CMAN 280 Exam 1

What percentage of the total health care budget is spent on public health services? 1% to 4% 5% to 9% 10% to 14% 15% to 19%

1% to 4% Public health funding remains low, between 1% and 4% of the total health care budget.

In which situation is the community health nurse legally obligated to intervene? A 20-year-old woman refuses to clean her apartment. A 55-year-old man refuses to take his antihypertensive medication. A 70-year-old woman has repeatedly canceled her doctor's appointment. A 3-year-old child has received a burn from a cigarette.

A 3-year-old child has received a burn from a cigarette. The community health nurse is legally obligated to intervene during cases of family abuse and neglect, potential suicide or homicide, and existence of communicable diseases that pose a threat of infection to others. In all other situations, the family retains the ultimate authority for health-related decisions and actions. Thus, the nurse has no legal obligation to report the 20-year-old woman who refuses to clean her apartment, the 55-year-old man who refuses to take his antihypertensive medication, or the 70-year-old woman who has repeatedly canceled her doctor's appointment

Which client would be considered homebound as defined by Medicare? A client who attends adult daycare for the purpose of receiving medical care A client who goes to the grocery store weekly A client who attends church services daily A client who goes to the hairdresser weekly

A client who attends adult daycare for the purpose of receiving medical care Clients are considered homebound when the client has difficulty in mobility and can leave the home only with considerable and taxing effort. If the patient does in fact leave the home, the patient may nevertheless be considered homebound if the absences from the home are infrequent or for periods of relatively short duration, or are attributable to the need to receive health care treatment. A client who attends adult daycare for the purpose of receiving medical care would be considered homebound.

How do employers submit accident reports?

Accident reports should be submitted electronically. For information on how to submit accident reports electronically, please visit the Commission's website at http://www.iwcc.il.gov/forms.htm.

Who pays for workers' compensation benefits?

By law, the employer is responsible for the cost of workers' compensation benefits. Most employers buy workers' compensation insurance, and the insurance company pays the benefits on the employer's behalf. No part of the workers' compensation insurance premium or benefit can be charged to the employee. Other employers obtain the state's approval to self-insure, which means that the employer will be responsible for paying its own claims. To identify the party responsible for paying benefits, an employee may check the employer's workplace notice, check the Commission's website, or contact the Commission at [email protected] or toll-free at 866/352-3033.

A community/public health nurse may ignore an individuals wishes in which of the following circumstances? a. Caring for a client with tuberculosis who refuses treatment b. Educating a client who adds salt to food while following a cardiac diet c. Discovering that a client drinks wine before dinner every night d. Finding evidence that the client may be smoking marijuana

Caring for a client with tuberculosis who refuses treatment Many states require treatment for patients whose diseases are contagious to persons around them. The other choices are unfortunate, but patients have the right to choose their lifestyle behaviors, and nurses are not police officers.

Which nursing role is being used when a nurse develops and coordinates a plan of care for a family? Networking Case management Collaboration Consultation

Case management Case management refers to the development and coordination of a plan of care for a selected client, usually an individual or family. Networking means the establishment and maintenance of relationships with other professionals and community leaders for the purpose of solving common problems, creating new projects or programs, identifying experts for future consultation, maintaining mutual support, or enlisting others to work toward common ground.Collaboration means working together and denotes the participants have relatively equal influence. Consultation means the seeking of advice, especially from an expert or professional

Which nursing role is being performed when an occupational health nurse coordinates appointments for a worker who sustained a back injury? Clinician Educator Case manager Consultant

Case manager As a case manager, the occupational health nurse coordinates health and rehabilitation services for an individual worker from the onset of an injury or illness to an optimal return to work status or satisfactory alternative. This role is being used when coordinating appointments for a worker who sustained a back injury. As a clinician, the occupation health nurse is responsible for preventing work-related and non-work-related health problems and restoring and maintaining health. As an educator, the occupational health nurse assumes responsibility for programming and administration of curricula and/or clinical experiences in occupational and environmental health nursing. As a consultant, the occupational health nurse serves as an advisor for developing, selecting, implementing, and evaluating occupational and environmental health and safety services.

Which health department would have the responsibility for providing direct health care services? U.S. Public Health Service New Jersey State Health Department Clayton County Health Department Missouri State Health Department

Clayton County Health Department Direct health care services are usually provided by the local health department, which may be a county, city, city-county, township, or multicounty/region. State health departments may provide some direct care, but they are more involved in the development and oversight of health-related regulations, coordination of statewide health assessments, and monitoring the health of special-risk populations

Who is considered a consumer of a home health care agency? Client's physician Client receiving care Discharge planner at the hospital Family of the client receiving care

Client receiving care The client receiving care is considered a consumer of a home health care agency. The consumer is the recipient of home health care. The client's physician, the discharge planner, and the family are all involved with the home health care agency but are not considered the consumer

Which statement about health concerns of school-age children is correct? The female teenage pregnancy rate has been increasing. The prevalence of obesity has been decreasing During the past 5 years, the prevalence of cigarette smoking has decreased. Dental caries is the single most common chronic childhood disease in the country.

Dental caries is the single most common chronic childhood disease in the country. Dental caries is the single most common chronic childhood disease in the country, five times more common than asthma. The female teenage pregnancy rate has been decreasing since its high in 1990. The prevalence of obesity among students has been increasing. It is now defined as an epidemic and is the fastest-rising public health problem in the United States. During the past 5 years, the prevalence of cigarette smoking among students has remained unchanged

Which strategy can be used to promote asepsis in the home? Double-bag waste material that is contaminated with blood or body fluids before disposal. Use the soap and towel that are available in the home. Take all equipment into the home to prevent several trips back to your automobile. Place the nursing bag under a chair when in the home.

Double-bag waste material that is contaminated with blood or body fluids before disposal. Double-bagging waste material that is contaminated with blood or body fluids before disposal will promote asepsis in the home. The soap and towel that are available in the home are not considered to be clean enough for the community health nurse to use. If there is liquid soap, a separate towel, and no known infection in the home, the nurse could use these separate family supplies. The nurse should take as little equipment into the home as he/she anticipates needing. Floors in the home are considered to be dirty, just as they are in the hospital. Newspapers are considered clean and provide a field on which to place a nursing bag

What does the law require of employers?

Employers are obligated to follow the provisions of the Workers' Compensation Act. Employers must: a) purchase workers' compensation insurance or obtain permission to self-insure from the Commission; b) post a notice in the workplace. Employers can obtain this notice at http://www.iwcc.il.gov/forms.htm; and c) keep records of work-related injuries and report to the Commission those accidents involving more than three lost workdays. Employers are prohibited from doing the following: a) charging the employee for any part of the workers' compensation insurance premium or benefits; and e) harass, discharge, refuse to rehire, or in any way discriminate against an employee for exercising his or her rights under the Workers' Compensation Act

What records about workplace injuries must the employer maintain?

Employers must maintain accurate records of work-related deaths, injuries, or illnesses. This does not include minor injuries requiring only first aid and not involving further medical treatment, loss of consciousness, restriction of work or motion, or transfer to another job.

Which act protects privacy by limiting access to student records only to parents, students older than 18 years or emancipated minors, and educators who have a legitimate educational interest? Public Law 94-142 Individuals with Disabilities Education Act (IDEA) No Child Left Behind Act Federal Educational Rights and Privacy Act (FERPA)

Federal Educational Rights and Privacy Act (FERPA) The Federal Educational Rights and Privacy Act (FERPA) protects student record privacy by limiting access only to parents, students older than 18 years or emancipated minors, and educators who have a legitimate educational interest. It also addresses the need to keep records in locked cabinets, to protect computer records with passwords, and to be vigilant about the illegal use of he health sign-in logs. Public Law 94-142, also known as the Education for All Handicapped Children Act, gives all students between 6 and 18 years of age the right to a "free and appropriate public education" in the least restrictive environment possible, regardless of their physical or mental disabilities. The Individuals with Disabilities Education Act (IDEA) succeeded Public Law 94-142 by further defining the responsibility of the school districts to provide students 3 to 21 years of age with disability participation in the general curriculum. The No Child Left Behind Act focuses on increasing accountability for student progress and achievement.

What are the time limits for notifying the employer of a workplace accident?

Generally, the employee must notify the employer as soon as practicable, but no later than 45 days after the accident. Any delay in the notice to the employer can delay the payment of benefits. For injuries resulting from radiological exposure, the employee must notify the employer 90 days after the employee knows or suspects that he or she has received an excessive dose of radiation. For occupational diseases, the employee must notify the employer as soon as practicable after he or she becomes aware of the condition.

Who is responsible for determining the frequency and duration of client care? Medical social worker Physician Home health care nurse Supervising nurse at the home health care agency

Home health care nurse The home health care nurse is responsible for determining the frequency and duration of client care. Frequency is how often home visits are made to the client in a specified period of time; duration is the length of time the client receives home care services. The medical social worker helps clients and families deal with the social and emotional issues associated with illness and long-term care. The role of the physician in home care is to provide information to the home care provider regarding the medical condition of the client, to serve as a resource to other home care providers, and to certify a plan of treatment. The supervising nurse at the home health care agency may review the determination of the frequency and duration of client care, but the home health care nurse who has assessed the client has that primary responsibilit

What is the first step of a community assessment? Identify the boundaries of the community. Notify the members of the community. Define the common interests of the community. Assess the strengths of the community.

Identify the boundaries of the community. Identification of boundaries of the community is the essential first step in community assessment. The definition of a community determines its boundaries. This helps the nurse determine what data will be collected and considered community information. It may be necessary to notify members of the community, define common interests, and assess strengths, but one would not be able to do these things until the community members are defined

What should I do if I suspect workers' compensation fraud?

If you wish to report a possibly fraudulent situation, contact the Workers' Compensation Fraud Unit, Department of Insurance ([email protected]; toll-free 877/923-8648). Anyone who intentionally makes a false report of fraud is subject to a Class A misdemeanor (maximum 12 months imprisonment, $2,500 fine).

Which is an example of private funding for health care? Insurance payment Federal government payment State government payment Local government payment

Insurance payment Insurance payment is an example of private funding. The private sector is composed of private organizations, both for-profit businesses and nonprofit organizations. Government is an example of public funding. The public sector consists of services provided by public funds and public organizations.

Which source of data could be used to identify the goals of a geopolitical community? Review maps of the community. Conduct a windshield survey. Interview key informants. Study the vital statistics.

Interview key informants. Interviewing key informants could be used to identify the goals of a geopolitical community. Reviewing maps of the community could be used to identify the boundaries of the community, but would not be useful in identifying the goals. Conducting a windshield survey could be used to learn about external influences from the environment. Studying the vital statistics could be used to learn about the health behavior and health status of the community, but would not be useful in identifying the goals of the community

Can an employee be fired for reporting an accident or filing a claim?

It is illegal for an employer to harass, discharge, refuse to rehire, or discriminate in any way against an employee for exercising his or her rights under the law. Such conduct by the employer may give rise to a right to file a separate suit for damages in the circuit court. An employee with a pending workers' compensation claim may still be disciplined or fired for other valid reasons.

Which is a characteristic of a healthy community? Dissatisfied residents Low crime rate Minimal interaction among residents Few employment opportunities

Low crime rate Characteristics of a healthy community include a low crime rate, satisfied residents, supportive interaction between families and neighborhoods, and availability of employment.

What is one of the goals of managed care? Encourage use of the health care system Increase insurance premiums Ensure adequate availability of resources Lower the cost of health care

Lower the cost of health care One of the goals of managed care is to lower the cost of health care. Organizations have demonstrated that services can be provided at a lower cost compared with other types of health care providers. It encourages consumers to be aware of the choices they make related to receiving health care. The goal of managed care is to lower costs, thus controlling the cost of insurance premiums. Managed care helps to ensure maximum value is received from the resources used; however, it does not ensure that there is adequate availability of these resources

Which federal program's goal is to support comprehensive health assessment services, appropriate education and counseling, referrals, and follow-up for pregnant women and their infants and children? Maternal/Child Health Block Grant Women, Infants, and Children Supplemental Food Program Centers for Disease Control and Prevention Funds Health and Human Services Funds

Maternal/Child Health Block Grant The Maternal/Child Health Block Grant supports comprehensive health assessment services, appropriate education and counseling, referrals, and follow-up for pregnant women and their infants and children. The Women, Infants, and Children (WIC) Supplemental Food Program provides direct services in the form of supplemental foods and infant formula, as well as nutrition education. The Centers for Disease Control and Prevention Funds assist in paying for childhood immunization programs and the influenza vaccine for elderly persons. The Health and Human Services Funds are generally competitive funds that are targeted for health education initiatives and frequently used to provide financial support to targeted community groups for professional counseling services

A home care agency that meets the conditions of participation is considered to be: Medicare certified. accredited by the Home Care Accreditation Program of the Joint Commission on Accreditation of Health Care Organizations (JCAHO). accredited by the Community Health Accreditation Program (CHAP). Medicaid certified.

Medicare certified. A home care agency that meets the conditions of participation is Medicare certified. The conditions of participation include rules, standards, and criteria established by the federal government. Medicare certification is required for an agency to receive reimbursement for services provided. Accreditation by the Home Care Accreditation Program of the Joint Commission on Accreditation of Health Care Organizations (JCAHO) is voluntary. Accreditation seeks to demonstrate to consumers that the agency far exceeds the minimum standards for operation and has achieved a standard of excellence that is superior to that of its nonaccredited competitors. Accreditation by the Community Health Accreditation Program (CHAP) is also voluntary. A home care agency that meets the conditions of participation is Medicare certified, not Medicaid certified. The conditions of participation include rules, standards, and criteria established by the federal government. Medicare certification is required for an agency to receive reimbursement for services provided

Which tool uses community-wide strategic planning in long-term planning of population-based health care? Mobilizing for Action through Planning and Partnerships (MAPP) model Assessment Protocol for Excellence in Public Health (APEXPH) Healthy People 2010 Public Health Nursing: Scope and Standards of Practice

Mobilizing for Action through Planning and Partnerships (MAPP) model The Mobilizing for Action through Planning and Partnerships (MAPP) model is a strategic approach to community health improvement to help communities improve health and quality of life through community-wide strategic planning. Communities seek to achieve optimal health by identifying and using their resources wisely, taking into account their unique circumstances and needs, and forming effective partnerships for strategic action. Assessment Protocol for Excellence in Public Health (APEXPH) involves internal assessment of the health agency as well as community assessment of health needs.

Which employees are covered by the Workers' Compensation Act?

Most employees who are hired, injured, or whose employment is localized in the State of Illinois are covered by the Act. These employees are covered from the moment they begin their jobs.

Which statement about nurse-family relationships in the home setting is correct? Families are required to allow nurses to enter their home and provide care. Families who have accepted home care are willing to accept change. Mutual goals are usually met within a short amount of time. Mutual goals should be emphasized to achieve long-term success.

Mutual goals should be emphasized to achieve long-term success. A greater emphasis must be placed on mutual goals if the nurse and family are to achieve long-term success. This is important because families have more control over their health in their own homes and because change usually occurs gradually. Families are not required to allow nurses to enter their home and provide care. They can control the nurse's entry into the home by explicitly refusing assistance, establishing the time of the visit, or deciding whether to answer the door. Families who have accepted home care may not be willing to accept change. Families have varying degrees of openness to change; even if they are open to having a nurse enter their home, they may not be receptive to change. Mutual goals are usually more long term than those with individual clients in hospitals.

Are workers' compensation benefits taxable income?

No. Workers' compensation benefits are not taxable under state or federal law and need not be reported as income on tax returns.

Which activity would be completed by a generalist nurse working in home care? Development of agency policies Staff development Providing direct care to clients Engagement in clinical research

Providing direct care to clients Providing direct care to clients is completed by a generalist nurse working in home care. The generalist nurse also engages in teaching, managing resources needed to provide care, collaborating with other disciplines in the provision of care, and supervising ancillary personnel. Development of agency policies is carried out by the advanced-practice nurse in the home care setting. Staff development is carried out by the advanced practice nurse in the home care setting. Clinical research is conducted by research nurses

Which level of government has the primary responsibility for meeting the public health needs of its residents? City County State Federal

State Under the U.S. Constitution, states retain the power to protect the health and welfare of their residents. Consequently, states have the primary responsibility for public health functions. States may delegate some of that responsibility to local health departments. However, states assume the primary responsibility for public health functions

Which level of prevention is used when preventing disability, complications, and death from disease? Active Primary Secondary Tertiary

Tertiary Tertiary prevention is used when preventing disability, complications, and death from disease. Active is not one of the levels of prevention. Primary prevention is the promotion of health and prevention of the occurrence of the disease. Secondary prevention is the detection (screening) and treatment of the disease as early as possible during the natural history of the disease

Are there any specific requirements for a notice of an accident to an employer?

The Act provides that the notice of accident shall include the approximate date and place of the accident, if known. Notice may be given orally or in writing.

What benefits are provided?

The Act provides the following benefit categories, which are explained in later sections of this handbook: a) Medical care that is reasonably required to cure or relieve the employee of the effects of the injury b) Temporary total disability (TTD) benefits while the employee is off work, recovering from the injury c) For injuries that occur on or after February 1, 2006, temporary partial disability (TPD) benefits while the employee is recovering from the injury but working on light duty for less compensation; d) Vocational rehabilitation/maintenance benefits are provided to an injured employee who is participating in an approved vocational rehabilitation program; e) Permanent partial disability (PPD) benefits for an employee who sustains some permanent disability or disfigurement, but can work; f) Permanent total disability (PTD) benefits for an employee who is rendered permanently unable to work; g) Death benefits for surviving family members.

What is the Illinois Workers' Compensation Commission?

The Illinois Workers' Compensation Commission is the State agency that administers the judicial process that resolves disputed workers' compensation claims between employees and employers. The Commission acts as an administrative court system for these claims. As the administrative court system, the Commission must be impartial. Staff explains procedures and basic provisions of the law to members of the public, but cannot provide legal advice or act as an advocate for either the employee or employer.

What injuries and diseases are covered under the law?

The Workers' Compensation Act provides that accidents that arise out of and in the course of employment are eligible to receive workers' compensation benefits. This generally means that the Act covers injuries that result in whole or in part from the employee's work.

What are an employee's options if the employer refuses to pay for workers' compensation benefits?

The employee or the employee's attorney should contact the employer directly to determine why benefits are not being paid. Poor communication often causes delays and misunderstanding. If the employer still does not pay any benefits, the employee's other option is to file a claim at the Commission. Please note that an accident report does not trigger any action by the Commission. The Commission becomes involved only if the employee files a claim and follows the procedures to request a hearing. For more information about the claims process at the Commission, please see the next section of the handbook.

What should an employee do if his or her employer does not have workers' compensation insurance?

The employee should give the employer's name and address, and the date of injury, to the Commission's Insurance Compliance Division. The Division can be reached at [email protected] or at 312/814-6611, toll-free 866/352-3033.

Who should an employee notify if injured at work?

The employee should inform their employer if they are injured at work.

What should the employer do after receiving notice of accident?

The employer should promptly take the following steps: a) provide all necessary first aid and medical services; b) inform the insurance carrier or workers' compensation administrator, even if the employer disputes the employee's claim; c) if the employee cannot work for more than three days because of the injury, the employer must do one of the following: (i) Begin payments of TTD; or (ii) Give the employee a written explanation of the additional information the employer needs before it will begin payments; or (iii) Give the employee a written explanation of why benefits are being denied.

What are the penalties for workers' compensation fraud?

The penalties for violations of the fraud provisions increase with the value of the property obtained or attempted to be obtained, starting with a Class A Misdemeanor for property valued at $300 or less (maximum 12 months imprisonment and a $2,500 fine), and ranging upwards to a Class 1 felony (maximum 4-15 years imprisonment, $25,000 fine) for property valued at more than $100,000. A convicted party is required to pay complete restitution, as well as court costs and attorney fees.

What would be found in a healthy psychosocial school environment? Sanitary conditions in classrooms Crosswalks in front of the school Tobacco- and substance-free environment Daily physical education classes for students

Tobacco- and substance-free environment A tobacco- and substance-free environment would be found in a healthy psychosocial school environment. This encompasses both physical and psychological safety. Sanitary conditions in the classrooms and crosswalks in front of the school would be part of a healthy physical school environment. Daily physical education classes for students would be part of the physical education component of a comprehensive school health program.

Which federal agency has the most health-related responsibilities? U.S. Department of Health and Human Services Office of public health and science Veterans affairs Department of Defense

U.S. Department of Health and Human Services The U.S. Department of Health and Human Services is the federal agency with the most health-related responsibilities. Most of the activities involve direct care, including health planning and resource development, research, health care, financing, and regulatory oversight. The Office of Public Health and Science contains the old administrative functions of the Public Health Service and is responsible to the Office of the Assistant Secretary for Health. Veterans Affairs is an independent agency that reports directly to the President. It is responsible for providing direct health care to certain groups of military veterans, especially those who have service-connected injuries, receive veterans' pensions, are 65 years of age or older, and/or are medically indigent. The Department of Defense provides both direct and indirect care to active-duty military members and their dependents.

Which type of home care agencies are governed by a volunteer board of directors and supported primarily with nontax funds and reimbursements from third-party payers? Official/public agencies Private agencies Hospital-based agencies Voluntary agencies

Voluntary agencies Voluntary agencies are governed by a volunteer board of directors and supported primarily with nontax funds (donations, endowments, United Way contributions) and reimbursements from third-party payers. They have a charitable mission and are nonprofit. Official/public agencies are supported by tax dollars and given power through statutes enacted by legislation. Private agencies are either for-profit or not-for-profit. They may be governed by a board of directors or the agency's owner. Hospital-based agencies are governed by the sponsoring hospital's board of directors and receive most of their referrals from the sponsoring hospital

What is workers' compensation?

Workers' compensation is a system of benefits provided by law to most employees who experience work-related injuries or occupational diseases. Generally, benefits are paid regardless of fault.

Are employers required to post any notices in the workplace?

Yes. Employers are required to post a notice developed by the Commission at each respective place of employment. The Commission maintains a copy of this notice on its website at http://www.iwcc.il.gov/forms.htm.

Are employers required to submit any reports to the Commission?

Yes. Employers are required to report accidents to the Commission on the form, "Employer's First Report of Injury" which is known as the Form 45. The Form 45 is available on the Commission's website, http://www.iwcc.il.gov/forms.htm. Written reports of all job-related deaths must be made to the Commission within two working days. Written reports of job-related injuries or illnesses resulting in the loss of more than three scheduled workdays must be made within one month. Employers are not required to submit a Form 45 for injuries that do not result in three or less days of lost work.

Is an employer subject to any penalties if they do not purchase workers' compensation insurance?

Yes. There are various provisions in the Workers' Compensation Act that address this issue. Negligent failure to provide workers' compensation insurance coverage is punishable by a Class A misdemeanor for each day without coverage (maximum 12 months imprisonment, $2,500 fine). Knowing failure to provide workers' compensation insurance coverage is punishable by a Class 4 felony for each day without coverage (maximum 1-3 years imprisonment, $25,000 fine). An uninsured employer may also be subject to a civil penalty of $500 for every day it lacked insurance, with a minimum $10,000 fine.Employers without workers' compensation insurance may be subject to a citation issued by the Insurance Compliance Division. The citation fine may range from $500 to $2,500. An uninsured employer loses the protections of the Workers' Compensation Act for the period of noncompliance. That means an employee who was injured during the period of noncompliance may choose to sue in civil court. In addition, if the Commission finds that an employer knowingly failed to provide insurance coverage, it may issue a stop-work order and shut the company down until it obtains insurance.

Does the Workers' Compensation Act address workers' compensation fraud?

Yes. Workers' compensation fraud falls into many different categories that affect employees, employers, and healthcare providers. The Act prohibits the intentional filing of any fraudulent workers' compensation claims or making a fraudulent statement to obtain workers' compensation benefits. Workers' compensation fraud may also involve making false statements in order to deny workers' compensation benefits. It is also unlawful to intentionally present a bill or statement for the payment of medical services that were not provided. Assisting or conspiring in any of these actions may also be considered workers' compensation fraud.

The National Association of School Nurses (NASN) states the minimum qualifications for a school nurse should be: an advanced-practice degree in school nursing. a baccalaureate degree and licensure as a registered nurse. licensure as a registered nurse and certification as a school nurse. at least 3 years of previous practice in an acute setting and a baccalaureate degree.

a baccalaureate degree and licensure as a registered nurse. A baccalaureate degree and licensure as a registered nurse are the minimum qualifications for a school nurse as stated by the NASN. NASN also recommends that school nurses receive national school nurse certification. An advanced-practice registered nurse provides services to students through expanded school health services. However, it is not the recommended minimum qualification for a school nurse according to the NASN. Licensure as a registered nurse and certification as a school nurse are not the minimum qualifications for a school nurse stated by the NASN. Certification is available through examination for registered nurses who have a current license, a bachelor's degree, current employment in school health services or school-related services, and a recommended 3 years of experience as a school nurse. Certain states may require certification in addition to the minimum qualifications. There is no recommendation for previous practice in acute care by the NASN. However, the NASN does state a baccalaureate degree as a minimum for entry into school nurse practice.

A baccalaureate-prepared nurse is considered to be: licensed as a community/public health nurse. a specialist in community/public health nursing. certified as a community/public health nurse. a generalist in community/public health nursing.

a generalist in community/public health nursing. A baccalaureate-prepared nurse is considered to be a generalist in community/public health nursing. Licensure does not award the title community/public health nurse. Specialists in community/public health nursing have graduate degrees in this specific area of nursing. Certification as a community/public health nurse validates an individual nurse's qualifications, nursing practice, and knowledge in a defined area of nursing and acknowledges that the nurse's education, experiences, and knowledge meet standards determined by the profession. Certification requires further preparation for the baccalaureate-prepared nurse.

Public health funding represents what percentage of total health care funding expenditures? a. 1% to 4% b. 5% to 9% c. 10% to 14% d. 15% to 19%

a. 1% to 4% Today public health funding remains low, at 3% of the total health care budget.

A community/public health nurse determines there are 200 persons in a particular community who are older than age 65, another 300 younger than 21, and about 1500 persons aged 21 to 65. What is that communitys dependency ratio? a. 1:3 b. 1:8.5 c. 1:9 d. Cannot be determined from the given data

a. 1:3 If 500 persons are younger than 21 or older than 65 and 1500 persons are aged 21 to 65, the dependency ratio is 1:3. That is, in terms of aggregates, there is 1 dependent person for every 3 who are probably able to care for themselves.

In addition to being licensed as a registered nurse to practice in that state, what academic preparation is recommended for a school nurse? a. A baccalaureate degree in any academic subject b. A baccalaureate degree in nursing c. A masters degree in nursing d. An associate degree plus a certificate in school nursing

a. A baccalaureate degree in any academic subject To be a school nurse, the nurse should have academic credentials comparable with those of other faculty members in the school. The minimum qualification that the National Association of School Nurses (NASN) advocates is a baccalaureate degree.

A nurse employed by a state health agency has been notified that her position within the agency will be eliminated. Which of the following factors has most likely contributed to this? a. A downturn in the economy and tax reform efforts mean fewer state tax dollars. b. Federal government funds given to states for health needs have been used for other purposes. c. The need to provide care is declining as new mandates from the federal level are felt by local communities. d. There is a decreased demand for public health services by the community.

a. A downturn in the economy and tax reform efforts mean fewer state tax dollars. The federal government has passed new laws with mandates for action. However, federal funds have decreased. Because of the economy and the national debate about tax reform states find it very challenging to raise taxes.

What variables are considered in the decision as to which screening tests are to be performed at a health fair? (Select all that apply.) a. A national day dedicated to a specific screening b. Preferences of the local politicians who support such events c. Preferences of the local church, which donated space to be used for the event d. The learning needs of the senior nursing students who are going to be helping e. The sociodemographics of the population that will probably attend f. What donations the nurse or the clinic has received

a. A national day dedicated to a specific screening e. The sociodemographics of the population that will probably attend On a population level, choice of screening test is based on general sociodemographic factors rather than individual risk factors. Age, gender, and ethnicity factors affect the risk status of a population. Hence, population data are an important consideration in the planning of a health fair. The other population-based screenings can be offered in conjunction with national screening days.

Why might the school nurse want to examine students academic achievement? a. Academic failure is a risk factor for adolescent drug use. b. Some teachers may need the nurses help to be effective in health education. c. Students are easier to teach if divided into groups by academic ability. d. The nurse may want to discuss the failure with the students family and friends.

a. Academic failure is a risk factor for adolescent drug use. Nurses are responsible for case finding, or identifying children at risk and developing appropriate interventions. Common risk factors for drug use include academic failure, low degree of commitment to education, and low level of attachment to teachers and schools.

Which commitments are unique to community/public health nursing? (Select all that apply.) a. Advocacy for equitable distribution of health care b. Care of ill, disabled, and suffering persons c. Political action for a healthful physical environment d. Promotion of self-responsibility or self-care in relation to health e. Focus on a standard of living that supports health for all f. Support for human growth and development throughout the life span

a. Advocacy for equitable distribution of health care c. Political action for a healthful physical environment e. Focus on a standard of living that supports health for all All nurses care for the ill, support human growth and development, and promote self-responsibility or self-care. Community/public health nurses promote equitable distribution of health care, a healthful physical environment, and a basic standard of living that supports the health and well-being of all persons.

What is the primary reason why home care agencies share information, such as how data are collected and terms defined? a. Agencies are required to report these data to the Centers for Medicare and Medicaid Services (CMS). b. Each is looking for weaknesses in the others that they can use as the basis of marketing campaigns for themselves. c. Each wants to determine the cost for an episode of care for both themselves and the others in order to remain competitive. d. Group data will help them negotiate managed care contracts with maximum gain on both sides.

a. Agencies are required to report these data to the Centers for Medicare and Medicaid Services (CMS). Beginning in fall 2003, the home care industry was the subject of a new program called Home Care Compare. In this program, the agencies must report key variables, and these variables will be made public by CMS. CMS took out full-page ads in newspapers in the region telling consumers how home care agencies fared on patient outcomes in relation to the variables in the Home Care Compare program.

A new mother asked the community/public health nurse what a nurse visiting her at home would do differently from what the nurses in the hospital had already done. Which of the following would be the best response from the nurse? a. All nurses try to help people stay well, but I can also help you assess your home for any dangers to the baby. b. Hospital nurses and I all try to be helpful, but I can also tell you how to obtain excellent child care. c. In the hospital, you had a nurse focus on your baby and another nurse focus on your care. Ill be focusing on both you and your baby. d. The other nurses in the hospital focus on helping you and the baby get off to a great start. Im going to repeat everything to be sure you really know it.

a. All nurses try to help people stay well, but I can also help you assess your home for any dangers to the baby. Although all nurses try to keep clients safe and healthy, the community/public health nurse is most qualified to assess the home environment and wider community for dangers as well as resources.

What findings would be expected if a school nurse collected data related to the health issues experienced by students? (Select all that apply.) a. Almost half of all high school students have had sexual relations. b. Asthma is a common cause of absenteeism. c. Dental caries is the most common chronic health problem of children. d. Children may be psychologically affected by skin disorders that affect their physical appearance. e. Scabies and pediculosis necessitate that the student stay home. f. Tinea capitis and impetigo are major contributors to absenteeism.

a. Almost half of all high school students have had sexual relations. b. Asthma is a common cause of absenteeism. c. Dental caries is the most common chronic health problem of children. d. Children may be psychologically affected by skin disorders that affect their physical appearance. The 2009 Youth Risk Behavior Survey (YRBS) revealed that 46% of all high school students had engaged in sexual intercourse. Asthma is a major public health problem; it accounts for millions of missed school days each year. Dental caries is the most common chronic childhood disease in the country, five times more common than asthma. Dermatologic disorders affect many children psychologically, especially if they affect their physical appearance or will cause their exclusion from school. Scabies and pediculosis are not reasons to have students stay home, because they are not dangerous. Tinea capitis and impetigo do not usually necessitate exclusion from school.

The nurse is to visit newly referred clients for the first time after their discharge from the nursing home back to their apartment. Which of the following is the most likely feeling the clients will have regarding the nurses visit to them? a. Ambivalence because the nurse could be helpful but also judgmental of their situation b. Glad because the nurse can be of immediate help c. Fearful because the nurse is someone who has the authority to intervene in their lives d. Angry because the nurse is essentially an intruder into their lives

a. Ambivalence because the nurse could be helpful but also judgmental of their situation Although all the options are possibly true, if the clients are home for the nursing visit they are at worst feeling ambivalent about the meeting. They are willing to consider what the nurse may have to offer.

A school health nurse contacted the public health department with concern that increasing numbers of parents were calling the school and reporting their child would not be in attendance because of a sore throat and fever. Which professional staff member would be most helpful in such a situation? a. An epidemiologist, who might determine whether a disease outbreak was occurring b. A nurse, who could give home care to each of the ill children c. A physician, who could visit each of the ill children d. The principal of the school, who could insist that the children stay in isolation

a. An epidemiologist, who might determine whether a disease outbreak was occurring The fact that an increasing number of children are ill on one day with the same symptoms is suggestive of an epidemic. The epidemiologist would be most helpful in determining whether a disease outbreak were occurring; this professional would use knowledge of statistics and the natural history of disease model.

A nurse visited a middle-aged client at home after his hospital discharge. The client was cleaning a gun. When the nurse asked the client to put the gun away, the client became agitated. What is the nurses best action at this time? a. Apologizing and saying that the visit will be rescheduled when the client is feeling better b. Focusing on client assessment and staying calm because filling out the necessary forms will not take long c. Hurrying through the visit and finishing the documentation inside the safety of the nurses car d. Using a low voice and slow, calm movements, and asking whether there is a problem

a. Apologizing and saying that the visit will be rescheduled when the client is feeling better When a client has a gun and has become agitated and the nurse is feeling uncomfortable, the number one priority is the safety of the nurse. Therefore, the nurse should leave the immediate environment.

When a nurse assesses a community, which of the following components is essential to determine first? a. Areas of strength b. Areas of need c. Balance of inputs to outputs d. Openness to intervention

a. Areas of strength When assessing, whether individuals or systems, it is essential to determine areas of strength, as well as areas of need. Several chapters in the text emphasize that strengths should be assessed first because strengths are the tools used to address weaknesses.

The nurse was caring for several single teenage mothers who desperately needed supplies such as diapers and cribs, but no resource in the community provided these specific items. Which of the following actions would be most helpful? (Select all that apply.) a. Asking churches and other community charities to donate such supplies b. Asking the local hospital to not bill the mothers for labor and delivery costs c. Empowering the mothers by helping them form a self-help group to share resources d. Engaging the community in recognizing the problem and implementing changes e. Holding fundraisers to give cash to the mothers to purchase such supplies f. Teaching a sex education course in all the schools for prepubescent students

a. Asking churches and other community charities to donate such supplies c. Empowering the mothers by helping them form a self-help group to share resources d. Engaging the community in recognizing the problem and implementing changes The immediate short-term need can be met by asking community resources such as churches to donate supplies. The young women themselves can be empowered by forming a group to share resources and pass them on to others when equipment (e.g., cribs) is no longer needed. However, in the long term, the community itself must recognize the problem and decide what actions might be appropriate. In a similar manner, in the long term, younger students need education on how to avoid the risks of early pregnancy.

The nurse is using previously collected data about the incidence and prevalence of lead poisoning in the community as a starting point when conducting a community assessment. What would be the nurses next step? a. Assessing the community in relation to lead poisoning b. Determining how best to help other personnel decrease the incidence of lead poisoning c. Gathering external resources to help meet the needs of the community d. Working with collaborating agencies to obtain external funding to prevent lead poisoning

a. Assessing the community in relation to lead poisoning One approach to community assessment is the problem-oriented approach. Using this approach, the nurse assesses a community in relation to a specific topic or health problem. The nurse begins the process with the problem or topic area and then assesses a specific community in relation to that topic. If a particular problem has been identified in previously collected data, the nurse should assess the community in relation to the identified need before gathering resources, working with others, or trying to help colleagues, who may have other priorities.

A nurse is employed by a local health department. Which of the following would be a core responsibility of this role? a. Assessment and surveillance of the health status of its residents b. Providing direct care to vulnerable populations in the community c. Using marketing strategies to educate citizens about healthy lifestyle choices d. Implementing quality assurance methods at local care facilities

a. Assessment and surveillance of the health status of its residents Local health departments cannot act without knowing, through assessment and surveillance, the health needs of its citizens. One of the essential services of public health is monitoring the health status of citizens to identify community health problems; such monitoring can be accomplished through assessment and surveillance.

Which of the following would be an appropriate response by a public health department if there is some evidence of a relationship between a substance and human health but research has not yet drawn conclusions? a. Be cautious. b. Do not worry about it. c. Contact the Centers for Disease Control and Prevention. d. Refuse to be involved.

a. Be cautious. The Precautionary Principle states that if there is some evidence about the relationship between toxic substances or environmental hazards and human health, even if scientific evidence about cause and effect is not available, precautionary measures should be taken to protect the environment and human health.

Which of the following would be appropriate to help ensure a nurses safety? a. Before leaving his or her car, he or she should check the immediate surroundings for anyone or any situation that makes the nurse uncomfortable. b. The nurse should intervene immediately with a family whose fighting is starting to become physical, before it escalates further. c. The nurse should visit a family over the weekend, when no one is expecting an outsider to drop by. d. When approached on the street by an unknown person, the nurse should stop and tell them how to reach the agency to be formally accepted as a client.

a. Before leaving his or her car, he or she should check the immediate surroundings for anyone or any situation that makes the nurse uncomfortable. Any of these behaviors could cause the nurse to be physically injured except checking ones surroundings before exiting the car, which is an effective precaution the nurse should always take.

A public health nurse is employed by a state health department and provides disease investigation and tracks contacts of persons infected with the human immunodeficiency virus (HIV). Which agency is most likely to provide funding for this position? a. Centers for Disease Control and Prevention b. Department of Agriculture c. Department of Health and Human Services d. Federal Public Health Department

a. Centers for Disease Control and Prevention Money from the Centers for Disease Control and Prevention (CDC) funds disease investigation staff who track contacts of persons infected with specific sexually transmitted diseases (STDs), including syphilis, gonorrhea, and HIV.

An infant has been born with several congenital anomalies and is ventilator dependent. The nurse discusses options for home care services with the infants parents. Why is home care considered in this situation? a. Children at home have fewer infections and more consistent development. b. Parents vastly prefer home care so that they can care for their child continuously. c. It is easier for family members to visit the child at home rather than in the hospital. d. There is better reimbursement for services provided in the home setting.

a. Children at home have fewer infections and more consistent development. Home care is more effective in development, socialization, and normal family functioning, and infections at home are fewer.

A nurse has recently been hired by a state health agency. Which of the following activities would the nurse most likely complete? a. Collaborating with other professionals on the states disaster plan b. Hiring physicians and nurses to provide direct care to needy clients c. Performing blood pressure screenings at a community center d. Assuring quality health care in facilities in the state

a. Collaborating with other professionals on the states disaster plan State health agencies may provide direct client services, but these are usually targeted at vulnerable or institutionalized populations. Reports have shown that more states have increased emphasis on health planning and development, quality improvement and performance management, bioterrorism preparedness, and emergency medical services oversight and have attempted to reduce direct care services.

Which of the following are included in the subsystems of Anderson and McFarlanes definition of a community? (Select all that apply.) a. Communication and health/social services b. Demographics and census data c. Economics and recreation d. Physical environment and education e. Politics and government f. Safety and transportation

a. Communication and health/social services c. Economics and recreation d. Physical environment and education e. Politics and government f. Safety and transportation The eight subsystems are communication, health and social services, economics, recreation, physical environment, education, politics and government, and safety and transportation. Demographics and census data are not subsystems.

Why will home health care continue to expand? (Select all that apply.) a. Complex care can be more efficiently provided in the home setting. b. Cost-containment measures are being implemented at all levels of government. c. Insurance companies are requiring increased use of generic medications. d. The public is demanding quality health care services in the home. e. The public is exerting pressure to receive care in the most comfortable setting. f. Technologic advances are occurring.

a. Complex care can be more efficiently provided in the home setting. b. Cost-containment measures are being implemented at all levels of government. d. The public is demanding quality health care services in the home. f. Technologic advances are occurring. There are numerous reasons that home health care will continue to expand, including advances in technologies, which allow equipment to move from hospitals to homes; policies for cost containment by care in less expensive settings; and the ongoing public demand for quality care.

What was the primary reason why Lillian Wald was able to develop the practice of school nursing in this country in the early twentieth century? a. Concern over the increasing number of school absences b. Expansion of public health care from adults to children c. Government mandate to have nurses in the schools d. Additional funds available to finance health care in school systems

a. Concern over the increasing number of school absences Walds project with Lina Rogers Struthers, the first school nurse, demonstrated that school nursing decreased school absences significantly, down 90% within 1 year.

Which variables must the nurse consider when planning a health fair? (Select all that apply.) a. Cost and convenience of possible screening tests b. Communitys culture and support for such screening tests c. Number and type of volunteers available to assist d. The health risks inherent in the target population e. The best photos to use in community advertising f. Needs of the local community-based agencies

a. Cost and convenience of possible screening tests b. Communitys culture and support for such screening tests c. Number and type of volunteers available to assist d. The health risks inherent in the target population The primary deciding factor is what health risks are present in the target population. Additional variables to be considered include significant health problems in the community; support available from the community, including cultural issues and possible volunteers; and the use of screening tests that are safe, simple to administer, and cost-effective. Although publicity is often very helpful, photographs should not be a primary consideration. Moreover, although the needs of community agencies may be a consideration, it is not of primary concern in the planning of a health fair.

The nursing students created a media spot to publicize a free screening for undergraduates to be held at the college. What must the students remember to do? (Select all that apply.) a. Discuss how listeners would benefit by attending. b. Emphasize the program is being given for everyones benefit. c. Keep the message short, at about 30 seconds or 75 words. d. Require that the ads run late in the evening when most students listen to the radio and watch television. e. Stress the health risks that students face that may be diagnosed at this screening. f. Use lots of visual aids to help listeners visualize the experience.

a. Discuss how listeners would benefit by attending. c. Keep the message short, at about 30 seconds or 75 words. Such media spots must be short (30 seconds or 75 words) and clarify how listeners will benefit. Fear (stressing the health risks) is not an effective long-term strategy. Visual aids would not be very effective with radio, which is an auditory medium. The screening is not for everyone, but for the college students (not staff or faculty). Although the students can request a late evening advertisement, the channels air public service announcements at whatever time they choose.

Which of the following professionals inspects or assesses the safety of water supplies, restaurants, dairies, sewers, and swimming pools for public health departments? a. Environmental sanitarians b. Epidemiologists c. Public health director d. Public health nurse

a. Environmental sanitarians Environmental sanitarians are concerned with safe air, water, food, and housing.

Which principles are considered commitments of public health specifically (select all that apply)? Select all that apply. a. Equitable, just distribution of health care to all b.Promotion of wellness integration during illness c.Support of the health and well-being of all persons d. Consideration of developmental stages when providing care e. Ensuring a healthful physical environment f. Treating clients equitably without bias

a. Equitable, just distribution of health care to all c.Support of the health and well-being of all persons e. Ensuring a healthful physical environment Equitable, just distribution of health care to all is a commitment of public health. A commitment of public health also ensures a basic standard of living that supports the health and well-being of all persons and ensures a healthful physical environment. Promotion of wellness integration during illness is a commitment of nursing. Consideration of developmental stages when providing care is a commitment of nursing. Treating clients equitably without bias is a commitment of nursing.

A public health nurse is employed by a state health department and is coordinating a lead screening program in the state. What is the most likely source of funding for this programming? a. Federal and state tax dollars b. Fees for services c. Local and county tax funds d. Research and grant funds

a. Federal and state tax dollars Most funding for state health departments comes from public tax dollars provided by the state and federal governments.

A senior student nurse asked the instructor, Why do we have to make home visits? The client learned self-care in the hospital. Which of the following statements would be the best response from the instructor? a. Home visits allow you to focus on the entire family and see threats to health and safety. b. Making home visits will increase your marketability after you graduate. c. Our State Board of Nursing requires home visits as part of community/public health education. d. The national accreditation policies require that students make home visits before they graduate.

a. Home visits allow you to focus on the entire family and see threats to health and safety. Home visits allow the nurse to see threats to the family health and safety in the home or immediate environment. Home visits also encourage a family focus, although they do not guarantee it. It is common for new nurses who have little experience in home visiting to feel uncertain and ambivalent about the experience.

Although originally school nursings purpose was preventing the spread of contagious diseases, what additional responsibility was quickly added? a. Incorporating health education into the curriculum b. Replacing physicians for those children whose parents could not afford a physician c. Substituting for classroom teachers when the teacher was ill d. Teaching safety, first aid, and universal precautions to teachers

a. Incorporating health education into the curriculum The health issues seen by the school nurses expanded the nursing practice to include prevention, examination, treatment, and advocacy.

After being invited into the apartment of some elderly clients, the nurse was shocked to realize the elderly husband was smoking marijuana. Which of the following actions should the nurse take? a. Indicating that he or she will return at another time and then leaving the home b. Asking the man to stop and stress that the nurse cannot return if they are going to engage in illegal behavior while the nurse is there c. Calling the police, reporting the illegal behavior, and agreeing to serve as a witness if the case goes to trial d. Leaving and refusing to come back until all illegal drugs are out of the apartment

a. Indicating that he or she will return at another time and then leaving the home In some households, members may be intoxicated from consuming alcohol or may be using illicit drugs during the visit. Such individuals are likely to be cognitively impaired and will not benefit from your visit. You should indicate that you will return at another time, and then leave the home.

What steps can clients take in the home to prevent the development of infectious disease (select all that apply)? a. Keep a clean kitchen and bathroom. b. Maintain an optimal nutrition status. c. Avoid cleaning birdcages and cat litter boxes. d. Maintain daily personal hygiene. e. Use a soft toothbrush after every meal. f Be as active as possible.

a. Keep a clean kitchen and bathroom. b. Maintain an optimal nutrition status. c. Avoid cleaning birdcages and cat litter boxes. d. Maintain daily personal hygiene. e. Use a soft toothbrush after every meal

What is one of the most prevalent and noxious pollutants in modern America? a. Noise b. Sewage in septic tanks c. Unsafe discarded medications d. Unsafe water

a. Noise Noise, although considered innocuous, has major effects on hearing, stress-related conditions, mental illness, social maladjustment, and pathologic conditions.

What is the value of nurses discussions of their vision for the health of the community? (Select all that apply.) a. Other persons are assisted in seeking possibilities that they may not have considered. b. Other persons are encouraged to become partners in a specific project. c. Other persons are forced to think about health issues and nurses power. d. Other persons are coerced to become partners in the nurses dream. e. Attention is drawn away from issues pushed by other professions. f. The vision becomes a source of energy and motivation for everyone involved in the discussion.

a. Other persons are assisted in seeking possibilities that they may not have considered. b. Other persons are encouraged to become partners in a specific project. f. The vision becomes a source of energy and motivation for everyone involved in the discussion. Discussing the vision empowers nurses and helps them remember why they became nurses. It also allows other persons to become involved and to recognize new possibilities. Expressing the vision provides an opportunity for other persons to become partners in working for potential outcomes: not only the broader vision but also in relation to specific projects. Nurses do not force or coerce other persons, and they often work with members of other professions on issues related to health.

For what population size are most local health departments responsible? a. Populations of 50,000 or fewer b. Very large populations of 100,000 or more c. Very large populations of 250,000 or more d. Populations of more than 1 million residents

a. Populations of 50,000 or fewer The majority of local public health programs, many in small towns and rural areas, serve populations of 50,000 or fewer.

What conclusions were drawn from the 2006 School Health Policies and Programs Study? (Select all that apply.) a. Progress toward meeting goals had improved since the 2000 data was collected. b. Progress toward meeting goals had declined since the 2000 data was collected. c. Teachers delivering health education were appropriately prepared. d. Teachers delivering health education were inadequately prepared. e. The percentage of states mandating the adoption of health education standards decreased. f. The percentage of states mandating the adoption of health education standards increased.

a. Progress toward meeting goals had improved since the 2000 data was collected. d. Teachers delivering health education were inadequately prepared. f. The percentage of states mandating the adoption of health education standards increased. A comparison of data gathered in 2000 with that collected in 2006 reveals progress made in regard to the core components of comprehensive school health and stressed in Healthy People 2020. The findings show that the percentage of states that have adopted a policy mandating schools and districts to follow national or state health education standards or guidelines has increased from 60.8% to 74.5%. However, only 25% of teachers delivering required health curricula received training in any of the 14 identified health topics.

A public health nurse is assessing the health of the community and planning appropriate public health interventions. Which of the following models could the public health nurse use? (Select all that apply.) a. Protocol for Assessing Community Excellence in Environmental Health (PACE-EH) b. Leiningers Cultural Beliefs in Practice model c. Mobilizing Action through Partnerships and Planning (MAPP) d. Neumans Adaptation of Systems model e. The Quad Councils Public Health Nursing model f. The Wheel (Minnesota Interventions Wheel)

a. Protocol for Assessing Community Excellence in Environmental Health (PACE-EH) c. Mobilizing Action through Partnerships and Planning (MAPP) f. The Wheel (Minnesota Interventions Wheel) PACE-EH, MAPP, and the Minnesota Interventions Wheel are frequently used. Leiningers Cultural Beliefs in Practice model, Neumans Adaptation of Systems model, and the Quad Councils Public Health Nursing model do not exist.

A home care client was no longer eligible for insurance reimbursement of needed home care. What is the appropriate action for the nurse to take next? a. Providing care until the client can be transferred to a different agency b. Explaining that care is not free and that the nurse will not be returning c. Consulting with the public health department so that the client will receive free services d. Referring the client to social services for assistance

a. Providing care until the client can be transferred to a different agency Home care agencies are prohibited from discharging clients from care simply because they are unable to pay for the needed service. Rather, the agency must continue to give care until care is no longer needed or referral can be made to another agency that will care for the client. Although the public health department may be able to provide free or reduced care to some clients, a consultation would not ensure that the client would receive these services

It was suggested a public health departments funding for home visits be cut because so much time and money were spent in travel and such expenses seemed inappropriate in a time of fiscal restraint. Which of the following would be the nurses best response to this suggestion? a. Research has shown home visits save far more than their cost in decreasing child abuse, drug-resistant infections, and even emergency department visits. b. The public health department staff members are the most knowledgeable concerning funding needed and how best to spend the funds. c. The voters agreed on the tax levy funding the department. It would not be politically wise to act against voters obvious desires. d. With all the fear about bioterrorism, it is an inappropriate time to cut funds to the public health department.

a. Research has shown home visits save far more than their cost in decreasing child abuse, drug-resistant infections, and even emergency department visits. Research has demonstrated that home visits result in fewer instances of child abuse and neglect and fewer emergency department visits, accidents, and poisonings during the childs first 2 years of life. These effects were still apparent 15 years later.

The only clear distinction between a community health nurse and a public health nurse is that a. The community health nurse gives care in community settings regardless of personal education, whereas public health nurses have specific educational preparation. b. Community health nurse is a title that has historically been used, whereas public health nurse is the new in title for the role. c. The community health nurse is employed to give care to families and groups, whereas the public health nurse works in public health departments. d. Community health nurse is the broader term that includes public health nursing, school nursing, and home health nursing.

a. The community health nurse gives care in community settings regardless of personal education, whereas public health nurses have specific educational preparation. Public health nurses synthesize all their nursing expertise, as well as knowledge, from public health, whereas nurses with varied educational backgrounds may be employed in community settings.

How would the actions of the community/public health nurse caring for a recently discharged client in his home differ from those of the acute care nurse? a. The community/public health nurse would assess the health and needs of all the family members. b. The community/public health nurse would be careful to be nonjudgmental about the familys living situation. c. The community/public health nurse would explain why each nursing intervention was being performed. d. The community/public health nurse would help the family understand the basis for the treatment.

a. The community/public health nurse would assess the health and needs of all the family members. Although both nurses would give excellent care to the individual client, the acute care nurse would assess the client individually and adapt interventions accordingly. The community/public health nurse would seek to identify others in the family who might need intervention or referral as well. The community/public health nurse provides care from a family-focused model, being concerned not only with the health of the identified client but also with the health of other family members.

Among other variables, upon what does damage from a specific chemical depend? a. The dose b. The environmental factors c. The toxicology d. The virulence and infectivity

a. The dose The extent of biologic damage produced by a chemical depends on the amount of the exposure and the response of the person. This is called a doseresponse ratio. The damage depends on the exposure or dose and the response of the person exposed. The higher the dose of the chemical, the greater the response usually is.

Which of the following is an example of a phenomenologic community? a. The employees of Delco Manufacturing b. The Miami Valley region c. The village of Yellow Springs d. The United States Census Bureau census tract #1017

a. The employees of Delco Manufacturing All of the options are examples of geopolitical communities except the staff of a company, which is a phenomenologic community or a community based on relationships, not geopolitical boundaries.

A community/public health nurse is planning to implement a new community-based education program. Why is it crucial for the nurse to understand the organizational structure of a community, as well as its leadership? a. The nurse may have to convince the informal leaders of the need for the program before it can be successful. b. The nurse may need to ask the formal leaders to provide leadership for the programs. c. The nurse will want to know political priorities before deciding on any actions to be taken. d. The nurse will want the approval of the elected governing body before making decisions about health programming.

a. The nurse may have to convince the informal leaders of the need for the program before it can be successful. It is important for the nurse to identify both formal and informal leaders. Informal leaders often have the social power, even though the formal leaders have the authority in decision making. To be successful in any kind of change, the nurse needs a thorough understanding of both the formal and informal leadership dynamics.

What is a reason why home health nurses do not engage in case finding and preventive health teaching to all members of the family? a. These services do not result in reimbursement for the agency. b. Caseloads are so high that there is no time to provide these services. c. Home health nurses do not feel comfortable providing these services. d. Federal regulations limit the amount of these services that agencies can provide.

a. These services do not result in reimbursement for the agency. Most home health agencies do not provide public health services such as case finding or health-promotion activities because traditional third-party payers do not reimburse for such activities.

The nurse was teaching refusal skills, coping with peer pressure, and avoiding certain situations. A group of parents visiting the school asked why the nurse was using their tax dollars to teach social skills. What might the nurse need to explain? a. These skills help students avoid smoking, use of drugs, and early sexual intercourse. b. The nurse was providing information that the teacher had requested. c. The nurse was fulfilling state-mandated standards under the No Child Left Behind Act. d. These students had been identified as being at high risk and needed this education.

a. These skills help students avoid smoking, use of drugs, and early sexual intercourse. Such life skills are components of successful programs that help students avoid smoking, drug use, and other high-risk behaviors.

A clinical specialist in gerontology accepted a position with the local health department as a community/public health nurse. For whom can the nurse expect to provide care? a. To geriatric clients and the local senior citizen centers b. To the neighborhood at highest risk in the city c. To the neighborhood where the nurse lives d. To wherever the nurse selects

a. To geriatric clients and the local senior citizen centers A nurse can be assigned a specific neighborhood or a specific aggregate. As a clinical specialist in gerontology, the nurse would probably be assigned to work where there is a need for such expertise. The nurse could also be assigned a specific neighborhood, but not on the basis of risk, the nurses own residence, or the nurses choice.

Why is it necessary for public health nurses to attend community health planning meetings? a. To network with other community groups b. To protect the health of special interest groups c. To coordinate case management efforts d. To seek advice from others in the community

a. To network with other community groups Nurses must establish and maintain relationships with professionals in other agencies and create partnerships to address community problems. Through networking with other community groups, nurses may be able to improve the health of special interest groups and improve case management services. The purpose of community health planning meetings is not to receive advice from others. However, the increased networking may help nurses solve problems that they may be encountering.

Which federal agency is most involved in both direct and indirect health-related responsibilities? a. U.S. Department of Health and Human Services b. National Health Care Service Agency c. Public Health Service d. Veterans Administration Medical Services Branch

a. U.S. Department of Health and Human Services The USDHHS has the most health-related responsibilities, with more than 69,839 employees and a budget of 854.1 billion dollars. It gives some direct services but primarily provides indirect care.

Which of the following features of hospice differentiates it from traditional home care? a. Use of direct service volunteers as part of the interdisciplinary team b. Need for accurate documentation in order to receive reimbursement c. Use of Medicare reimbursement for services provided d. Provision of direct nursing services for the client

a. Use of direct service volunteers as part of the interdisciplinary team One of the unique features of hospice is that direct service volunteers are part of the interdisciplinary team. Volunteers provide a variety of services, including respite care, meal preparation, and friendly visiting. Accurate documentation, Medicare reimbursement, and direct nursing services are all part of hospice, but they are also part of traditional home care services.

A home care nurse is caring for an adult client who has an infectious disease. What measures should the nurse tell the clients family members to take to protect themselves from the disease? (Select all that apply.) a. Use protective barriers to prevent exposure to blood and other body fluids. b. Body substances should be put in the toilet along with 1 cup of bleach each time the toilet is flushed. c. Keep young children out of direct contact with the client. d. Soiled dressings should be thrown in a trash can labeled Hazardous Waste. e. Use disposable dishes when serving the client his food. f. Wash hands frequently.

a. Use protective barriers to prevent exposure to blood and other body fluids. f. Wash hands frequently. Specific measures to control infection do not include disposable dishes if regular dishes can be washed in hot, soapy water; isolation of the ill family member compromises quality of care and may create social-psychological issues; client wastes can just be flushed without further action. It is important for everyone to wash their hands frequently and to use protective barriers when one may have potential contact with hazardous body fluids.

Which of the following situations would be the best time for the school nurse to engage in informal teaching? a. When a student asks a question, thereby creating a teachable moment b. When a written request is submitted by a classroom teacher c. When parents have requested information on a particular topic d. When the principal has concluded that specific content should be added to the curriculum

a. When a student asks a question, thereby creating a teachable moment Although any of the options might cause a school nurse to consider teaching a specific program of study, teaching is most effective when the learner (an individual or a group) has a teachable moment or has expressed a desire or need to know.

Comprehensive school health curricula should (select all that apply): a. emphasize student assessments that measure skill and knowledge. b. introduce content in the early grades and reinforce it in later grades. c. provide at least 50 hours of health education at every grade level. d. be taught by all school teachers. e. accommodate local needs and preferences. f. include input from a comprehensive health education advisory committee.

a. emphasize student assessments that measure skill and knowledge. b. introduce content in the early grades and reinforce it in later grades. c. provide at least 50 hours of health education at every grade level. e. accommodate local needs and preferences. f. include input from a comprehensive health education advisory committee. Comprehensive school health curricula should emphasize student assessmentsthat measure skill acquisition as well as knowledge. Comprehensive school health curricula should introduce content in the early grades and reinforce it in later grades and provide at least 50 hours of health education at every grade level. Curriculum planning and development should accommodate the unique local needs and preferences of each community. Creation of a comprehensive health education advisory committee that includes parent representation should help guide the school health curricula. Comprehensive school health curricula should be taught by teachers who are trained to teach the subject

The disadvantages of home care are that it (select all that apply): a. is less efficient than hospital or clinic-based care. b. is costly in terms of travel costs. c. presents with distractions such as television and noisy children. d. may compromise the nurse's safety. e. most people prefer to receive hospital-based care. f. is more costly than hospitalization.

a. is less efficient than hospital or clinic-based care. b. is costly in terms of travel costs. c. presents with distractions such as television and noisy children. d. may compromise the nurse's safety. A disadvantage of home care is that it is less efficient than hospital- or clinic-based care. The nurse is unable to see as many patients in home care compared with an ambulatory setting. Home care is costly in terms of travel costs. Distractions such as television and noisy children may be more difficult to control. Nurse safety can be compromised during home visits. Most people prefer to receive care at home rather than in the hospital. Home care is less costly than hospitalization and can reduce overall costs by preventing future hospitalizations and shortening the length of time spent in hospitals

A population is defined as (select all that apply): Select all that apply. a. people residing in a particular area. b. a group under statistical study. c. a system of individuals who engage in face-to-face interactions. d. a set of persons with common characteristics. e. all the people in a community. f. the public.

a. people residing in a particular area. b. a group under statistical study. d. a set of persons with common characteristics. e. all the people in a community. f. the public. A population is the people residing in a particular area; a group under statistical study; a set of persons with common personal or environmental characteristics; and all the people in a certain community. A population is also referred to as the public. A population is not a system of individuals that engage in face-to-face interactions. Individuals in a population may or may not interact

The three critical components of a community are (select all that apply): a. people. b. place. c. social interactions. d. recreational activities e. crime rate. f. employment rate.

a. people. b. place. c. social interactions. People, place, and social interactions are the critical components of a community. Although crime rate, employment rate, and recreational activities are all considerations within a community, people, place and social interactions are the critical components.

In order to be admitted into hospice, a client must have (select all that apply): Select all that apply. a. provided informed consent. b. a prognosis of 6 months or less. c. a terminal illness. d. the ability to pay for services provided. e. a diagnosis of cancer. f. a diagnosis of AIDS

a. provided informed consent. b. a prognosis of 6 months or less. c. a terminal illness. In order to be admitted into hospice, a client must have a diagnosis of a terminal illness. The client's terminal illness must be certified by the attending physician and the medical director of the hospice providing the care. In order to be admitted into hospice, a client must have a prognosis of 6 months or less and the client must give informed consent for services. The ability to pay for services provided is not a requirement to be admitted into hospice. Many insurance providers, including Medicare, have a hospice benefit. The client may have cancer, AIDS, or any other terminal illness.

External feedback (select all that apply): a. provides an opportunity for the community to adapt. b. includes the physical and social environment. c. is received from within the community. d. offers a source of identity and support for the community. e. negotiates interchanges with its environment. f. allows for community modification.

a. provides an opportunity for the community to adapt. e. negotiates interchanges with its environment. f. allows for community modification. External feedback provides an opportunity for the community to adapt to the changing environment, negotiates interchanges with its environment, and allows the community to modify itself. Environmental factors include the physical and social environment. Internal feedback is information from within the community that helps the community monitor its functioning. Communication provides identity and support to its members, that is, a sense of belonging

A nurse demonstrates positive regard by: understanding someone else's experience. accepting the family, not necessarily the family's behavior. saying everything that he/she thinks. performing a client-focused assessment.

accepting the family, not necessarily the family's behavior. Positive regard is demonstrated by accepting the family, not necessarily the family's behavior. This involves recognizing the value of persons because they are human beings. A nurse who understands someone else's experience is demonstrating empathy. Empathy is the ability to put yourself in someone else's shoes, to be able to walk in his or her footsteps so as to understand his or her journey. Positive regard is not demonstrated by speaking everything that you think. Actually, the opposite is true; the nurse may feel differently about the situation, but instead accepts the family for who they are despite their shortcomings. Performing a client-focused assessment is an important role of the nurse in the home setting. However, performing this task does not demonstrate positive regard

A suprasystem is: part of a phenomenological community. found within the community. needed in order to define the community. anything outside the boundary of the community.

anything outside the boundary of the community. A suprasystem is anything outside the boundary of the community. It is the environment external to, or outside, the community that affects the community system. A suprasystem is not needed in order to define the community; rather, the community must be defined before the suprasystem can be identified

Which illness accounts for the most absences from school for school-age children? head lice bacterial infection asthma depression

asthma Asthma accounts for the most absences from school for school-age children. The environment, environmental tobacco smoke, birth history, and family history of asthma are all associated with the etiology of the disease.

Of the five clients listed below, whom should a nurse visit first? a. A married couple who have been having problems with independent living since the husband developed a staphylococcal infection b. A client with acquired immune deficiency syndrome (AIDS) who is waiting for a hospice opening c. A new admission who was discharged from the hospital with a diagnosis of pneumonia d. A man with a draining chest abscess who is receiving intravenous antibiotics

b. A client with acquired immune deficiency syndrome (AIDS) who is waiting for a hospice opening Because an AIDS client is immunosuppressed, the nurse should visit that client before visiting clients who have, or may have, an infection.

Which of the following is an essential characteristic of a community? a. A geographic area with defined boundaries b. A particular place over time for common purposes c. A place and beliefs or value systems d. A place or common demographic characteristics

b. A particular place over time for common purposes The three common factors that constitute a community are people, place, and social interaction or common goals.

A nurse is referring a client who needs follow-up care. Which of the following actions should the nurse take? (Select all that apply.) a. Asking whether the client prefers to have the nurse make all the arrangements b. Assessing whether the client meets the eligibility requirements for the receiving agency c. Discussing with the client the payment mechanism for follow-up care d. Determining whether the client is interested in following up at that particular agency e. Arranging for the client to have transportation and child care available f. Contacting several agencies in the area to see whether they are willing to accept a referral

b. Assessing whether the client meets the eligibility requirements for the receiving agency c. Discussing with the client the payment mechanism for follow-up care d. Determining whether the client is interested in following up at that particular agency The nurse must be sure the client meets eligibility requirements and is interested in the referral. The nurse must be aware of the payment mechanism that will be used for follow-up care so the client can be given names of community resources that are able to provide care on the basis of the source of payment. Contacting agencies about follow-up before the other actions with a client referral are completed is premature. Most agencies cannot provide free transportation and child care for clients to attend a different agency. It would encourage dependency for the nurse to make all the arrangements and then announce to clients what they should do. The client must be actively involved in follow-up care.

What would a new baccalaureate-prepared community/public health nurse be expected to do to improve personal competency and quality of care? (Select all that apply.) a. Apply the nursing process to a large aggregate. b. Be actively involved in peer review. c. Provide the best possible care to individuals and families. d. Participate in relevant continuing education programs. e. Integrate relevant research findings for evidence-based practice. f. Systematically evaluate personal professional practice performance.

b. Be actively involved in peer review. d. Participate in relevant continuing education programs. e. Integrate relevant research findings for evidence-based practice. f. Systematically evaluate personal professional practice performance. Performing tasks such as applying the nursing process or providing the best care possible is not maintaining competence. Competency is maintained by ongoing professional development such as attending educational programs, becoming involved in peer review, reading and integrating relevant research findings, and continually evaluating ones personal practice.

What would be the school nurses motivation for educating adolescent girls about self-esteem and body image? (Select all that apply.) a. Body image is strongly related to a tendency to engage in bullying and verbal violence. b. Bulimia is associated with major depression. c. Disturbed eating patterns are associated with distorted body image and low self-esteem. d. Eating disorders have the highest mortality rate of any psychiatric disorder. e. Obesity is strongly related to distorted body image. f. Obsessive-compulsive disorder commonly accompanies anorexia.

b. Bulimia is associated with major depression. c. Disturbed eating patterns are associated with distorted body image and low self-esteem. d. Eating disorders have the highest mortality rate of any psychiatric disorder. f. Obsessive-compulsive disorder commonly accompanies anorexia. Both anorexia nervosa and bulimia nervosa are characterized by disturbed eating patterns. Major depression commonly accompanies both anorexia and bulimia, and obsessive-compulsive disorder is associated with anorexia. These eating disorders have the highest mortality rate of any psychiatric disorder.

A nurse briefly summarized a home visit with the agency supervisor. How can discussing clients with a colleague help the nurse? a. By ensuring that the agencys policies and procedures are correct b. By confirming the nursing inferences that have been developed c. By ensuring that appropriate referrals are made for the client d. By confirming that the client understands the obligations of the agency

b. By confirming the nursing inferences that have been developed Nurses are in the position to share assessment information, determine what it means to the family, and discuss nursing inferences that have been made. Consultation and collaboration with other professionals within the agency are important to make sure that the nurse is seeing the complete situation of the patient and that an appropriate plan of care has been developed for the client.

A nurse is admitting a client to home care services, using Medicare as the funding source for the care that will be provided. Which of the following substantiated findings would make a client ineligible for these services? a. Care is needed from both a nurse and a physical therapist. b. Care is needed 24 hours a day on an ongoing basis. c. The client is incapable of leaving the home. d. None of these; the requested care seems reasonable and medically necessary.

b. Care is needed 24 hours a day on an ongoing basis. The five criteria for Medicare reimbursement are (1) being homebound, (2) having a completed plan of care, (3) needing skilled professional services, (4) needing skilled services that are reasonable and necessary, and (5) needing services on a part-time or intermittent basis. Needing full-time care would not be the purpose of home care services under Medicare.

Why do clients typically prefer home care over hospital care? a. Clients feel better wearing personal clothing and preparing their own favorite foods. b. Clients are comforted by the feeling of control and the familiarity of their own home. c. Clients know that more visitors can stop by without concern for having limited space. d. Clients resent the constant interruptions by nurses and other caregivers in a hospital.

b. Clients are comforted by the feeling of control and the familiarity of their own home. Although all of the options could on occasion be true, the primary reason that clients feel better at home is because it is their own, familiar territory where they are in control.

Which of the following are framework models currently in use in community health nursing? (Select all that apply.) a. American Nursing Community Health Model (ANCHM) b. Community-as-Partner model c. Mobilization for Action through Planning and Partnerships (MAPP) d. Helvie Energy Framework e. General Ethnographic and Nursing Evaluation Studies in the State (GENESIS) f. The geopolitical phenomenological model

b. Community-as-Partner model c. Mobilization for Action through Planning and Partnerships (MAPP) d. Helvie Energy Framework e. General Ethnographic and Nursing Evaluation Studies in the State (GENESIS) There is no such model as ANCHM. Geopolitical and phenomenological models are two ways of addressing a community. Community-as-Partner, MAPP, Helvie Energy Framework, and GENESIS are all framework models currently in use in community health nursing.

A community/public health nurse wants to use key informants to gather additional information. Which of the following actions would be useful to perform first? a. Sending an e-mail message to all community residents b. Conducting a focus group with informal leaders from the community c. Publishing a survey in the local newspaper d. Requesting that childrens parents complete a survey

b. Conducting a focus group with informal leaders from the community Although any of these options might be useful, a focus group with the communitys leaders would probably yield the most reliable data. Further meetings or focus groups might then concentrate on special at-risk groups.

What underlying values should be a part of a healthy community? a. Responsibility and respect b. Connectedness and caring c. Stability and safety d. Marketability and security

b. Connectedness and caring The World Health Organization (WHO) points out that values underlying health for a community include equity, empowerment, and cooperation. As a balance to some of the values of efficiency, materialism, and hierarchic power structures, nurses are speaking for connectedness and caring.

A school nurse completed a needs assessment and concluded that illegal use of drugs, including alcohol and tobacco, was a major problem. What would be the nurses first intervention? a. Ask police officers to educate the students about the penalties for illegal drug use. b. Create, with administrative support, a policy of no smoking while on school grounds. c. Inform teachers that smoking on school grounds will not be tolerated. d. Tell the local newspapers of the findings so that the media can inform parents.

b. Create, with administrative support, a policy of no smoking while on school grounds. One of the recommendations for school substance use prevention programs is to develop and enforce a school policy on substance abuse; creating a no-smoking policy meets this recommendation. The other interventions, although important, do not address the recommendations addressed in the text.

Which of the following activities is an ergonomist most likely to perform? a. Studying the prevention, detection, and treatment of work-related injuries b. Designing equipment for the interface of humans, their tools, and work activities c. Recognizing natural history of occupational disease and injuries in certain groups d. Describing the toxic properties of chemical agents used in the employment setting

b. Designing equipment for the interface of humans, their tools, and work activities An ergonomist studies, designs, and promotes the healthy interface of humans, tools, and their work requirements. Physicians diagnose and treat disease, an epidemiologist studies and describes the natural history of diseases or injuries, and toxicologists examine toxic properties of chemicals.

Which of the following changes have occurred in public health since 1990? (Select all that apply.) a. Renewed focus on primary care to the medically indigent b. Development of coalitions and partnerships to provide care to populations c. Improved emergency preparedness with funding for such preparation d. Improved surveillance and infrastructure as a result of fears about terrorism e. Increased emphasis on primary care to individuals and families f. Increased funding from Medicaid for services rendered

b. Development of coalitions and partnerships to provide care to populations d. Improved surveillance and infrastructure as a result of fears about terrorism In response to the Institute of Medicine report titled The Future of Public Health, there has been an emphasis on population-based care and the development of coalitions and partnerships to provide health care. Fears about terrorism and possible biologic infections have led to improvements in surveillance. Primary care is being increasingly referred to various managed care providers and is not a priority of local health departments. Thus, most local health departments no longer collect Medicaid fees. Emergency preparedness is federally mandated, but no federal funds were forwarded to the states in order to achieve preparedness.

A home care nurse is going to a clients home to admit the client for home care services. What should the nurses priority action be during the admission visit? a. Complete the Outcomes Assessment and Information Set (OASIS) form for the Centers for Medicare and Medicaid Services (CMS). b. Discuss the availability of financial resources or eligibility for a third-party payer. c. Inform the client of his or her responsibility to follow the plan of care to continue receiving services. d. Set up the equipment for the computer to relay data between the nurse and the client.

b. Discuss the availability of financial resources or eligibility for a third-party payer. Although the OASIS questionnaire is required under Medicare, the patient may have insurance or other financial resources. The nurse must first discuss financial resources to determine how payment will be made, which will affect decisions regarding planning of care and whether the OASIS form must be completed.

Which action by home health nurses is crucial because of current national health care goals? a. Administer medications and treatments correctly and safely. b. Document the savings and benefits of home care services. c. Guide a group to an appropriate resource to best meet their needs. d. Teach an ill persons family how to promote self-care.

b. Document the savings and benefits of home care services. Because cost containment in health care continues to be a national goal, it is important for community/public health nurses to continue to document the cost of nursing care and the savings that nursing care can provide (Deal, 1994). Home care expanded because nurses demonstrated that quality care can be provided for some clients in the home at a lower cost than in the hospital.

A community/public health nurse is speaking with a group of elderly citizens about how the state health agency operates as part of the state government. Which of the following information would likely be included? a. Every state health agency has a similar organizational structure and offers similar services to its citizens. b. Each state health agency has many different departments, commissions, agencies, and boards. c. Each state health agency depends primarily on federal funding and guidance in meeting health concerns. d. Every state health agency delegates authority or funds to local boards of health.

b. Each state health agency has many different departments, commissions, agencies, and boards. Because state governments have diverse organizational structures, there is no consistency in which health care services are organized or supplied by states. There are approximately 36 state agencies outside the state health agency with health-related responsibilities. Responsibilities are divided over an extensive number of departments, commissions, agencies, and boards.

What has been a traditional focus of school health programs since the 1980s? a. Drug abuse b. Environment c. First aid and safety d. Sexual behaviors

b. Environment The traditional school health approach included the three domains of health services, health education, and environment.

A registered nurse was attending new employee orientation at a home nursing agency. The agency supervisor reviewed the Conditions of Participation. To what was the supervisor referring? a. County statutes regarding who could be employed as a caregiver b. Federal rules, standards, and criteria for Medicare certification c. Professional standards concerning appropriate care documentation d. State legislation regarding who was eligible for care

b. Federal rules, standards, and criteria for Medicare certification For Medicare certification, agencies must meet the Medicare conditions of participation (COPs), which include rules, standards, and criteria established by the federal government.

In which situation would the community/public health nurse be applying the ethical principle of doing good for the greatest number of persons with the least amount of harm? a. Asking the agency supervisor how to approach an ethical dilemma b. Focusing on providing basic services for everyone in the community c. Following agency policies d. Delivering care to families who have health insurance

b. Focusing on providing basic services for everyone in the community To provide for the greatest good to the greatest number, it is often necessary to focus on basic services, such as immunization or prenatal care, because such care has the most effect on the whole community.

What is the nurses most appropriate action when it becomes apparent that another agency is needed to help a family best meet their health needs? a. Call the other agency to set up care for the family. b. Give the family information to initiate contact with the other agency. c. Report the need to the community/public health nurses supervisor for action. d. Write a letter to the appropriate agency suggesting that it contact the family.

b. Give the family information to initiate contact with the other agency. Nurses usually encourage clients to initiate contact as one way of maintaining responsibility for their own care without encouraging dependency. Nurses work with clients with a specific difficulty or barrier, such as language, in a way that empowers them to follow up on the referral.

Which nursing actions would help ensure a healthful environment? (Select all that apply.) a. Help an elderly couple obtain access to a health clinic that will accept Medicare. b. Help parents fight to get soda and candy vending machines out of the school. c. Help the high school student government establish a waste recycling program. d. Refer a single mother to a public assistance program. e. Recognize that individuals have a right to smoke if they so desire. f. Support members of Mothers Against Drunk Driving who testify to Congress.

b. Help parents fight to get soda and candy vending machines out of the school. c. Help the high school student government establish a waste recycling program. f. Support members of Mothers Against Drunk Driving who testify to Congress. While all the options would be excellent interventions, finding a source of medical care or referring a single mother to a public assistance program, even recognizing the right to autonomy, does not change the environment. Improving the environment by having only healthy choices available, establishing waste recycling, and helping get drunk drivers off the road makes the world safer for everyone.

How are home health agencies reimbursed for care from Medicare? a. Diagnostic-related groups (DRGs) b. Home Health Resource Group (HHRGs) c. Outcomes Assessment and Information Set (OASIS) d. Preferred Provider Organizations (PPOs)

b. Home Health Resource Group (HHRGs) The HHRG in which the client will be placed is determined by OASIS questionnaire data. Each HHRG has a set amount of dollars reimbursed to the home health agency caring for the patient. DRGs are used for hospital reimbursement. PPOs are managed health organizations comprised of medical providers who offer discounted services for their members.

The Nursing Home without Walls (NHWW) staff compared the cost of care in the home with care in the hospital and drew what conclusion? a. Home care services are slightly less expensive than what hospital care would cost. b. Home care services are about half of what hospital care would cost. c. Home care services are roughly equivalent to what hospital care would cost. d. Home care services do not clearly demonstrate a difference in cost.

b. Home care services are about half of what hospital care would cost. An NHWW study concluded in 2001 demonstrates that the cost of home care services has been half of the cost of corresponding institutional care.

Which of the following reasons explains why new community/public health nurses are very uncomfortable with home visiting, even in nice neighborhoods? a. Home visits are a new skill to be mastered, and learning is uncomfortable. b. Home visits reflect a situation under the clients control and in the clients environment. c. Home visits require lots of supervision, backup, and extra resources. d. Home visits take much more time and effort than does giving care in the hospital.

b. Home visits reflect a situation under the clients control and in the clients environment. All of these factors can lead a nurse, especially an inexperienced one, to feel uncomfortable. However, the major difference is that the setting and the control are clearly the clients, not the nurses.

A nurse visited a new family to help them adapt to the needs of their newborn. The family asked the nurse to help them obtain diapers, formula, and transportation to the clinic. How should the nurse respond? a. I cant believe you even asked me that. I dont have any money! b. I cant help with those items, but I can share with you some other resources that may help you adapt to having this new little person in your lives. c. Ill ask at the home office and see if someone knows a resource for you. d. My sister has some cloth diapers she isnt using anymore; I can bring those over, but I dont have any formula. Have you tried asking the hospital for free samples?

b. I cant help with those items, but I can share with you some other resources that may help you adapt to having this new little person in your lives. Families may test what the nurse is willing to do, or they may be so overwhelmed that they make inappropriate or unrealistic demands. The nurse must state limits immediately to maintain trust. However, referrals are appropriate for emergency food, clothing, and shelter, including formula for newborns.

What was the primary reason home care agencies expanded so drastically in the late 1960s and 1970s? a. Hospitals chose to focus on providing care for more acutely ill clients. b. Increased numbers of elderly and poor persons were eligible for care because of federal legislation. c. Early discharges influenced the need for clients to receive home care services after hospitalization. d. There was lack of interest by the American society to contribute to charitable causes.

b. Increased numbers of elderly and poor persons were eligible for care because of federal legislation. Home care agencies expanded in the 1960s and 1970s as a result of Medicare/Medicaid legislation to pay for care of elderly persons and those in poverty.

Which of the following actions demonstrates a home care nurse integrating the Healthy People 2020 objectives into home care practice? a. Referring a client to physical therapy b. Instructing a client to visit the dentist on an annual basis c. Administering an insulin injection to a diabetic client d. Counseling a client about how to prevent the spread of infectious disease

b. Instructing a client to visit the dentist on an annual basis Instructing a client to visit the dentist on an annual basis demonstrates the nurse integrating the Healthy People 2020 objective Increase to 49% the proportion of children and adults who use the oral health care system each year. The other actions are important actions of the home care nurse but do not address the Healthy People 2020 objectives.

What should a nurse bring to the home visit when first going to the apartment of a newly admitted patient whose referral sheet was essentially blank? a. Everything that might possibly be needed b. Liquid soap, paper towels, educational materials, and assessment equipment c. Nothing; the nurse should assess the situation and then get supplies d. Agency forms and a pen

b. Liquid soap, paper towels, educational materials, and assessment equipment Not knowing what he or she will see or need, the nurse should bring safety supplies (soap, paper towels) and basic assessment tools. The nurse can return to the car for additional supplies or equipment if it is needed.

A community member asks a community/public health nurse, How much progress has been made toward consolidating state health services into a single agency? Which of the following statements would be accurate for the nurse to make? a. Incredible progress; about half the states have done so. b. Little progress; no state has completely done so. c. Some progress; about one third of the states have done so. d. Successful progress; most states have done so.

b. Little progress; no state has completely done so. There has been little progress in 50 years, and no substantial consolidation is foreseen. The states health care responsibilities are still divided over an extensive and bewildering number of departments, commissions, agencies, and boards. It is hoped that consolidation would streamline bureaucracy, reduce duplication of efforts, and potentially cut costs.

A home care nurse was scheduled to attend a Medicare case conference for a client who was receiving care from the nurse and a physical therapist. What was the probable reason why the case conference was scheduled? a. It offers an opportunity for the financial officer to evaluate the nurse and the physical therapist, as well as the appropriateness of care being given. b. Medicare mandates a case conference every 60 days to coordinate care. c. The home care staff was providing inadequate care and needed additional staff in-services. d. Data could be collected and reported to the primary physician to ensure continued reimbursement for the physician.

b. Medicare mandates a case conference every 60 days to coordinate care. Medicare mandates case conferences at periodic intervals, and a written summary must be sent to the primary physician for review. Sometimes the client or the clients caregivers may be included in the case conference. There is no evidence that any of the other possible responses are true.

The school nurse reported suspected child abuse to the appropriate local authorities. The parents became very upset and stormed into the school, demanding a copy of all the records related to their child, including the health record that led the nurse to make such an accusation. What would be the nurses best response? a. No; I will need to get permission from the principal before I release those records to you. b. No; you are unable to view these because school health records are not part of your childs educational record. c. Yes; as parents you have the right to your childs records, but you must allow me time to pull the records together. d. Yes; you have every right to a copy of the records, although not the originals, which must remain at the school.

b. No; you are unable to view these because school health records are not part of your childs educational record. School-based health clinical and center records, records connected to drug or alcohol abuse, and records connected with child abuse or neglect are not considered part of the educational record available to the parents.

Aside from administrative staff, which professional group represents the majority of professionals in public health departments? a. Epidemiologists b. Nurses c. Physicians d. Environmental sanitarians

b. Nurses The majority of public health providers are nurses.

The Mr. Yuk educational campaign and the practice of routinely dispensing medications in childproof containers are examples of a. Primary prevention programs that have had little effect on poisoning deaths. b. Primary prevention programs that have notably decreased deaths from poisoning. c. Secondary prevention programs that have had little effect on poisoning deaths. d. Secondary prevention programs that have notably decreased deaths from poisoning.

b. Primary prevention programs that have notably decreased deaths from poisoning. Both campaigns were extremely effective, as seen in a dramatic decrease in poisoning deaths among children from birth to 4 years of age. Both interventions are examples of primary prevention.

What is the rationale behind public health departments not offering home nursing? a. Most of the agencies energy and resources are spent on controlling communicable diseases instead. b. Priorities have changed to focus on addressing the increasing public health problems. c. Profit-making agencies are now providing more care for homebound clients. d. Public health has not traditionally been involved in home care of individuals.

b. Priorities have changed to focus on addressing the increasing public health problems. Public health agencies are supported by tax dollars and give care under state legislation, as well as local statutes. The focus is on public health more than on direct client care. The highest priorities are bioterrorism and mothers and children at high risk for health problems.

The federal government obtains its authority to be involved in health care from the a. Legislation that was passed giving the federal government that privilege. b. Regulation of interstate commerce and its responsibility to provide for the general welfare. c. Constitution, specifically allocating authority for health care to the federal government. d. States requesting the federal government, because of its taxing ability, to accept that responsibility.

b. Regulation of interstate commerce and its responsibility to provide for the general welfare. The responsibility for health rests, like all powers not directly given to the federal level, with the state government. Although not explicitly stated, the federal authority is presumed from the overall charge to provide for the general welfare and its role in regulation of interstate commerce.

Which branch of the federal government funds the Women, Infants, and Children (WIC) supplemental food program? a. The Centers for Disease Control and Prevention b. The Department of Agriculture c. The Department of Health and Human Services d. The Public Health Department

b. The Department of Agriculture WIC is funded by the Department of Agriculture to provide supplemental foods, infant formula, and nutrition education.

A nurse knew that the home health agency had been accredited by the Community Health Accreditation Program (CHAP). What will be the agencys status in relation to required Medicare visits and self-study? a. The agency will have difficulties because Medicare reimburses only agencies accredited by the Joint Commission. b. The agency will have deemed status as accreditation standards are more rigorous than Medicare criteria. c. The agency will need to demonstrate evidence of achieving positive outcomes in order to receive Medicare reimbursement. d. The agency will need to engage in another self-evaluation and submit to Medicare peer review site visits.

b. The agency will have deemed status as accreditation standards are more rigorous than Medicare criteria. Medicare criteria are more than minimum standards but are not really quality standards. Accreditation represents quality service. Consequently, any agency that meets the quality standards of accreditation from either the CHAP or The Joint Commission has more than met Medicare standards and is considered to have deemed status. An agency that meets accreditation standards is deemed to have met the Medicare standards as well.

When community/public health personnel speak of a community of solution, to what are they referring? a. A community that has resolved its major problems at least temporarily b. The area in which some problems are approached on a wider regional basis c. The fact that communities have to solve their own problems d. The reality that some problems have to be approached on a federal basis

b. The area in which some problems are approached on a wider regional basis A community of solution refers to the boundaries within which a problem can be identified, addressed, and solved. Such problems are often beyond one communitys boundaries but affect several communities, which must work together to resolve the problem.

A nurse is employed by a local public health department and provides direct care services to clients in the community. Which of the following payer sources is likely to be responsible for reimbursing for this care? (Select all that apply.) a. Legislative appropriations b. The client who uses a sliding fee scale c. Private insurance d. State health agency e. Centers for Disease Control and Prevention f. Medicare and Medicaid

b. The client who uses a sliding fee scale c. Private insurance f. Medicare and Medicaid Many nursing services providing direct care have a service fee. A sliding fee scale is used to determine what percentage of the fee the client will pay on the basis of the clients financial assets. If the client has a third-party payer, such as Medicare, Medicaid, or private insurance, some departments will bill that source or provide the client with a receipt to file for reimbursement. Legislative appropriations and state health agencies may pay for programming at the local level; however, most of these funds are not used for direct care services.

Why would a nurse be concerned when a community has relatively closed, rigid boundaries? a. The community does not have an identity. b. The community is probably resistant to change. c. The nurse will not be able to share community resources. d. The nurse may have limited access to the community.

b. The community is probably resistant to change. A closed, rigid system is resistant to change, whereas an open, more flexible system is more receptive to change and to help from the health care delivery system.

Why did home care agencies expand in the 1980s? a. Clients discovered they much preferred home care to hospital care. b. The diagnostic-related group (DRG) system of reimbursement was phased into hospitals. c. An increased number of elderly and poor persons became eligible for care because of federal legislation. d. There was a lack of interest by American society in contributing to charitable causes.

b. The diagnostic-related group (DRG) system of reimbursement was phased into hospitals. A significant result of the DRG system was a decrease in the clients length of hospital stay and an increased demand for home health agencies to provide care to clients who were still recovering from surgery or an illness. The federal legislation that increased the number of elderly and poor persons eligible for care happened with the passage of Medicare and Medicaid in 1965.

Which of the following primarily determines the school nurses role in a community? a. The communitys priorities for its schools b. The local school systems goals as influenced by federal and state legislation c. The nurse practice act of the state in which the nurse practices d. The employed nurses education, credentials, and skill level

b. The local school systems goals as influenced by federal and state legislation School health programs vary markedly across the United States. The local schools primarily define their program but are influenced by federal, state, and local regulations.

Which statements about state health agencies (SHA) are correct (select all that apply)? Select all that apply. a. States receive direction from the federal government about how to spend their funds. b. The majority of state health departments have freestanding, independent health agencies. c. The chief executive of the state health agency (SHA) usually is appointed by the state's governor. d. State budgets for public health activities have been decreasing. e. Some states require a physician to serve as health officer. f. The SHA assists, delegates to, and/or oversees local health departments.

b. The majority of state health departments have freestanding, independent health agencies. c. The chief executive of the state health agency (SHA) usually is appointed by the state's governor. d. State budgets for public health activities have been decreasing. e. Some states require a physician to serve as health officer. f. The SHA assists, delegates to, and/or oversees local health departments There has been a movement toward integrating state health departments into larger superagencies. However, the majority of state health agencies (SHAs) have not merged into superagencies. The chief executive of the SHA usually is appointed by the state's governor and serves at the discretion of the governor. State budgets for health and welfare programs have been reduced because of decreases in federal funding and strain on state sources of money. In some states, the health code requires a physician to serve as the health officer. SHA assists, delegates to, and/or oversees local health departments. States vary in the degree to which they fund public health and population-focused activities. Funding for SHAs comes from public tax dollars provided by the state and federal government

Which of the following would most likely be a problem for the nurse making home visits? (Select all that apply.) a. Assessing the client may be more complex when family and environmental factors are considered in the assessment. b. The nurse may be unable to care for as many clients because of the time lost in transportation. c. Clients will be unable to receive individualized care. d. Teaching may be more time-consuming when both the client and the family are involved. e. The nurse may sometimes be concerned for personal safety. f. It may be difficult to control distractions, such as noisy children.

b. The nurse may be unable to care for as many clients because of the time lost in transportation. e. The nurse may sometimes be concerned for personal safety. f. It may be difficult to control distractions, such as noisy children. Travel time is costly, and it is less efficient for the nurse than working with groups or seeing many clients in an ambulatory site. Distractions, such as television and noisy children, may be more difficult to control. In addition, nurse safety can be an issue.

The core functions of school health services are to provide (select all that apply): a. healthy school meals. b. referrals and linkages with other health providers. c. safe extracurricular activities for students. d. health-promotion programming for staff. e. health-promotion and disease-prevention education. f. direct client care, such as screening.

b. referrals and linkages with other health providers. e. health-promotion and disease-prevention education. f. direct client care, such as screening. One of the core functions of school health services is to provide referrals and linkages with other health providers and communication with school staff and families. Other core functions include direct client care and health-promotion and disease-prevention education. Direct client care includes screening, diagnosis, and treatment, including the administration of medications; provisions for emergency care; and counseling and mental health services. Healthy school meals should be provided through the nutrition services component of comprehensive school health; it is not one of the core functions of school health services. Providing safe extracurricular activities for students should be provided through a healthy school environment. Health-promotion programming for staff is a component of a comprehensive school health program, but it is not one of the core functions of school health services

Responsibilities of an epidemiologist in a health department are to (select all that apply): Select all that apply. a. conduct routine sampling of air and private water sources. b.explore the causes of a measles outbreak in the community. c. predict health hazards in the community. d. evaluate the interventions used in managing a measles outbreak. e. provide personal health services to populations and individuals. f. offer case management and client support and guidance.

b.explore the causes of a measles outbreak in the community. c. predict health hazards in the community. d. evaluate the interventions used in managing a measles outbreak. Epidemiologists are responsible for describing the health of communities, exploring the causes of specific disease outbreaks (like measles), predicting health hazards, and evaluating interventions. Environmental sanitarians are responsible for conducting routine sampling of air and private water sources. Public health nurses provide personal health services to populations as well as individuals in the community. Public health nurses offer follow-up, case management, and continuing family and client support and guidance

In a prospective payment model, the agency is reimbursed: based on the anticipated cost of providing care. after care has been provided. by an HMO provider. for all the services that are provided.

based on the anticipated cost of providing care. In a prospective payment model, the agency is reimbursed based on the anticipated cost of providing care. Using several factors, including a standardized assessment tool, the average or usual cost of the care for a client is calculated. The agency is paid a set amount after the admission of that client to service. In a retrospective payment model, the agency is reimbursed after care has been provided. HMO providers may reimburse based on a prospective or retrospective payment model depending on the reimbursement policies of the provider. The prospective payment model may not pay for all the services that are provided. The agency receives a certain amount of money based on the average or usual cost of care for a client. If the client uses more services than anticipated, the agency has to provide the care and assume the financial costs.

A public health nurse working in the late 1800s would have most likely provided care to which of the following clients? a. An 80-year-old man who had diabetes b. A 40-year-old woman who did not have health insurance c. A 20-year-old woman who was pregnant d. A 30-year-old man who had Down syndrome

c. A 20-year-old woman who was pregnant From its beginning, public health nursing focused on persons living in poverty and ill persons, especially pregnant women and new mothers and their newborns. The 20-year-old female who was pregnant is the best example of the population that was served during this time period. Persons with chronic diseases and disability were not the focus of care, and health insurance did not exist at that time.

What is the meaning of the term aggregate as used in community health? a. A group of persons who reside in a specific geographic area b. All the persons who live in a specific community c. A set of persons who have some characteristic in common d. The public in professional terminology

c. A set of persons who have some characteristic in common By definition, an aggregate is a group of persons who have one or more characteristics in common, particularly a set of persons under statistical study with some common personal or environmental characteristic. Aggregate is a synonym for population.

What is the significance of the credentials APHN, BC? a. A special professional development program for community/public health nurses b. A special title given to nurses who join the American Nurses Association c. A voluntary process that demonstrates knowledge, education, and experience d. A title given to a nurse who has a special masters degree

c. A voluntary process that demonstrates knowledge, education, and experience Certification is a voluntary process that validates an individual registered nurses qualifications in a specified area of nursing. A community health nurse who completes educational preparation in community health or public health at the graduate level may choose to seek certification in this specialty area. After passing the certification exam, the credentials APHN, BC may be used.

Which of the following would be the best way to determine the health of a community? a. Ask a firefighter which neighborhoods have the fewest fires. b. Ask a realtor which neighborhoods have the most expensive houses. c. Ask people living in the neighborhood if they are happy with where they live. d. Ask the police department which neighborhoods have the lowest crime rates.

c. Ask people living in the neighborhood if they are happy with where they live. A healthy community is one in which residents are happy with their choice of location and exhibit characteristics that would draw others to the location. Thus, the best way to determine the health of the community is to talk to those living in it.

What can a nurse do to promote safety when performing home visits (select all that apply)? a. Carry her purse into the home. b. Make home visits outside of scheduled business hours. c. Carry an identification badge and wear a name pin. d. Perform all home visits independently. e. Determine the safest times to visit. f. Ask for specific directions to the home.

c. Carry an identification badge and wear a name pin. e. Determine the safest times to visit. f. Ask for specific directions to the home. Carrying an identification badge and wearing a name pin promotes nurse safety when performing a home visit. Consider whether certain times of the day are safer for visits in certain areas. Ask for directions to the family's road, driveway, building, or apartment. Do not carry purses into the home or wear jewelry other than engagement or wedding rings. Visit only during your scheduled work hours. If you must make an exception to this time, permission from your supervisor must be obtained. Consider whether an escort is needed when traveling to certain areas

Which interventions are most commonly used by community/public health nurses caring for families? (Select all that apply.) a. Administering screening tools to all family members b. Applying the nursing process to the care of individuals c. Collaborating and coordinating referrals as needed d. Providing health teaching, including anticipatory guidance e. Participating in collecting data on clients for clinical research f. Resolving conflict among family members

c. Collaborating and coordinating referrals as needed d. Providing health teaching, including The predominant intervention strategies used with families are primary care, health teaching (including anticipatory guidance), referral, and collaborating and coordinating care. Screening can be performed by various nurses, as can care of individuals. Nurses probably cannot resolve conflict, although they may help family members cope with conflict. Collecting data for research can be done only with a clients permission.

After a completing a home visit, which of the following would be the priority action for the nurse? a. Submit the insurance and other third-party payer forms correctly. b. Call the family and determine their satisfaction with the visit. c. Complete the documentation and discuss questions beyond the nurses expertise with a consultant. d. Order the necessary supplies and equipment for the return visit.

c. Complete the documentation and discuss questions beyond the nurses expertise with a consultant. After the visit, the nurse should make sure that documentation is complete, make any necessary referrals, and consult with colleagues or an expert in a particular clinical area about unresolved issues. Legal documentation is always required after a home visit.

Which of the following conclusions would require the nurse to obtain more assessment data? a. A major health problem is identified. b. An identified subpopulation is seen to be at high risk for and vulnerable to medical problems. c. Data that have been collected are incongruent and contradictory. d. Strengths in the community outweigh the areas of weakness.

c. Data that have been collected are incongruent and contradictory. The data must be congruent, or data explaining the discrepancies must be found, before inferences about the level of community health can be made.

A nurse is planning the evaluation of a mental health screening program in the community. What should be included in the process evaluation of this program? a. Asking whether program goals were adequately met b. Determining whether more people sought follow-up care after the screening c. Determining the number of people who attended and were screened d. Measuring whether the incidence of disease changed

c. Determining the number of people who attended and were screened In process evaluation, investigators examine actual program performance, such as number of people served by the screening. Asking whether program goals were met, determining amount of follow-up care sought, and measuring changes in the incidence of disease are all outcome evaluation measures.

How might case management be defined? a. An incident that necessitates intervention b. A synonym for cost containment c. Developing and coordinating a plan of care for a client d. Advocating for groups of clients who have a specific illness

c. Developing and coordinating a plan of care for a client Case management is defined as the development and coordination of a plan of care for a selected client.

A young man has repeatedly visited the sexually transmitted disease (STD) clinic for human immunodeficiency virus (HIV) testing. What should the nurse do in addition to completing the testing? a. Determine whether the young man is heterosexual or homosexual. b. Emphasize repeatedly the importance of abstinence. c. Discuss his perceived barriers to practicing safe sexual behaviors. d. Teach the importance of using protection for engaging in sexual acts.

c. Discuss his perceived barriers to practicing safe sexual behaviors. Because the young man has presumably been taught the advantages of abstinence or protection for engaging in sex, and yet continues to return for further testing, it is clear that information alone has not changed his behavior. Therefore, the nurse should interview the client about his values and help him perceive how reducing his risks may help him achieve his goals.

Which demographic factors of a community are important for the nurse to consider when assessing a community? a. Census tract data can be used to determine needed agency staffing. b. Density of housing is associated with contagious infections. c. Ethnicity determines how health is defined and protected. d. Income determines what community services can be financed.

c. Ethnicity determines how health is defined and protected. Although demographic factors (age, race, gender, ethnicity, and density of population) are important for many reasons, the focus of assessment is on promoting and maintaining health. Therefore, health as the community defines it must be understood. Ethnicity determines how the community addresses health problems and attempts to protect the health of its members.

Which nursing activity is unique to community/public health nurses? a. Care for the sick and dying b. Commitment to promote health of individuals and families c. Focus on vulnerable groups in the community d. Provide holistic care to clients in the presence of their families

c. Focus on vulnerable groups in the community Beliefs of the nursing profession in general are to care for the sick and dying, promote the health of individuals and families, and provide holistic care to clients. One difference between community/public health nurses and other nurses is that they pay special attention to vulnerable and at-risk populations, especially elderly persons; infants; and disabled, ill, and poor persons.

Which of the following statements is the most accurate description of a client who has received a diagnosis of hypersensitivity? a. He or she gets his or her feelings hurt frequently. b. His or her skin burns very easily from sunlight. c. He or she reacts to much smaller doses of chemicals than do most people. d. He or she experiences an allergic reaction.

c. He or she reacts to much smaller doses of chemicals than do most people. Hypersensitivity, or hypersusceptibility, means the person will have a sensitivity response to a much lower than expected dosage of a certain chemical.

Which of the following would be considered a key element of a comprehensive school health education program? a. Offering daily physical education classes b. Ensuring safety on the school playground c. Involving parents and the community members in health education programs d. Facilitating a well-balanced diet through the school lunch program

c. Involving parents and the community members in health education programs Key elements of a comprehensive school health education program include a documented, planned, and sequential program of health instruction for students in grades kindergarten through 12; a curriculum that addresses and integrates education about a range of categorical health problems; activities that help young people develop skills to avoid health problems; instruction for a prescribed amount of time at each grade level; management and coordination by an educational professional; instruction from teachers who are trained to teach the subject; involvement of parents, health professionals, and community members; and periodic evaluation. Involving parents and community members in health education programs meets the identified key elements. The other options, although important, are not part of a comprehensive school health education program.

During the second visit, a nurse noticed that although an elderly gentleman had not been able to clean up the apartment, he had been able to clean up the kitchen. Why would the nurse praise him for his cleaning efforts when only one room had changed? a. It demonstrated that the home-bound man was trying to be compliant with the nurses suggestion. b. It made the apartment so much nicer for both the client and the nurse. c. It was a successful short-term achievement toward the long-term goal of environmental safety. d. The elderly gentleman obviously expected considerable praise for doing such a female task.

c. It was a successful short-term achievement toward the long-term goal of environmental safety. Short-term objectives are often helpful toward slowly achievable long-term goals. It is also wise to be aware of and verbalize small, subtle changes or achievements.

Which ethical principle might be difficult for the community/public health nurse to implement? a. Nonmaleficence b. Beneficence c. Justice d. Respect for autonomy

c. Justice The ethical principle of justice is defined as treating all people fairly. One way that community/public health nurses would exhibit justice is by providing nursing services to all, regardless of their ability to pay. Community/public health nurses can give care only within the limitations of third-party payer requirements. A difficulty for community/public health nurses is coping with the disparities in our current health care system.

A nurse is working with nonprofessional staff in the school setting. Which of the following actions is important for the nurse to take? a. Writing grants for funds to support the use of nonprofessional staff in the school b. Engaging in political action to educate legislators about the need for funding for school health c. Keeping records that document training and ongoing evaluation of the nonprofessional staff d. Providing direct care services as needed for the children and staff in the school system

c. Keeping records that document training and ongoing evaluation of the nonprofessional staff School personnel in general have no training in health-related fields and generally do not anticipate having to perform health care functions when they accept employment as teachers or school employees. Because lack of funding impedes the presence of full-time nurses at many school buildings, school nurses must train and delegate some tasks to unlicensed school staff. Thus, keeping documentation of the training and evaluation of their performance of the skills that have been delegated is essential.

Which of the following sources produces the most revenue at the local level? a. Grants b. Fees for service c. Levies d. Resource allocation

c. Levies Funding sources for local health departments is a combination of local, state, and federal funds. Revenue from local sources is primarily from taxes or a levy. A levy is a mechanism for raising money through the ballot box.

Why is the data from the National Notifiable Diseases Surveillance System (NNDSS) not absolutely accurate? a. A great deal of data is lost en route from physician to NNDSS. b. Computer operators do not always enter data accurately. c. Not all cases of such diseases are managed or are reported. d. Not all physicians know or obey the law to report cases to the NNDSS.

c. Not all cases of such diseases are managed or are reported. The law requires reporting diseases to the state agencies, but reporting to the Centers for Disease Control and Prevention (CDC) or NNDSS is voluntary. Furthermore, not all affected patients receive medical care, and not all treated cases are reported. In addition, the completeness of reporting varies.

Which of the following would be the best definition of a community? a. People with open boundaries living in a particular area b. People gathered together to solve a particular problem c. People with a sense of belonging or common identity d. People with at least one common demographic characteristic

c. People with a sense of belonging or common identity In this text, community is defined as an open social system that is characterized by people in a place who have common goals over time. The sense of belonging or common identity is true both of geopolitical and of phenomenologic communities. A population is defined as a collection of individuals who share common characteristics.

What are todays children and adolescents more likely to confront as health problems in comparison with previous generations? a. Problems resulting from alcohol and tobacco use b. Problems resulting from sexually transmitted diseases c. Problems resulting from high-risk behaviors d. Problems resulting from communicable diseases

c. Problems resulting from high-risk behaviors Formerly, children and adolescents had to confront contagious diseases, but today adolescents face risks related to high-risk behaviors. Adolescents die from motor vehicle crashes, other unintentional injuries, homicides, and suicide.

When assessing a community by using the structural-functional framework, the nurse recognizes that all communities must a. Address financial needs of residents. b. Engage in functions that can be measured. c. Provide for socialization and a sense of identity. d. Require that public safety structures be built.

c. Provide for socialization and a sense of identity. All communities fulfill certain functions, including coordination, control, and direction of activities to attain goals, as well as socialization and identity for their members. Providing for both socialization and a sense of identity best address community goals and internal functioning.

A nurse has recently been hired to work as a public health nurse at a local health department. She wonders what her role will be in this new setting. Which of the following documents would provide this information? a. Community Health Certification Criteria from the American Nurses Credentialing Center (ANCC) b. The states nurse practice act c. Public Health Nursing: Scope and Standards of Practice d. The Future of Public Health

c. Public Health Nursing: Scope and Standards of Practice The American Nurses Association publishes a Scope and Standards of Practice for most clinical specialties. The scope and standards provide guidance and define and direct public health professional nursing practice in all settings, including the role of the advanced-practice public health nurse. The ANCC offers specialty certification in advanced public health nursing; however, these criteria do not describe the role of the public health nurse. The state nurse practice act outlines nursing practice in the state, but it is not specific to the public health setting. The Future of Public Health indicated public health functions were poorly focused and the public health infrastructure was inadequate. It noted changes that should be made in the future.

When a community/public health nurse cannot meet a need of the client, it is most appropriate for the nurse to a. Encourage the client to pay someone to meet that need. b. Inform the client that insurance will not pay for the care. c. Refer the client to a person or agency that may be able to provide assistance. d. Suggest that the client discuss the need with the physician.

c. Refer the client to a person or agency that may be able to provide assistance. Referral or directing someone to another source of assistance is an appropriate response when the nurse cannot fulfill the need.

Which of the following is an example of the relationship between demographic factors and health needs? a. Persons with high incomes typically have nutritional problems resulting from diet choices. b. Low educational level is associated with more health promotion behaviors. c. Religion may suggest beliefs concerning use of contraception, health care, and food choices. d. Being the majority population group, young adult men help determine which service agencies are most needed.

c. Religion may suggest beliefs concerning use of contraception, health care, and food choices. The religion of the community members may suggest their beliefs about contraception, abortion, living will, circumcisions, organ donations, and so on.

What is the appropriate approach for the community/public health nurse in balancing individual privacy and autonomy and the communitys needs for safety and security? a. Fulfill agency policies first. b. Implement professional standards of nursing practice. c. Seek a balance between individuals needs and the communitys needs. d. Remember that group needs outrank individual needs.

c. Seek a balance between individuals needs and the communitys needs. While the nurses practice should be consistent with employing agency policies, legal mandates, and professional standards, the nurse must seek a balance between individual autonomy and other individual rights and the rights of all other community members. It is a delicate balance.

Under the U.S. Constitution, which level of government has primary responsibility for health care of American citizens? a. County/district level of government b. Federal level of government c. State level of government d. Town/city/village level of government

c. State level of government Under the U.S. Constitution, states retain the power to protect the health and welfare of their residents. Consequently, states have the primary responsibility for public health functions.

A new mother seemed hesitant to let the community/public health nurse into her apartment. However, the visit seemed to go well, with the nurse sharing information, resources, and positive support to the new mother. At the end of the visit, the mother thanked the nurse profusely but said she thought she was all right now so there was no need for the nurse to return. Which of the following actions would be most appropriate for the nurse to take? a. Chart that the mother was noncompliant and would not let the nurse return. b. Plan on returning in 1 week to answer any new questions the mother might have about her baby, how to care for him, or how infants grow and develop. c. Stress how to get in touch with the public health agency if the mother ever has questions or needs assistance and then wish her the very best. d. Try to find free formula, baby cereal, infant clothes, and other goodies to give the new mother so she will let the nurse back into the apartment.

c. Stress how to get in touch with the public health agency if the mother ever has questions or needs assistance and then wish her the very best. After discussing the options and choices that the family has if it declines further visits, the nurse has provided information so the family can engage in informed decision making. The nurse has no further obligation.

What is the primary reason why entire populations are not surveyed to determine a communitys health needs? a. A nurse would not know how to conduct the survey. b. Community members would refuse to answer questions. c. Such a survey would be too expensive and time consuming. d. No community agency would want to be responsible for the results.

c. Such a survey would be too expensive and time consuming. Although a survey of an entire population would be informative, it is typically too impractical in time, cost, and ability to reach all community members.

What might be the implications of knowing where members of the community are employed (i.e., their occupations)? a. How or whether community members worship b. How and when the community members prefer to engage in recreation c. The diseases or injuries for which they may be at risk d. Where residents do their grocery shopping and what they typically buy

c. The diseases or injuries for which they may be at risk Knowing the occupations may suggest particular diseases and injuries for which employees are at risk.

On the first home visit, a nurse explained to an elderly couple how the nurse could help them. Who would be the most knowledgeable concerning the couples health needs? a. The nurse who had analyzed all of the background data b. The hospital case manager who had coordinated the couples care c. The elderly couple themselves d. The nurse who had been the primary care provider in the hospital before discharge

c. The elderly couple themselves The clients are the experts in their own health, their health history, their experience in various stages of health and illness, and their health and illness concerns.

When a community is assessed from a developmental framework, which data must be determined? a. The demographics (such as age) of the persons living in the community b. The emotional maturity of the communitys residents c. The history of the community d. The number and quality of daycare centers and schools

c. The history of the community Although all the listed options may be helpful information, the development of a community would most easily be observed in its history. A developmental framework explores the history of a community to determine change and trends. Identifying trends in health status over time helps clarify health outcomes.

Why would a school nurse seek funds to implement a program to teach adolescents how to recognize depression and low self-esteem in their peers? a. Funds are available for such mental health programs. b. Such programs are a priority in Healthy People 2020. c. The incidence of adolescents considering or attempting suicide is high. d. The nurse has expertise in this area and wants to share this knowledge with others.

c. The incidence of adolescents considering or attempting suicide is high. Suicide is the third leading cause of death among young people; 6.3% of high school students report making at least one suicide attempt.

A public health nurse has been asked to be part of a coalition to promote legislation to ban smoking in public places in the state. Why is it important for the nurse to be part of this coalition? a. The nurse can prioritize community health care needs to address the problem. b. The nurse can determine the needs of others and the priority of any care needed. c. The nurse can effectively communicate among various stakeholder groups. d. The nurse can educate other people and enforce the legislation when it is passed.

c. The nurse can effectively communicate among various stakeholder groups. Although not the only ones with expertise in public health, public health nurses are very effective at communication among various interested groups, such as support groups and legislators. It is not easy to assess and prioritize among competing needs, especially when legislation requiring certain actions without funds to engage in those actions is passed.

Why would a school nurse encourage the school district to create a violence prevention program? a. A government-endorsed teaching unit that focused on this topic is available. b. Additional funds are being offered in the state to provide this educational program. c. The prevalence of violence, including homicide, among adolescents is recognized. d. High-risk behaviors are common among adolescents.

c. The prevalence of violence, including homicide, among adolescents is recognized. Violence and abusive behaviors are major causes of death and injury. Violence prevention programs have been established in many schools. One of the most important recommendations made by the Centers for Disease Control and Prevention (CDC) is to implement violence prevention programs to promote substantial reductions in antisocial and delinquent behaviors.

A local health department is considering writing a grant to expand services for young women and children in the community. Which of the following factors would lead the agency to decide not to apply for available grant funding? a. The employment of quality grant writers at the agency is too expensive. b. The grant-writing process is not the most efficient way to obtain more funding. c. The restrictions and accountability costs may exceed the money received. d. The staff is unfamiliar with the grant application process.

c. The restrictions and accountability costs may exceed the money received. The costs to the department of the restrictions and accountability imposed by the grantor may exceed the benefits obtained with the money. When money is no longer granted, the jobs paid for by those funds are lost.

Which of the following situations is a reason why a community/public health nurse would choose to focus on a particular subgroup instead of on the entire community? a. The subgroup can more easily afford health care services. b. The subgroup has more political power and can influence health funding. c. The subgroup has notably higher statistical risk for experiencing health problems. d. The subgroup knows how to obtain publicity if their needs are not met

c. The subgroup has notably higher statistical risk for experiencing health problems. Although all of the options present good reasons, the community/public health nurse tries to change factors that contribute to the vulnerability to health problems of high-risk groups.

Which of the following best describes a group? a. Those who are all living in the same geopolitical area b. Those who are all members of the same phenomenologic community c. Those who engage in repeated face-to-face communication d. Those who respect each others perspective

c. Those who engage in repeated face-to-face communication A group consists of two or more people engaged in an interdependent relationship that includes repeated face-to-face communication.

Why would a nurse choose to be an active member of several professional associations? a. To be able to spend time with friends and colleagues b. To be part to the organizations annual convention/conference c. To be part of the decision-making and political action activities d. To be able to have professional development opportunities

c. To be part of the decision-making and political action activities Community/public health nurses obtain membership in decision-making groups as another way to increase their influence and contribute to health planning.

Which of the following would be the nurses primary goal during the first visit to home-bound clients? a. To assess the health of all family members and the immediate environment b. To discuss the time and financial limits to the care the nurse can give c. To establish rapport with the clients and work with them to define mutually agreeable goals d. To implement the nursing care plan established before hospital discharge

c. To establish rapport with the clients and work with them to define mutually agreeable goals Although all the steps are important, establishing rapport, defining problems, and agreeing on goals must be done before it is possible to begin the other steps. These events occur during the initiation phase, which starts during the first visit and may take several visits.

A school nurse attended school-wide parents meetings and gave a report on the health education courses currently being taught and some of the feedback from students in those courses. What would be the primary reason for the nurse to share such information on a regular basis? a. To ensure job security in the future with all the school budget cuts b. To convince the principal of the importance of having a school nurse on staff c. To increase awareness and, it is hoped, support from the local community d. To show progress in meeting state school standards

c. To increase awareness and, it is hoped, support from the local community Curriculum must accommodate the unique local needs and preferences of each community to increase support from and awareness of community members.

Which of the following would be the first priority when a nurse is completing a home visit? a. Consistency with agency rules and procedures b. Legally, whatever the medical referral requires c. Unless a medical emergency, whatever the client believes is most important d. What the nurses professional judgment determines to be the major threat to health

c. Unless a medical emergency, whatever the client believes is most important Because the client is the ultimate decision maker, the clients priorities must be addressed first.

A nurse is completing a community assessment by using a systems framework. Which of the following is the key to the success of the assessment? a. Demanding a reasonable budget for assessment expenses b. Telling everyone what he or she is doing so that the listener may have input c. Using a tool to systematically identify, collect, and organize appropriate data d. Allowing at least 2 weeks to collect data to ensure thoroughness

c. Using a tool to systematically identify, collect, and organize appropriate data An organized framework helps the nurse collect appropriate data systematically. The systems model serves as a tool to help the nurse identify, collect, and organize appropriate data, include the critical components and their relationship to each other.

After leaving the home of a new mother and her newborn, the student nurse asked the instructor, What will the new mother do when we arent there to help? Which of the following statements would be the best reply from the nursing instructor? a. I am going to ask you to come back tomorrow to help the new mother further. b. Why would the new mother experience any problems? c. We have to assume that the new mother will be able to manage without us. d. Well have another nurse stop by tomorrow to help the new mother.

c. We have to assume that the new mother will be able to manage without us. The purpose of care in the community is to enable the family to remain at home and manage without the constant presence of health care providers.

As the nurse entered the house of an elderly couple and was invited to sit, three cats rubbed against the nurses legs. Which of the following would be the most appropriate comment for the nurse to make? a. Are these cats hungry? Or do they want something else? b. Cats can really cause health problems. Would you like me to call the animal shelter for you? c. Would you like to introduce me to your cats? d. Would you please lock up your cats until were done?

c. Would you like to introduce me to your cats? The appropriate response to animals in the house is to first assess for safety. If safety is not an issue, then ask for an introduction. Pets are often considered members of the family.

In the general systems theory, an outcome is defined as: a. information channeled back into the system from the environment. b. the matter, energy, and information that come into the system from the environment. c. created products, energy, and information that emerge from the system into the environment. d. everything outside the boundary of the system.

c. created products, energy, and information that emerge from the system into the environment. Outcome is defined as created products, energy, and information that emerge from the system into the environment. Feedback is defined as information channeled back into the system from the environment. External influences are defined as the matter, energy, and information that come into the system from the environment. Environment is defined as everything outside the boundary of the system

Public health nurses provide tertiary prevention when providing: immunization clinics. outreach to identify targeted populations. environmental surveillance case management for disabled children.

case management for disabled children. Case management for disabled children is an example of the public health nurse providing tertiary prevention services. Immunization clinics are an example of the public health nurse providing primary prevention services. Environmental surveillance and outreach to identify targeted populations are both examples of the public health nurse providing secondary prevention services

The original focus of school nursing was to: control communicable disease. incorporate health education into the curriculum. offer medical examinations. provide family-centered care.

control communicable disease. The original focus of school nursing was to control infectious diseases. Originally, school health services identified and excluded students with infectious diseases. The first school nurse, Lina Rogers Struthers, drafted protocols for specific illnesses and was able to drop the absenteeism rate by 90%. After World War I, one of the focus areas was to incorporate health education into the curriculum to teach students responsible health behaviors. Also during this time, one of the focus areas was to offer medical examinations for all children to ensure child health. This expanded in the 1970s when the school nurse practitioner concept emerged. School nursing during the 1940s and 1950s provided a more family-centered approach to care

Which of the following is an example of a customer of home care? a. An agency that employs and pays the nurse b. A group of colleagues who evaluate the nurses care c. A client for whom the nurse is caring d. A physician who refers a client to the home care agency

d. A physician who refers a client to the home care agency Patients or clients are the health care consumers. However, customers are those people or agencies that refer the patient or client to the particular home care agency.

A nurse was told that the home health nursing agency had just been accredited by the Community Health Accreditation Program (CHAP). Among other requirements, what has the agency probably just completed? a. A review of policies and procedures from other similar agencies b. A walk-through assessment of the agency c. Certification of the staff of the agency d. A thorough self-evaluation

d. A thorough self-evaluation The process of accreditation requires the agency to conduct a thorough self-evaluation based on identified objectives, write a self-evaluation report, and submit to an unannounced, on-site survey by peer reviewers, including home visits to clients.

A nurse was assessing the neighborhood near the health agency. The nurse drove around observing the condition of the buildings, sidewalks, and the people in the community. Which of the following best describes the actions of the nurse? a. A drive-through b. A neighborhood observation c. A quick overview d. A windshield survey

d. A windshield survey A walk- or drive-through is frequently referred to as a windshield survey. This is one way that the nurse can get a feel for the community that cannot be obtained from just reading about it.

How does a community/public health nurse provide indirect care to clients in homes, clinics, senior citizen centers, schools, prisons, homeless shelters, and other living environments? a. Being employed in community settings such as outpatient clinics b. Providing anticipatory guidance and health promotion activities to community members c. Providing care in mobile vans to citizens in their own neighborhoods d. Being involved on a political action committee to create new client services

d. Being involved on a political action committee to create new client services Nurses give care directly, as in all the answers given, but provide care indirectly by trying to promote health and well-being through creating new resources, improving the environment, or using social and political mechanisms for solving problems.

Which of the following characteristics would be most indicative of a healthy community? a. Excellent private schools and superb fire and police systems b. A United Way that receives large donations each year c. An extensive array of services offered by private physicians d. Clean air and water and a sense of community cohesion

d. Clean air and water and a sense of community cohesion Although all items sound positive, a sense of community cohesion in a safe community (clean air and water) would be most helpful to its residents.

A home health nurse was making an initial visit to an elderly man. As the nurse began the assessment, the wife gave all the information requested. Which of the following actions would the nurse take next? a. Agreeing upon appropriate interventions with the family b. Creating appropriate nursing diagnoses c. Assessing the environment of the wider community d. Confirming the information obtained with the client

d. Confirming the information obtained with the client Having heard from only the wife, the nurse must attempt to validate the information with the husband or recognize that all information was from only one perspective.

When the nurse is caring for a family or a community, it is important that the nurse provide care that is a. Similar to that described in the textbook or procedure manual b. Consistent with agency policies c. Inexpensive d. Culturally congruent

d. Culturally congruent Although the nurse should provide care in all the ways described, for recipients to accept the care, the care must be consistent with their cultural expectations and norms.

Which of the following activities is a public health nurse most likely to be involved in during the twenty-first century? a. Preventing the spread of communicable diseases b. Assisting uninsured clients in obtaining health care services c. Providing direct care services for uninsured individuals d. Developing multiagency collaborations and partnerships

d. Developing multiagency collaborations and partnerships Public health nursing is more effective when problems are approached in collaboration with other agencies. The trend is toward development of numerous and diverse health-related partnerships and this activity is recommended in the Institute of Medicines report The Future of Nursing.

Which of the following would be the focus of a nurse who is using an epidemiologic framework to assess a community? a. Interviewing health care professionals concerning the community b. Researching findings from epidemiologic studies c. Learning about the health of the communitys population d. Discovering groups among the community residents who are most at risk

d. Discovering groups among the community residents who are most at risk In an epidemiologic framework, investigators examine the health of the community and suggest targeting programs toward the groups most at risk for illness or disability. Different aggregates have different health needs.

A nurse includes well-being in her definition of health. What will the focus be when the nurse provides care to a family confronting the imminent death of a family member? a. Sharing the nurses knowledge of the physiology behind the clients symptoms and the appropriate interventions for comfort b. Administering pain medication so that the client can be kept comfortable c. Reinforcing the need for the whole family to adapt to the impending death d. Discussing the perceived meaning of life with the family

d. Discussing the perceived meaning of life with the family Well-being requires learning to create meaning and a sense of belonging in life while recognizing that control (i.e., preventing the death) is not always possible.

What is the most crucial aspect of the first visit to a new client? a. Confirming that all needed assessment data are obtained b. Creating an accurate and appropriate list of nursing diagnoses c. Establishing a systematic evaluation plan d. Establishing trust for a productive relationship

d. Establishing trust for a productive relationship Although all the options listed are important, the relationship is the most important because without it, the other tasks cannot be completed. Without at least earning trust, the nurse will not be able to visit the family again. Also, building and preserving relationships is a central focus of home visiting.

A home care client suffering from cancer asked the home care nurse if he could be referred to hospice, considering his diagnosis. How should the nurse respond? a. Certainly, since you are going to die regardless of what we do. b. If you and your physician agree to keep you comfortable while battling the cancer, your doctor can refer you. c. If you are sure you will die within the next 6 months and no longer want a physicians care, I will be happy to make the referral to hospice. d. For your physician to refer you to hospice, you need to decide to concentrate on enjoying life and staying comfortable rather than treating your cancer.

d. For your physician to refer you to hospice, you need to decide to concentrate on enjoying life and staying comfortable rather than treating your cancer. To be accurate, positive, and supportive of the client, the nurse must discuss the alternative of seeking comfort rather than cure. To be eligible for hospice, a person must have the diagnosis of a terminal illness, with a prognosis of 6 months or less, with informed consent from the client and a referral by the clients attending physician. Hospice implies ceasing to battle for length of life and focusing on comfort and quality of life.

Which of the following data is collected by the U.S. Department of Commerce? a. Health of businesses in America b. Locations of all hospitals and clinics c. Property values in each county and state d. Growth in areas of the country

d. Growth in areas of the country The U.S. Department of Commerce collects data related to health and economics, including which area of the country is growing the fastest, which state has the highest median age, household and family data, fertility data, numbers in the labor force, and poverty and unemployment rates.

A community/public health nurse is best defined as a nurse who a. Applies concepts and knowledge from nursing and public health. b. Gives care to families in the community. c. Has a baccalaureate and previous experience in community health. d. Is employed outside of an acute care setting.

d. Is employed outside of an acute care setting. The term community health nursing is an umbrella term used for all nurses who work in a community. This term denotes the setting of practice for the nurse.

The supervisor suggested that a nurse use a contract to confirm goals and plans with an elderly man who had recently moved into a self-care halfway house. Which of the following is an advantage of such a contract? a. It documents the cost of each nursing service. b. It protects the nurse if the nurse is ever sued for malpractice. c. It is legally binding for both parties. d. It clarifies who will do what, when, where, and why.

d. It clarifies who will do what, when, where, and why. A contract clarifies and documents mutual understandings. The agreement usually entails one or more family members continuing to meet with the nurse for a specific number of visits or weeks. Initially, specific goals and the nurses role regarding health promotion and illness prevention may be unclear.

A young pregnant woman is unemployed and does not have access to health insurance. Which of the following programs would be able to assist her in obtaining health insurance? a. Sliding fee scale b. Women, Infants, and Children Supplemental Food program (WIC) c. Medicare d. Medicaid

d. Medicaid Medicaid, also known as Title XIX, consists of both federal and state funds and is the primary source of money for service reimbursement. The priority populations for Medicaid funding are pregnant women, infants, and children (2 through 18 years of age) and some older adults who need chronic disease treatment or nursing home care.

An elderly woman receiving care reimbursed by Medicaid was moving to a different state to stay with her daughter-in-law. The disabled woman asked about Medicaid reimbursement in her daughters state. How should the nurse respond? a. Because you paid into Social Security (FICA), you are eligible for assistance no matter where you go. b. Just be sure to call a home care agency as soon as you arrive so that they can assess your daughter-in-laws house and make sure it is acceptable. c. Medicaid is a federal program, so the rules will be the same wherever you go. d. Medicaid is sponsored in part by the state, so the rules may be very different there.

d. Medicaid is sponsored in part by the state, so the rules may be very different there. Medicaid is based on income and assets and is not contingent on any previous payments to the federal or state government. However, Medicaid is jointly sponsored by the federal government and the states. Therefore, Medicaid coverage differs from state to state. These differences can often be dramatic. The elderly disabled woman may not be eligible in her daughters state of residence and may want to check this carefully before moving permanently.

When asked, What does your state health department do for you? the average citizen might well respond, Nothing. What does such a response illustrate? a. Citizens are woefully uninformed about health and health care. b. Citizens resent being asked personal questions. c. Health is not a priority for Americans. d. Most direct services are provided by local health departments.

d. Most direct services are provided by local health departments. Most direct services that citizens would receive or know about are provided by local health departments, whereas state agencies are more involved in regulation, coordination, and health monitoring. The more visible services are at the local level.

What would be the school nurses primary goal when choosing to teach a class about the importance of daily physical activity? a. Fulfilling federal legislation requirements b. Fulfilling state legislation requirements c. Helping the children avoid disease and injury d. Motivating the children to promote their own health and well-being

d. Motivating the children to promote their own health and well-being Although all of the options may be the nurses goals, the primary purpose of health education is to promote health maintenance and wellness, not just to prevent disease and injury.

What would a nurse who is aware of national statistics regarding mortality, morbidity, and epidemics in the United States emphasize at school meetings for parents and staff? a. Dangers of bioterrorism and how staff must be prepared for disasters b. How to react in the safest manner if violence breaks out in the school c. Importance of not sharing personal items to avoid spread of infections and parasites d. Need for physical exercise for each student on a daily basis

d. Need for physical exercise for each student on a daily basis One of the biggest epidemics in the United States today is that of obesity. Benefits of regular physical activity are clearly documented. The 2006 School Health Policies and Programs Study (SHPPS) recommended an increase in quantity and quality of physical exercise.

To qualify to be the chief executive in most state health departments, which of the following is the requirement? a. Medical doctor with a degree in public health b. Nurse with expertise in public health and administration c. PhD in any profession and a degree in public health d. Political appointment, serving at the discretion of the governor

d. Political appointment, serving at the discretion of the governor In most states, the appointments are made by the governor within the limits of the health code of that state. By tradition and, in some states, by law, the chief executive is often a physician.

Which of the following would be essential characteristics of a professional helping relationship? a. Acceptance and sympathy b. Enthusiasm and energy c. Positive intent, supportiveness, and trust d. Positive regard, empathy, and genuineness

d. Positive regard, empathy, and genuineness Carl Rogers wrote that the three characteristics of a helping relationship are positive regard, empathy, and genuineness, which are relevant in all nurseclient relationships.

How might the goals of communities best be summarized? a. Ensuring that the communitys history is remembered b. Encouraging socialization with persons outside the community c. Maximizing availability of financial and other resources d. Promoting survival and maximizing the well-being of members

d. Promoting survival and maximizing the well-being of members Communities must survive and ensure that the needs of community members are met, including the need for well-being.

In 1995, which type of agency provided most of the home care services? a. Hospital-based home care agencies b. Local and county health departments c. Privately owned, but nonprofit, entrepreneurial home care agencies d. Proprietary for-profit incorporated home health agencies

d. Proprietary for-profit incorporated home health agencies Proprietary for-profit, freestanding home health agencies constituted the largest percentage of home care agencies in 1995. Hospital-based home care agencies represented the second largest percentage.

Which document is helpful in describing competent and appropriate nursing care in the community? a. Community Health: Standards of Nursing b. Healthy People 2020 c. The Joint Commission: The Comprehensive Accreditation Manual d. Public Health Nursing: Scope and Standards of Practice

d. Public Health Nursing: Scope and Standards of Practice The document Public Health Nursing: Scope and Standards of Practice (2007) was developed in concert with the steps of the nursing process to help nurses promote the health of persons. Healthy People 2020 focuses on achieving health goals for persons living in the United States. The Joint Commission Manual is used by organizations pursuing accreditation from this organization. There is no such document as Community Health: Standards of Nursing.

Which of the following actions demonstrates the occupational health nurses need to balance conflict between what is legal and what is ethical? a. Ensuring the employers profit and keeping the employees happy b. Fulfilling what the nurses supervisor wants and what the employees want c. Encouraging primary prevention and first aid to the injured d. Reporting health problems to employers and keeping health records confidential

d. Reporting health problems to employers and keeping health records confidential The conflicts arise because the nurse has a responsibility to the employer and to the client. Thus the nurse needs to report health problems in the aggregate but also has to keep individual information confidential. The American Association of Occupational Health Nurses (AAOHN) has issued two useful advisories to help nurses manage confidentiality and record-keeping.

Which group of persons is least likely to be considered a vulnerable group at high risk for medical problems? a. Homeless women and children b. Intravenous drug users c. Pregnant single teenage girls d. Single adolescent boys

d. Single adolescent boys In examining person-related factors, the nurse looks particularly for vulnerable aggregates and risky behavior. Homeless persons, intravenous drug users, and pregnant single teenage girls are all at high risk for medical problems. As a group, single adolescent boys do not have a condition that makes them vulnerable to illness.

Which of the following determines the authority, responsibility, and funding of local health departments? a. County/district legislation b. The federal government c. The local health department d. State legislation

d. State legislation Local health departments obtain their authority through state law. Local health departments may build on state delegation, with additional responsibilities as decided through local ordinances.

How would a typical home care nurse spend the majority of his or her time? a. Providing direct care in clients homes b. Calling physicians and getting certification for treatment c. Supervising the home health aides who are giving the clients personal care d. Teaching other family members and home care aides how to care for the client

d. Teaching other family members and home care aides how to care for the client Although a home care nurse engages in all of the tasks listed, the most common intervention performed is teaching, because most care provided in the home is the responsibility of someone other than the nurse.

Besides professional home health care, what other kind of home care may be needed? a. Community health home care, based on care needed in a community b. Public health home care, based on principles of caring for aggregates c. Technologic home health care, based on reimbursement guidelines d. Technical home health care, based on a need for a piece of medical equipment

d. Technical home health care, based on a need for a piece of medical equipment There are two types of home care, the first being professional home care, which consists of professionals in practice giving care. The second type of home care is technical home care, which consists of agencies that sell or rent durable medical equipment.

The community/public health nurse leads a support group for clients and their families who have been affected by cancer. Which of the following best describes this nursing intervention? a. Specific protection b. Primary prevention c. Secondary prevention d. Tertiary prevention

d. Tertiary prevention Support groups are considered tertiary prevention. The clients and their families have already been affected by cancer, and the nurse is assisting them to prevent further problems.

A home health nurse was competent and efficient, and yet a client simply was not ready to be discharged from care, although the clients date of discharge had now expired. What will happen to the client now that the original assessment and plan of care suggested that the client be discharged? a. A different nurse can begin again with assessment and planning in preparation for an appeal of discontinuation of financial reimbursement. b. The nurses original assessment and plan were inaccurate, so a correction has to be filed to justify continued financial reimbursement. c. The client will be discharged as planned and will have to depend on family or friends for assistance. d. The client will continue to receive care as needed, and the agency will suffer a financial loss.

d. The client will continue to receive care as needed, and the agency will suffer a financial loss. Under the prospective payment system, if it takes more visits than anticipated to meet the clients documented needs, the agency has to provide the care and assume the financial costs.

What might be a school health nurses concern regarding the No Child Left Behind Act? a. The law does not meet local needs as the school boards perceive them. b. The law is based on erroneous assumptions. c. The law meets the needs of urban states but not rural ones. d. The law will divert funds from health services and physical education.

d. The law will divert funds from health services and physical education. Because the law focuses exclusively on academic progress to determine the funding that schools receive, it encourages schools and districts to funnel resources in ways that limit support for necessary but indirect influences on academic outcomes. This has resulted in diminished support for health services, which are shown to improve learning readiness, promote student retention rates, and improve academic performance.

A nurse is often frustrated when clients do not comply with the nurses suggestions that would improve their health. What might be helpful to remember in such situations? a. It takes a long time and much effort to change peoples behavior. b. The clients may not change today, but they may change tomorrow. c. The nurse may have to change the clients values in order for the client to want to change behaviors. d. The only person the nurse can change is the nurse.

d. The only person the nurse can change is the nurse. The only person the nurse can change is the nurse. Trying to change another person may make that person feel dominated and thus feel more strongly that change must be resisted.

Which of the following events illustrates how the suprasystem affects a community as a system? a. A group of concerned citizens points out the rising number of homeless persons in the community. b. A subgroup of the community demands that housing for homeless persons be built. c. Homeless persons decide to picket in front of the city government building. d. The state legislature passes a law that all communities must build some housing for homeless persons.

d. The state legislature passes a law that all communities must build some housing for homeless persons. Only if the state dictates a legal requirement to a local community is it an instance of the suprasystems directly affecting the (community) system.

When faced with an ethical conflict about limited resources and unlimited need, which action is the most just? a. Giving care to clients whose needs most closely match the nurses abilities b. Giving care to whichever prospective clients ask for care first c. Working as hard as possible and not worrying about it d. Trying to achieve the outcome of the greatest good for the greatest number of persons

d. Trying to achieve the outcome of the greatest good for the greatest number of persons Although option B fulfills the criteria of egalitarian (equal) justice, it is a short-term answer to an ongoing problem. Trying to achieve the outcome of the greatest good for the greatest number of persons is a utilitarian approach to justice, which is more helpful in dealing with large populations such as clients seen by the community/public health nurse.

Which of the following is a very practical and feasible way of obtaining comprehensive community health data? a. Completing a comprehensive survey with community residents b. Performing a windshield survey c. Requesting community residents respond to an Internet survey d. Using data already collected and available on the Internet

d. Using data already collected and available on the Internet Many sources of demographic and epidemiologic data already collected, and often available on the Internet, may be used. It is not feasible or financially possible for the nurse to do a comprehensive community assessment in isolation. Performing a windshield survey does not allow the nurse to collect comprehensive health data about the community. Requesting community residents respond to an Internet survey can be a very time-consuming process for the nurse to undertake, especially when there are already data collected and available.

A home care nurse was discussing her day with a nursing colleague who worked in acute care at the nearby metropolitan hospital. You have it easy, said the home care nurse. You never have to . . . . Complete the home care nurses sentence accurately. a. Remember to take exactly what you need with you on the visit. b. Spend hours every day documenting everything you did. c. Worry about whether your client will recover. d. Worry about who is going to pay for services or the rules of that payer.

d. Worry about who is going to pay for services or the rules of that payer. Acute care nurses also spend hours on documentation, have to remember what supplies to take in preparation for giving care, and worry about their clients. Usually, however, they do not have to remember the requirements of the third-party payers or determine the clients ability to pay on a sliding fee scale. A unique aspect of the role of the home care nurse is involvement in the financial aspects of delivering care. The home care nurse must know who is going to pay for services.

The Public Health Nursing: Scope and Standards of Practice: serves as the nurse practice act for public health nurses. is written by state boards of nursing. defines public health professional nursing practice in all settings. certifies public health nurses.

defines public health professional nursing practice in all settings.

A typical nursing activity that would be performed during the initiation phase of a home visit would be: completing a physical assessment. discussing the purpose of the visit. approaching the visit with self-confidence. summarizing the accomplishments of the visit.

discussing the purpose of the visit. Discussing the purpose of the visit would be performed as part of the initiation phase. During the initiation phase, the nurse and family get to know one another and how the family health problems are mutually defined. Completing a physical assessment would be performed as part of the implementation/working phase of a home visit. Approaching the visit with self-confidence would be performed as part of the preinitiation or preplanning phase of a home visit. Summarizing the accomplishments of the visit would be performed as part of the termination/ending phase of a home visit.

The process of assisting others to uncover their own inherent abilities, strengths, vigor, wholeness, and spirit is called: public health nursing. population-focused care. general systems theory. empowerment.

empowerment. Empowerment is the process of assisting others to uncover their own inherent abilities, strengths, vigor, wholeness, and spirit. Public health nursing describes specific educational preparation for a practice of nursing. Population-focused care describes care where assessment, planning, and evaluation occur at the population level. General systems theory provides a way to link many of the concepts related to nursing

A phenomenological community: has a spatial designation. is the most traditional in the study of community. is formed by a boundary. has a relational designation.

has a relational designation. A phenomenological community has a relational designation. A sense of place emerges through the members' awareness of their experiences together. A geopolitical community has a spatial designation—a geographical or geopolitical area or place. A geopolitical community is the most traditional in the study of community and is formed by either natural or human-made boundaries

The home care provider who is primarily responsible for the personal care needs of the client, including grooming and bathing, is the: home care nurse. home care aide. occupational therapist. medical social worker.

home care aide. The home care aide is primarily responsible for the personal care needs of the client, including grooming and bathing; ensuring a clean, healthy home environment; and shopping and preparing meals. The home health care nurse supervises the home care aide. The home care nurse, either registered nurse or licensed practical nurse, is responsible for assessing the client as well as consulting with other professionals and paraprofessionals involved in care. The occupational therapist helps the client acquire the skills necessary to perform activities of daily living. The medical social worker helps clients and families deal with the social and emotional issues associated with illness and long-term care

Demographics of the community: change quickly. do not affect health behaviors. describe the boundaries of the community. include the physical, biological, and psychosocial factors of the community.

include the physical, biological, and psychosocial factors of the community. Demographics of the community include the physical, biological, and psychosocial factors of the community. Demographics of the community usually change slowly. The demographics of the community can help describe why certain health behaviors occur within the community. The demographics of the community describe the community, but do not describe the boundaries of the community.

When a nurse meets with legislators about improving health care reimbursement for Medicare recipients, the nurse is providing: indirect community/public health nursing. direct community/public health nursing. targeted community/public health nursing. collaborative community/public health nursing.

indirect community/public health nursing. Indirect community/public health nursing does not involve interpersonal relationships with all persons who benefit from care. Meeting with legislators about improving health care reimbursement is an example of indirect community/public health nursing. Direct community/public health nursing is the application of the nursing process to individuals, families, and groups and involves face-to-face relationships. Targeted care is provided in community/public health nursing as the care is directed toward individuals, families, groups, and aggregates based on those at risk. Collaborative community/public health nursing is not a categorization of nursing care provided. However, collaboration means working together and denotes the participants have relatively equal influence.

A nurse can facilitate growth of the nurse-client relationship by: learning about the family before the home visit. insisting the client follow the prescribed therapeutic regimen. offering financial assistance to clients. acting on the initial emotion that is felt.

learning about the family before the home visit. One strategy that a nurse can use to facilitate growth of the nurse-client relationship is to learn about the family before the home visit. Insisting that the client follow the prescribed therapeutic regimen can cause conflict between the client and the nurse. The nurse should work with the client and establish mutual goals. Although offering clients financial assistance may decrease the number of conflicts that occur, it is not an appropriate role for the nurse. The nurse should be aware that families sometimes ask for time, money, rides, or assistance with tasks that they can accomplish themselves. Acting on initial emotions does not help reduce conflicts with families. Our emotional responses are often automatic and certainly color our perceptions, but they are usually not rational. One goal in the therapeutic nursing relationship is to be open to possible interpretations of the situation other than your initial, automatic one

The school nurse seeks input from the community when initiating the establishment of a school-based clinic at the school. This is an example of the nursing role of: liaison between school personnel, family, community, and health care providers. provider of direct health care to students and staff. health screener and source of referrals for health conditions. promoter of a healthy school environment.

liaison between school personnel, family, community, and health care providers. As a liaison between school personnel, family, community, and health care providers, the school nurse seeks input from the community when initiating the establishment of a school-based clinic at the school. Involving the community in planning health services programs increases support for these initiatives if they have participated in the planning of the program. As a provider of direct health care to students and staff, the school nurse provides direct care to students and staff who have been injured or are suffering from acute illness. As health screener and source of referrals for health conditions, the school nurse performs routine health screenings in the schools. As promoter of a healthy school environment, the school nurse is concerned with the physical and emotional safety of the school community

A community health nurse contacts the outpatient laboratory to come to the home and draw blood for a lab test that has been ordered for the client. This is an example of: evaluating the visit. consulting with others. making a referral. completing documentation.

making a referral. Making a referral is the act or instance of sending or directing someone for treatment, aid, information, or a decision. Contacting the laboratory to come to the home and perform a blood draw is an example of making a referral. Evaluating the visit is performed when the nurse looks at the scope and specificity of the nursing process, the degree of client satisfaction, the quality of the nurse-client relationship, and the health behavior and status of the client. Consulting with others is performed when seeking the advice or opinion of an expert. Completing documentation involves recording all patient interactions and encounters

One of the overall goals of physical education is to: decrease premature mortality. reduce the risk of developing chronic illness. encourage participation in interscholastic sports. participate regularly in physical activity.

participate regularly in physical activity. One of the overall goals of physical education is to promote regular participation in physical activity. Decreasing premature mortality and reducing the risk of developing chronic illness are both benefits of engaging in regular physical activity. However, these are not considered to be overall goals of physical education. Participation in interscholastic sports should be encouraged as a form of physical activity outside of formal physical education, but it is not one of the overall goals of physical education.

The overall purpose of the National Institute for Occupational Safety and Health (NIOSH) is to: ensure safe and healthful working conditions. ensure that specific standards for workplace safety are being met. promote workplace satisfaction. perform occupational health and safety research.

perform occupational health and safety research The overall purpose of the National Institute for Occupational Safety and Health (NIOSH) is to perform occupational health and safety research. NIOSH has developed and funded the first Education and Research Centers across the United States. The role of the Occupational Safety and Health Administration (OSHA) is to ensure safe and healthful working conditions and that specific standards for workplace safety are being met. The three priority categories that are addressed by NIOSH include disease and injury, work environment and work force, and research tools and approaches. Although research about workplace satisfaction may be performed, that is not the overall purpose of NIOSH

Conducting a windshield survey is an example of obtaining data from: personal observation. secondary data. geographical information systems. key informants.

personal observation. Conducting a windshield survey is an example of obtaining data by personal observation. This provides an opportunity to observe, listen, and collect information. Secondary data is a way of obtaining data from an existing data source. Geographical information systems are computer-based programs used to store and statistically manipulate geographical and location-based data to provide visual maps. Data are collected using key informants when people in the community and the leaders of the community are used to collect data about the community.

A poorly designed child safety seat would be classified as a: biological hazard. physical hazard. chemical hazard. psychosocial hazard.

physical hazard. Physical hazards include poorly designed or unsafe construction of equipment, buildings, roads, or playgrounds; improperly placed items, and general lack of attention to safety, noise, and radiation. A poorly designed child safety seat would be classified as a physical hazard. Biological hazards are related to the spread of infectious disease. Dusts, fumes, mists, vapors, and gases are examples of chemical hazards. The major psychosocial hazard is stress. This category is the most difficult to describe because it is the most difficult to measure

When a nurse assesses a community in relation to a specific health problem, the nurse is using a: single-population approach. problem-oriented approach. comprehensive needs assessment. familiarization approach.

problem-oriented approach. When a nurse assesses a community using a problem-oriented approach, the nurse assesses a community in relation to a specific topic or health problem. The nurse begins the process with the problem or topic area and then assesses a specific community in relation to that subject. When a nurse assesses a community using a single-population approach, the nurse assesses one population in a community. The nurse begins the process with defining the population and then assesses the population in a specific community. When a nurse assesses a community using the comprehensive needs approach, the nurse begins with the total community and uses a systematic process to assess all aspects of the community to identify or validate actual and potential health problems. When a nurse assesses a community using a familiarization approach, the nurse studies data already available on a community. This helps the nurse focus on special populations that have similar characteristics and may have health needs

One of the five basic goals of community health nursing practice in the home is: contacting community resources. conducting patient assessments. promoting a healthful environment. discussing family relationships.

promoting a healthful environment. Promoting a healthful environment is one of the five basic goals of community health nursing practice in the home. Although a community health nurse may contact community resources, conduct patient assessments, and discuss family relationships, these do not belong to the five basic goals of care.

The community/public health nurse uses surveillance when: collecting data to help describe the population, its health status, and the health risks. talking to parents about the risks of not having smoke detectors in the home. reporting a child who has lead poisoning. advocating for policies to improve air quality.

reporting a child who has lead poisoning. Surveillance is used when reporting environmental diseases, such as cancer registries, birth defect registries, and blood lead level registries. Assessment is used when collecting data to help describe the population, its health status, and the health risks. Risk communication is used when the community/public health nurse communicates to others about health risks, such as talking to parents about the risks of not having smoke detectors in the home. Advocacy is used when advocating for policies that influence the health of the population.

Community health nursing describes a: specific educational training. setting for practice of nursing. specific term for nursing developed by American Public Health Association. care model focused on caring for populations.

setting for practice of nursing. Community health nursing describes a setting for the practice of nursing and does not require specific educational training. Public health nursing requires specific educational preparation. The American Public Health Association used the term

Revenues coming from local sources primarily come from: federal block grants. appropriated funding. general fund of the state. taxes or a levy.

taxes or a levy. Revenue coming from local sources primarily comes from taxes or a levy. A levy is a mechanism for raising money through the ballot box. It is similar to a bond issue in that it is a determined percentage of the local property tax or local income tax approved by voters. Federal block grants provide limited funding to programs administered by state and local health departments. Appropriated funding is determined by the state or federal legislature that determines the amount of money that will be budgeted for a specific program. Many states have legislatively allocated a local health department subsidy of a few cents to a few dollars per capita. This is not sufficient to support local health department programs but is important in the total financial schem

When resources are distributed to provide the greatest good for the greatest number with the least amount of harm, it is called: utilitarian justice. egalitarian justice. distributive justice. social justice.

utilitarian justice. Utilitarian justice is used when resources are distributed to provide the greatest good for the greatest number with the least amount of harm. Egalitarian justice is used when each person has equal access to equal health services. Distributive justice is concerned with fairly providing opportunities, goods, and services to populations of people. Social justice is the principle that all persons are entitled to have their basic human needs me