NUP 411 - Self Assessments (Wk 1-6)

Organize the following steps in the epidemiologic study from first to last: 1. Collect the data 2. Identify the problem 3. Analyze the findings 4. Disseminate the findings 5. Review the literature 6. Develop conclusions and applications 7. Design the study

2. Identify the problem 5. Review the literature 7. Design the study 1. Collect the data 3. Analyze the findings 6. Develop conclusions and applications 4. Disseminate the findings

Determinants of health are: (SATA) a. The economic factors impacting individuals or populations b. The physical environment impacting individuals or populations c. A person's individual characteristics and behaviors d. A person's genetic makeup e. The social factors impacting individuals or populations

ALL Determinants of health encompass a wide range of personal, social, economic, and environmental factors that impact the health status of individuals or populations. The following are all determinants of health: social environment, economic environment, physical environment, a person's individual characteristics and behaviors, income and social status, education, social support networks, genetics, health services, and gender.

An asthma action plan helps to: a. Take the guesswork out of treating episodes by telling you what to do when you or your child has an asthma episode. Often, you can treat symptoms without going to the doctor's office or the hospital b. Prevent or reduce the severity of episodes by letting you know what to watch for and how to treat the episode early c. Control asthma symptoms so that you or your child continues to be active with fewer asthma problems d. All of the above

ALL OF THE ABOVE

When employing a population-oriented focus, which would the community health nurse do? a. Assess the groups' relationships looking for a common need b. Promote the groups' dependency for improving health c. Consider the members individually for similarities d. Focus on the geographical area of the population

a. Assess the groups' relationships looking for a common need A population-oriented focus requires the assessment of relationships, considering the groups or communities in relationship to the rest of the community to discover common needs or risks for a common health problem. The nurse does not consider the groups or communities separately but rather in context. The population may or may not be delineated by the geographical area. The community health nurse encourages individuals' participation to promote their autonomy rather than permitting dependency.

After discussing the meaning of cultural diversity and its significance for community health nursing, the nursing instructor recognizes some points need to be clarified when the student makes which comment? a. "Dominant values are those held by the male head of the household in most American families." b. "The percentages of minorities are rising, and this group is projected to comprise 50% of the population by 2044." c. "Nurses maintain their original culture as they are socialized throughout the educational process." d. "America has become an amalgamation of people who have different values, ideals, and behaviors, rather than the melting pot that was once envisioned."

a. "Dominant values are those held by the male head of household in most American families." The beliefs and sanctions of the dominant or majority culture are called dominant values. The proportion of the population identified as White is projected to continue to fall below other ethnicities between 2010 and 2050. Nurses will still have the same culture as they did before they were socialized in the nursing educational process, but they may be able to see things differently. America is not the ideal melting pot once described, but rather an amalgamation of people who have different values, ideals, and behaviors.

Community health nurses need to know that families are systems. Which attributes of systems are also attributes of families? a. A change within the family system not only affects the individual member but all of the family members. b. Family members are independent. c. Families cannot be visualized as a mobile in which all of the pieces are suspended freely by a string. d. Families are only a subsystem.

a. A change within the family system not only affects the individual member but all of the family members. Families are part of a larger suprasystem that includes many subsystems. Family member actions affect other family members. A family is greater than the sum of all its parts. A change within the family system not only affects the individual member but all of the family members. All the members of a family are interdependent, not independent. They exist for a purpose, and in order to fulfill this purpose, they must work toward goals. Families can be visualized as a mobile in which all of the pieces are suspended freely by a string.

A community health nurse is conducting a program for local community leaders about rural and urban area needs. The nurse identifies the need for additional teaching based on which statement by the group? a. A rural area has six or fewer persons per square mile b. There are many factors that are considered when determining if a community rural or frontier other than population density c. Urban areas are much more densely populated than rural areas d. An urban area consists of at least 50,000

a. A rural area has six or fewer persons per square mile Rural is defined as communities with fewer than 10,000 residents and a county population density of less than 1,000 persons per square mile. This definition of rural is arbitrary b/c rural clients do not merely consider population density or community size when defining their ruralness. They have a multitude of reasons for defining their community as rural, such as distance from a large city, major occupations in the area (e.g. agriculture), or number of students in local schools. An urbanized area consists of densely settled territory with a population of at least 50,000 people.

Which of the following variables that occur in nature would not have a negative impact on humans? a. Apples grow on trees b. Risks for waterborne and food-borne pathogens in drinking water, seafood, and fresh produce because of climate variability c. The effect of climate change upon weather extremes (droughts, floods, and storms) d. Changes in rainfall and water supply for soil

a. Apples grow on trees The variables related to the food supply that occur in nature and could have a negative impact on humans include the effect of climate change upon weather extremes (droughts, floods, storms); changes in rainfall and water supply for soil; ecology of microbial growth; and risks for water-borne and food-borne pathogens in drinking water, seafood, and fresh produce b/c of climate variability. There are currently food shortages in parts of the world, and this is likely to continue and maybe worsen.

Which intervention by the community health nurse would be classified as a secondary prevention measure to combat homelessness? a. Assist homeless clients in locating temporary shelter b. Provide effort for services for the mentally ill and homeless c. Prevent individuals and families from becoming homeless by assisting them w/ factors that contribute to homelessness d. Make referrals for employee assistance programs to allow clients to eliminate factors that contribute to homelessness

a. Assist homeless clients in locating temporary shelter Assisting homeless clients in locating temporary shelter would be classified as a secondary prevention measure that aims to reduce the impact of a disease, injury, or incidence that has already occurred. Primary prevention aims to prevent disease, injury, or incidence before it even occurs, such as preventing individuals and families from becoming homeless by assisting them w/ factors that contribute to homelessness and making referrals for employee assistance programs to allow clients to eliminate factors that contribute to homelessness. Tertiary aims to soften the impact of an ongoing injury or illness that has lasting effects. Health promotion measures fall under primary prevention. Providing effort for services for the mentally ill and homeless is a form of advocacy, which occurs at each level of prevention to effect positive change.

A community health nurse is preparing a presentation for a group of local community nurses about measures to help decrease health disparities. Which suggestion would be the least effective? a. Avoiding political involvement in issues b. Working w/ schools to reduce the dropout rate c. Organizing task forces to raise community awareness d. Holding community meetings to identify needs

a. Avoiding political involvement in issues To help decrease health disparities, political advocacy is necessary to influence health policy. In addition, working w/ schools to reduce the dropout rate helps to address the connection between education and outcomes. Organizing task forces, raising community awareness, and community input for need identification are all effective methods to address vulnerable populations and health disparities.

What is the most important reason for the nurse to conduct a cultural assessment? a. Because understanding the values, beliefs, and practices of a designated cultural group is critical to effective nursing action b. To meet the nurse's professional learning needs c. Because usually there is no culturally based reason that causes clients to engage in or avoid certain actions d. Because it is often assigned by nursing faculty

a. Because understanding the values, beliefs, and practices of a designated cultural group is critical to effective nursing action The most important reason for the nurse to conduct a cultural assessment is b/c understanding the values, beliefs, and practices of a designated cultural group is critical to effective nursing action. There is usually some culturally based reason that causes clients to engage in or avoid certain actions but that is not the most important reason for the nurse to conduct a cultural assessment. The nurse does not necessarily collect a cultural assessment to meet his or her own needs primarily.

The community health nurse is leading a discussion with a group of students about the eight principles of public health nursing. When asked why following the principles is important, what is the best response? a. Can help achieve the most beneficial outcomes b. The word principle is universally understood c. They were identified by the ANA d. They must be adhered to in order to protect the health of the community

a. Can help achieve the most beneficial outcomes The principles apply to universals in practice that can guide public health nursing practice in a way that can help achieve the most beneficial outcomes. It does not matter if the word principle is variable or universally understood. That they were identified by the ANA may not be compelling to all. They should be adhered as they facilitate the goals of public health nursing. However, the word "must" is an imperative command.

A community health nurse uses Roy's model with a community that is dealing with a particular health issue. The nurse would focus community assessment on which community action? a. Coping mechanisms for use in adaptation b. Lines of resistance and defense to stresses c. Environmental conditions to improve negative conditions d. Collective ability for independence and self-care

a. Coping mechanisms used for use in adaptation With Roy's model, people are viewed as open and adaptive systems that experience stimuli, develop coping mechanisms, and produce responses that are adaptive or maladaptive. Thus, the nurse would assess the community's coping mechanisms. Neuman's model would require assessment of lines of resistance and defense to stresses by her model. Nightingale's theory would require assessment of environmental conditions. Orem's model would require assessment of the community's ability for self-care.

Which one of the statements about families is most accurate? a. Culture explains why families behave as they do b. Individual family members decide which one role they will play c. Family behavior influences family values d. Family members are always cognizant of all family values

a. Culture explains why families behave as they do Culture explains why families behave as they do. Family roles are prescribed and defined for family members, and family members may enact more than one role simultaneously. Family values influence family behavior. Family members may not be consciously aware of all family values.

Which statement regarding mental illness and homelessness is most accurate? a. 75% of the sheltered homeless report a severe mental illness b. Deinstitutionalization or being released from institutions into the community contributes to the number of persons who have a severe mental illness who are homeless c. Mental illness only contributes to homelessness b/c poor mental health adversely affects an individual's ability to make sound judgments, solve problems, and make wise decisions d. Mental illness and substance abuse are not often comorbid conditions that contribute to homelessness

a. Deinstitutionalization or being released from institutions Deinstitutionalization or being released from institutions into the community contributes to the number of severely mentally ill persons represented in the homeless population. 25% of the sheltered homeless report a severe mental illness. Mental illness contributes to homelessness b/c poor mental health adversely affects an individual's ability to make sound judgments, solve problems, and make wise decisions. Mental illness and substance abuse are often comorbid conditions, which, coupled w/ poor physical health, make is especially difficult to secure employment and safe, affordable housing.

A community health nurse is working to change the focus of the public health department from one of needs oriented to one of being a partner and recognizing the community's strengths. Which nursing priority will help assist make the transition? a. Determine available assets. b. Identify barriers to communication. c. Evaluate previous unsuccessful programs for weaknesses. d. Identify local subcultures to ensure all are represented.

a. Determine available assets Assets assessment begins w/ what is present in the community. This approach requires that the assessor look for the positive or see the glass as half full. Identifying barriers, evaluating previous programs for weaknesses, and identifying local subcultures are all needs oriented and conducted in response to needs, barriers, weaknesses, problems, or perceived scarcity in the community.

Which statement made by a student would the nurse educator recognize as evidence that a student understands the health continuum? a. Illness refers to a state of being relatively unhealthy b. Treatment of acute conditions reflects the current focus of health care c. The distinction between health and illness is well demarcated d. The term health is limited to reflect an individual's state

a. Illness refers to a state of being relatively unhealthy Although society typically depicts an absolute line of difference between being either well or ill, health is considered a relative term. Thus, illness is viewed as a state of being relatively unhealthy. Health is typically described as a continuum that involves a range of degrees from optimal health at one end to total disability or death at the other. The line of demarcation is not clear. Health applies to individuals, families, and communities. Traditionally, most health care has focused on the treatment of acute and chronic conditions at the illness end of the continuum, but this emphasis is shifting to focus on the wellness end.

A community health nurse is part of a group working with local and state legislators to expand health insurance coverage for those w/ inadequate or no insurance. Which outcome would the nurse hope to achieve if the group is successful? a. Increase use of early screenings b. Increase emergency room visits c. Increase episodic care d. Increase disparities in care

a. Increase use of early screenings Having inadequate or no health insurance leads to poor health outcomes due to lack of early screening and preventive measures, incl. regular physical exams and immunizations, delays in getting treatment, and use of emergency rooms for worsening conditions w/ no continuity of care, all as efforts to save money. Expanding health insurance hopefully would promote increased use of early screenings, decreased emergency room visits, more continuity of care, and better health outcomes all around with less disparities.

A community health nurse is asked to be part of a community-wide effort to address the issue of teen parenthood. When planning appropriate programs, which would be important to include as the priority? a. Increased focus on preventing teen pregnancy b. Increased insurance coverage for contraception c. Increased male involvement in teen pregnancies d. Increased access to prenatal services

a. Increased focus on preventing teen pregnancy Although increased insurance coverage for contraception, increased male involvement in teen pregnancies, and increased access to necessary services are important and part of the goals of Healthy People 2020, the priority is to reduce pregnancy rates among adolescent females.

Which of the following are reasons why it is difficult to estimate the number of persons who are homeless? (SATA) a. It is difficult to estimate the number of people who are homeless b/c homelessness is a temporary condition b. It is difficult to locate and account for people who are homeless c. Some people are unable to access shelters where they would be counted as homeless b/c the shelter is overcrowded and there is limited capacity d. In rural areas, there are fewer housing options and resources for the homeless; as a result, people may be forced to temporarily live w/ friends or family e. Homelessness is increasing due to poverty and the growing shortage of affordable rental housing

a. It is difficult to estimate the number of people who are homeless b/c homelessness is a temporary condition b. It is difficult to locate and account for people who are homeless c. Some people are unable to access shelters where they would be counted as homeless b/c the shelter is overcrowded and there is limited capacity d. In rural areas, there are fewer housing options and resources for the homeless; as a result, people may be forced to temporarily live w/ friends or family

Employees working with hazardous chemicals have the "Right to Know" about the chemicals they are working with. Which resource teaches employees about information regarding the chemicals they may be exposed to? a. Material Safety Data Sheet (MSDS) b. Consumer Confidence Report c. CDC Fact Sheets d. AQI Reports

a. Material Safety Data Sheet (MSDS) The "Right to Know" legislation and use of Safety Data Sheets provide some assurance in teaching employees and community members about the chemicals they may be exposed to. The Consumer Confidence Report describes water quality, CDC fact sheets summarize diseases, and AQI Reports refer to air quality.

The community health nurse is developing a plan of secondary prevention activities. Which actions would the nurse incorporate into the plan? a. Participating in diabetes screening programs at health fairs b. Educating high school students about safe sex practices c. Developing an exercise plan for COPD clients d. Providing a community-based stroke rehabilitation program

a. Participating in diabetes screening programs at health fairs Secondary prevention activities are those used to DETECT AND TREAT EXISTING HEALTH PROBLEMS AT THE EARLIEST POSSIBLE STAGE, when disease or impairment is already present. Activities may include HTN and cholesterol screening programs to identify high-risk individuals and encourage early treatment to prevent heart attacks or stroke. Other examples are encouraging breast and testicular self-examination, regular mammograms, and Pap smears for early detection of possible cancers and providing skin testing for TB (in infants at 1 year of age and periodically t/o life, w/ increasing frequency for high-risk groups. Secondary prevention attempts to discover a health problem at a point when intervention may lead to its control or eradication.

Actions to protect against disease and disability are: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Both a and b

a. Primary prevention Primary seeks to promote health and prevent disease from occurring. Secondary includes interventions designed to increase the likelihood that a person with a disease will be diagnosed early enough so that treatment may result in a cure. Tertiary's goal is to interrupt the process of the disease, reduce the amount of disability, and begin rehabilitation.

You are working to offer increased health care services to meet the needs of a local migrant population. Which idea would be most effective for the nurse to implement with this population? (SATA) a. Providing a mobile van clinic that comes to the farms during the day b. Offering a clinic at the migrant camp from 7PM to 10PM c. Asking local doctors to stay open until 6PM during the summer d. Offering school-based health services for the children e. Providing a breakfast program for the children at school

a. Providing a mobile van clinic that comes to the farms during the day b. Offering a clinic at the migrant camp from 7PM to 10PM d. Offering school-based health services for the children e. Providing a breakfast program for the children at school Migrant workers are in the fields until dark, which may be 9PM in the summer; thus, a physician that stays open until 6PM will not be effective.

When fulfilling the function of assessment, which action would be most important for the community health nurse to take? a. Secure the trust of the clients b. Gather appropriate information c. Interact with key community leaders d. Use a variety of assessment tools

a. Secure the trust of the clients Although securing and maintaining the trust of others is pivotal to all nursing practice, it is even more critical when working in the community. Trust can afford a nurse access to client populations that are difficult to engage, to agencies, and to health care providers. As difficult as it may be for the nurse to gain the trust and respect of the community, if it is ever lost, these attributes can be difficult if not impossible to regain. Gathering information, interacting with key community leaders, and using a variety of assessment tools are important, but they can only occur after trust is established.

A public health nurse is collecting information to present at a meeting of community members who are trying to decide the best response to a local health care need. What information will be important for the nurse to include? Select all that apply. a. Short-and long-term costs oft he program b. List of potential grants to apply for c. Sample poll of community members desires d. Latest research regarding suggested solution e. Ways to improve existing program

a. Short-and long-term costs oft he program d. Latest research regarding suggested solution e. Ways to improve existing program When collaborating with others in the community, the nurse should be prepared with information to include short-and long-term costs of the program, what the latest research says regarding the suggested solutions, and ways to either improve the existing programs or reasons to terminate them. Complying a list of potential grants and a sample poll are not considered a part of the seventh principle that is to promote optimum allocation of resources.

Which is the best example of a community health nurse focusing on the secondary level of prevention? a. Teaching clients how to navigate the health care system to receive prompt treatment b. Teaching clients about the importance of immunization c. Teaching stroke survivors about the importance of diet, rest, and exercise to prevent a secondary health problem d. Teaching a class on sensible nutrition for adolescents

a. Teaching clients how to navigate the health care system to receive prompt treatment The secondary level of prevention would be exemplified by the community health nurse when teaching clients how to navigate the health care system to receive prompt treatment. Teaching clients about the importance of immunization is focused on the primary level of prevention. Teaching stroke survivors about the importance of diet, rest, and exercise to prevent a secondary health problem is focused on the tertiary level of prevention. Teaching a class on sensible nutrition for adolescents is focused on the primary level of prevention.

While making a family health visit, an older relative who is visiting has been drinking and becomes verbally abusive and increasingly loud. Which action by the community health nurse would be best? a. Terminate the visit, making plans for another visit b. Ask the sober family members to take the visitor home c. Suggest the relative go in another room and take a nap d. Continue the visit with caution

a. Terminate the visit, making plans for another visit Terminating the visit is the best choice. It appears the problem is escalating, and the nurse's safety should always come first. Continuing the visit puts the nurse and possibly the other family members at risk. Making a suggestion to go into another room and take a nap may agitate the relative and make a deteriorating situation worse. Making a suggestion for a family member to take the visitor home may agitate the relative and make a deteriorating situation worse. Additionally, this is the client's home and the suggestion should be the client's.

Which are examples of a community health nurse providing health promotion teaching? (SATA) a. The community health nurse teaches a class of kindergartners how to properly wash their hands. b. The community health nurse is a guest on a radio talk show to provide information how to avoid an infection that is endemic. c. The community health nurse encourages an individual whose blood pressure screening was elevated to have his or her blood pressure rechecked in 1 week. d. The community health nurse teaches a group of preschoolers about different fruits and vegetables that they might like to try. e. The community health nurse teaches a mother and baby exercise group. f. The community health nurse leads a group of stroke survivors in soft exercise.

a. The community health nurse teaches a class of kindergartners how to properly wash their hands. d. The community health nurse teaches a group of preschoolers about different fruits and vegetables that they might like to try. e. The community health nurse teaches a mother and baby exercise group. Health promotion is behavior that is motivated by the desire to increase well-being and actualize human potential. This is different from disease prevention/health protection, which is behavior motivated by a desire to actively avoid illness, detect it early, or maintain functioning within the constraints of illness. The activities of teaching a class of kindergartners how to properly wash their hands, teaching a group of preschoolers about different fruits and vegetables that they might like to try, and teaching a mother and baby exercise group are focused on well-being and not a particular illness. The activities of being a guest on a talk show to provide information how to avoid an infection that is endemic, encouraging an individual whose blood pressure screening was abnormal to have their blood pressure rechecked in 1 week, and leading a group of stroke survivors in soft exercise are focused on avoiding specific illnesses and not on improved general health.

A community health nurse is preparing to assess a family. Which characteristics would the nurse NOT integrate into the assessment as universal? a. The family members are stuck in one stage of development b. Cultural values and rules c. Every family has structure d. Every family is a small social system

a. The family members are stuck in one stage of development Characteristics universal to all families include that every family is a small social system, moves through stages in its life cycle, has its own cultural values and rules, has structure, and has certain basic functions.

You are a health care worker at a County Health Department. You have been working closely with Juan, a 35-year-old Hispanic agricultural worker. Juan was diagnosed with TB about 2 months ago. You have been providing DOT (directly observed therapy) to Juan at a local farm where he picks oranges. Orange season is coming to an end and you realize that Juan will soon be heading North to look for more work. You have spoken to him about where he will be going next. He tells you that he is going to a farm in the next state over. He is not exactly sure where it is, but he thinks he remembers the farm is located near a town called Jasper. What steps will you take before Juan leaves to ensure the continuity of care? a. The state health department TB control officer should be contacted and made aware of the need for f/u and the next possible destination of the patient b. Juan should be given a clean set of clothes to prevent cross contamination c. Juan's new employer should be made aware of his diagnosis d. The oranges must be tested for contamination

a. The state health department TB control officer should be contacted and made aware of the need for f/u and the next possible destination of the patient You need to find out Juan's destination and have locating/contact information for him (e.g. phone number) before he leaves. You should follow these procedures to help him continue his TB care: Juan should be given (1) records he can take with him to indicate his current treatment and diagnostic status and (2) a supply of medications to self-administer during the transition of care. Special care should be taken to instruct Juan on how to take his medications and how and where to get additional medication and medical care at the destination site. (3) All relevant medical information, incl. TB lab reports, and patient contact info should be forwarded to the destination jurisdiction. (4) The state health department TB control officer s/b contacted and made aware of the need for f/u and the next possible destination of the patient. Although sharing information about Juan is encouraged to maintain continuity of care, measures s/b taken to ensure confidentiality.

A community health nurse is orienting a new group of nurses recently hired by the community agency. The nurse is describing the Public Health Nursing Practice model used by the agency. Which would the nurse include? a. Twelve leading indicators for Healthy People 2020 b. Practice priorities for achieving public health c. Regulator processes in response to stimuli d. Modifying factors that influence people's perceptions

a. Twelve leading indicators for Healthy People 2020 The Public Health Nursing Practice model integrates the Public Health Nursing Standards of Practice, the 10 Essential Public Health Services, the 12 Leading Health Indicators from Healthy People 2020, and the Minnesota Public Health Nursing Interventions model. Salmon's Construct for Public Health Nursing addresses three practice priorities for achieving public health. Regulator processes are a component of Roy's Adaptation model. Modifying factors are an element of Pender's Health Promotion model.

The community health nurse must apply the social determinants of health when caring for clients: a. b/c the social determinants of health affect a wide range of health, functioning, and quality-of-life outcomes and risks b. b/c in our country all people are treated equally c. b/c it is the right thing to do d. b/c the community health nurse believes in social justice

a. b/c the social determinants of health affect a wide range of health, functioning, and quality-of-life outcomes and risks The social determinants of health affect a wide range of health, functioning, and quality-of-life outcomes and risks. There is a growing inequity in the distribution of disease, illness, and wellness across our society and not all people are treated equally. It is not enough to do this because it is the right thing to do. If the community health nurse believes in social justice, this is one thing but really implementing social justice in considering outcomes and risks is more accurate.

A community health nurse determines that it is time for teaching a family about health promotion activities one member states: a. "Is there a place we can go for the medicine?" b. "It's time we do something about eating right." c. "When are you coming back to visit?" d. "Our grandchildren visit every summer."

b. "It's time we do something about eating right." Teaching health promotion activities should begin only after family members express an interest and recognize a need, such as the statement about eating right. Asking about where to get medicine and when the nurse is coming back do not reflect an interest or need. The statement about grandchildren reflects information about the family structure and demographics.

The community health nurse is discussing family health nursing with a group of students. Which statement made by a student nurse indicates an effective teaching regarding family health nursing? a. "The family does not play a critical role in the health of its members." b. "The community health nurse is in a unique position to influence and promote family health." c. "Health habits are not developed in the context of family." d. "Genetic influences always take place within the family environment."

b. "The community health nurse is in a unique position to influence and promote family health." The community health nurse is in a unique position to influence and promote family health. The family plays a critical role in the health of its members. Health habits such as preventative care, diet, exercise, and physical activity are developed in the context of family. Health beliefs, genetic influences, and care of the ill family member all take place within the family environment. Sometimes genetic influences do not affect the family environment; for instance when a family is not biologically related, there are no genetic influences.

Which would the community health nurse include when integrating epidemiology of wellness into practice? a. Communicable disease control b. Lifestyle with its self-created risks c. The natural history of disease d. Vital statistics and reportable diseases

b. Lifestyle with its self-created risks Today, there is an increased focus on lifestyle behaviors and how they relate to a person's state of wellness or illness. It is a basic component of a wellness model. Communicable disease control focuses on an illness state, not a wellness state, and is not part of a wellness model. The four states states of the natural history of a disease or health condition is not part of the wellness model. Vital statistics and reportable diseases are not part of the wellness model.

Which statements about family structures is not true? a. Throughout the world, families in all varied forms are the basic social unit. b. A family consists of a husband, wife, and children living under one roof with the man as breadwinner and the woman as homemaker. c. The people who are members of a family interact, care for one another, and bond in ways that may never be fully understood by anyone outside the family. d. Families structures can be categorized into two general categories: traditional and contemporary.

b. A family consists of a husband, wife, and children living under one roof with the man as breadwinner and the woman as homemaker. Throughout the world, families in all varied forms are the basic social unit. The people who are members of a family interact, care for one another, and bond in ways that may never be fully understood by anyone outside the family. The varying family structures or compositions comprise the collective characteristics of individuals who make up a family unit. Families structures can be categorized into two general categories: traditional and contemporary. A nuclear family structure is not the norm for every family.

After teaching a group of students about factors assoc. w/ vulnerable populations, the instructor determines the need for add'l teaching when the students identify which as a factor? a. Homelessness b. Acute illness c. Income d. Immigrant status

b. Acute illness Factors assoc. w/ vulnerable populations incl. income and education, age and gender, race and ethnicity, homelessness, chronic illness and disability, and immigration among others. Chronic, not acute, illness is considered as a factor.

Community health nurses practice within three levels of prevention. In which actions would the community health nurse engage at the primary level of prevention for communicable disease control? Select the answer that does NOT apply. a. Administering immunizations to senior citizens b. Administering prompt treatment for the symptoms of gonorrhea c. Teaching kindergarten students to wash their hands d. Encouraging parents to complete their children's immunizations

b. Administering prompt treatment for the symptoms of gonorrhea Primary prevention interventions include administering immunizations, teaching about hand washing, and encouraging adherence to the recommended schedule for childhood immunizations. Providing TB skin testing, chest x-rays, and promptly treating symptoms of gonorrhea are examples of interventions at the secondary level of prevention.

A community health nurse who will be working with a homeless population is planning care. Which action would the nurse need to take first? a. Develop trust w/ the population b. Clarify personal values and beliefs c. Focus on the issue of homelessness d. Visit the local shelter where the clients are

b. Clarify person values and beliefs When working w/ the homeless population, it is crucial that the nurse clarify personal beliefs and values about poverty, homelessness, addictions, and mental disorders to ensure nonjudgmental care. Trust too is essential, but this would need to occur after the nurse has clarified his or her values and beliefs. Biases or judgments on the nurse's part would undermine the development of trust. The nurse needs to use a comprehensive, holistic approach or focus, not just focus on the population's homelessness. Visiting the local shelter may be helpful to gather information about what the nurse might expect, but it isn't the first thing the nurse would do.

A community health nurse is collecting data about the local community concerning a recognized health issues. Understanding there are various sources for the information, the nurse chooses to start with a primary source that would involve which entity? a. World Health Organization b. Community members c. State health department d. Other community health nurses

b. Community members Primary sources of information include community members, incl. formal and informal leaders, and can frequently offer the most accurate insights and comprehensive information. Information gathered by talking to people provides primary data, because the data are obtained directly from the community. The WHO is an international source of information. State health department is a state level source. Other community health nurses, as well as health team members, client records, community health (vital) statistics, census bureau data, reference books, and research reports are secondary sources of information.

Which statement best describes the difference between health promotion and disease prevention? a. Health promotion and disease prevention include all efforts that seek to move people closer to optimal well-being or higher levels of wellness. b. Disease prevention differs from health promotion in that disease prevention is targeted toward a specific disease or diseases. c. Health promotion can be described in terms of primary, secondary, and tertiary prevention. d. The goal of disease prevention is to raise levels of wellness for individuals, families, populations, and communities.

b. Disease prevention differs from health promotion in that disease prevention is targeted toward a specific disease or diseases. Health promotion includes all efforts that seek to move people closer to optimal well-being or higher levels of wellness. The goal of health promotion is to raise levels of wellness for individuals, families, populations, and communities. Disease prevention is targeted toward a specific disease or diseases and consists of primary, secondary, and tertiary prevention.

Which statement made by a student would the nurse educator recognize as evidence that a student understands the health continuum? a. The distinction between health and illness is well demarcated. b. Illness refers to a state of being relatively unhealthy. c. The term health is limited to reflect an individual's state. d. Treatment of acute conditions reflects the current focus of health care.

b. Illness refers to a state of being relatively unhealthy Although society typically depicts an absolute line of difference between being either well or ill, health is considered a relative term. Thus, illness is viewed as a state of being relatively unhealthy. Health is typically described as a continuum that involves a range of degrees from optimal health at one end to total disability or death at the other. The line of demarcation is not clear. Health applies to individuals, families, and communities. Traditionally, most health care has focused on the treatment of acute and chronic conditions at the illness end of the continuum, but this emphasis is shifting to focus on the wellness end.

The term health can be described in many different ways. How would the community health nurse interpret health? a. The potential to lead a productive life b. The absence of disease c. A holistic state of well-being d. An environment free of toxins

c. A holistic state of well-being Community health nurses view health as a holistic state of well-being, which includes soundness of mind, body, and spirit. Along with this foundational view is the emphasis on wellness, which includes the definition of health as well as the capacity to develop a person's potential to lead a fulfilling and productive life. Health is more than just the absence of disease or an environment free of toxins.

A community health nurse arrives at a family's home. Which behaviors by the nurse would be nontherapeutic? a. Maintaining eye contact with the family members b. Paging through paperwork for information c. Sitting on the furniture near the family members d. Placing car keys in the nurse's carryall bag

b. Paging through paperwork for information Community health nurses, like all nurses, need to be aware of their own body language. Fidgeting with car keys during the entire visit, noisily chewing gum, giving minimal eye contact, continuously looking at or paging through paperwork, appearing rushed, and refusing to sit on any of the furniture are behaviors that tell the family a great deal about the nurse, including how he or she feels about being in their home. These actions are nontherapeutic. Sitting on the furniture near family members demonstrates interest in the family. Placing car keys in the carryall bags prevents inadvertent distractions.

Which intervention by the nurse is most likely to have a positive influence on the client's adoption of a new healthy behavior? a. Providing feedback about what the client is doing incorrectly b. Providing feedback about what the client is doing correctly c. Not providing feedback d. Not providing role modeling of the desired change

b. Providing feedback about what the client is doing correctly The nurse who recognizes clients' participation in a group praises them for completing assignments or commends them for sticking to diet plans will have more success than the nurse who only criticizes failures. Frequently, clients view nurses as a positive role model; for this reason, nurses should try to demonstrate healthy behaviors. Nurses should be good communicators and provide constructive feedback to clients.

A group of community health nurses are evaluating the community to determine which issues should be addressed. As the group complete various assessments, they recognize an assets assessment will be important to evaluate which factor of the community? a. Key informants b. Strengths of the community c. Specific problem of the community d. Overall life of the community

b. Strengths of the community An assets assessment focuses on the strengths and capacities of a community rather than its problems. Key informants are important sources of information w/ a comprehensive assessment. Info about a specific health problem is gathered during a problem-oriented assessment. Info about an overall view of the community and its life is gathered with a familiarization or windshield survey.

What principle guides and enhances family nursing practice? a. The nurse should expect that the family will be normal and will not change. b. The nurse should start where the family is at the present time and not the ideal level of functioning. c. The nurse should focus on each family member individually. d. The nurse should evaluate the family based on consistency with traditional family patterns.

b. The nurse should start where the family is at the present time and not the ideal level of functioning. When working with families, community health nurses begin at the present, not the ideal level of functioning. This is accomplished after the nurse views the family collectively, not individually. The nurse should expect that what is normal for one family is not necessarily normal for another and that families are constantly changing. The nurse should recognize the validity of family structure variations.

How would a community health nurse define vulnerable populations? a. Those persons with higher mortality rates b. Those with increased risk for adverse health outcomes c. Individuals with lower life expectancy d. Individuals with chronic illness

b. Those with increased risk for adverse health outcomes Vulnerable populations are groups who have a heightened risk for adverse health outcomes. They may include various populations such as those w/ higher mortality rates, lower life expectancies, or chronic illnesses. However, presence of just one of these does not necessarily indicate that the population is vulnerable.

The community health nurse is discussing the roles assumed by community health nurses w/ a student nurse. Which statement made by the student nurse demonstrates the correct interpretation of which role must be assumed in every situation? "A community health nurse assumes the role of... a. researcher b. manager c. leader d. clinician ...in each situation."

b. manager The type and number of roles that are practiced vary w/ each set of clients and each specific situation, but the nurse should be able to function in each of these roles as the particular situation demands. The role of manager is one that the nurse must play in every situation, b/c it involves assessing clients' needs, planning and organizing to meet those needs, directing and leading clients to achieve results, and controlling and evaluating the progress to ensure that the goals and clients' needs are met.

After teaching a group of nursing students about the similarities and differences between public health and community health, which statement by a nursing student would best describe the similarities and differences between public health and community health? a. "Community health nursing is defined as nursing care that is provided in a community setting, rather than an institutional setting." b. "Public health nursing is defined as nursing care that is provided in an institutional setting." c. "Community health nursing can shape the quality of community health services and improve the health of the general public." d. "Public health nursing is focused on the health of individuals."

c. "Community health nursing can shape the quality of community health services and improve the health of the general public." Operating within an environment of rapid change and increasingly complex challenges, this nursing specialty holds the potential to shape the quality of community health services and improve the health of the general public.

The nurse educator is aware that the nursing student understands the importance of roles within a family when the nursing student states: a. "Family members can only play one role at a time." b. "Family roles are restricted to the immediate family." c. "Selection of specific roles to be played in any family depends on the family's structure, needs, and patterns of functioning." d. "Family member roles are determined by those outside the family."

c. "Selection of specific roles to be played in any family depends on the family's structure, needs, and patterns of functioning." Selection of specific roles to be played in any family depends on the family's structure, needs, and patterns of functioning. Family members may play several roles at the same time. Family roles may extend beyond the immediate family. Family member roles are determined by the family.

A prospective nursing student is interested in working in community health nursing after graduation. Which level of education would be most appropriate for this student to complete? a. Diploma program b. Associate degree c. Baccalaureate degree d. Master's degree

c. Baccalaureate degree Community health nursing is a challenging specialty in nursing. The demands of this type of nursing require add'l courses in liberal arts and science, along with courses in community health nursing practice as a student. The min. preparation for community in many states is a baccalaureate degree. The diploma and associate degree level prepares students for basic nursing practice. Students can build on this basic knowledge by entering a BSN completion program, which will prepare them to enter the specialty of community health nursing.

How is tuberculosis (TB) spread? a. Direct contact b. Fecal-oral route c. Droplets d. Cross contamination

c. Droplets TB is spread from person to person through the air. When a person with infectious TB disease coughs, sneezes, speaks, or sings, tiny particles containing M. tuberculosis may be expelled into the air. These particles, called droplet nuclei, are about 1 to 5 microns in diameter - less than 1/5000 of an inch. Droplet nuclei can remain suspended in the air for several hours, depending on the environment.

Which activities would be associated w/ a community health nurse? a. Participating in a health clinic office party b. Providing emergency care in an acute care facility c. Examining infants in a city well-baby clinic d. Caring for elderly stroke victims in the hospital

c. Examining infants in a city well-baby clinic Community health nurses work in every conceivable kind of community agency, from a state public health department to a community-based advocacy group. Their duties range from examining infants in a well-baby clinic or teaching elderly stroke victims in their homes to carrying out epidemiologic research or engaging in health policy analysis and decision making. Providing care in an acute care facility would not be an activity assoc. w/ a community health nurse.

When applying the epidemiologic triad model to a community's plan of care, which would the community health nurse address? a. Incidence, prevalence, and case fatality b. Health, illness, and injury c. Host, agent, and environmental model d. Immunity, causation, and risk

c. Host, agent, and environmental model The purpose of this model is to demonstrate the relationship among host, agent, and environment. Each component has to be present to a certain degree in order for any disease, illness, or injury to exist or happen. If one component is missing, illness or injury will not occur. Incidence, prevalence, case fatality, health, illness, injury, immunity, causation, and risk are terms used in epidemiology but do not refer to the epidemiologic triad model.

Which statement about immunization is most accurate? a. Immunization is helpful in the spread of all communicable diseases. b. Immunization cannot provide herd immunity. c. Immunization is the process of introducing a form of a disease-causing organism into a person's system to promote the development of antibodies that will resist the disease. d. Immunization is the process of administering antibodies to a person.

c. Immunization is the process of introducing a form of a disease-causing organism into a person's system to promote the development of antibodies that will resist the disease. There are many communicable diseases that a vaccine is not known for. Immunization can help to promote herd immunity. Immunization does not involve the administration of antibodies to a person.

A community health nurse is conducting orientation for new nurses to the clinic. Which factor should the nurse emphasize as most important when dealing with the community? a. Cyclic nature b. Client focus c. Interaction d. Flexibility

c. Interaction Although the nursing process is cyclical, deliberative, flexible (adaptable), client focused, and need oriented, interaction is an essential first consideration for community health nursing. All steps of the nursing process depend on interaction.

A group of community health nurses are assessing the current health status of the community and note certain individuals are not utilizing the services of the clinic. What is the best action for the nurses to take? a. Increase advertisement of services b. Meet w/ local leaders to inform of disparity c. Investigate the situation to determine possible cause d. Offer incentives to new clients for checking out the services available

c. Investigate the situation to determine possible cause The nurses should conduct a community subsystem assessment to evaluate the situation. This would involve investigating the situation to determine the cause by focusing on a single dimension of community life. Increase advertisement or offering incentives would not accomplish the goal of determining shy the individuals are not utilizing the services. The nurses should meet with the local leaders to get them involved in correcting the disparity.

Which statement about teaching at three levels of prevention is most accurate? a. Ideally, the community health nurse would focus at the tertiary level of prevention. b. The outcome of focusing on the tertiary level of prevention is to help diminish years of morbidity and limit subsequent infirmity. c. It is ideal to focus on the primary level of prevention. d. Community health nurses do not spend a significant share of time teaching at the secondary level.

c. It is ideal to focus on the primary level of prevention Ideally, the community health nurse focuses on the primary level. Because the primary level of prevention is not possible in all cases, a significant share of the nurse's time is spent teaching at the secondary or tertiary level.

An instructor is teaching a group of students about the history of public health nursing. The instructor recognizes the teaching is successful when the students identify which individual to use the term "public health nursing" first? a. Margaret Sanger b. Lina Rogers c. Lillian Wald d. Jessie Sleet

c. Lillian Wald Lillian Wald, a leading figure in the expansion of district nursing, was the first to use the term "public health nursing" to describe the specialty. Jessie Sleet was credited as being the first Black public health nurse. Lina Rogers was the first school nurse. Margaret Sanger was the nurse who opened the first birth control clinic in America that eventually resulted in the formation of the International Planned Parenthood Federation.

A community health nurse is explaining the chain of causation to a family that includes a child who has developed Lyme disease. The nurse correctly describes the opening in the child's skin caused by the actual tick bite as the: a. reservoir b. mode of transmission c. portal of entry d. host

c. portal of entry The opening in the child's skin caused by the actual bite is the portal of entry in the chain of causation. The mode of transmission would be the tick biting the child. The reservoir would refer to the tick. The host would be the child who has been bitten by the tick.

When reporting the identification of a communicable disease and need for investigation, which organization would the community health nurse notify first? a. CDC b. State health department c. Local health department d. National Reported Disease list

c. Local health department The local health department is the initial point of notification of communicable disease investigation. Each local health department or agency will investigate the specific disease. The CDC is the federal agency that provides guidance and recommendations for each state health department. The state health department may be the primary agency or the guiding agency for local disease control policies. States use the National Reported Disease list as the guidance for state reportable diseases.

Activities that strive to identify and detect disease in its earliest stages or try to prevent the spread of communicable diseases are: a. Health promotion b. Primary prevention c. Secondary prevention d. Tertiary prevention

c. Secondary prevention Primary seeks to promote health and prevent disease from occurring. Secondary includes interventions designed to increase the likelihood that a person with a disease will be diagnosed early enough so that treatment may result in a cure. The goal here is to detect the disease in the early stages before s/sx become apparent to make an early diagnosis and begin treatment. Tertiary's goal is to interrupt the process of the disease, reduce the amount of disability, and begin rehablilitation.

Which statement best represents an upstream focus? a. The upstream approach does not focus on socioeconomic factors and the environmental origins of disease and health problems b. The upstream approach pertains to the purity of water supplies c. The focus of an upstream approach is the institution and system level d. The focus of an upstream approach is the healthy lifestyle issues

c. The focus of an upstream approach is the institution and system level The focus of an upstream approach is the institution and system level and not just healthy lifestyle issues. The upstream approach does focus on socioeconomic factors and the environmental origins of disease and health problems. The upstream approach does not pertain to the purity of water supplies.

The nursing student is preparing a report for class relating to Healthy People 2020 and environmental health. Which should the nurse highlight in this report? a. One of the six focus areas is individual health b. The document provides instructions for persons in the community regarding how to protect their own health c. The overall goal is to promote health for all through a healthy environment d. The agency that prepared this initiative is the WHO

c. The overall goal is to promote health for all through a healthy environment The overall goal of Healthy People 2020 is to promote health for all through a healthy environment. The document does provide guidance for nurses to identify targets for health (not instructions for individuals). The six areas that are focused on include outdoor air quality, surface and ground water quality, toxic substances and hazardous wastes, homes and communities, infrastructure and surveillance, and global environmental health. The agency that prepared this initiative is the U.S. Department of Health and Human Services.

For which reason are homeless youth at higher risk for HIV, hepatitis, and sexually transmitted infections? a. They are not likely to receive treatment for HIV, hepatitis, and STIs b. Homeless adolescents may have difficulty accessing emergency shelter because of shelter policies that prohibit older youth from the facility c. They lack education or job training skills and may resort to prostitution or survival sex, which increases risk for HIV, hepatitis, and STIs d. It is not uncommon for homeless youth to be arrested for running away, breaking curfews, or being w/o supervision

c. They lack education or job training skills and may resort to prostitution or survival sex, which increases risk for HIV, hepatitis, and STIs The reason that homeless youth are at higher risk for HIV, hepatitis, and STIs is they lack the education or job training skills and may resort to prostitution or survival sex. The other options listed do not increase risk.

The home health nurse is making an initial home visit with a family and asks the family to identify their extended family and other persons/groups they interact with each week. Which statement provides the best rationale for asking the family this question? a. To assist the family in identifying financial resources b. To identify an emergency contact person c. To understand how the family operates as a social system d. To assess the family's environment

c. To understand how the family operates as a social system Knowing the attributes of living systems can help strengthen the understanding of the family and the family structure. Inquiring about the family's identification of extended family members does not assist the nurse in assessing the family's environment. The nurse would not ask for the identification of an extended family member as a contact person or need to identify extended family who could provide financial assistance at this time.

When a community health nurse is planning to teach a group of new immigrants from a non -English-speaking country about the need for immunizations, the nurse should include which in his or her plans? a. Using a lot of pictures b. Guessing about the native language and attempting to speak it c. Using an interpreter d. Talking clearly and slowly, being sure to enunciate each word

c. Using an interpreter Planning to use an interpreter when presenting information to a group of new immigrants from a non-English-speaking country is the best option among those listed. Pictures will not effectively convey the meanings that the clients need. Guessing about the native language and attempting to speak it will not be effective either, as the nurse should never assume anything and unless the language is native to the nurse, the nurse will not be any more effective at communicating with the clients. Talking clearly and slowly, being sure to enunciate each word, might be appropriate for a group of immigrants from a non-English-speaking country who have been in this country for a while and have been learning the language.

A community health nurse is preparing a presentation for a group students about community health nursing. Which description about community health nursing would the nurse most likely include in the presentation? a. Encouraging clients to reach out to the nurse b. Engaging in tertiary prevention as a priority c. Working with the client as an equal partner d. Focusing on addressing continuous needs

c. Working with the client as an equal partner The community health nurse works with the client as an equal partner, encouraging autonomy. At any time, the nurse deals with continuous and episodic needs simultaneously. Primary prevention is the priority for community health nurses, having an obligation to actively reach out to all who might benefit from a specific activity or service.

The community health nurse is discussing the importance of understanding the concept of culture in relation to delivering quality nursing care. Which statement made by the student indicates a need for further education on the concept of culture? a. "Culture refers to the beliefs, values, and behavior that are shared by members of a society." b. "Culture tells what is acceptable or unacceptable in a given situation." c. "Culture provides a 'roadmap' for living." d. "Culture is not a learned behavior."

d. "Culture is not a learned behavior." Culture refers to beliefs, values, and behaviors that are shared by members of a society and provide a template or "roadmap" for living. Culture tells people what is acceptable or unacceptable in a given situation. Culture dictates what to do, say, or believe. Culture is learned.

You are conducting a program for a group of nurses working w/ Spanish-speaking migrant families. After describing this population and their health issues to your Caucasian group, you determine that add'l teaching is necessary when the group identifies which situation as problematic? a. "Yes, this group has higher rates of TB and we must understand how to help in their treatment." b. "Yes, this group has higher rates of nutritional deficiencies and we should focus on how to improve this." c. " Yes, this group has increased access to care now, but we must address barriers to get the care they need." d. "Yes, this group has a higher life expectancy than the general population, but it's b/c they work in the fresh air."

d. "Yes, this group has a higher life expectancy than the general population, but it's b/c they work in the fresh air." The life expectancy of a migrant worker is much lower than the general population, with higher rates of TB and reduced access to health care. Children of migrant workers also have higher rates of nutritional deficiencies, with many food unsure but at the same time experiencing obesity.

The term health can be described in many different ways. How would the community health nurse interpret health? a. The absence of disease b. The potential to lead a productive life c. An environment free of toxins d. A holistic state of well-being

d. A holistic state of well-being Community health nurses view health as a holistic state of well-being, which includes soundness of mind, body, and spirit. Along with this foundational view is the emphasis on wellness, which includes the definition of health as well as the capacity to develop a person's potential to lead a fulfilling and productive life. Health is more than just the absence of disease or an environment free of toxins.

The community health nurse is caring for a farm migrant worker client who reports difficulty in paying for his medications. Which action would the nurse take next to assist the client with acquiring their medication? a. Contact the pharmaceutical sales representative for sample packs of medications. b. Ask the client if his cultural health practices have a remedy he could use instead. c. Ask the health care provider which medications the client could have discontinued. d. Ask the health care provider to prescribe a less expensive medication on behalf of the client.

d. Ask the health care provider to prescribe a less expensive medication on behalf of the client The nurse may need to contact HCPs to prescribe a less expensive medication or change to the generic form of the same drug, usually sold at a fraction of the cost. The nurse should not suggest the elimination of medications due to a client's inability to pay for their meds. Clients can change their enrollment pharmaceutical coverage annually. The nurse should contact the HCP, not the pharmaceutical sales rep, for the availability of samples in the office as the nurse does not have prescriptive authority.

When working with different cultural groups in the area of health care practices, the nurse acts as an effective advocate for the client. Which action must the nurse take first? a. Prepare to teach clients about the limits and benefits of cultural health practices b. Assess the client or family adequately to ascertain their belief system and choices c. Individualize caregiving for the client within his or her culture d. Be knowledgeable about health care practices and choices

d. Be knowledgeable about health care practices and choices When working with different cultural groups in the area of health care practices, the community health nurse can be an effective advocate for the client. First, however, the nurse must be prepared to speak knowledgeably about health care practices and choices. The nurse also must be able to assess the client or family adequately so as to know what belief system motivates their choices. Finally, the nurse must be prepared to teach clients about the limits and benefits of cultural health care practices. The community health nurse should always individualize assessment and caregiving for the client within his or her culture and should not generalize about the client based on cultural group norms.

When preparing to conduct research on a vulnerable population, which of the following would the community health nurse attribute to the differential vulnerability hypothesis? a. Exposure to risk factors affects the population's social and human capital b. Everyone is at risk b/c of stressful events occurring in life c. A risk for a negative outcome increases w/ lower education and income levels d. Certain groups are impacted by stressful events more than others

d. Certain groups are impacted by stressful events more than others The differential vulnerability hypothesis states that everyone is subjected to stressful events but that these events hurt some people more than others, thus they are vulnerable populations. Although everyone experiences stresses, not everyone is vulnerable. Deficits or problems in social and human capital can increase the population's risk. Lower education and income are assoc. w/ a higher relative risk, but these alone do not describe the hypothesis.

Which action would the community health nurse take first when making an ethical decision? a. Engage in critical thinking b. Choose a value c. Identify isolated values d. Clarify one's values

d. Clarify one's values Clarification of a person's values is the first step in the process of ethical decision-making. Critical thinking is a strategy that can be used to help clarify values. Choosing a value is the first step in the process of valuing. Identifying isolated values are those which are organized into a hierarchical system where certain values have more weight or importance than others.

Which definition of family is most inclusive and yet the simplest? a. Families are the primary social agent in the promotion of health and well-being. b. Families consist of two or more individuals who share a residence or live near one another. c. Families possess some common emotional bond and engage in interrelated social positions, roles, and tasks. d. Families are defined by the members.

d. Families are defined by the members. The definition of family that is the most inclusive and the simplest is "family is whoever they say it is." The World Health Organization characterized the family as "the primary social agent in the promotion of health and well-being." Many family theorists suggest that a family consists of two or more individuals who share a residence or live near one another; possess some common emotional bond; engage in interrelated social positions, roles, and tasks; and share cultural ties and a sense of affection and belonging.

A public health nurse using an upstream approach to improve heart health would most likely focus on which contributing factors to improving heart health? a. Unhealthy diets b. Decreased physical activity c. Smoking tobacco d. Lack of safe places to exercise

d. Lack of safe places to exercise The upstream approach focuses on the factors at the institutional and system level rather than looking at healthy lifestyle issues. Healthy diets, increased physical activity, and smoking cessation are all healthy lifestyle issues. The root causes of the decreased physical activity would include lack of safe places to exercise.

When assessing a population's vulnerability, which would the community health nurse identify as a predisposing factor? a. Social support networks b. Crime rates c. Transportation d. Living conditions

d. Living conditions Predisposing factors incl. demographic variables (e.g., gender, age, marital status), social variables (e.g., education, employment, ethnicity, social networks), and health beliefs (e.g., values, and attitudes toward health and health care services, knowledge of disease). Social structures (e.g., acculturation and immigration), sexual orientation, and childhood characteristics (e.g. mobility, living conditions, history of substance abuse, criminal behavior, victimization, or mental illness) are also considered as predisposing factors. Enabling factors incl. personal and family resources, public benefits, transportation, telephone, crimes rates, social services resources.

When a community health nurse is conducting a family assessment on an assigned family, which action would be most appropriate? a. Use quantitative data only to maintain and preserve objectivity b. Interview one family member to avoid confusion and repeated information c. Use a checklist format, completing the tool in the family's presence d. Make several visits and accumulate data from all family members

d. Make several visits and accumulate data from all family members Completing a family assessment takes time. It is better to keep notes from several visits with the family and observe the family as a group during some family activity. The nurse should not use obtrusive questionnaire techniques or take notes in the family's presence. Quantitative data will give a one-sided view of family data. It is best to interview all family members over time. The nurse should collect both quantitative and qualitative data, which will provide a rich family assessment.

A community health nurse is developing a community diagnosis which addresses an issue that has been identified. What should the nurse remember to do when writing the diagnosis? a. Focus primarily on deficits of the community b. Use broad statements to guide a range of interventions c. Employ a revised nursing diagnosis format d. Substitute the terms client, family, group, or aggregate for the word patient

d. Substitute the terms client, family, group, or aggregate for the word patient Community diagnoses should include statements about the strengths of the community and possible sources for community solutions, as well as weaknesses or problem areas. In addition, they should portray a community focus, include the community response, and identify any related factors that have potential for change through community health nursing. These may also include wellness diagnoses, which indicate maintenance or potential change responses (due to growth and development), when no deficit is present. Diagnoses statements should be narrow enough to guide interventions and use the standard nursing diagnosis format.

A community health nurse is developing a community diagnosis which addresses an issue that has been identified. What should the nurse remember to do when writing the diagnosis? a. Focus primarily on deficits of the community. b. Use broad statements to guide a range of interventions. c. Employ a revised nursing diagnosis format. d. Substitute the terms client, family, group, or aggregate for the word patient.

d. Substitute the terms client, family, group, or aggregate for the word patient. Community diagnoses should include statements about the strengths of the community and possible sources for community solutions, as well as the community's weaknesses or problem areas. In addition, they should portray a community focus, include the community response, and identify any related factors that have potential for change through community health nursing. These may also include wellness diagnoses, which indicate maintenance or potential change responses (due to growth and development), when no deficit is present. Diagnoses statements should be narrow enough to guide interventions and use the standard nursing diagnosis format.

Activities that attempt to prevent disease related complications are considered: a. Health promotion b. Primary prevention c. Secondary prevention d. Tertiary prevention

d. Tertiary prevention Primary prevention seeks to promote health and prevent disease from occurring. Secondary includes interventions designed to increase the likelihood that a person with a disease will be diagnosed early enough so that treatment may result in a cure. Tertiary prevention's goal is to interrupt the process of a disease that has already occurred, reduce the amount of disability, and begin rehabilitation.

Which statement about the steps of evidence-based practice is most accurate? a. One of the last steps of the EBP process is to search for and collect the most relevant best evidence. b. One of the earliest steps in the EBP process is to disseminate the outcomes of the EBP decision or change. c. It is optional to integrate the best evidence with one's clinical expertise and patient preferences and values in making a practice decision or change. d. The first step in the EBP process is to cultivate a spirit of inquiry.

d. The first step in the EBP process is to cultivate a spirit of inquiry. The steps of the EBP process in order are (1) cultivating a spirit of inquiry; (2) asking the burning question in PICOT format; (3) searching for and collecting the most relevant best evidence; (4) critically appraising the evidence for its validity, reliability, and applicability and then synthesizing that evidence; (5) integrating the best evidence with one's clinical expertise and patient preferences and values in making a practice decision or change; (6) evaluating outcomes of the practice decision or change based on evidence; and (7) disseminating the outcomes of the EBP decision or change.

As a nurse, you are designated as a "mandated reporter." Which best describes this designation? a. The nurse must witness abuse and neglect before being mandated to report. b. The nurse commands that battered women report the abuse. c. The supervising community health nurse is responsible for reporting only known cases of elder abuse. d. The nurse must report any case of known or suspected abuse and neglect in children or elders.

d. The nurse must report any case of known or suspected abuse and neglect in children or elders. The abuse or neglect simply needs to be suspected in order for the nurse to report. In most states, the nurse can receive a jail sentence and a fine for not reporting suspected abuse. Reporters may never witness the actual abusive event, but they can often see the resulting damage. Each nurse follows through with reporting abuse and neglect cases she or he suspects according to the community's laws.

A nursing instructor is discussing the fundamental concepts of community health nursing with a group of students. The instructor recognizes the students understand the discussion by identifying which entity as the primary client? a. Aggregate b. Agent c. Community d. Total system

d. Total system It was proposed by Mundinger and Jauron that the use of nursing diagnoses in the community could be formulated by substituting the terms client, family, group, or aggregate for the word patient. Community health nurses look for evidence of all kinds of needs that relate to or influence a client's level of wellness. Needs cover the whole span of the health illness continuum and the total person, family, group, aggregate, population, or community the total system. Not all clients are communities. They may be individuals or families. Not all clients are in the category of groups, aggregates, or populations. When using the epidemiological triad, there are three components: host, agent, environment. A client would be considered the host; an agent is a factor that causes or contributes to a health problem or condition.

Which is the proper sequence of stages of change? a. Unfreeze, plan, and integrate b. Plan, organize, and coordinate c. Plan, relearn, and integrate d. Unfreeze, change, and refreeze

d. Unfreeze, change, and refreeze According to Lewin, change occurs in the following stages: unfreezing the old behavior, implementing the change, and then refreezing the new change in place to integrate it into the system. Planning, relearning, integrating, coordinating, and organizing are not stages of change.