great Britain c. the United States d. Australia

Canada The term evidence-based was first attributed to Gordon Gyatt, a Canadian physician at McMaster University in 1992. Great Britain, the United States, and Australia did not use this term before it was used in Canada.

A physician receives a set amount of money to provide care to a given group of clients for a set period of time. Which term is being described? a. Retrospective reimbursement b. Prospective reimbursement c. Fee-for-service d. Capitation

Capitation Capitation describes the practice of paying physicians and other practitioners a set amount to provide care to a given client or group of clients for a set period of time and amount of money. This is similar to prospective reimbursement for health care organizations. Prospective reimbursement is the method of paying an organization whereby the third-party payer establishes the amount of money that will be paid for the delivery of a particular service before offering the services to the client. Retrospective reimbursement is the method whereby fees for the delivery of health care services in an organization are set after services are delivered. Fee-for-service is the traditional method of paying the health care practitioner; the practitioner determines the costs of providing a service, delivers the service, and submits a bill for the delivered service to a third-party payer who then pays the bill.

According to Leininger and Watson, what is the moral ideal of nursing? a. Caring b. Advocacy c. Responsibility d. Accountability

Caring This conceptualization occurred as a response to the technological advances in health care science and the desire of nurses to differentiate nursing practice from medical practice. Advocacy, responsibility, and accountability are not part of the moral idea of nursing proposed by Leininger and Watson.

A nurse is organizing a fundraiser for a philanthropic organization. Which organization is the nurse most likely working with? a. International Red Cross b. Carnegie Foundation c. Nestlé d. Johnson & Johnson

Carnegie Foundation The Carnegie Foundation is a philanthropic organization, receiving funding from private endowment funds. The Red Cross is a nongovernmental agency, and Nestlé and Johnson & Johnson are private voluntary organizations.

A public health nurse (PHN) is using collaboration, coalition building, and community organizing to develop a new program in the community. Which of the following strategies is the nurse most likely using? a. Providing case management, referral, and follow-up services with individuals b. Carrying out collective action at the systems or community levels of practice c. Conducting a community assessment d. Implementing primary and secondary prevention strategies

Carrying out collective action at the systems or community levels of practice Collaboration, coalition building, and community organizing are the interventions often carried out at the systems and community levels of practice. These interventions can be used at all levels of prevention. Providing case management, referral, and follow-up services with individuals represents another group of interventions described by the green wedge. These interventions are not part of conducting a community assessment.

A nurse is working with a religious organization to provide food to starving people in a lesser- developed country. Which organization is the nurse most likely working with? a. International Red Cross b. Church World Service c. Maryknoll Missionaries d. Catholic Relief Services

Catholic Relief Services Catholic Relief Services alleviates suffering and provides assistance to people in need affected by war, starvation, famine, drought, and national disasters without regard to race, religion, or nationality. The Red Cross is not a religious organization, and the Church World Service and Maryknoll Missionaries do other things besides providing food.

Historically, which statement is true about African American nurses in public health? a. Certificate and graduate education were more difficult to obtain. b. Segregation limited areas where they practiced. c. They often belonged to the Frontier Nursing Service (FNS). d. They were recruited heavily as military nurses.

Certificate and graduate education were more difficult to obtain. Due to segregation, certification and graduate education were more difficult to obtain. They were faced with many challenges because of discrimination and had a limited presence in public health nursing practice. They were not part of the FNS or recruited as military nurses.

A public health nurse (PHN) is implementing interventions at the systems level of practice. Which of the following interventions would be used by the nurse? a. Involve the entire community in solving the health problem. b. Identify health problems in the community. c. Change laws, policies, and practices that influence population-based issues. d. Provide outreach services to populations at risk.

Change laws, policies, and practices that influence population-based issues. Systems level practice consists of changing laws, policies, and practices that influence population-based issues. The individual level of practice focuses on interventions that involve working with individuals, either singly, or in groups, and with families is demonstrated through providing outreach. Community level interventions are carried out with the community as a whole and is demonstrated by involving the entire community in identifying and solving health problems.

When a school nurse reports suspected child abuse, there is a breach of confidentiality. Which of the following best describes why this breach is allowed? a. Civil immunity b. Sovereign immunity c. Nurse practice act d. Respondeat superior

Civil immunity The law mandates that a health professional may breach patient confidentiality norms to protect someone who may be in a helpless or vulnerable position. Sovereign immunity states that PHN practice has been granted personal immunity to cover all aspects of their practice. The nurse practice act defines the nurse's scope of practice. The doctrine of respondeat superior says that when a nurse is employed and functioning within the scope of that job, the one responsible for that negligence is the nurse's employer.

What is the purpose of public health core functions? a. Clarifying the role of the government in fulfilling the mission of public health b. Ensuring the safety of populations in receiving quality health care c. Providing community-based individualized care to every person in the United States d. Uniting public and private providers of care in a comprehensive approach to providing health care

Clarifying the role of the government in fulfilling the mission of public health As defined by the Institute of Medicine in its 1988 report The Future of Public Health, assessment, policy development, and assurance are core functions at all levels of government for the purpose of clarifying the government's role.

Which environmental law sets basic structure for regulating pollutants to United States waters? a. Safe Drinking Water Act b. Toxic Substance Control Act c. Clean Water Act d. Pollution Prevention Act

Clean Water Act The Clean Water Act sets basic structure for regulating pollutants to United States waters. The Safe Drinking Water Act authorized the EPA to establish safe standards of purity and required all owners or operators of public water systems to comply with primary standards. The Toxic Substance Control Act gives the EPA the ability to track the 75,000 industrial chemicals currently produced or imported into the United States. The Pollution Prevention Act focused industry, government, and public attention on reduction of the amount of pollution through cost-effective changes in production, operation, and use of raw materials.

A nurse promotes alliances among organizations for a common purpose. Which of the following public health interventions is being implemented? a. Health teaching b. Coalition building c. Surveillance d. Referral and follow-up

Coalition building One example of coalition building is promoting alliances among organizations for a common purpose. Referral and follow-up assists individuals, families, groups, organizations, and/or communities to identify and access necessary resources in order to prevent or resolve problems or concerns. Surveillance describes and monitors health events through ongoing and systematic collection, analysis, and interpretation of health data. Health teaching communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, and practices of individuals, families, systems, and/or communities.

A public health nurse (PHN) uses a published systematic review to determine which exercises should be incorporated into a newly developed older adult exercise program. Which of the following resources would most likely contain this information? a. Evidence-Based Practice for Public Health Project b. PubMed c. Cochrane Public Health Group (PHRG) d. Task Force on Community Preventive Service

Cochrane Public Health Group (PHRG) The PHRG works with contributors to produce and publish Cochrane reviews of the effects of population- level public health interventions. The PHRG undertakes systematic reviews of the effects of public health interventions to improve health and other outcomes at the population level, not those targeted at individuals. The Evidence-Based Practice for Public Health Project provides access to numerous databases of interest concerning public health. PubMed is a bibliographical database that includes references for nursing, medicine, dentistry, the health care system, and preclinical sciences. The Task Force on Community Preventive Services is charged with determining the topics to be addressed by the CDC's Community Guide and the most appropriate means to assess evidence regarding population-based interventions.

A nurse who was working in the 1960s used the code of ethics to guide making an ethical decision. Which code of ethics would have been used? a. Nightingale Pledge b. Code for Professional Nurses c. Code of Ethics for Nurses with Interpretive Statements d. International Council of Nurses (ICN) Code of Ethics for Nurses

Code for Professional Nurses Florence Nightingale lived in the 1800s. The Code for Professional Nurses was adopted in 1950, the Code of Ethics for Nurses with Interpretive Statements was adopted in 2001, and the ICN Code of Ethics for Nurses was adopted in 2000.

In early colonial North America, a colonist worked in the public health sector. Which activity would have most likely been the focus? a. Establishing schools of nursing b. Developing vaccines to administer to large numbers of people c. Collecting vital statistics and improving sanitation d. Developing public housing and almshouses

Collecting vital statistics and improving sanitation The early colonial public health efforts included the collection of vital statistics, improvements to sanitation systems, and control of communicable disease introduced through seaports. Establishing schools of nursing, developing vaccines, and developing public housing are all events that happened after the colonial period.

How is a population best defined? a. High-risk group b. Those interacting within a school or institutional setting c. Collection of individuals who share at least one common characteristic d. Geographical location within a community

Collection of individuals who share at least one common characteristic A population or aggregate is a collection of individuals who have one or more personal or environmental characteristics in common. High-risk groups, school or institutional setting, and geographical location within the community all describe types of populations, not the definition of population.

A nurse is interested in census data. Which federal department's website would be a good place to start? a. Department of Labor (DOL) b. USDHHS c. Commerce Department d. World Health Organization (WHO)

Commerce Department The Commerce Department handles the United States Census and population estimates and projections. The DOL has information about the consumer price index, employment, and earnings. The USDHHS has information about the national vital statistics and several health-related surveys. The WHO has statistics about world health.

What levels of practice are encompassed by the Intervention Wheel? a. Communities, individuals and families, and systems b. Assessment, diagnosis, and evaluation c. Primary, secondary, and tertiary d. Communities, populations, and aggregates

Communities, individuals and families, and systems Communities, individuals and families, and systems are the three levels of public health nursing practice. The other responses do not describe the levels of practice.

A social marketing campaign urging community members to avoid driving motorized vehicles after consuming alcohol is implemented in a local community. Which of the following levels of practice is being demonstrated? a. Individual b. Systems c. Community d. Government

Community Community level interventions are carried out with the community as a whole. This level changes community norms, attitudes, awareness, practices, and behaviors. It is directed toward entire populations within the community or occasionally toward populations at risk or populations of interest. Individual level intervention changes knowledge, attitudes, beliefs, practices, and behaviors of individuals. Systems level interventions change organizations, policies, laws, and power structures within communities. Government is not a level of intervention described by "The Wheel."

A nurse is conducting vision screenings on children in the school setting. Which type of nursing practice is the nurse performing? a. Community-oriented b. Public health c. Community health d. Community-based

Community-based Community-based nursing practice is a setting-specific practice whereby care is provided for clients and families where they live, work, and attend school. Community-oriented nursing emphasizes the prevention of disease and disability. Public health nursing focuses on the care within the whole community. Community health nursing focuses on the health status of individuals and the effect of their health status on the whole community.

Which of the following are ethical tenets that underlie the core function of assessment? (Select all that apply.) a. Competency: the persons assigned to develop community knowledge are prepared to collect data on groups and populations. b. Moral character: the persons selected to develop, assess, and disseminate community knowledge possess integrity. c. Service to others over self: a necessary condition of what is "good" or "right" policy. d. "Do no harm": disseminating appropriate information about groups and populations is morally necessary and sufficient. e. Providers of public health services should be competent and available.

Competency: the persons assigned to develop community knowledge are prepared to collect data on groups and populations., Moral character: the persons selected to develop, assess, and disseminate community knowledge possess integrity., "Do no harm": disseminating appropriate information about groups and populations is morally necessary and sufficient. Service to others over self is an ethical tenet of policy development. Providers of public health services should be competent and available is an ethical tenet of assurance. Competency, moral character, and "do no harm" are the ethical tenets of assessment.

A public health nurse (PHN) is conducting a community assessment. Which of the following is the best example of this action? a. Visiting an elderly person at home to assess and evaluate safety and fall risk b. Developing diagnoses to identify nursing interventions at a health clinic c. Evaluating services at an immunization clinic where a translator provides services d. Compiling recent data from the county health department on child abuse cases

Compiling recent data from the county health department on child abuse cases Compiling recent data from the county health department on child abuse cases is an example of community assessment, assessing needs and data within a community. Community assessment does not happen with an individual. Community assessment must be completed before diagnoses can be developed. Evaluation of services is not part of community assessment.

A nurse fulfills the environmental health competency of "assessment and referral." Which of the following actions has the nurse most likely completed? a. Advocating for public policy changes b. Understanding policy framework and major pieces of legislation c. Completing an environmental health history d. Describing the scientific principles about environmental health

Completing an environmental health history Assessment and referral states that all nurses should be able to successfully complete an environmental health history, recognize the potential environmental hazards and sentinel illnesses, and make appropriate referrals for conditions with probable environmental causes. Advocating for public policy changes is part of advocacy. Understanding policy framework and legislation is part of legislation and regulation. Describing the scientific principles of environmental health is part of basic knowledge and concepts.

Which intervention is the nurse most likely to implement when addressing one of the primary goals of public health? Ensuring that a newly diagnosed 40-year-old hypertensive man takes his medication b. Finding home care for a 70-year-old client recuperating from a hip replacement c. Conducting an infant car seat safety check d. Contacting a local hospice to admit a terminally ill 60-year-old woman

Conducting an infant car seat safety check The correct answer is concerned with the health of many people, while the other answers address individual interventions. According to the Core Functions Project, all levels of health care, including population-based public health care, must be funded or the goal of health of populations may never be reached.

The state orders a person newly diagnosed with tuberculosis to be quarantined. Which of the following best describes the type of law that allows the state to do this? a. Constitutional b. Common c. Judicial d. State

Constitutional Constitutional law provides overall guidance for selected practice situations. Judicial law is based on court or jury decisions. Common law means that judges are bound by previous decisions unless they are convinced that the older law is no longer relevant or valid. State law is not one of the types of law.

A nurse is applying genetic and genomic knowledge when completing a client assessment. Which of the following actions is most likely being taken by the nurse? a. Constructing a pedigree from a collected family history b. Identifying a client who may benefit from genetic counseling c. Referring a client to specialized genetic services d. Incorporating knowledge of genomic risk factors

Constructing a pedigree from a collected family history Constructing a pedigree from a collected family history demonstrates assessment in the nursing process. Identification is demonstrated by identifying a client who may benefit from genetic counseling. Referral is demonstrated by referring a client to specialized genetic services. Provision of education, care, and support is demonstrated by incorporating knowledge of genomic risk factors.

A nurse evaluates a smoking cessation program, the gained or increased financial income, the improvements in the community attributable to the program, and the costs that would result if the program was not offered. Which term best describes the action of the nurse? a. Cost-effectiveness analysis b. Cost-benefit analysis c. Supply and demand d. Microeconomic theory

Cost-benefit analysis Cost-benefit analysis involves the listing of all costs and benefits that are expected to occur from an intervention during a prescribed time. Cost-effectiveness analysis expresses the net direct and indirect costs and cost savings in terms of a defined health outcome. Supply and demand is in force when few goods or services are available, and then the price tends to rise. Microeconomic theory is examining the behaviors of individuals and organizations that result from trade-offs in utility and budget constraints of health care.

A public health nurse (PHN) would like to incorporate evidence-based practice into the clinical practice at the health department. According to Melnyk and associates, which of the following steps should the nurse take first? a. Integrating the evidence with clinical expertise b. Cultivating a spirit of inquiry c. Asking clinical questions d. Searching for the best evidence

Cultivating a spirit of inquiry According to Melnyk and Fineout-Overholt et al., the first step is step 0: cultivating a spirit of inquiry. Integrating evidence with clinical expertise is step 4. Asking clinical questions is step 1. Searching for the best evidence is step 2.

To meet a client's needs, it is sometimes necessary to integrate into the client's care a culturally relevant practice that lacks scientific utility. Which term describes this action? a. Cultural accommodation b. Cultural awareness c. Cultural preservation d. Cultural repatterning

Cultural accommodation Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help people of a particular culture to accept nursing strategies, or to negotiate with nurses to achieve satisfying health care outcomes. Cultural awareness refers to the self-examination and in-depth exploration of one's own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups. Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values so they can maintain, promote, and restore health. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial.

A Mexican American mother insists on using special candles to help her daughter's ear infection. The nurse asks the mother if she would also give her daughter antibiotics. Which of the following best describes the action of the nurse? a. Cultural accommodation b. Cultural repatterning c. Culture brokering d. Cultural awareness

Cultural accommodation This means that the nurse supports and facilitates the use of cultural practices with interventions from the biomedical health care system. Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies or negotiate with nurses to achieve satisfying health care outcomes. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial. Culture brokering is advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients. Cultural awareness refers to the self-examination and in-depth exploration of one's own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups.

The tendency to ignore all differences between cultures and to act as though the differences do not exist is identified by what term? a. Cultural conflict b. Culture shock c. Cultural blindness d. Cultural imposition

Cultural blindness Cultural blindness is an inability to recognize the differences between one's own cultural beliefs, values, and practices and those of the client's culture. In cultural blindness nurses employ health strategies which suggest that health care is devoid of cultural meaning and all populations interpret health care practices in the same way. Cultural conflict is a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual's cultural practice because of unfamiliarity with the practice. Culture shock is the feeling of helplessness, discomfort, and disorientation experienced by an individual attempting to understand or effectively adapt to a cultural group whose beliefs and values are radically different from the individual's culture. Cultural imposition is the act of imposing one's cultural beliefs, values, and practices on individuals from another country.

A nurse implements nursing interventions considering the uniqueness of the person's culture. Which of the following best describes this action? a. Cultural diversity b. Cultural knowledge c. Cultural competence d. Cultural awareness

Cultural competence Providing care based on the uniqueness of the client's cultural norms and values is one of the three guiding principles of culturally competent nursing care. Cultural diversity refers to the degrees of variation represented among populations based on lifestyle, ethnicity, race, interest, across place, and place of origin across time. Cultural knowledge refers to the process of searching for and obtaining a sound educational understanding about culturally diverse groups. Cultural awareness refers to the self- examination and in-depth exploration of one's own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups.

A client comes into the clinic and reports visiting an acupuncturist for pain. The nurse suggests taking pain medication instead. Which of the following best describes the action taken by the nurse? a. Cultural conflict b. Cultural blindness c. Cultural relativism d. Cultural imposition

Cultural imposition This is an example of cultural imposition—the act of imposing one's cultural beliefs, values, and practices on individuals from another culture. Cultural conflict is a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual's cultural practice because of unfamiliarity with the practice. Cultural blindness occurs when people state that everyone is treated the same, regardless of their cultural orientation. Cultural relativism recognizes that clients have different approaches to health, and that each culture should be judged on its own merit and not on the nurse's personal beliefs.

A nurse supports the use of traditional home remedies in conjunction with Western medicine to promote healthy behaviors. Which of the following is being demonstrated by the nurse? a. Cultural accommodation b. Cultural awareness c. Cultural preservation d. Cultural repatterning

Cultural preservation Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values, so they can maintain, promote, and restore health. Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies or negotiate with nurses to achieve satisfying health care outcomes. Cultural awareness refers to the self- examination and in-depth exploration of one's own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial.

A nurse advocates and intervenes between the health care system and the client's cultural beliefs on behalf of the client. Which term best describes the nurse's action? a. Cultural accommodation b. Culture brokering c. Cultural preservation d. Cultural repatterning

Culture brokering Culture brokering is advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients. Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies or negotiate with nurses to achieve satisfying health care outcomes. Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values, so they can maintain, promote, and restore health. Cultural repatterning refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture to change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial.

A nurse resigns from a position in a hospital to accept a job in a community setting. After starting the new job, the nurse feels helpless and confused, wondering if this was the right career choice. Which of the following terms best describes how the nurse is feeling? a. Cultural conflict b. Cultural relativism c. Culture shock d. Culture brokering

Culture shock Culture shock can happen to individuals within their own culture when they are having experiences such as starting a new job or career. Culture shock is brought on by anxiety from losing familiar signs and symbols of social interaction. Feelings associated with culture shock are helplessness, discomfort, and disorientation. Cultural conflict is a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual's cultural practice because of unfamiliarity with the practice. Cultural relativism recognizes that clients have different approaches to health, and that each culture should be judged on its own merit and not on the nurse's personal beliefs. Culture brokering is advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients.

What is a characteristic of the fourth developmental stage of the health services delivery framework? a. Nurses in the United States being predominantly women b. The expansion of the number and type of health care facilities c. Dependence on technology for patient care d. The discovery and development of pharmacological advances

Dependence on technology for patient care Nurses have become dependent on technologies to monitor client progress, make decisions about care, and deliver care in innovative ways as part of the fourth stage. The discovery and development of pharmacological advances is only one way that technology has increased during the fourth phase. Stage one was concerned with epidemics and infectious disease control. Physicians and nurses attained skills in scientifically based programs in stage two. Stage three included the expansion of hospital clinics and long-term care facilities.

While collecting a medical history, a client reports having a family history positive for Huntington's disease. However, the client states not wanting to have genetic testing performed. Which of the following best describes why the client may refuse genetic testing? a. Impact it may have on obtaining health insurance in the future. b. Legal consequences that may result. c. Inaccuracy of the results that are obtained. d. Decreased quality of life that may occur if the results are positive.

Decreased quality of life that may occur if the results are positive. Barriers to genetic testing are: some individuals do not have an insurance carrier that reimburses for genetic testing, a high-deductible insurance policy, and feelings that testing may decrease the quality of life and increase anxiety for the future if the results were positive. Others may also feel guilty about passing along a disease to children and grandchildren. Health insurance cannot be denied to individuals because of genetic testing results. There are no legal implications for genetic testing. There is not a high inaccuracy of results that are obtained through genetic testing.

A nurse is working with a member of the military. Which of the following describes the department that provides this person with health care services? a. Defense b. Labor c. Agriculture d. Justice

Defense The Department of Defense (DOD) delivers health care to members of the military, including their dependents and survivors, and to retired members and their families. The DOL houses the Occupational Safety and Health Administration (OSHA), which imposes workplace requirements on industries. The Department of Agriculture houses the Food and Nutrition Service, which oversees a variety of food assistance activities. The Department of Justice (DOJ) provides health services to federal prisoners.

According to the Center for Disease Control's (CDC's) "Genomic competencies for the public health workforce," which of the following should all public health workers be able to do? (Select all that apply.) a. Demonstrate basic knowledge of the role that genomics play in disorders. b. Make appropriate referrals to those with more genomic experience. c. Counsel individuals about their genetic susceptibility for particular disorders. d. Recommend appropriate genetic screening tests for clients. e. Plan appropriate care for those who have positive genetic tests.

Demonstrate basic knowledge of the role that genomics play in disorders, Make appropriate referrals to those with more genomic experience. The CDC's "Genomic competencies for the public health workforce" apply to all public health professionals. All public health workers should demonstrate basic knowledge and be able to make appropriate referrals. The other statements would not be true of competencies of all public health workers.

A nurse is examining the income levels and social networks of individuals in a community. Which term is used to identify the factors the nurse is investigating? a. Culture b. Development c. Community d. Determinants

Determinants Determinants are conditions and factors that are important considerations in population health. Culture refers to the beliefs and customs of a certain group. Development refers to something that is being created. Community is a group of people living in the same geographic location.

A nurse is assessing for environmental health risks in the community. Which of the following approaches would be most appropriate for the nurse to use? (Select all that apply.) a. Asking legislators to provide a list of environmental pollutants in the area b. Developing a list of exposures associated with urban, rural, or suburban settings c. Assessing the risk by medium such as air, water, soil, or food d. Dividing the environment into functional locations: home, school, workplace, and community e. Recruiting community members to sign a petition to decrease pollution

Developing a list of exposures associated with urban, rural, or suburban settings, Assessing the risk by medium such as air, water, soil, or food, Dividing the environment into functional locations: home, school, workplace, and community Developing a list of exposures associated with urban, rural, or suburban settings, assessing the risk by medium such as air, water, soil, or food, and dividing the environment into functional locations: home, school, workplace, and community are ways a nurse can assess the environment. Asking legislators for a list of pollutants or recruiting community members to sign a petition are not effective means to assess for environmental health risks.

A nurse working with Mary Breckinridge, would likely have assisted with what activity? a. Establishing the Henry Street Settlement b. Developing health programs geared toward improving the health care of the rural populations c. Blazing a nursing trail through the Rockies, providing nursing care to miners and their families d. Teaching birth control measures to large numbers of women in the South

Developing health programs geared toward improving the health care of the rural populations Mary Breckinridge developed health programs geared toward improving the health care of the rural and often inaccessible populations in the Appalachian regions of southern Kentucky. Lillian Wald established the Henry Street Settlement.

A nurse would like to propose legislation requiring all schools to employ a registered nurse. Which of the following would be the first step taken as the nurse implements the legislative process? a. Introducing the bill to the legislature b. Moving the bill to the other house c. Developing the policy option into a bill d. Hearings, testimony, and lobbying

Developing the policy option into a bill The first step in the legislative process is developing the policy option into a bill. This is then followed by introducing the bill to the legislature; hearings, testimony, and lobbying; and the bill moving to the other house.

A government agency is planning a project in hopes of receiving funding from the World Bank. Which project would most likely receive this funding? a. Development of a sanitation system b. Improvement of roads and bridges c. Creation of a national health insurance plan d. Recovery efforts following a hurricane

Development of a sanitation system The World Bank lends money to lesser-developed countries so that they might use it to improve the health status of their people. Projects include control and eradication of disease, providing safe drinking water and affordable housing, developing sanitation systems, and encouraging family planning and childhood immunizations. Improvement of roads and bridges, creation of a national health insurance plan, and recovery efforts following a hurricane would not be projects where World Bank funds would be used.

What term described when planning, delivering, and financing responsibility for programs is shifted from the federal level to the state level? a. Evolution b. Devolution c. Block granting d. State administration

Devolution The process of shifting the responsibility for planning, delivering, and financing programs from the federal level to the state level is called devolution. This was a major effort during the Reagan administration. Block grants have increased because of devolution. State administration does not describe this shift of responsibility; rather it describes who is administering the program. Evolution describes how something is gradually developed.

A nurse is employed by an agency that addresses global health needs. Which roles are the nurse most likely to assume? (Select all that apply.) a. Medications and vaccines for worldwide use b. Direct patient care for members of the community c. Knowledge and skill in countries where nursing is an organized profession d. Consultation to auxiliary personnel e. Facilitation of education and health promotion within the community

Direct patient care for members of the community, Knowledge and skill in countries where nursing is an organized profession, Consultation to auxiliary personnel, Facilitation of education and health promotion within the community Nurses perform many roles related to global health, including providing direct patient care, facilitating education and health promotional needs of the community, providing knowledge and skill in countries where nursing is an organized profession, and providing consultation to auxiliary personnel. Providing medications and vaccines for worldwide use would not be part of the role of the nurse in relation to global health.

A local health department provides a hypertension screening to all individuals. Which of the following general categories of health care functions is being used? a. Direct services b. Financing c. Information d. Policy setting

Direct services Direct services are actions that provide health care directly to individuals. Financing occurs as the government pays for health care services. Information is used as all branches and levels of government collect, analyze, and disseminate data about health care and health status of the citizens. Policy setting occurs as all branches of government make policy decisions about health care.

In the past, what term was used to identify population-centered nurses? a. District nurses b. Almshouse nurses c. Soldier nurses d. Sisters

District nurses In the past, population-centered nurses have been called public health nurses (PHNs), district nurses, visiting nurses, school nurses, occupational health nurses, and home health nurses. Many women who performed nursing functions in almshouses and early hospitals in Great Britain were poorly educated, untrained, and often undependable. The original soldier nurses worked with Florence Nightingale at Scutari. Various groups of "sisters" have been used throughout history to care for the poor.

A neighborhood health center is researching its origins. Which legislative act most likely provided funds for its development? a. Emergency Maternity and Infant Care Act of 1943 b. Medicaid legislation c. Social Security Act of 1935 d. Economic Opportunity Act

Economic Opportunity Act Funding for neighborhood health centers, Head Start, and other community action programs began in 1964 with the Economic Opportunity Act. The Social Security Act of 1935 expanded opportunities for health protection and promotion through education and employment of PHNs. Medicaid legislation focused on medical care insurance for the poor. The Emergency Maternity and Infant Care Act of 1943 provided funding for medical, hospital, and nursing care for the wives and babies of servicemen.

When preparing for a bioterrorism event, which would be the best strategy for the government to implement? a. Threatening lesser-developed countries so they don't develop biological weapons b. Banning biological weapons worldwide c. Effectively detecting pathogens and managing services d. Developing antidotes for biological agents

Effectively detecting pathogens and managing services Health care professionals and public health officials need to be able to effectively detect pathogens, manage services, and communicate during a bioterrorism threat. Any country can develop biological weapons that can be used for bioterrorism, not only lesser-developed countries. By effectively detecting pathogens, one is able to know what antidotes need to be developed.

A nurse implements a teen pregnancy prevention program in a high school that has been shown to decrease the rate of teen pregnancy. Which term best describes the nurse's action? a. Effectiveness b. Efficiency c. Microeconomics d. Production

Effectiveness Effectiveness refers to the extent to which a health care service meets a stated goal or objective, or how well a program or service achieves what is intended. Efficiency refers to producing maximum output using a given set of resources. Microeconomic theory is examining the behaviors of individuals and organizations that result from trade-offs in utility and budget constraints of health care. Production refers to how goods are produced or created.

A nurse conducts a class at a public health clinic on breast self-examination for a group of 50 women. Which term best describes the nurse's action? a. Supply and demand b. Macroeconomics theory c. Efficiency d. Effectiveness

Efficiency Efficiency refers to producing maximum output, such as a good or service, or using a given set of resources or inputs, such as labor, time, and available money. Teaching one topic to many people is an example of this. Macroeconomic theory focuses on the "big picture." Supply and demand is in force when few goods or services are available, and then the price tends to rise. Effectiveness refers to the extent to which a health care service meets a stated goal or objective, or how well a program or service achieves what is intended.

A nurse believes everyone is entitled to equal rights and equal treatment in society. Which of the following principles is being applied? a. Distributive or social justice b. Egalitarianism c. Libertarian view of justice d. Communitarianism

Egalitarianism Egalitarianism is defined as the view that everyone is entitled to equal rights and equal treatment in society. Distributive justice requires that the distribution of benefits and burdens on a society be fair or equal. The libertarian view of justice holds that the right to private property is the most important right. Communitarianism views that individual rights need to be balanced with social responsibilities; individuals do not live in isolation but are shaped by the values and culture of their communities.

A community health nurse reviews Healthy People 2020 when considering the health needs that will be addressed in the community. Which goal would the nurse find in this document? a. Promote healthy behaviors for children. b. Cure cancer. c. Eliminate health disparities. d. Provide primary care to all citizens.

Eliminate health disparities. Elimination of preventable disease, disability, injury, premature death; achievement of health equity; elimination of health disparities; and creation of social and physical environments that will promote good health and healthy development and behavior at every stage of life are the four major goals cited in Healthy People 2020.

What is the focus of the Division of Nursing? a. Enhancing nursing's competence in providing high-tech skills b. Applying disease prevention, environmental health, and health promotion concepts c. Providing scholarships for advanced nursing education d. Ensuring distribution of qualified nursing personnel to meet the nation's health needs

Ensuring distribution of qualified nursing personnel to meet the nation's health needs The Division of Nursing is the key federal focus for nursing education and practice, and it provides national leadership to ensure an adequate supply and distribution of qualified nursing personnel to meet the health needs of the nation. The Division of Nursing does not enhance the competency of the profession. The Division of Nursing does not apply nursing concepts. The Division of Nursing does not provide scholarships.

Asians may perceive illness as disharmony with other forces and that medicine is only able to relieve the symptoms rather than cure the disease. They may look to naturalistic solutions and acupuncture to resolve or cure health problems. Which of the following types of cultural variations is being demonstrated? a. Communication b. Personal space c. Social organization d. Environmental control

Environmental control Environmental control refers to the ability of individuals to control nature and to influence factors in the environment that affect them. Communication is the means by which culture is shared (verbal and nonverbal). Personal space is the physical distance between two individuals during an interaction. Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions.

Which statement regarding mutations is true? a. Mutations in the deoxyribonucleic acid (DNA) sequence occur on a regular basis. b. Mutagens are a result of a mutation. c. Environmental factors can be linked to many mutations. d. Spontaneous mutations occur because of environmental exposure.

Environmental factors can be linked to many mutations. Many agents are known to cause mutations. These mutations are attributed to known environmental causes. DNA replication is very accurate; thus, mutations do not occur on a regular basis. Mutagens are the factors that cause mutations. Spontaneous mutations occur naturally during DNA replication.

A facility is inspected after it has obtained a permit. The inspection is completed for the purpose of observing whether the plans submitted in the permit application are being implemented as approved. Which of the following environmental protection strategies is being applied? a. Controlling pollution b. Waste minimization c. Land use planning d. Environmental monitoring

Environmental monitoring Environmental monitoring would be an inspection of a facility after a permit is obtained to observe whether the plans submitted in the permit application are being implemented as approved. Permitting is an important step in controlling pollution. Waste minimization and land use planning are activities aimed at prevention of pollution.

A city sets the standard of an acceptable level of emissions or a maximum contaminant level allowed for factories. Which concept is being applied? a. Controlling pollution b. Waste minimization c. Land use planning d. Environmental standard

Environmental standard An example of an environmental standard is an acceptable level of emissions or a maximum contaminant level allowed. Although this does help to control pollution, environmental standard is best applied in this example. Setting a standard for emissions does not impact waste minimization or land use planning.

The first stage of development of the health care system was characterized by what event? a. The rise in technology b. Epidemics of infectious disease, such as typhoid, influenza, and malaria c. Physicians and nurses who attained their skills in scientifically based programs d. An expansion of hospital clinics and long-term care facilities

Epidemics of infectious disease, such as typhoid, influenza, and malaria Stage one was concerned with epidemics and infectious disease control. Technology is characteristic of stage four, and physicians and nurses attained skills in scientifically based programs in stage two. Stage three included the expansion of hospital clinics and long-term care facilities.

What was Lillian Wald's major contribution to public health nursing? a. Founding the American Nurses Association b. Developing the New York Training Hospital for Nurses c. Creating the Public Health Service d. Establishing the Henry Street Settlement

Establishing the Henry Street Settlement Lillian Wald established the Henry Street Settlement. Isabel Hampton Robb founded the American Nurses Association. Lillian Wald was a graduate of the New York Training Hospital for Nurses. The Public Health Service was established by the federal government.

What term is used to describe an orderly process that considers ethical principles, client values, and professional obligations? a. Moral distress b. Ethical decision making c. A value d. A code of ethics

Ethical decision making Ethical decision making is defined as an orderly process that considers ethical principles, client values, and professional obligations. Moral distress is an uncomfortable state of self when one is unable to act ethically. Values are beliefs about the worth or importance of what is right or esteemed. A code of ethics is a moral standard that delineates a profession's values, goals, and obligations.

A nurse is providing care using the idea of "servicing citizens, not customers." Which of the following ideas is being applied by the nurse? a. Ethical tenets of policy development b. Basic concepts of the feminist theory c. Underlying premise of virtue ethics d. Components of distributive justice

Ethical tenets of policy development There are three tenets of both policy and ethics. The approach is based on the voice of the community as the foundation on which policy is developed. The basic concept of feminist theory allows us to think critically about connections among gender, disadvantage, and health as well as the distribution of power in public health processes. The goal of virtue ethics is to enable persons to flourish as human beings. Distributive justice requires that there be a fair distribution of the benefits and burdens in society based on the needs and contributions of its members.

A nurse is grading the strength of evidence when critiquing a research study. Which of the following domains will the nurse need to consider? a. Randomness, sample size, and blinding b. Selection, variables, and description c. Nursing, medicine, and physiology d. Quality, quantity, and consistency

Quality, quantity, and consistency Quality, quantity, and consistency are the three domains for evaluating systems. The others are not criteria used to grade the strength of evidence.

To better address emerging public health issues, a public health nurse (PHN) plans to complete continuing education in this area. Which content areas should be included in the course that is chosen? a. Leadership b. Ethics c. Communication d. Finance

Ethics Public health workers should be educated in eight content areas to be able to address emerging public health issues and advances in science and policy: (1) informatics, (2) genomics, (3) cultural competence, (4) community-based participatory research, (5) policy, (6) law, (7) global health, and (8) ethics.

A client shares with the nurse that her grandparents immigrated to the United States from Germany. Which of the following best describes what she has disclosed? a. Multiculturalism b. Ethnicity c. Race d. Culture

Ethnicity Ethnicity represents the identifying characteristics of culture, such as race, religion, or natural origin. Multiculturalism is the blending of diverse cultures. Race is primarily a social classification that relies on physical markers. Culture is a set of beliefs, values, and assumptions about life that are widely held among a group of people and transmitted intergenerationally.

A nurse believes that the best treatment for illness is the use of Western medicine and alternative therapies should not be used for healing. Which of the following best describes what has happened? a. Ethnocentrism b. Cultural imposition c. Racism d. Stereotyping

Ethnocentrism Ethnocentrism is the belief that one's own cultural group determines the standards by which another group's behavior is judged. Cultural imposition is the act of imposing one's cultural beliefs, values, and practices on individuals from another culture. Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior on the basis of intelligence, morals, beauty, inheritance, and self-worth. Stereotyping is ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences.

A nurse is employed by the U.S. Department of Health and Human Services (USDHHS). Which of the following branches of government is the nurse working for? a. Judicial b. Executive c. Legislative d. Health

Executive The executive branch includes regulatory departments, one of which is the USDHHS. The judicial branch is composed of a system of federal, state, and local courts guided by the opinions of the Supreme Court. The legislative branch is made up of the Senate and the House of Representatives, whose members are elected by the citizens of particular geographic areas. There is not a health branch of the government.

A public health agency is considering implementing an electronic health record. Which action best describes one of the benefits the agency will experience? a. Facilitation of interprofessional care b. Improved client compliance with medical regimens c. Cost savings to the agency d. Compliance with the Joint Commission of Accreditation of Healthcare Organizations (JCAHO) standards

Facilitation of interprofessional care The electronic medical record facilitates interprofessional care in chronic disease management and coordination of referrals; 24-hour availability of records with downloaded laboratory results and up-to- date assessments; incorporation of protocol reminders for prevention, screening, and management of chronic disease; improvement of quality measurement and monitoring; and increased client safety and decline in medication errors. There is no data to support that the agency will have improved client compliance or cost savings. Electronic medical records are not a requirement by JCAHO.

A public health nurse (PHN) is addressing the problem of obesity at the community level of practice. Which of the following nursing diagnoses would be most appropriate for the nurse to use? a. Alteration in nutrition: More than body requirements b. Need for increased knowledge of proper nutrition c. Families at risk for obesity because of inactivity d. Overweight child related to poor dietary habits

Families at risk for obesity because of inactivity Nursing diagnoses must be modified to meet the needs of population-focused care in public health nursing practice. Families at risk for obesity because of inactivity is the only nursing diagnosis that addresses a community group that is in need of further intervention. The alteration in nutrition and overweight child nursing diagnoses both address the individual level, not the community level. Need for increased knowledge does not identify the level that is being addressed.

A nurse is counseling a client who is considering having genetic testing completed to determine carrier status of the gene linked to Huntington's disease. Which of the following would be the first assessment the nurse would take? a. Vital signs b. Family history of this disorder c. Client's past medical history d. Current medications

Family history of this disorder Taking a family history is a useful place to begin when considering a genetic connection prior to the onset of testing. The best way to identify whether there is a mutation in a family where a hereditary disease is suspected is to test the person who displays the most evidence of being a mutation carrier. This would take precedent over assessing vital signs, current medications, and past medical history.

A nurse is counseling a client who has just learned that she is a carrier of the BRCA2 gene. Which of the following best describes potential reactions by this client? (Select all that apply.) a. Feelings of guilt b. Fear of loss of insurance coverage c. Feelings of anxiety d. Fear for children e. Feelings of insecurity

Feelings of guilt, Feelings of anxiety, Fear for children Feelings of guilt, anxiety, and fear for future susceptibility for children are all potential reactions this client may have. The GINA protects clients from losing insurance benefits based upon genetic information. The feeling of insecurity is not a common reaction experienced from those diagnosed with a genetic disorder.

The public health workforce should demonstrate competency in which of the following competency categories? a. Financial planning and management b. Workforce needs assessment c. Acute care services d. Curriculum development

Financial planning and management Workforce needs assessment, acute care services, and curriculum developments are not considered categories of core competencies of public health. Rather there are eight categories of competency, which include: (1) analytic/assessment, (2) policy development/program planning, (3) communication, (4) cultural competence, (5) community dimensions of practice, (6) basic public health sciences, (7) financial planning and management, and (8) leadership and systems thinking.

A nurse who was working in public health care (PHC) has gotten a new job in primary care. Which of the following differences would be seen by the nurse in this new care setting? a. Focus on individuals. b. Services provided by specialists. c. Autonomy in the practice setting. d. Community focused care is provided.

Focus on individuals. Primary care focuses on individuals. It is also provided by generalists, is dominated by health care professionals, and is not community focused.

What are the cornerstones of public health nursing practice? (Select all that apply.) a. Focus on the health of the entire population. b. Reflect community priorities and needs. c. Promote health through strategies driven by epidemiological evidence. d. Are grounded in an ethic of collaboration. e. Provide a framework for ethical decision making.

Focus on the health of the entire population, Reflect community priorities and needs, Promote health through strategies driven by epidemiological evidence. Cornerstones of public health nursing practice focus on the health of the entire population, reflect community priorities and needs, promote health strategies driven by epidemiological evidence, and are grounded in social justice. Nursing is grounded in an ethic of caring.

A nurse is advocating for increased funding for an international agency. Which activity best describes how these funds will likely be used? a. Development and installation of technology b. Food relief, worker training, and disaster relief c. Support of dictatorships and corrupt governments d. Funding of local private organizations

Food relief, worker training, and disaster relief Many international organizations have an ongoing interest in global health. Despite the presence of these well-meaning organizations, it is estimated that the lesser-developed countries still bear most of the cost for their own health care and that contributions from major international organizations provide for less than 5% of needed costs. Recent reports indicate that most funds raised by international organizations are used for food relief, worker training, and disaster relief.

There are two medically indigent clients in the clinic who have come to get their monthly supply of free insulin. There is only enough for one client. Which of the following actions would the nurse take first? a. Identify all options. b. Determining who arrived first. c. Gather additional information. d. Act and assess decisions made.

Gather additional information. The steps of the ethical decision-making framework are to first identify the ethical issues and dilemmas, then place them within a meaningful context, obtain all relevant facts, reformulate ethical issues and dilemmas if needed, consider appropriate approaches to actions or options, make decisions and take action, and evaluate decisions and action.

A nurse is studying the recent increase in Type I diabetes in the community. Which of the following factors should the nurse consider when examining the development of disease? (Select all that apply.) a. Genetics b. Lifestyle c. Environment d. Technology e. Communication patterns

Genetics, Lifestyle, Environment The knowledge of human genetics can improve the safety, quality, and effectiveness of care for clients. It is important for nurses to understand the predisposition to disease as well as the impact of behavior and social conditions on overall community health and well-being. Many genetic disorders have an environmental link. Technology and communication patterns do not have a strong association with the development of genetic disorders.

A nurse learns more about the Human Genome Project to better counsel families about the process of genetic testing. Which of the following terms best describes what the nurse is learning? a. Genetics b. Genomics c. Genes d. Genetic susceptibility

Genomics Genomics refers to the study of individual genes to understand the structure of the genome, including the mapping of genes and sequencing the DNA. Genetics refers to the study of the function and effect of single genes that are inherited by children from their parents. Genes are the DNA segments that carry the genetic information. Genetic susceptibility is the likelihood of developing a disease based on the presence of a genetic mutation.

A public health nurse (PHN) is organizing a multidisciplinary team to address the issue of water pollution in the community. Which group of professionals would be invited to address this issue? a. Physicians, water sanitation workers, and occupational therapists b. Pharmacologists, radiologists, and epidemiologists c. Nurse practitioners, pharmacologists, and environmentalists d. Geologists, meteorologists, and chemists

Geologists, meteorologists, and chemists Scientists who study how pollutants travel in air, water, and soil are geologists, meteorologists, and chemists. The other professionals are not experts in the area of water pollution in the community.

A nurse becomes actively involved in the development of a health policy in the community. Which of the following describes why this is an important role of the nurse? a. Government and policy have a large impact on nursing and health. b. Policy affects nursing values as set forth by Florence Nightingale. c. Political science is a course of study that parallels nursing. d. Nurses must interpret laws to fit their practice.

Government and policy have a large impact on nursing and health. Nurses should be advocates for the health of the population. In order to do this, nurse professionals must have a working knowledge of government, health care law, the policy process, and the political forces that are shaping the future of health care. Policy does not affect nursing values. Political science does not parallel nursing. Nurses are unable to interpret laws to fit their practice.

Who is considered the father of genetics? a. Charles Darwin b. Gregor Mendel c. James Watson d. Francis Galton

Gregor Mendel Gregor Mendel is considered to be the father of genetics. Charles Darwin expounded on theories of evolution. Francis Galton performed family studies using twins to understand the influence of heredity on various human characteristics. James Watson was the co-discoverer of DNA.

A nurse is working in a state health department. Which program would the nurse most likely be working with? a. Senior health b. Dental services c. H1N1 flu education d. Mental health

H1N1 flu education Typical programs in a state health department include: communicable disease service, H1N1 flu services, and budget and finance. Senior health, dental health, and mental health are typically found in a local health department.

What are the newest threats to health in the United States that community health nurses deal with? a. Diphtheria, cholera, and hepatitis b. HIV, influenza, and bioterrorism c. Avian flu, tuberculosis (TB), and radiation d. Polluted water and air

HIV, influenza, and bioterrorism The newest threats to health that PHNs are involved in are HIV, H1N1 influenza, and bioterrorism. Hepatitis is also a current threat, but diphtheria and cholera are not concerns in the United States. Avian flu may be a threat, but radiation and TB are ongoing. Environmental pollution has been reduced; however, there are pollution issues that do raise concerns.

Employees working with hazardous chemicals have the "Right to Know" about the chemicals they are working with through the creation of which resource? a. Material Safety Data Sheet (MSDS) b. Consumer Confidence Report c. Hazard Communication Standard d. Environmental Protection Agency (EPA)

Hazard Communication Standard The Hazard Communication Standard requires employers to maintain a list of all hazardous chemicals that are used on site. Each of the chemicals should have an associated chemical information sheet known as an MSDS, which is written by the chemical manufacturer. Consumer Confidence Reports summarize the results of the annual testing of the public water supply. The EPA sets forth policies, regulations, and public laws for the safety of the environment and the population.

An employee can receive health insurance from a former employer after changing jobs. The enactment of which legislation makes this possible? a. Health Insurance Portability and Accountability Act (HIPAA) b. Omnibus Budget Reconciliation Act c. Balanced Budget Act of 1997 d. Social Security Act of 1935

Health Insurance Portability and Accountability Act (HIPAA) HIPAA is a federal intervention to protect health insurance coverage for workers and families following a job change or loss. The Omnibus Budget Reconciliation Act was a major effort to regulate and control the costs of physician fees. The Balanced Budget Act of 1997 determined that payments to Medicare skilled nursing facilities (SNFs) would be made on the basis of prospective payment system (PPS). The Social Security Act of 1935 signaled the federal government's increasing interest in addressing social welfare problems.

A public health nurse (PHN) becomes involved in health care reform. Which of the following best describes the purpose of this action? a. Promotion of the nursing profession b. Increases funding for public health nursing c. Addresses the concerns of nurses d. Improves health care access and reduce health care costs

Improves health care access and reduce health care costs PHNs have been involved in health care reform for several years. An emphasis of reform is that health promotion and disease prevention appear to yield reduction in costs and illness/injury incidence while increasing years of healthy life. The focus of health care reform is not on nursing, but rather the population as a whole.

The allocation of scarce resources within the health care sector and the focus on resource allocation issues related to producing and distributing health care is referred to by what term? a. Economics b. Health economics c. Public health economics d. Microeconomic theory

Health economics Health economics is the allocation of scarce resources within the health care sector and the focus on resource allocation issues related to producing and distributing health care. Economics is the science concerned with the use of resources, including the production, distribution, and consumption of goods and services. Public health economics focuses on the production, distribution, and consumption of goods and services as related to public health and where limited public resources might best be spent to save lives or increase the quality of life. Microeconomic theory deals with the behaviors of individuals and organizations and the effects of those behaviors on prices, costs, and the allocation and distribution of resources.

What has caused the number of uninsured Americans to dramatically increase? a. Medicare took over payment of health care costs. b. With a declining population, the costs for health care rose. c. Nursing salaries greatly increased, causing health care costs to rise. d. Health insurance coverage was dropped from employment-based health plans.

Health insurance coverage was dropped from employment-based health plans. Although most Americans continue to obtain health insurance from their employer as a benefit, employment does not guarantee insurance. Employer-sponsored health insurance is sensitive to both the general economy and changes in health insurance premiums. As costs for insurance premiums rose, employers either shifted more of these costs to their employees or declined to offer employment-based health coverage at all. Medicare provides coverage only to the elderly and other special populations. The costs for health care are continuing to rise regardless of the size of the population. There has not been a significant change to nursing salaries, and a change in nursing salaries would not impact the number of uninsured Americans.

A nurse is working with a client who receives health insurance through a managed care organization. Which term best describes this form of insurance? a. Medicare b. Medicaid c. Medical savings accounts (MSAs). d. Health maintenance organizations

Health maintenance organizations Health maintenance organizations and preferred provider organizations are types of managed care. Medicare and Medicaid are government insurance programs. MSAs are not a type of health insurance but rather provide tax advantaged monies for eligible health care costs for individuals who have specific health insurance coverage and meet certain qualifications.

The public health nurse (PHN) analyzes data related to the number and type of United States Environmental Protection Agency air quality standards that a community failed to meet. This data is an example of using which community health profile indicator? a. Sociodemographic characteristics b. Health status c. Health risk factor d. Functional status

Health risk factor Health risk factors discuss proportions of populations who have particular health conditions or health risks; breathing air of poor quality is a risk to health. The number and proportion of people is a sociodemographic characteristic. Health status includes birth and death rates. Functional status refers to reports of good health status by members of the population.

A nursing student develops a teaching plan about hand washing to present to a group of elementary school children at the local school. Which of the following public health interventions is being implemented? a. Collaboration b. Surveillance c. Health teaching d. Screening

Health teaching Health teaching communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, and practices of individuals, families, systems, and/or communities. Collaboration commits two or more persons or organizations to achieve a common goal through enhancing the capacity of one or more of the members to promote and protect health. Surveillance describes and monitors health events through ongoing and systematic collection, analysis, and interpretation of health data. Screening involves identifying individuals with unrecognized health risk factors or asymptomatic disease.

A public health nurse (PHN) is compiling information about how to promote early detection of breast cancer in women. Which document would most likely provide useful information about this topic? a. The Future of Public Health b. Healthy People 2020 c. Patient Protection and Affordable Care Act d. Scope and Standards of Public Health Nursing Practice

Healthy People 2020 The Healthy People documents propose national strategies to improve significantly the health of Americans by preventing or delaying the onset of major chronic illnesses, injuries, and infectious diseases. The other documents do not address health promotion topics.

A public health nurse (PHN) uses Assumption 2, "Public health nursing practice focuses on populations," to guide practice. Which of the following would be considered a population of interest? a. Healthy school children b. Homeless individuals c. A person recently diagnosed with diabetes d. Teenage parents

Healthy school children A population is a collection of individuals who have one or more personal or environmental characteristics in common. Populations of interest are populations that are essentially healthy but could improve factors that promote or protect health; one such population is healthy school children. Homeless individuals and teenage parents would both be considered a population at risk. A person recently diagnosed with diabetes is not a population.

Which health problem is of greatest concern in the world's developed countries? a. Hepatitis b. Malaria c. Polio d. Smallpox

Hepatitis Current health concerns in more developed countries are hepatitis, infectious diseases, and new viral strains such as hantavirus, SARS (severe acute respiratory syndrome), H1N1, and avian flu. Malaria, polio, and smallpox are more commonly found in lesser-developed countries.

Which of the following statements about public health is accurate? a. Prevention of early deaths can be more effectively accomplished by medical treatment than by public health approaches. b. Expenditures and resources for public health have increased in recent years. c. Historically, gains in the health of populations have been related largely to changes in safety, sanitation, and food safety. d. Reform of the medical insurance system is the single change needed to improve the health of Americans.

Historically, gains in the health of populations have been related largely to changes in safety, sanitation, and food safety. Fielding and Tilson have asserted that most of the increase in life span has been made through improvements in sanitation, clean water supplies, making workplaces safer, improving food and drug safety, immunizing children, and improving nutrition, hygiene, and housing. Medical treatment has not made as significant of an impact on the life span as public health measures. Funding for public health in recent years has been on a gradual decline. Although reform of the medical insurance system may help improve the health of Americans, there are many other factors that will need to be addressed.

In the United States, what are most health care dollars spent on? a. Prescription drugs b. Hospital care c. Physician services d. Public health services (PHSs)

Hospital care The largest share of health care expenditures goes to pay for hospital care, with physician services the next largest item. The money spent for PHSs is significantly lower than the other categories of expenditures. Other significant drivers of the increasingly high cost of health care include prescription drugs, technology, and chronic and degenerative disease.

An increased knowledge about genetics and genomics will influence what change in nursing practice? a. How nurses collect and use health histories? b. How nursing students complete clinical experiences? c. How referrals to other disciplines are made? d. How ethical dilemmas are solved?

How nurses collect and use health histories? Genetics and genomics will change future practice in several areas including: how students are educated, how nurses collect and use health histories, how nurses learn and apply innovative biotechnology, how prevention and health education is provided, administration of new therapies, and public health debates.

A nurse considers that clients may not want to have genetic testing done because of the impact that it may have on future life decisions. Which of the following best describes how the nurse is incorporating genetics/genomics into practice? a. Assessment b. Identification c. Referral d. Provision of education, care, and support

Identification One of the ways that a nurse uses identification is by identifying ethical, cultural, and societal issues related to genetic and genomic information and technologies. Assessment is not being performed here because the nurse is not assessing a particular client's needs or history. Referral is not taking place, nor is education, care, or support of a patient.

When would it be appropriate for a nurse to use a Geographic Information System (GIS)? a. Recording client data collected at a foot clinic b. Identifying areas with an increased incidence of lead poisoning c. Evaluating effectiveness of a farm safety program d. Scheduling health promotion programs in the community

Identifying areas with an increased incidence of lead poisoning The use of a GIS allows the PHN to apply the principles of epidemiology into practice. GIS allows nurses to code data so that it is related spatially to a place on earth and is helpful in determining concentrated areas for incidence of disease and illness. An electronic health record (EHR) would be the most appropriate place to record client data from a foot clinic. Evaluation of effectiveness of a farm safety program would need to be done through some type of assessment or evaluation method—GIS would not be useful to collect this data. GIS is not a scheduling system and would not be helpful when scheduling health promotion programs in the community.

Public health nurses (PHNs) across the United States implement similar types of interventions to improve the health of various groups. Which of the following explains why a common set of interventions is used? a. Describe the proper order of implementation. b. Emphasize surveillance as the focus of public health practice. c. Guide practice and generate agency protocols. d. Improve the health status of communities, systems, individuals, and families.

Improve the health status of communities, systems, individuals, and families. Interventions are actions taken on behalf of communities, systems, individuals, and families to improve or protect health status. The interventions do not describe a particular order for implementation. Surveillance is only one of the 17 interventions described. PHNs may use any or all of the interventions. No single PHN is expected to perform every intervention at all three levels of practice.

A community health nurse is utilizing telehealth. Which factor best describes the rationale for its use? a. Enables clients to get nursing care in their homes. b. Substitutes for health department delivered care. c. Improves access to care in rural areas. d. Replaces face-to-face care for those who cannot afford it.

Improves access to care in rural areas. Telehealth provides increased access to health care using a computer monitor and telephone line. It is useful for monitoring clients with chronic disease but is not a substitute for health care. Telehealth may or may not be accompanied by home care nursing.

A public health staff nurse (PHN) who has a clear understanding of population-focused practice, would most likely engage in what activity? a. Volunteering for a local community action coalition b. Performing interventions with individuals in the community c. Improving the effectiveness of care provided d. Considering earning a PHN certification

Improving the effectiveness of care provided Public health staff nurses who have a clear understanding of population-focused care improve their effectiveness and efficiency of practice; have professional satisfaction by seeing how individual care contributes to health at the population level; and appreciate the practice of others who are population- focused specialists. PHN specialists are prepared at the master's level and function in an administrative role.

A nurse is unable to provide culturally competent care to a population within the community. Which of the following is an effect of this type of care? a. Enhanced communication b. Increased cost of health care c. Achievement of health indicators d. Improvement in client compliance

Increased cost of health care Care that is not culturally competent may increase health care costs and decrease positive client outcomes. Communication is inhibited through care that is not culturally competent. It is not possible to achieve health indicators if culturally competent care is not given. Client compliance decreases if culturally competent care is not provided.

A nurse is working to improve the health status of a population in a lesser-developed country. Which intervention would the nurse most likely support? a. Decreasing the number of people who need outside resources b. Increasing the number of children who can attend school c. Increasing the monetary resources that can be used to treat disease and illness d. Improving the ability to pay debt to more developed countries

Increasing the number of children who can attend school Health status improvement in children can lead to better education that eventually helps the country's economic growth. Because children are educated, there is more economic growth. This allows for additional monetary resources to be spent on economic development rather than on treatment of illness and disease.

Public health nurses (PHNs) utilize registries to identify children with delayed or missing immunizations. They subsequently follow up with families by phone calls or home visits. Which of the following levels of practice is being implemented? a. Systems b. Community c. Policy d. Individual

Individual The individual level of practice focuses on interventions that involve working with individuals, either singly, or in groups, and with families. Individual level intervention changes knowledge, attitudes, beliefs, practices, and behaviors of individuals. Community level interventions are carried out with the community as a whole. This level of intervention changes community norms, attitudes, awareness, practices, and behaviors. Systems level interventions change organizations, policies, laws, and power structures within communities. Policy is not a level of intervention described by "The Wheel."

Which of the following statements about race is true? a. In the United States, children of biracial parents are usually assigned the race of the father. b. Ethnicity and race are synonymous terms. c. Individuals may be of the same race but of different cultures. d. No social significance is usually placed on race.

Individuals may be of the same race but of different cultures. It is often a misconception that persons of the same race have the same culture. For example, African Americans may have been born in Africa, the Caribbean, North America, or elsewhere and have very different cultures. In the United States, biracial babies who had one white parent were assigned the race of the nonwhite parent. Ethnicity is a contrasting term to race. Race is a characteristic that allows for some groups to be separated, treated as superior, and given access to power and other valued resources, while others are treated as inferior and have limited access to power and resources.

Which country is referred to as being lesser-developed? a. France b. Japan c. Indonesia d. Sweden

Indonesia A country that is not yet stable with respect to its economy and technological development is lesser- developed, which describes Indonesia. France, Japan, and Sweden are considered developed countries.

Which statement fits with those of the Liberal Democratic Theory? a. One should reject any idea that societies, states, or collectives of any form can be the bearers of rights or can owe duties. b. Inequalities result from birth, natural endowment, and historic circumstances. c. Everyone has a right to private property. d. Government should be limited.

Inequalities result from birth, natural endowment, and historic circumstances. Rawls acknowledges that inequities are inevitable in society, but he tries to justify them by establishing a system in which everyone benefits, especially the least advantaged. This is an attempt to address the inequalities that result from birth, natural endowments, and historic circumstances. The other choices relate to libertarianism.

Public health nurse (PHNs) are looking to improve population-focused care in the community. Which activity best describes a key opportunity for the nurses to accomplish this goal? a. Assuming traditional nursing roles b. Influencing public health policy c. Conducting community assessments d. Specializing in community-based nursing practice

Influencing public health policy PHNs must move into positions in which they can influence policy formation. They must assume positions that are not traditionally considered nursing. Conducting community assessments is part of public health nursing practice, not necessarily a key opportunity to improve practice. Specializing in community-based nursing practice is setting-specific and does not relate to a key opportunity to improve population-focused care.

Why is public health nursing considered a nursing specialty? a. It has a distinct focus and scope of practice. b. It requires a master's degree in nursing. c. It is focused on disadvantaged citizens. d. It performs interventions at the acute care level.

It has a distinct focus and scope of practice. Public health nursing has a distinct focus and requires a special knowledge base. The other answers are not characteristics of a specialty.

The public health nurse (PHN) must participate in the essential services of public health. What is one of the essential services of public health nursing? a. Monitoring health status by completing a community assessment b. Diagnosing and investigating health problems in the world c. Informing, educating, and empowering people about health issues d. Working in law enforcement to regulate health and ensure safety

Informing, educating, and empowering people about health issues The PHN monitors health status in several ways, completing a community assessment is only one way that health status is monitored. The PHN would not diagnose or solve "world" problems, or work in law enforcement. Rather, the PHN would participate with local regulators to protect communities and empower people to address health issues.

A nurse is using clinical experience and client preference to guide clinical decision making. Which of the following is being demonstrated by the nurse? a. Evidence-based practice b. Internal evidence c. Research utilization d. External evidence

Internal evidence Internal evidence refers to the use of the nurse's clinical experiences and the client's preferences. Evidence-based practice includes the best available evidence from a variety of sources, including research studies, nursing experience and expertise, and community leaders. Research utilization is the process of transforming research knowledge into practice and the use of research to guide clinical practice. External evidence includes research and other evidence, like reports and professional guidelines.

A nurse worked in a school setting during the early twentieth century. Which activity would have been the focus of this nurse's practice? a. Investigating causes of absenteeism b. Teaching school as well as being a nurse c. Promoting nursing as an autonomous practice d. Providing medical treatment to enable children to return to school

Investigating causes of absenteeism Early school nursing focused on investigating causes of absenteeism, not providing medical treatment. That was the responsibility of physicians. Early school nurses did not teach in the schools. Early school nurses did not promote nursing as an autonomous practice.

A nurse is completing the first phase of a risk assessment. Which of the following questions would the nurse most likely try to answer? a. Has the chemical been released into the environment? b. How much and by which route of entry can the chemical enter the body? c. Is the chemical known to be associated with a negative health effect? d. What is the prediction for potential harm?

Is the chemical known to be associated with a negative health effect? The first phase is determining if a chemical is known to be associated with negative health effects (in animals or humans): Is the chemical known to be associated with a negative health effect? The second step is determining if the chemical has been released into the environment: Has the chemical been released into the environment? The third step is estimating how much and by which route of entry the chemical might enter the human body: How much and by which route of entry can the chemical enter the body? The final step considers the previous steps: What is the prediction for potential harm?

A nurse is caring for a client who has been diagnosed with tuberculosis (TB). Which medication would the nurse most likely administer? a. Isoniazid b. Nevirapine c. Amodiaquine d. Bacille Calmette-Guérin (BCG)

Isoniazid Isoniazid is one of several chemotherapeutic medications used to treat TB. Nevirapine is used to decrease the likelihood of maternal transmission of HIV-AIDS. Amodiaquine is one of several medications used to treat malaria. BCG is a vaccine that has been promoted as effective in inducing active immunity against TB.

Which statement about community health nursing practice is correct? a. It focuses on the delivery of personal health services to individuals and families. b. It provides care to protect the health of the whole community. c. It emphasizes the setting where care is provided for clients and families. d. It requires a baccalaureate preparation for practice.

It focuses on the delivery of personal health services to individuals and families. Public health nursing provides care to protect the health of the community as a whole. Community-based nursing practice emphasizes the setting where care is provided for clients and families. It is generally assumed that a graduate of any baccalaureate program has the necessary basic preparation to function as a beginning staff PHN; however, this is not a requirement for public health nursing or community health nursing practices.

Since the Intervention Wheel was first published in 1998, what related event has occurred? a. It has guided national policy. b. It has been used as a tool in deciding licensure issues for State Boards of Nursing. c. It has been incorporated into the public health curricula of many nursing programs. d. It has gained wide acceptance internationally.

It has been incorporated into the public health curricula of many nursing programs. Since being published, the Intervention Wheel has been incorporated into the public/community health coursework of numerous undergraduate and graduate curricula. The Wheel was derived from the practice of PHNs and intended to support their work. It gives PHNs a means to describe the full scope and breadth of their practice. It serves as a model for practice in many state and local health departments. It has been presented internationally but is not used widely at the international level.

What statement accurately describes the characteristics of epidemiology? a. It is a science that studies the poisonous effects of chemicals. b. It explains the association between learning disabilities and exposure to lead-based paint at the cellular level. c. It helps nurses understand the strength of the association between exposure and health effects. d. It is a method for tracking the prevalence of health outcomes.

It helps nurses understand the strength of the association between exposure and health effects. Epidemiology studies the incidence and prevalence of disease, helping nurses understand the strength of the association between exposure and health effects. Toxicology is the science that studies the poisonous effects of chemicals. Environmental surveillance provides data with which to track and analyze the incidence and prevalence of health outcomes. Epidemiology does not examine causes at the cellular level.

What statement is true about public health care (PHC) in the United States? a. It has dramatically improved since the passage of the Declaration of Alma Ata. b. It focuses on the use of government-funded insurance programs. c. It lacks community participation and a multidisciplinary health care delivery team. d. IT utilizes Preferred Provider Organizations to meet needs of the citizens.

It lacks community participation and a multidisciplinary health care delivery team. Although PHC has been endorsed by the United States, it faces many challenges. PHC emphasizes broad strategies, community participation, self-reliance, and a multidisciplinary health care delivery team; however, this is not the primary method of health care delivery in the United States.

Which statement about the Intervention Wheel is true? a. It provides a graphic illustration of population-based public health practice. b. It describes in detail the components of public health nursing. c. It demonstrates the practice of community health nurses for policy and lawmakers. d. It is a framework used by all health departments in the United States.

It provides a graphic illustration of population-based public health practice. The Intervention Wheel provides a graphic illustration that gives public health nurses (PHNs) a means to describe the full scope and breadth of their practice. The Wheel was derived from the practice of PHNs and intended to support their work. It gives PHNs a means to describe the full scope and breadth of their practice. It serves as a model for practice in many state and local health departments, but not all.

Which statement is true about the origins of the Intervention Wheel? a. A panel of nurses from Iowa, Minnesota, North Dakota, South Dakota, and Wisconsin developed and refined the Intervention Wheel. b. It was conceived by a group of international nurses from Norway, Kazakhstan, and Japan. c. It was a result of a qualitative analysis carried out by the State Boards of Nursing. d. It resulted from a grounded theory process carried out by public health consultants at the Minnesota Department of Health.

It resulted from a grounded theory process carried out by public health consultants at the Minnesota Department of Health. Public health consultants with the Minnesota Department of Health carried out a grounded theory process in response to uncertainty about the contributions of public health nursing to population health level improvement, resulting in the identification of the Intervention Wheel components. It was not developed by a panel of nurses in the Midwest or by a group of international nurses. It was not a qualitative analysis process and the State Boards of Nursing were not involved in its development.

A nurse is sued for malpractice and goes to court. Which of the following types of law is being used? a. Constitutional b. Common c. Judicial d. Institutional

Judicial Judicial law is based on court or jury decisions. Constitutional law provides overall guidance for selected practice situations. Common law means that judges are bound by previous decisions unless they are convinced that the older law is no longer relevant or valid. Institutional law is not a type of law that has importance in the United States.

A nurse investigates the interpretation of a state's right to grant abortions. Which of the following branches of government would the nurse be looking at? a. Executive b. Legislative c. Judicial d. Federal

Judicial The judicial branch interprets laws and their meaning, as in its ongoing interpretation of states' rights to define access to reproductive health services for citizens of the states. The executive branch suggests, administers, and regulates policy. The legislative branch identifies problems and proposes, debates, passes, and modifies laws to address those problems. The federal branch refers to the top level of government agencies.

A community health nurse is applying the Ethical Principles for Effective Advocacy. Which of the following best describes the action(s) of the nurse? (Select all that apply.) a. Act in the health care provider's best interest. b. Keep the client (group, community) properly informed. c. Maintain client confidentiality. d. Carry out instructions with diligence and competence. e. Provide advice to all members of the community.

Keep the client (group, community) properly informed., Maintain client confidentiality., Carry out instructions with diligence and competence. Keep the client (group, community) properly informed, maintain client confidentiality, and carry out instructions with diligence and competence are ethical principles for effective advocacy. The nurse should act impartially and offer frank, independent advice, which does not necessarily mean that advice should be provided to all members of the community.

Which are barriers to implementation of evidence-based practice? (Select all that apply.) a. Lack of available time b. Inferior quality of available research c. Unwillingness of organizations to fund research d. Inability to understand the evidence e. Limited support from accreditors to implement evidence

Lack of available time, Inferior quality of available research, Unwillingness of organizations to fund research, Inability to understand the evidence Lack of time, inferior quality of research, unwillingness of organizations to fund research, and inability to understand the evidence are all barriers to the implementation of evidence-based practice. As public health departments are beginning to seek accreditation, there is an increased emphasis on the use of evidence-based practice.

Which event best describes a cultural encounter? a. Sharing significant assessment findings with members of a racial minority b. Visiting the native land of the clients served at a community health center c. Telephoning the priest at a Hispanic church to discuss the health issues of a client d. Learning about traditional healing practices from an American Indian client

Learning about traditional healing practices from an American Indian client Cultural encounter refers to the process that permits nurses to seek opportunities to directly engage in cross-cultural interactions with clients of diverse cultures to modify existing beliefs about a specific cultural group and possibly avoid stereotyping. Learning about traditional healing practices is an example of a direct cultural encounter. This occurs when a nurse engages in cross-cultural interactions. Sharing significant assessment findings demonstrates the nurse sharing information, not an engagement with the population. When visiting a native land, there may not be interaction with any other culture. Telephoning a priest at a Hispanic church does not demonstrate an interaction, but rather the nurse calling the priest to accomplish a nursing task.

States have certain continuing education requirements for persons to renew a nursing license. Which of the following best describes the type of law that is being used? a. Constitutional law b. Legislation and regulation c. Judicial and common law d. Police power

Legislation and regulation Licensing is regulated by each state's nurse practice act as a function of the board of nursing. Constitutional law provides overall guidance for selected practice situations. Judicial law is based on court or jury decisions. Common law means that judges are bound by previous decisions unless they are convinced that the older law is no longer relevant or valid. Police power is state power concerning health care. This power allows states to act to protect the health, safety, and welfare of their citizens.

A public health nurse (PHN) working with a family living in poverty is concerned about their exposure to environmental hazards. Which of the following factors should the nurse identify as possibly putting the family at risk? (Select all that apply.) a. Limited funds to pay for health care b. Poor nutrition c. Homes located closer to hazardous waste sites d. Less education e. Unsafe working conditions

Limited funds to pay for health care, Poor nutrition, Homes located closer to hazardous waste sites Families living in poverty are more likely to experience environmental justice issues such as disproportionate environmental exposures. Substandard housing, living closer to hazardous waste sites, working in more hazardous jobs, poorer nutrition, and less access to quality health care all contribute to this issue. Although limited education is related to poverty, it is not discussed as causing an increase in environmental exposure.

A nurse is demonstrating advocacy in personal nursing practice. Which of the following actions best demonstrates this principle? a. Offering a smoking cessation program b. Screening for hypertension c. Lobbying for health care reform d. Conducting home visits

Lobbying for health care reform Nurses should participate in implementing new directions for health care and help envision these new directions. Nurses can be an important voice in advocating for access to consistent, effective, and efficient health care for all. This is best accomplished by performing interventions at the population level.

A community health nurse is investigating international diseases. Which of the following would the nurse track by using the global burden of disease (GBD)? a. The number of cases of HIV/AIDS in a country b. Losses from premature death and losses of healthy life that result from disability c. The economic impact of disability on lesser-developed countries d. The rate of disability in industrialized nations

Losses from premature death and losses of healthy life that result from disability The GBD combines losses from premature death and losses of healthy life that result from disability. The GBD represents units of disability-adjusted life-years (DALYs). This statistic is not specific to a particular disease or a particular developmental stage of a country.

A doctorally prepared nurse (PhD) at a university wants to submit a grant to study the impact of a nursing activity on patient outcomes. From which of the following federal agencies could this nurse potentially seek funding? a. Centers for Disease Control and Prevention (CDC) b. National Institute of Nursing Research (NINR) c. U.S. Department of Health and Human Services (USDHHS) d. World Health Organization (WHO)

National Institute of Nursing Research (NINR) NINR funds the development of the knowledge base of nursing and promotion of nursing services in health care. The CDC, USDHHS, and WHO do not provide funding specific to nursing research.

A public health nurse (PHN) reports being able to demonstrate the minimum competencies set forth by the National Coalition of Health Professional Education in Genetics (NCHPEG). Which of the following describes the action that is taken by the nurse? a. Organizing a meeting to discuss the care of cystic fibrosis clients b. Making a referral to a genetics specialist c. Advocating for legislation to support stem cell research d. Educating a client about the results of genetic testing

Making a referral to a genetics specialist The minimum competencies for health care professionals set forth by NCHPEG are: be able to examine competence of practice, understand the social and psychological implications of health-related genetic information, and know how and when to make referrals to a genetics professional. Making a referral is the only example that is described in these competencies.

A nurse works to promote the passage of a public health law to protect the health of the community. Which activity would the nurse most likely be promoting? a. Requiring all persons to have health insurance coverage b. Administering flu shots in the late fall and early winter c. Mandating immunizations for all children entering kindergarten d. Monitoring and licensing nuclear power plants

Mandating immunizations for all children entering kindergarten Public health laws protect the community. Required immunizations are an example. Requiring health insurance coverage would not protect the community. Administration of flu shots is not promotion of a law. Monitoring and licensing nuclear power plants are beyond the scope of public health.

A nurse is caring for a client with tuberculosis (TB). Which statement would the nurse recognize as being true? a. Meningitis is the leading cause of death from TB. b. Chemotherapy, if made widely available, could eradicate the disease. c. Many TB cases are associated with HIV. d. The TB bacillus is difficult to isolate.

Many TB cases are associated with HIV. The rise in HIV has led to an increase in TB because the disease depresses the immune system. Chemotherapy is not always effective, especially in the new drug-resistant strains. Meningitis is not a leading cause of death from TB. TB is becoming more difficult to treat because of the new drug-resistant strains, but the TB bacillus is not difficult to isolate.

Which legislation was considered the first national health insurance plan in the United States? a. Health Maintenance Organization (HMO) Act b. Marine Hospital Service c. Medicare d. Medicaid

Marine Hospital Service The Marine Hospital Service was created in 1798 by the federal government to provide medical service for sick and disabled sailors and to protect the nation's borders against the importing of disease through seaports. The HMO Act provided assistance and expansion for HMOs in the 1970s. Medicare and Medicaid were established in 1965 to provide health care services to certain populations.

A nurse is working to reform a program that was based on the Elizabethan Poor Law of 1601. Which of the following programs is the nurse most likely working on? a. Welfare b. Food Stamps c. Medicaid d. Medicare

Medicaid The Poor Law guaranteed medical care for poor, blind, and "lame" individuals, making it most similar to Medicaid since this program provides medical insurance to these types of individuals. Welfare provides more than health care. Food stamps do not provide medical care. The Medicare program provides medical care to the elderly population.

According to the 1999 Institute of Medicine report, as many as 98,000 deaths each year could be attributed to what cause? a. Cardiovascular disease b. Obesity c. Medical error d. Drug overdose

Medical error In 1999 it was thought that our health care system was expensive, and that access and quality were not optimal, but we had not considered this important fact: many people die of preventable medical errors in the United States. This number is not the correct statistic for cardiovascular disease, obesity, or drug overdose.

A nurse is working to manage the public health aspects of a bioterrorist event. Which concept does the nurse need to understand? (Select all that apply.) a. Medical management and public health measures b. The names and descriptions of the agent/disease c. The chemical features of the pathogens d. How to address mental health concerns e. The amount of risk that each type of event will have for the public

Medical management and public health measures, The names and descriptions of the agent/disease, How to address mental health concerns Nurses need to understand the names of the pathogens and the disease they cause, the medical management and public health measures (so that accurate information can be disseminated), and how to help people cope with their feelings. The chemical features of the pathogens and the amount of risk that each type of event will have for the public would not be part of the nurses' role when managing the public health aspects of a bioterrorist event.

A nurse is caring for a client who has end-stage kidney failure and is on dialysis. The nurse recognizes that this client is eligible for which form of insurance? a. Medicaid b. Blue Cross c. Medicare d. Health Maintenance Organization (HMO)

Medicare Medicare is available to anyone on dialysis regardless of age. Blue Cross and HMO are both private insurance options. Medicaid provides financial assistance to states and counties to pay for medical services for the aged poor, the blind, the disabled, and families with dependent children who are below state poverty income levels.

A 66-year-old person is retired and no longer has health insurance. Which of the following programs would be appropriate for his or her health insurance needs? a. Medicare b. Medicaid c. Social Security d. Economic Opportunity Act

Medicare The Social Security Act was amended to include health insurance benefits for the elderly, which is addressed through Medicare. Medicaid focuses on care for the poor. Social Security does not provide health insurance. The Economic Opportunity Act provided funding for neighborhood health centers, Head Start, and other community action programs.

A business offers wellness incentives to its employees and then notices a decrease in the frequency of physician visits among employees. Which term best describes what has happened? a. Macroeconomic theory b. Efficiency c. Supply and demand d. Microeconomic theory

Microeconomic theory Microeconomic theory is examining the behaviors of individuals and organizations that result from trade- offs in utility and budget constraints of health care. Efficiency refers to producing maximum output using a given set of resources. Supply and demand are two basic principles of microeconomic theory. Macroeconomic theory focuses on the "big picture."

Which statement regarding poverty and health insurance is true? a. Millions of people in the United States are without health insurance. b. The poor in the United States are as healthy as persons with higher incomes. c. Persons with money or health insurance are less likely to seek health care. d. The poor are more likely to receive health care through private agencies.

Millions of people in the United States are without health insurance. In 2016, 28.1 million people were without health insurance in the United States. The poor in the United States are generally not as healthy as persons with middle or higher incomes. Persons with money and/or health insurance are more likely to seek health care. The poor are less likely to receive health care through private agencies.

A nursing program has initiated a recruitment campaign focusing on increasing the minority students in its program. Which of the following best describes the rationale for this program? a. The number of minority versus non-minority nurses should be equal. b. Minority health care professionals who share the same culture with the clients may provide more effective care. c. The profession should be more diverse. d. Minority nurses can mentor other nurses when providing care for diverse

Minority health care professionals who share the same culture with the clients may provide more effective care. It is thought that increasing minority representation in the health workforce not only is a commitment to diversity, but also will improve the health care delivery system. Minority health professionals can be expected to practice in underserved areas at a greater rate and health professionals who share the same culture and language with the clients they serve can provide more effective care. It has been suggested that the number of minority nurses should be representative of the population served rather than there being equal numbers of minority and non-minority nurses. Minority nurses are able to mentor other nurses; however, is not the main reason that there is a focus on increasing recruitment of minorities.

A nurse is working for the federal government to provide for the protection of the public's health. Which of the following actions would the nurse most likely complete? a. Interpreting decisions related to women's right to privacy b. Setting up immunization clinics for smallpox vaccine c. Regulating nursing at the state level d. Monitoring the influx of disease at the borders

Monitoring the influx of disease at the borders The United States Constitution gives the federal government the authority to provide for the protection of the public's health. By monitoring the influx of disease at the borders the public's health is being protected. Interpreting decisions does not support the protection of the public's health. Smallpox has been eradicated so it would not be necessary to set up immunization clinics. Regulation of nursing at the state level does not support protection of the public's health by the federal government.

Which statement describes the consequence of the successful implementation of the Affordable Care Act? a. Americans will pay closer attention to their health status. b. Most of the population will be covered by health insurance. c. Public health departments will need to increase the number of nursing positions. d. The prevalence of obesity will decrease.

Most of the population will be covered by health insurance. One consequence of successful implementation of the Affordable Care Act might be that the majority of the population would be covered by insurance and public health agencies will not need to provide direct clinical services in order to assure that those who need them can receive them. The Affordable Care Act will not directly cause Americans to pay closer attention to their health status or decrease the prevalence of obesity.

What is the greatest single source of air pollution in the United States? a. Waste incineration b. Power plants c. Motor vehicles d. Molds

Motor vehicles Mobile sources such as cars and trucks are the greatest single source of air pollution in the United States. Waste incineration and power plants are major contributors after motor vehicles. Molds contribute to poor indoor air quality.

A nurse who is working in a community setting applies evidence-based practice when planning community health education. Which of the following should the nurse use in order to enrich the application of this evidence? a. Randomized clinical trials b. Qualitative studies c. Quantitative studies d. Multiple research methods

Multiple research methods Evidence from multiple research methods has the potential to enrich the application of evidence and improve nursing practice. Qualitative and quantitative studies are both used when using multiple research methods. Randomized clinical trials are difficult to accomplish in a community health setting.

A nursing student is researching various health care services that are provided in prisons. Which of the following describes these services? a. Funded by the Department of Defense (DOD). b. Focus on health promotion interventions. c. Must be provided at an adequate level. d. Are available to those diagnosed with a chronic illness.

Must be provided at an adequate level. Health care services for prisoners are required at an adequate level for all incarcerated individuals. This is administered by the DOJ. Prisoners will receive health care services when diagnosed with chronic illnesses as well as acute illnesses.

A nurse understands the significant impact that genetic testing can have on an individual and family. This competency is described by which of the following organizations? a. National Coalition of Health Professional Education in Genetics (NCHPEG) b. Centers for Disease Control and Prevention (CDC) c. American Nurses Association d. International Council of Nurses

National Coalition of Health Professional Education in Genetics (NCHPEG) The NCHPEG identifies one competency of health care professionals as being able to understand that health-related genetic information can have social and psychological implications for individuals and families. The CDC, American Nurses Association, and International Council of Nurses do not address any competencies specifically related to genetic testing.

A visitor from Japan comes to the United States for a 2-week vacation. Which of the following best describes this person? a. Non-immigrant b. Refugee c. Legal immigrant d. Lawful permanent resident

Non-immigrant A non-immigrant is admitted for a limited duration for a specific purpose. Refugees are people who seek protection in the United States because of fear of persecution in their homeland. Legal immigrants are people who are not citizens but are legally allowed to live and work in United States, usually because they fulfill labor demands or have family ties. Lawful permanent resident is another name for legal immigrants.

Which ethical principle requires "doing no harm?" a. Respect for autonomy b. Nonmaleficence c. Beneficence d. Distributive justice

Nonmaleficence Nonmaleficence refers to doing no harm. Respect for autonomy requires that individuals be permitted to choose those actions and goals that fulfill their life plans unless those choices result in harm to another. Beneficence requires that we do good. Distributive justice requires that there be a fair distribution of the benefits and burdens in society based on the needs and contributions of its members.

A nurse makes clinical judgments based upon trial and error and past clinical experiences. Which of the following problems can result from using these data sources in clinical decision making? a. Not all sources of information are reliable. b. Authority always leads to faulty decision making. c. Ethical knowledge is not taken into account. d. This process generally leads to poor outcomes.

Not all sources of information are reliable. Nurses have always used various resources for problem solving. However, not all of these resources are reliable, and all have not consistently produced desired outcomes. Authority does not always lead to faulty decision making. Ethical knowledge should be taken into account when making clinical judgments. Trial and error may or may not lead to poor outcomes.

Which statement about the reimbursement of health services for nurses is accurate? a. Reimbursement for health care services can be directed only to physicians. b. Nurse practitioners and clinical nurse specialists are reimbursed for Medicare Part B services. c. Nursing care is a separate budget item in determining hospital service costs. d. Nursing care is reimbursed separately from medical care in outpatient settings.

Nurse practitioners and clinical nurse specialists are reimbursed for Medicare Part B services. Nurse practitioners and clinical nurse specialists were granted third-party reimbursement for Medicare Part B services only on January 1, 1998 under Public Law 105-33. Nursing care is not billed for or reimbursed for in hospital or outpatient settings.

A nursing student is researching advanced practice nursing options. Which of the following discoveries would most likely be made by the nursing student? a. Nurse practitioners may work independently depending on the state practice act. b. Certified nurse midwives have limited prescriptive authority. c. Clinical nurse specialists typically provide primary care services. d. The Doctorate in Nursing Practice emphasizes the importance of research.

Nurse practitioners may work independently depending on the state practice act. Nurse practitioners may work as independent practitioners and can be reimbursed by Medicare or Medicaid for services rendered. Certified nurse midwives have prescriptive authority in some form in all states. Clinical nurse specialists may provide primary care services, but often work in consultation, research, education, and administration. The Doctorate in Nursing Practice role is a clinical role.

A nurse enrolls in a microeconomics course at a local college. Which statement best describes the rationale for taking this course? a. Nurses are often the ones to allocate resources to solve a problem. b. Nurses are often involved in federal policy making. c. Health care policy can be influenced using these principles. d. Health care supplies can be very costly and nurses must use them wisely.

Nurses are often the ones to allocate resources to solve a problem. Nurses often allocate resources, design, plan, coordinate, and evaluate community-based health services. Policy making addresses a macroeconomics issue. It is true that nurses need to know about microeconomics in order to use resources appropriately, but the scope of quality of care and use of health care supplies is larger than the scope of only microeconomics.

Why is it important for nurses to understand the premises of environmental health? a. Nurses should be able to assess risks and advocate for policies that support healthy environments. b. Toxicologists often consult nurses about environmental pollutants. c. Pollutant exposures such as lead are reported by nurses to the Environmental Protection Agency (EPA). d. Many Americans live in areas that do not meet current national air quality standards.

Nurses should be able to assess risks and advocate for policies that support healthy environments. Potential risks to health are concerns for professional nurses. It is the responsibility of the nurse to understand as much as possible about these risks: how to assess them, how to eliminate/reduce them, how to communicate and educate about them, and how to advocate for policies that support healthy environments. Toxicologists do not often consult nurses about environmental pollutants. Pollutant exposures are not routinely reported by nurses. Although there may be problems with air quality standards in the United States, this would not be the primary reason why nurses should understand environmental health.

Which statement regarding Florence Nightingale's ideas about ethics is correct? a. Nursing is a call to service, and the moral character of persons entering nursing is important. b. Ethical principles are based on the values of the individual nurse. c. Society will dictate the ethical principles to which nurses must adhere. d. Ethics are very important in times of war, such as in the Crimean War, when she set up public health centers.

Nursing is a call to service, and the moral character of persons entering nursing is important. Florence Nightingale saw nursing as a call to service and viewed the moral character of persons entering nursing as important. Florence Nightingale did not set up public health centers. Florence Nightingale did not believe that nurses must adhere to society's view of ethical principles. Ethical beliefs are based on the values of the individual nurse, not ethical principles.

A nurse is examining the characteristics that affect one's health. Which factor is of greatest concern to the nurse? a. Obesity b. Marital status c. Health insurance d. Age

Obesity Personal behavior/lifestyle (obesity) has the greatest effect on health. Environmental factors (marital status) and human biology (age) are next followed by the health care system (health insurance).

How have nurses historically learned to identify a possible relationship between environmental chemical exposures and their potential harm? a. Extrapolation by toxicologists b. Biomonitoring c. Completing chemistry courses d. Observing signs and symptoms in clients

Observing signs and symptoms in clients Nurses have historically made discoveries related to chemical exposure when people presented with signs and symptoms related to known chemical toxicity. Extrapolation by toxicologists and biomonitoring are modern methods. Completing a chemistry course does not show how to identify these possible relationships.

A nurse is exploring a job opportunity at a community health center. Which expectation would the nurse have about the center? a. Would be situated in a large metropolitan area. b. Provides care only to the economically disadvantaged. c. Offers comprehensive primary care services and supportive services. d. Is used for preventive services such as flu shots.

Offers comprehensive primary care services and supportive services. Community health centers serve the entire community for primary health care (PHC) services, regardless of income. They are in a high need or medically underserved community, which can be urban or rural.

A community health nurse is utilizing the health care system in the United Kingdom. Which expectation should the nurse have? a. Employer and citizen share equally in the cost of health care. b. Ownership and operation of the system is by the government. c. Nurse practitioners are the primary providers of care in the system. d. Primary care is provided for in hospitals.

Ownership and operation of the system is by the government. The United Kingdom has a tax-supported health system that is owned and operated by the government. Services are available to all without cost or for a small fee. Physicians are the primary providers in this system; nurses and allied health professionals are also recognized and used. Services are made available through hospitals, private physicians and allied health professional clinics, health outreach programs such as hospice, boroughs, and environmental health services.

Which intergovernmental organization focuses its efforts on assisting countries in Latin America? a. Pan American Health Organization b. World Bank c. World Health Organization (WHO) d. United Nations Children's Fund

Pan American Health Organization The Pan American Health Organization serves as a regional field office in Latin America for the WHO. The World Bank's major aim is to lend money to the lesser-developed countries so that they might use it to improve the health status of their people. The WHO addresses the wide scope and nature of the world's health problems. The United Nations Children's Fund is an advocate for the health needs of women and children under the age of 5.

Which statement about the Medicare program is accurate? a. Part A provides coverage for hospitalization. b. Part A requires payment of a monthly premium for coverage. c. Part B provides payment for home health services and extended care facilities. d. Part B is available without cost to all elderly people who have paid social security taxes.

Part A provides coverage for hospitalization. Medicare Part A covers hospital care, home care, and skilled nursing care. Medicare Part B is a supplemental program available to all Medicare-eligible persons for a monthly premium.

A Medicare recipient has elected to pay a monthly premium for Medicare that will cover expenses, such as laboratory services and equipment. Which part of Medicare is being described? a. Part A b. Part B c. Part C d. Part D

Part B Medicare Part B is a supplemental (voluntary) program; it provides coverage for services that are not covered by Part A, such as laboratory services, ambulance transportation, prostheses, equipment, and some supplies. Part A provides coverage for hospital care, home care, and skilled nursing care. Part C is an option that can be chosen for additional coverage. Part C includes services of both Parts A and B. The Part C plans are coordinated care plans that include HMOs, private fee-for-service plans, and medical savings accounts (MSAs). Part C provides for all health care coverage costs after a high deductible. Part D provides prescription coverage.

In the Vietnamese culture, individuals may focus on wishes and memories of their ancestors and look to them to provide direction for current situations. Which of the following types of cultural variations is being demonstrated? a. Communication b. Personal space c. Social organization d. Perception of time

Perception of time Perception of time is the duration or period between successive events, where some cultures assign greater or lesser emphasis to events that occur in the past, present, or future. Communication is the means by which culture is shared (verbal and nonverbal). Personal space is the physical distance between two individuals during an interaction. Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions.

What is the first step the nurse would take when addressing the problem of air pollution in the community? a. Setting standards b. Monitoring c. Permitting d. Compliance

Permitting Permitting is a process by which the government places limits on the amount of pollution emitted into the air or water. Environmental standards may describe a permitted level of emissions, a maximum containment level, an action level for environmental cleanup, or a risk-based calculation. Monitoring is an ongoing process after an action has happened. Compliance refers to the processes for ensuring that permit/standard/regulatory requirements are met.

A nurse acts to protect the health, safety, and welfare of citizens, such as requiring immunizations of children before admission to school. Which of the following levels of power is being used? a. Executive b. Legislative c. Judicial d. Police

Police Police power is state power concerning health care. This power allows states to act to protect the health, safety, and welfare of their citizens. Executive power comes as the executive branch suggests, administers, and regulates policy. Legislative power occurs as this branch of government identifies problems and proposes, debates, passes, and modifies laws to address those problems. Judicial power occurs as the judicial branch interprets laws and their meaning, as in its ongoing interpretation of states' rights to define access to reproductive health services for citizens of the states.

A nurse discusses with legislators the importance of passing legislation to ban smoking in all public places. Which of the following is the nurse becoming involved in? a. Policy b. Politics c. Law d. Health policy

Policy Politics is the art of influencing others to accept a specific course of action. Therefore, political activities are used to arrive at a course of action (the policy). Policy is a settled course of action to be followed by a government or institution to obtain a desired end. Law is a system of privileges and processes by which people solve problems based on a set of established rules. Health policy is a set course of action to obtain a desired health outcome for an individual, family, group, community, or society.

A public health nurse (PHN) develops and implements local public health policies through partnerships with agencies, organizations, and consumers within the community. Which of the following core public health functions is the nurse addressing? a. Assessment b. Prevention c. Assurance d. Policy development

Policy development Policy development deals with developing and implementing health policies. Prevention is not a core function, assurance is making sure essential services are available, and assessment refers to systematic data collection.

A nurse discusses services with a federal Congressional representative. Which service would the nurse most likely be discussing? a. Family planning b. Counseling c. Policy making d. Prevention of communicable diseases

Policy making Policy making is offered at the federal level. Family planning, counseling, and preventing communicable and infectious disease are offered at the state and local levels.

Population health is an approach and perspective that focuses on what? a. Controlling the spread of the HIV virus worldwide b. The broad range of factors and conditions that influence health c. Community-based care for all citizens d. Prevention and diagnosis of disease worldwide

Population health is an approach and perspective that focuses on what? a. Controlling the spread of the HIV virus worldwide b. The broad range of factors and conditions that influence health c. Community-based care for all citizens d. Prevention and diagnosis of disease worldwide

A nurse is assessing a refugee who fled the genocide in Darfur. Which disease/disorder should the nurse anticipate finding? a. Tuberculosis (TB) b. Post-traumatic stress disorder (PTSD) c. Chronic obstructive pulmonary disorder (COPD) d. Malnutrition

Post-traumatic stress disorder (PTSD) The biopsychological changes seen following genocide include physical stress reactions (cardiovascular, neurological) and mental stress responses, especially PTSD and depression. The biopsychosocial changes are the major concern over any physical illnesses that may be present.

A nurse is completing an exposure history using the mnemonic I PREPARE. What data would a nurse collect when asking questions about the first "P"? a. Present work b. Potential exposures c. Personal protective equipment use d. Past work

Present work Present work is the first "P." Potential exposures are part of the "I"—investigate potential exposures. Personal protective equipment use is not part of the mnemonic. Past work is the second "P."

A nurse is employed by the Department of Homeland Security. Which activity would be expected by this department? a. Prevention and protection against terrorist attacks b. Regulation of licensure of medical personnel c. Inspection of the safety of food and cosmetics d. Regulation of managed care organizations

Prevention and protection against terrorist attacks The Department of Homeland Security was created after the terrorist attacks of September 11, 2001. Its mission is to prevent and deter terrorist attacks and to protect against and respond to threats and hazards to the nation. Regulating the licensure of medical personnel, inspecting the safety of food and cosmetics, and regulating managed care organizations are not responsibilities of this department. These activities are regulated by other state or federal government agencies.

What term is used to describe when a third-party payer establishes the amount of money that will be paid for the delivery of a service before offering the service to the client? a. Retrospective reimbursement b. Prospective reimbursement c. Fee-for-service d. Capitation

Prospective reimbursement Prospective reimbursement is the method of paying an organization whereby the third-party payer establishes the amount of money that will be paid for the delivery of a particular service before offering the services to the client. Retrospective reimbursement is the method whereby fees for the delivery of health care services in an organization are set after services are delivered. Fee-for-service is the traditional method of paying the health care practitioner; the practitioner determines the costs of providing a service, delivers the service, and submits a bill for the delivered service to a third-party payer who then pays the bill. Capitation is similar to prospective reimbursement for health care organizations; third-party payers determine the amount that practitioners will be paid for a unit of care.

What activity is associated with the implementation of the Genetic Information Nondiscrimination Act (GINA)? a. Protecting individuals from discrimination based on their genetic information b. Allowing health insurance companies to deny coverage for preexisting conditions c. Allowing state employers to collect genetic information from employees as needed d. Requiring employees to report genetic disorders to their employer

Protecting individuals from discrimination based on their genetic information GINA was designed to prohibit the improper use of genetic information in health insurance and employment. It protects individuals from discrimination based on their genetic information, prevents denial of coverage based solely on genetic predisposition to disease, and limits disclosure of genetic information.

The Refugee Act of 1980 had what effect on refugees who were immigrating into the United States? a. Allowed specific provisions for refugees from Southern and Eastern Europe. b. Provided a uniform procedure for refugees to be admitted into the United States. c. Permitted refugees to set up communities in or around major metropolitan areas. d. Allowed refugees access to "green cards" allowing them to work in the United States.

Provided a uniform procedure for refugees to be admitted into the United States. The Refugee Act of 1980 provided a uniform procedure for refugees to be admitted into the United States. Refugees were immediately eligible to receive Temporary Assistance for Needy Families, Supplemental Security Income, and Medicaid. This procedure was in effect for all refugees not just those from specific countries. It did not provide "green card" access or permit development of specific communities for refugees.

A nurse is implementing community-based nursing care. Which intervention is the nurse most likely to complete? a. Assessing the health needs of a defined community b. Providing care to families in a community c. Promoting the health of an entire community d. Investigating environmental health problems in a community

Providing care to families in a community Community-based nursing practice is a setting-specific practice whereby care is provided for families where they live, work, and attend school. The focus is on acute and chronic care and the provision of services. Providing care to families is the only intervention that accurately describes this definition. Assessing the health needs of a community, promoting the health needs of an entire community, and investigating environmental health problems in a community would be considered public health nursing practice.

What was the first major federal government action relating to health? a. The Social Security Act b. The National Institutes of Health (NIH) c. The Public Health Service (PHS) d. Medicare and Medicaid

The Public Health Service (PHS) The first major federal governmental action relating to health was the creation in 1798 of the PHS. The Social Security Act was passed in 1935. The NIH was founded in 1887. Medicare and Medicaid were created in 1965.

A nurse is using the Codes of Ethics developed by the International Council of Nurses and the American Nurses Association. Which of the following describes the action being taken by the nurse? a. Providing confidential genetic testing for a client b. Advocating for the inclusion of genetic content in a nursing curriculum c. Considering the pros and cons of an ethical dilemma d. Becoming competent in genomics

Providing confidential genetic testing for a client The Codes of Ethics include in this mandate the right that people may seek and receive genomic heath care, that is, nondiscriminatory, confidential, private, and that enables those served to make informed decisions. Being competent in genomics, considering pros and cons of ethical dilemmas, and advocating for the inclusion of genetic content in a nursing curriculum are not part of the Code of Ethics.

A clinic nurse working in the 1970s was employed by a primary care physician. Which of the following describes how the nurse would have applied genetic concepts? a. Providing genetic counseling to those with genetic disorders b. Educating clients about using genetic testing for risk identification c. Explaining the purposes of the Human Genome Project to clients d. Facilitating referrals for specialized genetic services for clients

Providing genetic counseling to those with genetic disorders In the 1970s, nurses working in genetics provided genetic counseling to persons with genetic diseases or risk factors for such disorders. The other activities performed by the nurse did not occur until the 1990s.

A nurse was employed by the Marine Hospital Service. Which of the following tasks would have most likely been the responsibility of the nurse? a. Setting policy on quarantine legislation for immigrants b. Establishing hospital-based programs to care for the sick at home c. Identifying and improving environmental conditions d. Providing health care for merchant seamen

Providing health care for merchant seamen Providing health care to seamen was an early effort by the federal government to improve public health. The purpose of the Marine Hospital Service was to secure its maritime trade and seacoast cities. Marine Hospital Service nurses did not establish policies or hospital programs. They also did not identify and improve environmental conditions as Florence Nightingale did. Their sole purpose was to provide care for this population.

What is one of the goals of the World Health Organization (WHO)? a. Providing public health nurse (PHC) services to everyone b. Preventing outbreaks of disease c. Preventing the transmission of communicable disease among nations of the world d. Providing humanitarian support in times of disaster

Providing public health nurse (PHC) services to everyone The WHO adopted a resolution in 1977 accepting the goal of attaining a level of health that permitted all citizens of the world to live socially and economically productive lives. This has been adapted to meet the needs of the new century and was deemed "Health for All in the 21st Century." The focus of this initiative is PHC services. The WHO does not prevent outbreaks of disease, prevention, transmittal of disease, or provide humanitarian support.

A public health nurse (PHN) is implementing the objectives related to genetics from Healthy People 2020. Which of the following describes the action that is being taken by the nurse? a. Educating clients that multiple factors influence the development of disease b. Counseling clients about the results of genetic testing c. Lobbying for legislation to support genetic research d. Providing screening and genetic testing for specific groups of individuals

Providing screening and genetic testing for specific groups of individuals The objectives of Healthy People 2020 related to genetics suggest that screening and genetic testing for specific groups still remain the standard of practice while other routine screenings or tests are questioned for their impact on morbidity and mortality. Healthy People 2020 objectives do not address client education, client counseling, or legislation for genetics.

What initiative began because of a resolution adopted by the WHO in 1977? a. Declaration of Alma Ata b. Medicare c. Healthy People d. Public Health Care (PHC) movement

Public Health Care (PHC) movement The WHO adopted a resolution accepting the goal of attaining a level of health that permitted all citizens of the world to live socially and economically productive lives. The name of the resolution that was adopted was the Declaration of Alma Ata. Medicare began as part of the Social Security Act. The Healthy People initiative began as part of the 1979 Surgeon General's Report addressing the health needs of Americans.

A nurse interacts with a 25-year-old woman at a community health center who is obtaining a gynecological examination and birth control pills. Which of the following types of care is the client receiving? a. Tertiary health care b. Public health care c. Public health care (PHC) d. Specialized care

Public health care (PHC) PHC includes basic health care services with the emphasis on prevention. Tertiary health care is highly specialized medical care. Public health care focuses on care for populations. Specialized care focuses on only one aspect of a patient's health.

A nurse is implementing quality performance standards in a public health department. Which statement best describes the importance of this action? a. Quality performance standards are used to guide improvement in the public health system. b. Quality performance standards rigidly control public health. c. Quality performance standards guide administrators to monitor public health at the national level. d. Quality performance standards can be used as hiring guidelines for nurses.

Quality performance standards are used to guide improvement in the public health system. These standards were developed by the Centers for Disease Control and Prevention in 1998. They set the bar for the level of performance that is necessary to deliver essential public health services (PHSs). These standards were developed around the 10 essential PHSs. They focus on the overall public health system rather than on single organizations and describe an optimal level of performance. They are intended to support a process of quality improvement. State and local communities can assess their performance using certain available tools. They are not meant to control public health or be used for hiring guidelines.

A nurse is working with a population that exhibits a large amount of diversity. The nurse recognizes that skin color of individuals within this population is an example of what? a. Multiculturalism b. Ethnicity c. Race d. Culture

Race Race is primarily a social classification that relies on physical markers. Multiculturalism is the blending of diverse cultures. Ethnicity is the shared feeling of peoplehood among a group of individuals and relates to cultural factors, such as nationality, geographic region, culture, ancestry, language, beliefs, and traditions. Culture is a set of beliefs, values, and assumptions about life that are widely held among a group of people and transmitted intergenerationally.

A city council discusses how former city laws promoted segregation in the community years ago. Which of the following was being demonstrated when segregation occurred? a. Prejudice b. Cultural imposition c. Racism d. Stereotyping

Racism Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior in, for example, intelligence, morals, beauty, and self-worth. Prejudice is the emotional manifestation of deeply held beliefs about a group. Cultural imposition is the act of imposing one's cultural beliefs, values, and practices on individuals from another country. Stereotyping is ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences.

Which type of research is defined as the gold standard of evidence in evidence-based practice? a. Clinical expertise b. Randomized controlled trials c. Case studies d. Systematic review

Randomized controlled trials The double blind randomized controlled trial (RCT) generally provides the highest level of evidence, followed by other randomized controlled trials. Clinical expertise, case studies, and systematic reviews are not at the top of the hierarchy of evidence.

A nurse who is working in a home care setting attends a local legislative meeting. Which of the following best describes why the nurse needs to be knowledgeable of health policy? a. Provide safe nursing care. b. Prevent elder abuse. c. Receive payment for the services provided. d. Influence future legislation.

Receive payment for the services provided. Although nurses should be involved in influencing future legislation by contacting their legislators, the best response is that nurses need to be knowledgeable of the current health policies needed so that payment can be received for services they are providing. Health policy does not address safe nursing care provision. Prevention of elder abuse can be part of health policy, but this is not the main reason why nurses should have this knowledge.

What is a characteristic of multilateral organizations? a. Receiving their funding from multiple sources b. Controlling the spread of disease c. Feeding the people of the world d. Using nurses as their main source of information

Receiving their funding from multiple sources Multilateral organizations are those that receive funding from multiple government and nongovernment sources. The other items are specific to the agencies listed, but do not include all the organizations.

A nurse working at the individual level to reduce pollution in the environment would most likely be involved in what activity? a. Providing a tax incentive to factories that do not pollute b. Making laws related to allowed levels of pollution in the area c. Recycling paper, glass, cans, and plastic d. Moving to an area with less pollution

Recycling paper, glass, cans, and plastic Nurses can reduce pollution by doing their part, which can include choosing to recycle paper, glass, cans, and plastic. Providing a tax incentive and creating laws would not be completed at the individual level to reduce pollution in the environment. Moving to an area with less pollution would not help to improve the problem.

Which goals do the Millennium Development Goals address? (Select all that apply.) a. Reduction of child mortality b. Eradication of communicable diseases c. Promotion of gender equality and empowerment of women d. Achievement of universal health care access e. Promotion of specialty practice by physicians

Reduction of child mortality, Promotion of gender equality and empowerment of women The Millennium Development Goals address reduction of child mortality and promotion of gender equality and empower women. Other goals include eradicating extreme poverty and hunger; achieving universal primary education; improving maternal health; combating HIV/AIDS, malaria, and other diseases; ensuring environmental sustainability; and developing a global partnership for development. Eradication of communicable diseases, achievement of universal health care access, and promotion of specialty practice by physicians are not part of the Millennium Development Goals.

A 35-year-old from Russia comes to the United States seeking asylum because of religious persecution in the native country. Which of the following best describes this type of immigrant? a. Legal immigrant b. Lawful permanent resident c. Refugee d. Unauthorized immigrant

Refugee Refugees are people who seek protection in the United States because of fear of persecution in their homeland. Legal immigrants are people who are not citizens but are legally allowed to live and work in United States, usually because they fulfill labor demands or have family ties. Lawful permanent resident is another name for legal immigrants. Unauthorized immigrants may have crossed a border into the United States illegally, or their legal permission to stay in the United States may have expired.

A nurse providing care in the 1970s follows a process when making clinical decisions. Which of the following processes would have been used? a. Evidence-based nursing practice b. The science of medicine c. Evidence-based medicine d. Research utilization

Research utilization Research utilization projects in the 1970s provided a guide to clinical practice. The term evidence-based was not used until 1992 and was first applied to medicine before it was used in nursing. There was a growing consensus in the 1970s among nursing leaders that scientific knowledge should be used as a basis for nursing practice, so there was a shift away from the practice of medicine.

A nurse is striving to be culturally competent. Which of the following actions would most likely be taken by the nurse? a. Respect individuals from different cultures and value diversity. b. Immerse himself or herself in different cultures. c. Design care for special ethnic groups. d. Give explicit instructions to avoid client decision making.

Respect individuals from different cultures and value diversity. Nurses who strive to be culturally competent respect individuals from different cultures and value diversity. Immersing oneself in a different culture, designing care for special ethnic groups, and giving explicit instructions so the client does not have to make a decision does not demonstrate cultural competence.

What term is used to describe when a health care organization's fees for delivery of services are not decided until after they are provided? a. Retrospective reimbursement b. Prospective reimbursement c. Fee-for-service d. Capitation

Retrospective reimbursement Retrospective reimbursement is the method whereby fees for the delivery of health care services in an organization are set after services are delivered. Prospective reimbursement is whereby the third-party payer establishes the amount of money that will be paid for the delivery of a particular service before offering services to the client. Fee-for-service is the traditional method of paying the health care practitioner; the practitioner determines the costs of providing a service, delivers the service, and submits a bill for the delivered service to a third-party payer who then pays the bill. Capitation is similar to prospective reimbursement for health care organizations; third-party payers determine the amount that practitioners will be paid for a unit of care.

A nurse is providing public health education based on the teachings of Lillian Wald. Which of the following topics will the nurse most likely discuss? a. Taking and recording blood pressures accurately b. Safe and sanitary baby and child care c. Environmental pollutants and their effects on lung disease d. Time management: balancing factory work and the home

Safe and sanitary baby and child care Lillian Wald provided health care that included educating the community on health care matters. The focus of most of her work was on health services and health promotion for families and children. Because of her focus on health promotion for families and children, her primary role would not have been taking and recording blood pressures, discussing environmental pollutants (as her focus was not occupational health), or time management (at the time, very few women were working outside of the home).

A nurse believes additional funding is necessary to support a home-delivered meal program for the elderly. Which of the following would be the best way to share these ideas with a legislator? a. Send an email. b. Write a formal letter. c. Attend a town hall meeting. d. Schedule a face-to-face visit.

Schedule a face-to-face visit. Face-to-face visits with legislators are viewed as the most effective means of communication. Sending an email, writing a letter, and attending a town hall meeting are all ways to share ideas with a legislator but are not viewed as the most effective method for sharing.

A nurse is looking for evidence-based practice (EBP) to support the methods used to facilitate smoking cessation. Which of the following types of evidence would be the best for the nurse to examine? a. Scientific literature found in systematic reviews b. Double-blind randomized controlled trial c. Quasi-experimental studies d. Expert opinion

Scientific literature found in systematic reviews Because it is difficult to find or perform randomized controlled trials in the community, other types of evidence have been highlighted as the best evidence in public health literature upon which to base EBPH practice; scientific literature found in systematic reviews is one type that is recommended. Although randomized controlled trials are the highest level of evidence with quasi-experimental studies and expert opinion both being lower on the list of evidence. It would not be possible to implement randomized control trials or quasi-experimental studies when studying smoking cessation. Expert opinion would not be as helpful when looking at methods that have literature that support their use.

The practices of health care providers, nurses, and other health care professionals are differentiated by which of the following? a. Health Resource and Services Administration (HRSA) b. State board of nursing c. Scope of practice d. U.S. Department of Health and Human Services (USDHHS)

Scope of practice Scope of practice involves defining nursing, setting its credentials, and then distinguishing between the practices of nurses, physicians, and other health care providers. HRSA and USDHHS do not differentiate the practices of health care providers. The state board of nursing only addresses the scope of practice of nursing, not the other health care providers.

A nurse is involved in identifying individuals with unrecognized health risk factors or asymptomatic disease. Which of the following public health interventions is being applied? a. Screening b. Referral and follow-up c. Surveillance d. Health teaching

Screening Screening involves identifying individuals with unrecognized health risk factors or asymptomatic disease. Referral and follow-up assist individuals, families, groups, organizations, and/or communities to identify and access necessary resources in order to prevent or resolve problems or concerns. Surveillance describes and monitors health events through ongoing and systematic collection, analysis, and interpretation of health data. Health teaching communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, and practices of individuals, families, systems, and/or communities.

A nurse plans to contact a multilateral organization. Which organization would the nurse most likely contact? a. United Nations (UN) b. United States Agency for International Development (USAID) c. Project Hope d. Catholic Relief Services

United Nations (UN) A multilateral organization is one that receives funding from multiple governments and nongovernmental sources, which describes the UN. Project Hope and Catholic Relief Services are private voluntary organizations. USAID is funded by one country, the United States.

A nurse is using the principles of virtue ethics in decision making. Which of the following describes the action that the nurse would take? a. Provide efficient and effective nursing care. b. Identify the meaningful facts in the situation. c. Seek ethical community support to enhance character development. d. Plan ways to restructure the social practices that oppress women.

Seek ethical community support to enhance character development. According to Aristotle, virtues are acquired and include interest in the concept of the good, including benevolence, compassion, trustworthiness, and integrity. One part of the process is seeking ethical community support to enhance character development. Nurses can demonstrate advocacy when providing efficient and effective nursing care. Identifying the meaningful facts in the situation is part of the ethical decision-making process. Planning ways to restructure the social practices that oppress women is part of the feminist ethics decision-making process.

A nurse supported the passage of needlestick legislation. Which of the following best describes the role of employers because of this legislation? a. Use universal precautions when dealing with all patients. b. Select safer needle devices as they became available. c. Provide needle disposal boxes. d. Incinerate all infectious waste, including needles.

Select safer needle devices as they became available. Health care facilities by law must select safer needle devices and involve employees in identifying and choosing the devices. The needlestick legislation did not address the use of universal precautions, provision of needle disposal boxes, or incineration of all infectious wastes.

What term was used to identify neighborhood centers that provided health care, education, and social welfare programs? a. Settlement houses b. Nursing care centers c. Nurse-managed clinics d. Public health services (PHSs)

Settlement houses Settlement houses were neighborhood centers that provided health care, education, and social welfare programs. Nursing centers, nurse-managed clinics, and PHSs are not necessarily in neighborhoods.

A nurse provides health services for women and children in the community. Which of the following provides the provisions to offer these services? a. Sheppard-Towner Act b. Public Protection of Maternity and Infancy program c. Early Periodic Screening and Developmental Testing (EPSDT) program d. Women, Infants, and Children (WIC) program

Sheppard-Towner Act The Sheppard-Towner Act also offered well-child and child-development services, provided adequate hospital services and facilities for women and children, and provided grants-in-aid for establishing maternal and child welfare programs. The Sheppard-Towner Act defined the role of the federal government in creating standards to be followed by states in conducting categorical programs, such as WIC and EPSDT programs.

A nurse is discussing the services that are covered under Medicare Part A with a client who has recently become eligible for Medicare. Which service is the nurse most likely to mention? a. Blood drawing to assess prothrombin time (PT)/International Normalized Ratio (INR) b. Physical therapy rehabilitation c. Skilled nursing facility care d. Ambulance transportation

Skilled nursing facility care Medicare Part A covers hospital care, home care, and skilled nursing care. Laboratory and physical therapy services and transportation by ambulance would be covered by Medicare Part B.

An example of a successful campaign against which of the following communicable diseases was carried out during the 1960s and 1970s? a. Tetanus b. Measles c. Pertussis d. Smallpox

Smallpox Smallpox was virtually eliminated throughout the world because of immunization. Tetanus, measles, and pertussis all continue to exist throughout the world.

A nurse plans to implement a primary prevention strategy in the community. The development of which program would the nurse most likely complete? a. Smoking prevention b. Support group for widows c. Hypertension screening d. A hospice care

Smoking prevention Primary prevention's aim is preventing disease. Development of a smoking prevention program is primary prevention. Development of a support group for widows and development of a hospice care program are examples of tertiary prevention. Development of a hypertension screening program is an example of secondary prevention.

The health priorities in HEALTH21 are based on what concept? a. Eradication of communicable disease worldwide b. Social justice and solidarity with an emphasis on the responsibility for health c. World trade and knowledge sharing about health concerns d. Provisions for the creation of the United Nations Children's Fund (UNICEF)

Social justice and solidarity with an emphasis on the responsibility for health HEALTH21 is not a single, finite goal but a strategic process that can lead to progressive improvement in the health of people. It is a call for social justice and solidarity with an emphasis on individual, family, and community responsibility for health. The concepts of eradication of communicable disease worldwide, world trade and knowledge sharing about health concerns, and provisions for the creation of UNICEF are not part of these health priorities.

Hispanics tend to believe that the needs of the family take priority over those of the individual. Which of the following types of cultural variations is being demonstrated? a. Communication b. Personal space c. Social organization d. Environmental control

Social organization Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions. Communication is the means by which culture is shared (verbal and nonverbal). Personal space is the physical distance between two individuals during an interaction. Environmental control refers to the person's relationship with nature and to plan and direct factors in the environment that affect them.

A community health nurse collects data about the number and proportion of persons aged 25 or older with less than a high school education. Which term best describes this type of data? a. Sociodemographic characteristics b. Health status data c. Health risk factors d. Health care resource consumption information

Sociodemographic characteristics The number and proportion of people is a sociodemographic characteristic. Health status includes birth and death rates. Health risk factors discuss proportions of populations who have particular health conditions or health risks. Health care resource consumption refers to spending on health care per capita.

A nurse was involved in the original work of the National Organization for Public Health Nursing. Which event best describes the influence this has had on nursing practice today? a. Requiring that public health nurses (PHNs) have a baccalaureate degree in nursing b. Standardizing public health nursing education c. Developing nursing cooperatives d. Opening the Henry Street Settlement

Standardizing public health nursing education The National Organization for Public Health Nursing sought to standardize public health nursing. The Henry Street Settlement was already in existence. The baccalaureate degree in nursing was not developed yet. Cooperative agreements were made between life insurance companies and visiting nurses' associations that expanded availability of public health nursing services.

A nurse is observing behaviors that may be defined by culture. Which of the following is the nurse most likely to observe? a. Speaking a dialect of a language in a local region b. Standing when an older adult gets on the bus to give him or her a seat c. Immigrating to the United States and seeking work d. An organizational structure of a cultural group

Standing when an older adult gets on the bus to give him or her a seat Culture is a set of beliefs, values, and assumptions about life that are widely held among a group of people and is transmitted intergenerationally. Behaviors may be culturally determined, as illustrated in the correct response. This behavior is based on the value of respect of elderly people. Speaking a particular dialect in a local area would not fit the definition of culture. An organizational structure of a group is not an observable behavior. Immigrating to the United States does not demonstrate culture.

A major provision of the Social Security Act of 1935 was the establishment of which service? a. Frontier Nursing Service (FNS) to provide nursing service to rural communities b. State and local community health services and training of personnel c. District nursing to provide home health care to sick people d. Community-based settlement houses

State and local community health services and training of personnel Title VI of the Social Security Act provided funding for expanded opportunities for health protection and promotion through education and employment of PHNs. Nurses completed educational programs in public health and funds were provided to assist states, counties, and medical districts in the establishment and maintenance of adequate health services.

The nurse labels a patient an alcoholic because of his or her ethnicity. Which of the following best describes this action by the nurse? a. Stereotyping b. Prejudice c. Racism d. Ethnocentrism

Stereotyping Stereotyping is ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences. Prejudice is the emotional manifestation of deeply held beliefs about a group. Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior in, for example, intelligence, morals, beauty, and self-worth. Ethnocentrism is the belief that one's own cultural group determines the standards by which another group's behavior is judged.

A nurse is working in the community with an aggregate/population. Who is the nurse most likely to interact with? a. Students in a county school system b. Christians around the world c. A patient in the intensive care unit at the local hospital d. People who drink coffee

Students in a county school system A population or aggregate is a collection of individuals who have one or more personal or environmental characteristics in common. Members of a community who can be defined in terms of geography or a special interest can be seen as constituting a population. The clients in the first option share a geographical and special circumstance (school) characteristic. Christians around the world are too large of a geographical space. A patient cannot be an aggregate/population as there is no one to interact with. People who drink coffee share a common interest but may not share a common geographical location to interact.

The Office of Homeland Security has a mission to rebuild the crumbling public health infrastructures of each state and to provide what service? a. Vaccines for smallpox b. Regulation of nuclear weapons c. Surveillance of bioterrorism threats d. Regulation of foreign nurses entering the United States

Surveillance of bioterrorism threats The USDHHS and the federal agency, the Office of Homeland Security, have provided funds to address serious bioterrorism threats to the people of the United States. The Office of Homeland Security does not provide vaccinations, regulation of nuclear weapons, or regulation of foreign nurses entering the United States.

What term is used to identify a summary of the research evidence that relates to a specific question and to the effects of an intervention? a. Evidence-based practice b. Meta-analysis c. Systematic review d. Narrative review

Systematic review A systematic review is a summary of the research evidence that relates to a specific question and to the effects of an intervention. Evidence-based practice includes the best available evidence from a variety of sources, including research studies, nursing experience and expertise, and community leaders. Meta- analysis is a specific method of statistical synthesis used in some systematic reviews, where the results from several studies are quantitatively combined and summarized. A narrative review is a review done on published papers that support the reviewer's particular point of view or opinion and is used to provide a general discussion of the topic reviewed.

An occupational health nurse works with an employer to develop a workplace wellness program for its employees. Which of the following levels of practice is being implemented? a. Individual b. Systems c. Community d. Government

Systems Systems level of practice consists of changing laws, policies, and practices that influence population- based issues. The individual level of practice focuses on interventions that involve working with individuals, either singly, or in groups, and with families. Individual level intervention changes knowledge, attitudes, beliefs, practices, and behaviors of individuals. Community level interventions are carried out with the community as a whole. This level of intervention changes community norms, attitudes, awareness, practices, and behaviors. Government is not a level of intervention described by "The Wheel."

A nurse demonstrates cultural desire to provide culturally competent care. Which of the following actions would be taken by the nurse? a. Relying on a textbook for information about an ethnic group b. Bringing a translator to the local community clinic c. Taking Spanish classes in the evening at a local college d. Judging others using his or her own cultural values

Taking Spanish classes in the evening at a local college Cultural desire refers to the nurse's intrinsic motivation to want to engage in the elements necessary to provide culturally competent care. The activity that suits the definition of cultural desire is one that a nurse would want to do instead of being directed to do so, referring to the intrinsic motivation of the nurse. Relying on a textbook for information, bringing a translator, and judging others do not demonstrate the definition of cultural desire as they are not demonstrating the intrinsic motivation of the nurse.

Local health departments were formed in urban areas in the late 1800s to accomplish what goal? a. Targeting environmental hazards associated with crowded living conditions b. Facilitating interdisciplinary efforts and promoting "practical nursing" c. Providing immunizations and health care services to all citizens d. Offering public health education to nurses who had finished basic training

Targeting environmental hazards associated with crowded living conditions Local health departments were formed to handle environmental issues in cities, including problems associated with crowded living conditions and dirty streets, and to regulate public baths, slaughterhouses, and pigsties. Because sanitation was such an issue, there was not a focus on interdisciplinary care, provision of immunizations, or public health education for nurses.

Factors that influence health care costs include which of the following? (Select all that apply.) a. Technology and intensity b. Demographics—the aging population c. Chronic illness d. Use of the health care system e. Type of health care insurance

Technology and intensity, Demographics—the aging population, Chronic illness Technology and intensity, demographics (especially the aging population), and chronic illness all influence health care costs. The fact that individuals have, over time, consumed more health care is not an adequate explanation for an influence of health care costs. The type of health care insurance does not influence health care costs.

A public health nurse (PHN) provides clinic-based services for HIV-positive citizens in the community. Which term best describe this activity? a. Primary prevention b. Health education c. Tertiary prevention d. Policy making

Tertiary prevention This clinic is for clients who already have a disease process; therefore, it is tertiary prevention (preventing deterioration in a patient, a relapse, or disability and dependency by anticipatory nursing and medical care). Primary prevention is using general and specific measures in a population to promote health and prevent the development of disease (incidence) and using specific measures to prevent disease in those who are predisposed to developing a particular condition. Health education would involve providing specific education to this population. Policy making is formulating plans by an organization in order to make decisions.

A nurse wants to find more information about indoor air quality. Which of the following websites would be most helpful? a. The National Institutes of Health (NIH) b. The American Lung Association c. "Right to Know" d. The Occupational Safety and Health Administration (OSHA)

The American Lung Association Indoor air quality is a growing public health concern in office buildings, schools, and homes and is reflected in the alarming rise in asthma incidence in the United States, particularly among children. Sources of information about indoor air quality include the EPA and the American Lung Association. The NIH is part of the U.S. Department of Health and Human Services (USDHHS) and is responsible for health and biomedical research. "Right to Know" is part of a workplace safety legislation. OSHA regulates safety in factories and businesses.

A student is enrolled in a nursing education program during World War II. Which group would the student most likely have joined? a. The Public Health Service of New York City b. The Marine Nurse Corps c. The Frontier Nursing Service (FNS) d. The Cadet Nurse Corps

The Cadet Nurse Corps The Bolton Act of 1943 established the Cadet Nurse Corps during World War II, which increased enrollment in schools of nursing at undergraduate and graduate levels. In 1925, Mary Breckinridge established the FNS based on systems of care used in the Highlands and islands of Scotland (before World War II). The first Marine Hospital opened in Norfolk, Virginia, in 1800. The Public Health Service of New York City was not a group during this time frame.

A nurse researcher wants to get information on the occurrence of an internationally important disease. Which of the following websites would be the best place to seek this information? a. The United Nations b. The WHO c. The World Bank d. The World Health Assembly

The WHO The WHO publishes day-to-day information about international occurrence of disease, injury, and death. The United Nations deals with human rights, world peace, international security, and the promotion of economic and social advancement of all of the world's people. The World Health Assembly is the WHO's policy-making body. The World Bank provides funding for lesser-developed countries.

A nurse wants to obtain information on the alternative methods of health care used by a 45-year- old female Hispanic client. Who would be the best person to ask about this? a. The husband of the client b. A community leader of the ethnic group c. The client herself d. The religious leader of the ethnic group

The client herself Clients provide a rich source of information about their own cultures. The client would be the preferred person to collect this information instead of the husband, community leader, or religious leader.

A nurse has promoted the introduction of health care technology into lesser-developed countries, but this has led to less-than-satisfactory results. Which statement best describes why this has happened? a. People do not want to use newer technology. b. The cost is so high that they cannot afford to use new technology. c. The community may not be ready for this technology. d. Technology is too complex for people in lesser-developed countries.

The community may not be ready for this technology. It is not generally a lack of desire, that is, a barrier to use of the new technological systems, but the lack of knowledge about them. It is essential to conduct needs assessments to learn what a community has, what a community wants, and what it can sustain. Well-intended projects have failed because the most basic needs were not met, nor was recognition given to what resources and services the country could sustain.

A client is receiving public health care (PHC) services. Which of the following expectations would the client have? a. The care would be provided by a physician. b. Private insurance would be necessary to receive care. c. The emphasis of care provided would be on prevention. d. A referral would be made to a specialist after receiving services.

The emphasis of care provided would be on prevention. The focus of PHC is a broad range of services that are designed to be affordable for the recipients of the care and the governments who provide them. The emphasis of care is on prevention and the means of providing the care is based on practical, scientifically sound, culturally appropriate, and socially acceptable methods. All clients can receive PHC services regardless of insurance status. Those receiving primary care services may or may not need referral to a specialist.

The growing multiculturalism of American society can contribute to ethnicity conflicts when considering what? a. Providing care to different cultural groups b. Aligning individual values with the cultural norms c. Ethnic groups overburdening the health care system d. The greater community's values being jeopardized by specific ethnic values

The greater community's values being jeopardized by specific ethnic values Callahan offered perspectives on judging diversity and suggests a thoughtful tolerance and some degree of moral persuasion (not coercion) for ethnic groups to alter values so that they are more in keeping with what is normative in American culture. Providing care to different cultural groups should not produce an ethnicity conflict. Individual alignment with cultural norms would make it less likely that an ethnicity conflict would occur. Ethnic groups using the health care system will not cause it to be overburdened or result in an ethnicity conflict.

What is the purpose of the color-coded wedges on the Intervention Wheel? a. The interventions are grouped together in related wedges. b. The wedges consist of referral information for each wedge. c. The element of health teaching is the predominant feature of each wedge. d. Coalition building must be implemented with each wedge.

The interventions are grouped together in related wedges. Each wedge consists of related interventions. The other answers describe some of the individual wedges.

What are considered barriers to public health nursing? (Select all that apply.) a. The mindset that the only role for the nurse is at the bedside. b. The structures within which nurses work and the process of role socialization within those structures. c. Few nurses receive graduate-level preparation in the concepts and strategies of the disciplines basic to public health. d. The steady decline in the number of job opportunities in the area. e. The inability to equally distribute the increasing funds.

The mindset that the only role for the nurse is at the bedside, The structures within which nurses work and the process of role socialization within those structures, Few nurses receive graduate-level preparation in the concepts and strategies of the disciplines basic to public health. Barriers exist in thinking that nurses only work in a hospital at the bedside, the process of role socialization in public health which can be a very autonomous profession, and that few nurses have had advanced education in public health. The number of job opportunities continues to increase, but the amount of funding allotted to public health continues to decline.

A public health nurse applies the principles of the macroeconomics theory when working with a community. Which statement best describes why this theory would be used? a. The nurse is concerned with factors that determine prices and affect resource allocation. b. The nurse is concerned with the positive effect of competitiveness on health care costs. c. The nurse is concerned with the supply, demand, and costs of services available to their clients. d. The nurse is concerned with the policies to support programs to improve the health of the community.

The nurse is concerned with the policies to support programs to improve the health of the community. Macroeconomic theory focuses on the "big picture"—the total, or aggregate, of all individuals and organizations (e.g., behaviors such as growth, expansion, or decline of an aggregate). The primary focuses of macroeconomics are the business cycle and economic growth. These cycles are influenced by a number of factors, such as political changes, policy changes, knowledge and technology advances, or simply the belief by a recognized business leader that the cycle is or should be shifting. Microeconomics focuses on the individual or an organization. Factors such as levels of income, employment, general price levels, and rate of economic growth are important in microeconomics.

A nurse is found to be negligent. Because of the doctrine of respondeat superior, who is responsible for the negligence? a. The institution's administrator b. The nurse's immediate supervisor c. The nurse's employer d. The nurse

The nurse's employer The doctrine of respondeat superior says that when a nurse is employed and functioning within the scope of that job, the one responsible for that negligence is the nurse's employer. In some instances, if the agency is found liable, the agency may in turn sue the nurse for negligence.

Which statement about the nursing workforce is true? a. The nursing workforce is overwhelmingly white. b. The number of minority nurses meets the needs of the country's demographics. c. The nursing workforce is becoming increasingly diverse with increasing minorities. d. Immigrants and refugees make up a large part of the nursing workforce in some areas.

The nursing workforce is overwhelmingly white. The nursing workforce is 83% white. Because of the large percentage of white nurses this does not meet the needs of the country's demographics. Immigrants and refugees do not make up a part of the nursing workforce.

Which statement is discussed in the Code of Ethics for Nurses with Interpretive Statements? a. The profession of nursing is responsible for making political statements and supporting nurse-friendly candidates for office. b. The nurse's primary focus is on acute bedside nursing, followed by community health care to promote seamless care. c. The nurse owes duty primarily to the physician to strive to protect health, safety, and the rights of the patient. d. The profession of nursing is responsible for articulating nursing values, for maintaining the integrity of the profession, and for shaping social policy.

The profession of nursing is responsible for articulating nursing values, for maintaining the integrity of the profession, and for shaping social policy. Provision 9 of the Code of Ethics for Nurses with Interpretive Statements discusses the need for the nursing profession to address national and global health concerns as well as be involved with shaping policies through political action. The Code of Ethics for Nurses with Interpretive Statements does not address the practice setting for nursing care. According to the Code of Ethics for Nurses with Interpretive Statements, public health should achieve community health in a way that respects the rights of individuals in the community, not owing duty primarily to the physician. Public health should seek the information needed to implement effective policies and programs that protect and promote health.

The impact of World War I on public health nursing included which of the following? (Select all that apply.) a. Many communicable diseases were eradicated. b. The ranks of public health nurses (PHNs) depleted because many went off to war. c. The feeling that the greatest patriotic duty was to stay at home. d. Expanding nursing services in the community was limited by lack of funding. e. More women entered the public health nursing workforce.

The ranks of public health nurses (PHNs) depleted because many went off to war, The feeling that the greatest patriotic duty was to stay at home, Expanding nursing services in the community was limited by lack of funding. Both World Wars I and II depleted the PHN population as nurses went off to war. The feeling of patriotism extended to the idea that patriotic duty could also be served on the home front. There was not an eradication of communicable diseases; rather, there was a worldwide influenza pandemic that swept through the United States, killing many people. Inadequate funding was the major obstacle to extending nursing services in the community.

A community is concerned about the threat of bioterrorism. Which of the following best describes the basis for this concern? a. Bioterrorism has the potential to dissolve community-based programs. b. This threat could cause the health care system to collapse. c. The threat may divert funds from other public safety health care programs. d. Fear of bioterrorism will increase the need for shelters.

The threat may divert funds from other public safety health care programs. Bioterrorism may have an impact on the availability of resources for public safety health care programs. Because funds are diverted it is possible that community-based programs would be eliminated, the health care system could experience changes, and that there would be an increase in the need for shelter. However, all the remaining options would happen because of the diversion of funds.

1. What is the key to achieving the goals of Health for All in the 21st Century (HFA21) worldwide? a. The cure of communicable disease b. The technological development of all nations c. The worldwide availability of health care insurance d. The worldwide implementation of primary health care

The worldwide implementation of primary health care The major key to attaining Health for All by the Year 2000 was the worldwide implementation of primary health care; this has extended into the next century with the document HFA21. The World Health Assembly in 1977 stated that all citizens of the world should enjoy a level of health that would permit them to lead a socially and economically productive life. Curing communicable disease, technological developments of all nations, and availability of health care insurance are not part of the key strategies to achieve the goals of HFA21.

A nurse is planning a refugee outreach clinic at the neighborhood health center. Which of the following considerations should be made by the nurse to provide culturally competent care? (Select all that apply.) a. Their own background, beliefs, and knowledge may be significantly different from those of the people receiving care. b. Language barriers may interfere with efforts to provide assistance. c. Certain risk factors may be present for a given population. d. Certain groups may use nontraditional healing practices. e. Introduction of the American culture will be an important part of the encounter.

Their own background, beliefs, and knowledge may be significantly different from those of the people receiving care., Language barriers may interfere with efforts to provide assistance, Certain risk factors may be present for a given population, Certain groups may use nontraditional healing practices. When working with immigrants, it is important to be aware of one's own beliefs while realizing that language barriers may exist, that different populations experience different risk factors and illnesses, and that nontraditional healing practices may be used. It would not be appropriate to impose the American culture into the encounter.

A nurse is entering the health care workforce. Which expectation should the nurse have for the workforce? (Select all that apply.) a. There is a shortage of nurses in the United States. b. Schools of nursing turn away qualified applicants due to lack of faculty and limitations of clinical sites. C. By 2026 there are expected to be 438,100 new nursing positions. d. More students are choosing laboratory science, pharmacy technology, and radiology technology over nursing. e. There is a shortage of physician specialists in the United States.

There is a shortage of nurses in the United States., Schools of nursing turn away qualified applicants due to lack of faculty and limitations of clinical sites., By 2026 there are expected to be 438,100 new nursing positions. The first three options are true. The laboratory science, pharmacy technology, and radiology technology programs have all seen declining enrollments. There is a shortage of primary care physicians as more physicians are choosing to specialize.

Which statement best describes one of the health trends that occurred in the United States between 1900 and 1955? a. There was a rise in heart disease and cancer. b. There was a rise in communicable disease. c. The crude mortality rate increased dramatically. d. The life span after diagnosis remained the same.

There was a rise in heart disease and cancer. Leading causes of death in 1955 were heart disease, cancer, and cerebrovascular disease, whereas in 1900 they were pneumonia, TB, and diarrhea/enteritis. The mortality rate decreased by 47%. There was a decrease in communicable disease, and the life span after diagnosis increased.

A local senator has proposed changes to the health care delivery system in the United States. Based on current trends, what is most likely to occur? a. There will be new opportunities provided for public health specialists. b. It will result in isolated care being provided to individuals. c. There will be an increased emphasis in specialty care. d. It will increase the utilization of acute care services.

There will be new opportunities provided for public health specialists. Proposed changes in the health care delivery system will provide new opportunities for public health specialists and result in the creation of new roles within the system. The proposed changes will build an integrated system (not isolated), decrease emphasis on acute care services, and focus on health promotion and disease prevention.

A nurse working in a lesser-developed country is caring for the women in the local community. Which existing factor regarding the women would be an important consideration for the nurse? a. They are at risk for a vitamin D deficiency. b. They are likely to have one child. c. They are at risk for death during pregnancy and childbirth. d. They are viewed as the leader of the family unit.

They are at risk for death during pregnancy and childbirth. Most deaths to women worldwide are related to pregnancy and childbirth. Most of these deaths occur in lesser-developed countries. Common nutritional deficiencies in this population are zinc, iodine, vitamin A, folic acid, and calcium. One of the reasons this problem exists is because women are not seen as valued members of society. In developing nations there is a significant incidence of lack of prenatal care during pregnancy and high fertility rates, often due to a lack of access to contraception and other family planning and reproductive health services, as well as cultural belief systems that increase the lifetime risk of maternal death.

Why is it important for a nurse to have knowledge of environmental health and the effects of chemical, biological, and radiological materials? a. They are a major cause of global warming. b. They are often found in the air, water, and products we use. c. They are frequently linked to the development of chronic illnesses. d. They are products that nurses work with daily.

They are often found in the air, water, and products we use. Chemical, biological, and radiological pollutants are often found in the air we breathe, the water we drink, and the products we use. These are not a major cause of global warming. They are not frequently linked to the development of chronic illnesses. These are not products that nurses work with daily.

Medicare and Medicaid are accurately described by which statement? a. Both are available to any citizen who wishes to enroll. b. They are two federal programs that provide insurance to special groups. c. Both are private insurance providers. d. They are funded by the state government.

They are two federal programs that provide insurance to special groups. Medicare provides insurance for persons over 65, and Medicaid provides financial assistance to states and counties to pay for medical services for the aged poor, the blind, the disabled, and families with dependent children who are below state poverty income levels. Medicare is financed by the federal government. Medicaid is jointly financed by state and federal government. They are not private insurance providers.

Which statement accurately describes a large portion of foreign-born residents of the United States? a. They tend to live in major metropolitan areas. b. Most reside in rural areas. c. Few have a high school education. d. They are refugees and non-immigrants.

They tend to live in major metropolitan areas. Two thirds of the foreign-born population lives in or around major metropolitan areas and works in mainly service-producing and blue-collar sectors. They are also more likely to be poorer. The majority of foreign born are legal immigrants (85%). More than 54% of the foreign-born adults in the labor force have completed high school, which would not be considered a large portion.

A nurse refers to the Code of Ethics for Nurses or the Public Health Code of Ethics. Which of the following describes why the nurse has referred to this document? a. To provide answers for ethical dilemmas b. To guide professional practice related to ethics c. To increase moral leadership in ethics d. To find a framework for ethical decision making

To guide professional practice related to ethics These codes provide general ethical principles and guide personnel in thinking about the underlying ethics of the profession. They do not provide answers for ethical dilemmas, only serve as a guide. They do not increase moral leadership, nor do they provide a framework for ethical decision making.

What term is used to refer to the basic science applied to understanding the health effects associated with chemical exposures? a. Toxicology b. Pharmacology c. Chemistry d. Environmental epidemiology

Toxicology Toxicology is the study of the health effects associated with chemical exposures. Pharmacology is the branch of medicine concerned with the multiple aspects of drugs. Chemistry is the branch of science with deals with the way that matter is composed. Environmental epidemiology is concerned with the discovery of environmental exposures that cause or protect against illness or disease.

A public health department is using the mission of public health as described by the Institute of Medicine when planning its health programming. Which of the following activities will most likely be implemented? a. Tracking avian flu outbreaks and doing surveillance in the United States b. Providing a flu shot for an elderly person at the health department c. Keeping track of alternative therapies in use in the United States d. Keeping snake antivenom at the Centers for Disease Control and Prevention in Atlanta

Tracking avian flu outbreaks and doing surveillance in the United States The Institute of Medicine's stated mission on public health is "to generate organized community and technical knowledge to prevent disease and promote health." Tracking avian flu outbreaks and doing surveillance applies this concept at a population level. Providing a flu shot for an elderly person only addresses individual care. Keeping track of the use of alternative therapies does nothing to prevent disease or promote health of the population. Keeping snake antivenom is aimed at disease care for an individual, not health promotion or disease prevention.

Which example contains the components necessary to form an epidemiologic triangle? a. Pesticides, water, food b. Lead, mercury, soil c. Trichloroethylene, water, infants d. Children under 12, elderly, temperature

Trichloroethylene, water, infants The epidemiologic triangle consists of an agent (chemical), host (community consisting of several variants), and environment (air, water, soil, etc.). The other examples do not contain an agent, host, and environment.

Which of the following diseases is the leading killer of people with human immunodeficiency virus (HIV)? a. Acquired Immunodeficiency Syndrome (AIDS) b. Malaria c. Hepatitis d. Tuberculosis (TB)

Tuberculosis (TB) TB is the leading killer of people with HIV, and up to 80% of TB clients are HIV positive in countries with a high prevalence of HIV. AIDS, malaria, and hepatitis are not the leading killer of people with HIV.

A nurse is caring for a client who has been diagnosed with a multifactorial disease. Which of the following best describes the client's diagnosis? a. Measles b. Hepatitis B c. Eczema d. Type I diabetes

Type I diabetes Disorders that are influenced by multiple factors including genetics/genomics, environment, lifestyle, and other factors are multifactorial. Type I diabetes is a multifactorial disease. The others are not multifactorial diseases.

Which federal agency included in the public health system is most involved with the health and welfare of United States citizens? a. Centers for Medicaid and Medicare Services b. U. S. Department of Health and Human Services c. U. S. Public Health Service (USPHS; or simply PHS) d. Health Resources and Services Administration

U. S. Department of Health and Human Services The U. S. Department of Health and Human Services is charged with regulating health care and overseeing the health status of Americans. The Centers for Medicare and Medicaid Services develops and oversees the rules and regulations specific to these two insurance programs. The PHS is a major component of the Department of Health and Human Services. The PHS consists of eight agencies: (1) Agency for Healthcare Research and Quality, (2) Agency for Toxic Substances and Diseases Registry, (3) Centers for Disease Control and Prevention, (4) Food and Drug Administration, (5) Health Resources and Services Administration, (6) Indian Health Service, (7) National Institutes of Health, and (8) Substance Abuse and Mental Health Services Administration.

The agency most heavily involved with the health and welfare concerns of United States citizens is the: a. U.S. Department of Health and Human Services (USDHHS). b. Public Health Service (PHS). c. Health Resources and Services Administration (HRSA). d. World Health Organization (WHO)

U.S. Department of Health and Human Services (USDHHS). The USDHHS is the agency most heavily involved with the health and welfare of United States citizens. It touches more lives than any other federal agency. The PHS was the first major federal government action relating to health. The Health Resources and Services Administration is part of the USDHHS. The WHO is concerned with access to health care across the world.

A nurse is creating a care plan for a client who is living in an area of the world where malaria is endemic. Which intervention would be appropriate to include? a. Receive a dose of intravenous (IV) quinine. b. Avoid direct contact with individuals who have malaria. c. Use insecticide-treated bed nets. d. Apply dichlorodiphenyltrichloroethane (DDT) spray.

Use insecticide-treated bed nets. An effective antimalarial intervention is the use of insecticide-treated bed nets. Malaria is contracted by being bit by an infected mosquito; it cannot be passed by direct person-to-person contact. IV quinine is the drug of choice for treating malaria, not preventing it. Some mosquitoes are resistant to DDT, so this may not be effective.

A nurse researcher is planning to use blinding when designing a research study. In which of the following instances would this be most important? a. Using a small sample size b. Measuring outcomes accurately c. Using a control group d. Studying the attrition rate

Using a control group Blinding refers to a procedure where the researcher or evaluator does not know which participants are in the experimental or control group. The other factors do not relate to the importance of blinding.

What was Florence Nightingale's contributions to public health? a. Caring for the sick, poor, and neglected in institutions and at home b. Using a population-based approach that led to improved environmental conditions c. Writing the Elizabethan Poor Law to guarantee medical care for all d. Founding of the district nursing association to provide health care to needy people

Using a population-based approach that led to improved environmental conditions During the Crimean War, Nightingale progressively improved the soldiers' health by adopting a population-based approach that used simple epidemiological measures and greatly decreased mortality. The focus of her care was on wounded soldiers, not those who were sick, poor, and neglected at homes and institutions. She did not write the Elizabethan Poor Law. William Rathbone founded the district nursing association.

During the time when the Rural Nursing Service was operating through the American Red Cross, a nurse needed to demonstrate resourcefulness. Which intervention would the nurse most likely have implemented? a. Using hot bricks, salt, or sandbags to substitute for hot water bottles b. Testing well water for pollutants c. Teaching school and developing curricula for rural nursing programs d. Providing post-surgical care

Using hot bricks, salt, or sandbags to substitute for hot water bottles In providing medical care, rural nurses were resourceful in finding alternatives when they did not have medical products that were available in urban areas. They were not involved in testing well water, providing post-surgical care, or teaching in rural nursing programs.

A nurse is promoting efficiency within the public health department. Which activity describes the action the nurse would be taking? a. Evaluating how well a program of service achieves what was intended b. Trying new products provided by sales representatives c. Using time wisely by delegating non-nursing tasks to unlicensed care providers d. Setting up a clinic to look aesthetically pleasing to clients

Using time wisely by delegating non-nursing tasks to unlicensed care providers Efficiency relates to producing maximal output given a set of resources. Using time wisely through delegation is the best example of using efficiency. Program evaluation, trying new products, and setting up a clinic are not examples of producing maximal output given a set of resources.

A nurse states that the client has exhibited an explicit cultural behavior. Which of the following has the nurse most likely observed? a. Verbal communication b. Body language c. Use of titles d. Perception of health and illness

Verbal communication Explicit behaviors such as language, interpersonal distance, and kissing in public can be observed and allow individuals to identify with other persons from the culture. Implicit behaviors are less exact and may be difficult to interpret, including body language, use of titles, and perception of health and illness.

Nurses who provided care to people in their homes were referred to as what type of nurses? a. Private duty b. Visiting c. Public health d. Community health

Visiting The visiting nurse cared for several families in a day and helped make care of the sick poor at home economical, whereas a private duty nurse may live with a family of clients receiving care and was to be available 24 hours a day. PHNs focused on care of populations. Community health nurses would be anyone who worked outside of a hospital setting.

A nurse is using the principles of supply and demand in daily practice. Which situation describes this phenomenon? a. The demand for nurses in public health is low, but the supply is high. b. When few goods or services are available, the price tends to rise. c. When supplies are low, nurses must find alternate resources. d. Lesser-developed countries receive supplies from other countries.

When few goods or services are available, the price tends to rise. Supply and demand is in force when few goods or services are available, and then the price tends to rise. The other examples do not demonstrate the use of the laws of supply and demand.

Which statement about feminist ethics is correct? a. Feminists include only women in their worldview. b. Persons who ascribe to feminist ethics are passive and wish to pursue their ideals through the legislative process. c. Feminists believe that men should not be nurses. d. Women's thinking, and moral experiences are important and should be taken into account.

Women's thinking, and moral experiences are important and should be taken into account. Feminist theory ascribes to the idea that women's thinking, and moral experiences are important and should be considered. A feminist perspective leads us to think critically about connections among gender, disadvantage, and health as well as the distribution of power in public health processes. Feminists are women and men who hold a worldview advocating economic, social, and political equality for women that is equivalent to that of men.

A public health nurse (PHN) is implementing the public health intervention of health teaching at the systems level of practice. Which of the following interventions is most likely being implemented by the nurse? a. Participating in the "Great American Smokeout" b. Working with a local employer to provide smoking cessation education c. Providing one-on-one counseling to smokers d. Advocating for increased taxes on tobacco products

Working with a local employer to provide smoking cessation education Working with a local employer to provide smoking cessation education is the only example of health teaching at the systems level of practice. Participating in the "Great American Smokeout" occurs at the community level and is not health teaching. Providing one-on-one counseling to smokers is health teaching at the individual level of practice. Advocating for increased taxes on tobacco products occurs at the systems level of practice, but it is not health teaching.

What are some of the untoward events categorized in the Institute of Medicine (IOM) report about medical errors? (Select all that apply.) a. Wrong-site surgery b. Adverse drug events c. Improper transfusions d. Restraint-related deaths e. Poor staffing patterns

Wrong-site surgery, Adverse drug events, Improper transfusions, Improper transfusions The untoward events of wrong-site surgery, adverse drug events, improper transfusions, and restraint- related deaths are listed in the IOM report. Although poor staffing patterns may result in medical error, this is not one of the untoward events discussed in this report.

Public health interventions are implemented with: a. legislators, policy makers, and community leaders. b. individuals and families, communities, and systems. c. children, adolescents, and adults. d. health departments, public health agencies, and visiting nurses' associations.

individuals and families, communities, and systems. It is important to know that public health nurses (PHNs) work with individuals and families, communities, and systems. The other answers may have true parts, but the second option lists the overall groups where PHNs are intervening.

The document Visiting Nursing in the United States highlighted the fact that: a. nurses were trained by Boards of Education. b. trained nurses adequately covered less densely populated areas. c. visiting nurse services were concentrated in the northeastern United States. d. nurses were curing diseases such as TB and typhoid fever.

visiting nurse services were concentrated in the northeastern United States. This report emphasized the fact that visiting nurse services were concentrated in the northeast, which underscored the need for rural health. The document did not address how the nurses were educated or the diseases that nurses were curing. This report showed that there was not adequate coverage for nurses in less populated areas.