7th Edition Chapter 14
The nurse in the community wants to implement a new program. To be more certain of success, the nurse should be sure to use which primary step in implementing a unified program? A) Bring together the agency and the target population. B) Use a piecemeal approach to emphasize each piece. C) Emphasize the agency involvement to get everyone excited about the change. D) Widely publicize the program immediately before implementation.
A) Bring together the agency and the target population. A unified program requires collaboration and coordination between the agency personnel who will implement the program. Bringing together the agency and the target population will enhance the success of the new program. Implementing a piecemeal approach minimizes the impact of the program. Allowing plenty of time for publicizing the program is crucial to whether people attend and the programs have an impact. Emphasizing the program itself, not the agency involved, will increase the impact of the program.
Which is the highest priority for success of a unified program between agency personnel who implement a community health program and the target population of program recipients? A) Collaboration B) Agency ownership for program C) Limited time for publicizing the program D) Limited need for coordination between these groups
A) Collaboration A unified program requires collaboration and coordination between the agency personnel who will implement the program and the program's recipients (the target population). Allowing plenty of time for publicizing the program (and how you perform the mechanics of publicity—how, where, and to whom) can make a crucial difference in whether people attend and what the subsequent impact will be.
The community health nurse is trying to locate information about ways to promote health and prevent disease among Americans. What government agency within the Public Health Service would the nurse contact to be most helpful in providing this information? A) Office of Disease Prevention and Health Promotion B) Centers for Disease Control and Prevention C) U.S. Department of Health and Human Services D) Health Resources and Services Administration
A) Office of Disease Prevention and Health Promotion Office of Disease Prevention and Health Promotion (ODPHP), located within the Public Health Service, publishes a tremendous amount of information that is designed to promote health and prevent disease among Americans.
Which is a goal for Healthy People 2020? A) Create social and physical environments that promote health. B) Increase the span of healthy life for Americans. C) Reduce health disparities among Americans. D) Achieve access to preventive services for all Americans.
A) Create social and physical environments that promote health. Healthy People 2000 identified three goals, which were to: 1. increase the span of healthy life for Americans; 2. reduce health disparities among Americans; and 3. achieve access to preventive services for all Americans. Healthy People 2010 identified two broad goals, which are to 1. eliminate health disparities and to 2. increase quality and years of healthy life. Healthy People 2020 identified four goals: 1. attain high-quality, 2. longer lives free of preventable disease, 3. disability, injury, and premature death; 4. achieve health equity, eliminate disparities, and improve the health of all groups; create social and physical environments that promote good health for all; and promote quality of life, healthy development, and healthy behaviors across all life stages.
The model for population- and community-based practice is public health nursing. Which is the most important cornerstone criterion for public health nursing? A) Entire populations B) Case management C) Health teaching D) Coalition building
A) Entire populations An example of criteria for public health nursing includes focusing on the entire population. Examples of interventions for population-based nursing practice include case management, health teaching, and coalition building.
When should the evaluation plan be established for a community health program? A) During implementation of the program B) Before the program is implemented C) Essential after implementation of the program D) When promoting health partnerships only with schools
B) Before the program is implemented Before a program is implemented, the manner in which it is to be evaluated must be established. Establishing criteria during or after implementation will not help direct the program. It should be done when promoting health partnerships with school, but not solely in this case, and should always be done before implementing any program no matter where it is implemented.
The community health nurse is trying to locate information about specific programs of the Office of Disease Prevention and Health Promotion. Which program identifies objectives for the nation? A) Dietary Guidelines for Americans B) Healthy People C) Healthy Communities, Worksites, and Schools D) National Health Information Center
B) Healthy People Dietary Guidelines for Americans is published with the U.S. Department of Agriculture and identifies federally mandated nutrition education activities. Healthy People was launched in 1979; it guides efforts to identify objectives for the nation. Healthy Communities, Worksites, and Schools is a coalition for healthier cities and communities that focuses on ways that communities can adapt the national Healthy People objectives for local use. National Health Information Center is a central health information service for consumers and professionals.
Healthy People 2020 has four primary goals. Which community activity would address one of these goals? A) Provide free dental screenings to all school age children. B) Open a senior wellness clinic. C) Overhaul the health insurance system. D) Decrease co-payments of medication prescriptions.
B) Open a senior wellness clinic. Healthy People 2020 identified four goals. Opening a senior wellness clinic focuses on better health, which is in agreement with goal 3, create social and physical environments that promote good health for all. None of the other answers focus on the other goals of Healthy People 2020. Goal 1 is to attain high-quality, longer lives free of preventable disease, disability, injury, and premature death; goal 2 is to achieve health equity, eliminate disparities, and improve the health of all groups; and goal 4 is to promote quality of life, healthy development, and healthy behaviors across all life stages.
The community health nurse considers specific interventions for population-based nursing practice when developing plans to address the problems identified in the community. Which action is based upon the cornerstones for public health nursing? A) Focus on individual family B) Policy development and enforcement C) Reflect individual priorities and needs D) Promote health through epidemiologic evidence
B) Policy development and enforcement An example of an intervention for population-based nursing practice is policy development and enforcement. Examples of criteria for public health nursing include focusing on entire population; reflecting community priorities and needs; and promoting health through epidemiologic evidence.
The community health nurse is taking care of a client with a minor traumatic brain injury resulting from an automobile accident. The client developed pneumonia and is on IV antibiotics at home. Which level of prevention does this address? A) Primary B) Secondary C) Tertiary D) Chronic care
B) Secondary Secondary prevention begins after a disease or condition is present. Emphasis is on screening, early diagnosis, and treatment of possible stressors that may adversely affect the community's health. Secondary prevention addresses the current health problem and interventions that will return the person to a pre-injury level. Primary prevention improves the health and well-being of the community, making it less vulnerable to stressors. Health-promotion programs are primary prevention, as are programs that focus on protection from specific diseases. Tertiary prevention focuses on restoration and rehabilitation. Tertiary prevention programs act to return the community to an optimum level of functioning.
The nursing practice model defines intervention as primary, secondary, and tertiary levels of prevention. Which is an example of tertiary prevention? A) Breast self-examinations B) Therapy programs for sexually abused children C) Immunizations against certain diseases D) Tine test for tuberculosis
B) Therapy programs for sexually abused children Tertiary prevention focuses on restoration and rehabilitation. Tertiary prevention programs act to return the community to an optimum level of functioning. Adequate shelters for battered women and counseling and therapy programs for sexually abused children are examples of tertiary prevention. Primary prevention improves the health and well-being of the community, making it less vulnerable to stressors. Health-promotion programs are primary prevention, as are programs that focus on protection from specific diseases. Usually health promotion is nonspecific and directed toward raising the general health of the total community, such as immunizations against certain diseases. Secondary prevention begins after a disease or condition is present. Emphasis is on screening, early diagnosis, and treatment of possible stressors that may adversely affect the community's health. The tine test for tuberculosis and breast self-examination assessments are secondary prevention interventions.
The community health nurse plans to implement a specific program that will involve use of the new community center that includes a pool and clubhouse. Which would be the best intervention when looking at who and how this center will be utilized? A) Focus on entire population B) Policy development and enforcement C) Reflect community priorities and needs D) Promote health through epidemiologic evidence
B) Policy development and enforcement An example of an intervention for population-based nursing practice is policy development and enforcement. It will be imperative to develop a policy for use and how this policy will be enforced. Focus on the entire population; reflect community priorities and needs; and promote health through epidemiologic evidence do not reach the goal of who and how the center will be utilized.
The community health nurse is trying to locate information about specific programs of the Office of Disease Prevention and Health Promotion. Which program would help the nurse focus on ways the communities can adapt the national Healthy People objectives for local use? A) Dietary Guidelines for Americans B) Healthy People C) Healthy Communities, Worksites, and Schools D) National Health Information Center
C) Healthy Communities, Worksites, and Schools Dietary Guidelines for Americans is published with the U.S. Department of Agriculture and identifies federally mandated nutrition education activities. Healthy People was launched in 1979; it guides efforts to identify objectives for the nation. Healthy Communities, Worksites, and Schools is a coalition for healthier cities and communities that focuses on ways that communities can adapt the national Healthy People objectives for local use. National Health Information Center is a central health information service for consumers and professionals.
The idea of a health program based on unified goals and objectives is central to the Healthy People documents. In 1979, the first "health" initiative for the United States promoted five goals. Which population should the health professional target for increasing their independence? A) Adolescents B) Children C) Older adults D) Young adults
C) Older adults In 1979, the first "health" initiative for the United States (Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention) promoted five goals. These broad goals focused on reducing mortality among targeted age groups—infants, children, adolescents, young adults, and adults—and on increasing the independence of older adults.
The community health nurse is involved in carrying out the community-based plan. What is the highest priority for the nurse to remember about the people of the community when carrying out the community-based plan? A) The people in the community do not need to assume any responsibility for implementation. B) The community health nurse will care for the individuals in the community. C) The people in the community need to feel a sense of ownership of the program. D) The community health nurses will interact professionally with individuals while carrying out the community plan.
C) The people in the community need to feel a sense of ownership of the program. The people of the community need to feel a sense of ownership of the program or event, which can come only with their full participation in the decisions regarding planning as well as their assuming some responsibility for implementation. The profession of nursing is one of nurturing, sustaining, and caring for others. It is part of our profession to do for others what they would do for themselves if they were able. Indeed, most nurses interact professionally with people during an altered health state that requires nurses to do for others, but this is not true in community health nursing.
The community health nurse is involved in carrying out the community-based plan. When carrying out this plan, the nurse is utilizing which phase of the nursing process? A) Assessment B) Planning C) Implementation D) Evaluation
C) Implementation Implementation is the action phase of the nursing process; it is carrying out the community-based plan. Assessment entails looking closely at what is needed or what is wrong; planning involves finding out what to do once the assessment is completed; and evaluation occurs after implementation and determines how well the plan worked to know whether it is working or needs adjustment.
The community health nurse needs to develop objectives for an upcoming program to improve health. Which type of objective attribute can be achieved through population-based and health service intervention? A) Drive action B) Measurable C) Prevention oriented D) Useful and relevant
C) Prevention oriented Prevention-oriented attributes should address health improvements that can be achieved through population-based and health service intervention. The objective attribute of drive action includes suggestion of steps that will achieve the proposed targets. Measurable should include a range of measures directed toward improving health outcomes and quality of life. Useful and relevant should be usable by states, localities, and private sector to target schools, communities, worksites, health practices, and other settings.
The community health nurse is trying to locate information about specific programs of the Office of Disease Prevention and Health Promotion. Which program would provide referrals services for consumers and professionals? A) Healthfinder B) Healthy People C) Healthy Communities, Worksites, and Schools D) National Health Information Center
D) National Health Information Center Healthfinder is a gateway Web site to link consumers and professionals to Health and Human Services information from the federal government. Healthy People was launched in 1979; it guides efforts to identify objectives for the nation. Healthy Communities, Worksites, and Schools is a coalition for healthier cities and communities that focuses on ways that communities can adapt the national Healthy People objectives for local use. National Health Information Center is a central health information service for consumers and professionals.
There is often an impatience and eagerness associated with new programs, often forgetting the initial reason for implementing the program was to improve health. Considering this, when evaluating the overall effectiveness of the program, the nurse must consider which of the following? A) How many participated in the program B) Short-term health improvements C) Public marketing within the community D) Sustainability of the lifestyle change
D) Sustainability of the lifestyle change The initial reason for implementing a new program, improvement of health, is often forgotten in the excitement of the new program. Considering that fact, sustainability of the lifestyle change is the primary criteria for evaluating success. How many participate, short-term health improvements, and public marketing are parts of the implementation process but will not affect the long-term health of the participants unless there is sustainability of the program.
The nursing practice model defines intervention as primary, secondary, and tertiary levels of prevention. Which is an example of primary prevention? A) Tine test for tuberculosis B) Denver Developmental Screening Test for developmental delays C) Community blood pressure screenings for elderly clients D) Weekly adult exercise and fitness sessions
D) Weekly adult exercise and fitness sessions Primary prevention improves the health and well-being of the community, making it less vulnerable to stressors. Health-promotion programs are primary prevention, as are programs that focus on protection from specific diseases. Usually health promotion is nonspecific and directed toward raising the general health of the total community, such as conducting adult exercise/fitness. Secondary prevention begins after a disease or condition is present. Emphasis is on screening, early diagnosis, and treatment of possible stressors that may adversely affect the community's health. The tine test for tuberculosis, the Denver Developmental Screening Test for developmental delays, and blood pressure assessments are secondary prevention interventions.
