Principles in Community and Public Health Nursing

A nurse is reinforcing teaching to community nurses about the scope of nursing practice in the community. Which of the following statements by a nurse indicates understanding of the "what" part of the American Nursing Associations's (ANA) description of the scope of practice? a. "I will focus on being committed as I provide care to protect the health and well-being of my clients." b. "I understand that scope of practice refers to staff such as LPNs, RNs, and APNs." c. "It is important that I remember that nursing care is to be provided wherever it is needed." d. "My goal is to collaborate with my colleagues effectively to create positive client outcomes."

a. "I will focus on being committed as I provide care to protect the health and well-being of my clients." Rationale: This statement shows the nurse has effectively understood the teaching. The "what" part is indicated by the care and commitment the nurse shows to protect and promote the health and well-being of their clients.

A community health nurse is caring for a client who informs the nurse that they need a kidney transplant but their insurance has been discontinued. Which ethical principle should the nurse be aware of to provide resources for this client? a. Veracity b. Autonomy c. Accountability d. Justice

d. Justice Rationale: The nurse is demonstrating the ethical principle of justice, which refers to fairness. Community and public health nursing agree to strive for justice in health care and resources for all clients' well-being.

A nurse is reinforcing teaching to a newly licensed nurse about client advocacy. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? a. "I will make sure clients understand treatment options before they sign a consent form." b. "I will make sure to speak to my client's adult children on deciding if a surgical procedure should be conducted." c. "I will inform clients they should research health information so they do not bother providers with questions." d. "I will not alert my client that they have access to their medical records via the patient portal."

a. "I will make sure clients understand treatment options before they sign a consent form." Rationale: One of the duties of a nurse advocating for clients is to ensure that the client understands treatment options, risks, and outcomes so that they are able to give informed consent before procedures.

A nurse is requesting a referral for a case manager for a client who requires financial assistance for their medications. Which of the following forms of advocacy is the nurse demonstrating? a. Client advocacy b. Professional advocacy c. Political advocacy d. Community advocacy

a. Client advocacy Rationale: The nurse is demonstrating client advocacy by requesting a referral for a case manager to assist with the client's financial concerns regarding affording their medications.

A nurse is reviewing a client's medical record with a dietician who is part of the client's interdisciplinary team. Which of the following elements of Nursing's Social Contract is the nurse demonstrating? a. Collaboration b. Responsibility and accountability c. Progress and Development d. Ethical Practice

a. Collaboration Rationale: The nurse is discussing the client's medical record with the dietitian, which is a demonstration of Collaboration. Collaboration with members of the interdisciplinary team is critical in providing effective care so that each aspect of the client's needs will be met.

A nurse is teaching a client who has asthma on the use of an inhaler. Which of the following resources should the nurse include in the teaching? a. Give a demonstration of how to use the inhaler followed by the teach-back approach. b. Provide only a video teaching about asthma. c. Offer the phone number of the manufacturer of the inhaler. d. Provide the client with a brochure to learn more about asthma.

a. Give a demonstration of how to use the inhaler followed by the teach-back approach. Rationale: The nurse should use informative communication, including effective verbal and nonverbal skills, when teaching a client who has asthma on the proper use of an inhaler. Teaching the information and then asking the client to demonstrate the use of an inhaler will ensure understanding of the instructions.

A community health nurse reports that some families are in desperate need of basic preventative health care services. Which of the following principles supports providing resources to families in the community that are in need? a. Justice b. Beneficence c. Autonomy d. Nonmaleficence

b. Beneficence Rationale: The nurse is demonstrating the ethical principle of beneficence. Beneficence is doing what is in the best interest of the client and protecting them from harm.

A nurse is caring for a client who does not have proper understanding of a surgical procedure that is scheduled for the next day. The nurse notifies the client's provider. Which of the following concepts is the nurse demonstrating? a. Client education b. Client advocacy c. Accountability d. Autonomy

b. Client advocacy Rationale: The nurse is demonstrating the concept of client advocacy. Client advocacy protects the client's rights and provides assistance in asserting these rights if the need arises. In this instance, the nurse is protecting the client by notifying the client's provider to ensure the client completely understands their surgery and questions are addressed.

A nurse is caring for a client who asks how their food choices might affect their blood pressure. To which of the following members of the interprofessional team should the nurse refer this client? a. Kinesiologist b. Dietitian c. Social worker d. Pharmacist

b. Dietitian Rationale: The nurse should request a referral for the client to see a dietitian. A dietitian is part of the interprofessional team and can go through the client's list of foods to determine if they are affecting their blood pressure.

A public health nurse is providing an explanation to newly hired public health nurses on the standards of care along with the policies and procedures that reflect Nurse Practice Acts. Which of the following is imperative that the new nurses know about Nurse Practice Acts? a. Nurse Practice Acts specify the scope and standards of practice for student nurses. b. Nurse Practice Acts are the laws governing nursing practice. c. Nurse Practice Acts specify the code of ethics to be used in hospital settings. d. Nurse Practice Acts are governed by the federal government, not state law.

b. Nurse Practice Acts are the laws governing nursing practice. Rationale: A Nurse Practice Act is a state law that outlines standards of care and provides guidance to nurses in safe and effective practice.

A nurse is speaking with the nursing supervisor about a staffing shortage and its implications for staff on their unit. Which of the following forms of advocacy is the nurse demonstrating? a. Political and legislative advocacy b. Professional advocacy c. Community advocacy d. Client advocacy

b. Professional advocacy Rationale: The nurse is demonstrating professional advocacy by speaking with the nursing supervisor regarding the staffing shortage on their unit and its implications for staff, such as burnout and safety concerns.

A nurse is preparing an orientation for newly licensed community health nurses on the standards of professional practice. Which of the following is a critical thinking model that describes a competent level of nursing care? a. Elements and Standards Model b. The nursing process c. The Minnesota Model for Public Health Nursing Practice d.Professional Nursing Model

b. The nursing process Rationale: The nursing process is a critical thinking model describing a competent level of nursing care. When the nursing process is applied in community health settings, the nurse has the opportunity to employ systematic strategies when caring for clients. The nurse will use interpersonal and intellectual skills in combination with clinical judgment to promote client health and safety of the populations involved.

A nurse working at a community health center is caring for a client that reports disappointment and feeling ashamed of their weight. Which of the following responses should the nurse give? a. "How about if you start tracking your caloric intake?" b. "Many people struggle with weight loss." c. "What has been bothering you the most about your weight?" d. "Medications may be able to help you lose a lot of weight if you'd like to try that."

c. "What has been bothering you the most about your weight?" Rationale: This is the most appropriate response by the nurse because it acknowledges the client's expressed concerns, is open-ended, and encourages further discussion.

A nurse is caring for a client who is dying and wishes to discontinue taking their medications. Which of the following ethical principles is the nurse demonstrating by respecting the client's decision? a. Nonmaleficence b. Beneficence c. Autonomy d. Justice

c. Autonomy Rationale: The nurse is demonstrating the ethical principle of autonomy by respecting the client's wishes. Autonomy is the ability to be able to make informed decisions independently.

A community health nurse is reinforcing education on insulin administration to a client who has diabetes mellitus. Which of the following elements of Nursing's Social Contract is the nurse demonstrating? a. Collaboration b. Ethical practice c. Autonomy of practice d. Promotion of the health of the public

c. Autonomy of practice Rationale: The nurse is demonstrating the element of autonomy of practice of nursing's social contract. Autonomy of practice involves providing education of disease management and insulin administration within the scope and standards of practice for a community health nurse.

A nurse working in the family planning clinic is working with an adolescent client who has expressed interest in birth control options. Which of the following is an example of how the nurse can practice with compassion and value the inherent dignity, worth, and unique attributes of the client? a. Take responsibility for recommending that the client use hormonal contraception. b. Advocate for the right of the minor's parents to authorize prescribed birth control medication. c. Establish a rapport by respecting the client's interests and providing education on all birth control options. d. Promote the use of contraception among the client's peers at a community event.

c. Establish a rapport by respecting the client's interests and providing education on all birth control options. Rationale: Provision 1 of the American Nurses Association (ANA)Code of Ethics is when the nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.

Due to a rise in whooping cough cases among middle school-age students, the school board requires an additional dose of Tdap vaccine to attend the 7th grade. Which of the following community outreach actions should the school nurse use to promote this updated policy? a. Recruit teachers to help spread the word about the immunization requirement. b. Establish one-on-one counseling sessions for each of the students' families about immunizations. c. Organize virtual educational sessions on immunizations within the school district. d. Inform the students who will enter 7th grade of the required additional vaccine.

c. Organize virtual educational sessions on immunizations within the school district. Rationale: The school nurse should realize that a public policy measure, such as increased immunizations for school attendance, is to promote the safety and well-being of clients in the school population. Therefore, it is appropriate for the school nurse to advocate for the approach that would be best suited to motivate the student population and inform their families of the new vaccine requirement.

A nurse working at a community health clinic is reviewing the staff schedule and notices the clinic has been working short staffed for the past 3 months. Which of the following actions should the nurse take to address this issue? a. Cancel and reschedule client appointments to times when staff are available. b. Speak to clients and get feedback about the scheduling challenges. c. Speak to the manager and advocate for a strategy that ensures adequate staffing. d. Close the clinic early due to staffing concerns.

c. Speak to the manager and advocate for a strategy that ensures adequate staffing. Rationale: By speaking to the stakeholder and advocating for better staffing considerations, the nurse is demonstrating an ability to help shape and inform policy making for this important issue.

A public health nurse has been assigned to call a client who speaks a different language than the nurse. Which of the following actions by the nurse demonstrates cultural competency? a. Ask the client's family member to help with interpretation. b. Ask the office receptionist who can speak multiple languages to help with interpretation. c. Use the organization's interpretation or translation service for this call. d. Speak slowly and use simple terms.

c. Use the organization's interpretation or translation service for this call. Rationale: Language barriers can lead to miscommunication, and use of an interpretation or translation service can help to improve satisfaction, quality, and safety of care.

A nurse working in a community health clinic is caring for a client who reports they have not slept for several days. Which of the following responses should the nurse give? a. "Have you tried melatonin?" b. "I have issues falling asleep every night as well." c. "You need to stop drinking coffee." d. "What has made it difficult for you to sleep lately?"

d. "What has made it difficult for you to sleep lately?" Rationale: The nurse should provide a response that demonstrates acknowledgment of the client's concern and that is open-ended as well as genuine. This provides an opportunity for the client to discuss their situation and emotions further.

A nurse is preparing to discharge a client with a newborn who has a tracheostomy and will require apnea monitoring at home. Which of the following resources should the nurse recommend to the client to assist with tracheostomy care and apnea monitoring? a. Community center clinic b. Ambulatory care center c. Occupational health center d. Home health care

d. Home health care Rationale: The home health care agency will provide services to the client by assisting with education on tracheostomy care and on using the apnea machine properly for the newborn.

A public health nurse working in the community center asks the nurse manager where nurses can obtain information on the competencies that public health nurses should possess. Which document should the nurse manager recommend? a. The Minnesota Model for Public Health Nursing Practice b. Nurse Practice Act (NPA) c. American Nurses Association (ANA): Code of Ethics d. Public Health Nursing Competencies

d. Public Health Nursing Competencies Rationale: The nurse manager should direct the public health nurses to the Public Health Nursing Competencies, which provide guidance on the competencies for public health nurses.

A public health nurse is providing an explanation to newly hired public health nurses on the concept of community health nursing as a population-based service. Which of the following interventions should the nurse include in the explanation? a. Physical assessment prior to hospital admission b. Intake interviews for long-term care placement c. Develop policies for health benefits at a local factory d. Screening and surveillance of communicable diseases

d. Screening and surveillance of communicable diseases Rationale: A key role of the community/public health nurse involves disease and health event investigation, as well as surveillance, screening, and community outreach for diseases including communicable and non-communicable diseases. Surveillance involves assessment of the population health prior to and following health events. Screening is employed to identify disease cases within the population.

A community health nurse is reinforcing teaching to new nures on a scenario in which a nurse has forgotten to refer a client to a social worker, causing a delay in medication coverage for the client. Which of the following actions by the nurse demonstrates the element of responsibility and accountability under nursing's social contract? a. The nurse requests to speak to their supervisor to discuss workload. b. The nurse explains the reason why the delay occurred. c. The nurse makes excuses for the delay. d. The nurse accepts fault in the delay of the client's medication coverage.

d. The nurse accepts fault in the delay of the client's medication coverage. Rationale: In accepting the fault for the situation, the nurse is demonstrating the element of responsibility and accountability of nursing's social contract. The nurse has accepted fault and is transparent about the situation.

A community health nurse is working in a clinic that treats many clients who do not have homes and have mental health needs, but follow-up care is inadequate. How can the nurse implement Provision 9 of the American Nurses Association (ANA) Code of Ethics? a. Take responsibility for improving the safety of mental health care at the community clinic. b. Allow mental health caregivers to address the issue to avoid crossing professional boundaries. c. Improve commitment to providing the best mental health care possible through continuing education. d. Write a letter to the head of the clinic to report the need for mental health follow-up care.

d. Write a letter to the head of the clinic to report the need for mental health follow-up care. Rationale: Provision 9 of the Code of Ethics 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, which includes writing a letter to report and address the issue. The nurse is advocating for the need for mental health follow-up care.