Population Health - Exam 2 Review - Evolve Questions

Analytic epidemiology differs from descriptive epidemiology because it searches for: A. "when" of disease patterns. B. "where" of disease patterns. C. "why" of disease patterns. D. "who" of disease patterns.

C. "why" of disease patterns.

Since 1998, nurse practitioners (NPs) and clinical nurse specialists (CNSs) are reimbursed by Medicare Part B at a rate that is what percent of physician rates for the same service? A. 50% B. 70% C. 85% D. 95%

C. 85%

An elementary classroom of 28 students has had 13 children who have developed chicken pox over the last 3 weeks. What is the pattern of occurrence? A. Common source outbreak B. Point source outbreak C. Continuous source D. Mixed outbreak

C. Continuous source

What are some of the benefits of an electronic medical record in the public health setting? (Select all that apply.) A. Timely billing and financial reimbursement for services provided B. Improved public reporting of medication errors C. Coordination of referrals and facilitation of chronic disease management D. Improvement of quality measurement and monitoring E. Incorporation of protocol reminders for prevention, screening, and management of chronic disease

C. Coordination of referrals and facilitation of chronic disease management D. Improvement of quality measurement and monitoring E. Incorporation of protocol reminders for prevention, screening, and management of chronic disease

The current-day definition of family refers to two or more individuals who depend on one another for emotional, physical, and/or financial support. Which of the following is the most important principle to support this broader definition? A. Families are defined by genetic ties. B. Family names are needed to confer status. C. Members of a family are self-defined. D. Traditional family functions have been redefined.

C. Members of a family are self-defined.

A useful way to distinguish between Medicare Part A and Medicare Part B is to recognize that: (select all that apply) A. Part A covers outpatient hospital care. B. Part B covers limited skilled nursing care. C. Part A is hospital insurance. D. Part B is noninstitutional care insurance. E. Part B is a voluntary supplemental program.

C. Part A is hospital insurance. D. Part B is noninstitutional care insurance. E. Part B is a voluntary supplemental program.

Which of the following systems of surveillance is used to monitor trends in commonly occurring diseases? A. Active B. Passive C. Sentinel D. Syndronic

C. Sentinel

A nurse in community health is conducting an assessment on a family of four. During the course of the assessment, the nurse collects information about previous generations of the family and siblings. The results are used to create a diagram for the family that displays the family unit across generations. Further discussions occur regarding the patterns of health and illness that relate to biological health risks. The diagram is called: A. an ecomap. B. a family plan. C. a genogram. D. a risk plot.

C. a genogram.

The nurse has just taught a client newly diagnosed with diabetes how to administer sliding-scale insulin. The most effective way to evaluate learning is to: A. provide an online test module. B. ask whether there are any questions. C. ask for a return demonstration. D. give a short paper-and-pencil quiz.

C. ask for a return demonstration.

The deliberate release of viruses, bacteria or other germs with the intent of causing illness or death is: A. event outbreak. B. chemical terrorism. C. biological terrorism. D. surveillance.

C. biological terrorism.

A school nurse is working with the Parent Teacher Organization (PTO) to improve the health status of preschool students in a lower socioeconomic urban community. Given the demographics of the community, the nurse is aware that this population is at greatest risk for: A. asthma. B. attention deficit disorder (ADD). C. childhood obesity. D. poisoning.

C. childhood obesity.

The nurse who works in the community setting must ensure that the application of the best available evidence to improve practice is also: A. accessible and diverse. B. competent and compliant. C. culturally and financially appropriate. D. reasonable and deliverable in a timely fashion.

C. culturally and financially appropriate.

A Public Health Service nurse working for the Indian Health Service is working with a client diagnosed with cancer. The client uses sweat lodges to "cure the disease." The nurse understands that within the culture, disease is often perceived as disharmony with other forces, and clients may look to hot or cold treatments to resolve or cure a cancerous condition. The nurse is integrating her knowledge of the cultural organizing factor of: A. biological variations. B. communication. C. environmental control. D. space.

C. environmental control.

The community health nurse asks a client, "Have you ever been exposed to any radiation or chemical liquids, dust, mists, or fumes?" The nurse is conducting an: A. environmental advocacy activity. B. environmental compliance activity. C. environmental health assessment. D. environmental risk communication.

C. environmental health assessment.

Elderly clients should be assessed for signs of abuse. The illegal use of a person for another person's profit is known as: A. neglect. B. incompetence. C. exploitation. D. self-determination.

C. exploitation.

A particular chronic health problem that adversely affects the aging experience for which it is difficult to estimate the number of individuals affected or the associated cost to manage is: A. iatrogenic drug reactions. B. immobility. C. incontinence. D. intellectual impairment.

C. incontinence.

A community-oriented nurse is interested in studying the hospital discharge data for facilities that typically provide services to members of the community where the nurse practices. The nurse accesses the National Hospital Discharge Survey database of the Department of Health and Human Services (DHHS) to identify data at national, regional, and local levels for comparison purposes. The government health care function being used by the nurse is: A. direct services. B. financing. C. information. D. policy setting.

C. information.

If a small business employer desires to control company benefit expenditures by turning health care decision-making control over to the employees, the insurance reform effort that best addresses the shifting of responsibility, knowledge, and decision-making involvement to the individual receiving the care would be: A. health spending accounts (HSA). B. managed care. C. medical savings account (MSA). D. prospective payment.

C. medical savings account (MSA).

One member of an older couple has just retired. This is considered a: A. developmental stage that will help the family with stress reduction. B. nonnormative event that will have psychological impact on the family. C. normative event and can increase the family's risk for illness. D. normative event and will have little effect on the family' well-being.

C. normative event and can increase the family's risk for illness.

The Food Quality Protection Act of 1996 increased the protection of infants and children from pesticide exposure from multiple sources by establishing a new health-based standard of reasonable certainty of "no harm" that: A. considers the cumulative impacts of all pesticides that may share a common mechanism of action. B. establishes a 15-year renewal process for all pesticides. C. prohibits taking into account economic considerations when children are at risk. D. uses an additional tenfold margin of safety when there are adequate data indicating developmental risks.

C. prohibits taking into account economic considerations when children are at risk.

The gold standard of evidence gathering in evidence-based practice is: A. clinical knowledge and judgment. B. expert opinions. C. randomized clinical trials D. theories of practice.

C. randomized clinical trials

A nurse in community health that speaks out in a public hearing in support of changes to existing requirements for reporting any long-term effects of structural or organizational changes within the community's health care organizations would be demonstrating: A. legislative action. B. health policy. C. regulatory action. D. regulatory monitoring.

C. regulatory action.

The 1989 changes to Medicaid required states to provide care for children younger than 6 years and to pregnant women under 133% of the poverty level. These changes also ensured adequate access to qualified providers by: A. adding coverage for the medically indigent. B. reimbursing early periodic screening, diagnosis, and treatment (EPSDT) for those younger than 21 years. C. reimbursing pediatric and family nurse practitioners. D. reimbursing skilled and intermediate nursing home care.

C. reimbursing pediatric and family nurse practitioners.

It is important that nurses understand the nontraditional healing practices of their clients because: A. folk practices are usually ineffective. B. nurses can refer clients to the appropriate local folk healers. C. safe, effective nontraditional healing methods can be blended with Western medicine. D. the nurse must understand them to help the client give them up.

C. safe, effective nontraditional healing methods can be blended with Western medicine.

A nurse in community health who teaches a client with asthma to recognize and avoid exposure to asthma triggers and assists the family in implementing specific protection strategies such as removing carpets and avoiding pets is intervening at the level of: A. assessment. B. primary prevention. C. secondary prevention. D. tertiary prevention.

C. secondary prevention.

A nurse in community health may have state-granted personal immunity for particular practice areas such as giving immunizations. If the state legislature has granted personal immunity to nurses employed by public agencies to cover all aspects of their practice, the legal theory that applies is: A. case law. B. respondeat superior. C. sovereign immunity. D. worker's right to know.

C. sovereign immunity.

Parents can expect their children to be immunized for communicable diseases before entering kindergarten in the local school system because: A. primary care clinics focus on prevention. B. primary care clinics maintain adequate supplies of immunization. C. the public health system has mandates for immunization. D. the public health system provides good access to immunization clinics.

C. the public health system has mandates for immunization.

The community-oriented nursing care function of policy development is supported by the ethical tenet of: A. competency. B. do no harm. C. what is ethical is also good policy. D. to each person a fair share.

C. what is ethical is also good policy.

Which of the following social science theories is used by public health nursing to describe how environments and systems outside of the family influence the development of a child over time? A. Life cycle theory B. Family developmental theory C. Family systems theory D. Bioecological systems theory

D. Bioecological systems theory

According to the Minnesota Model of Public Health interventions, what is the first step of surveillance for the public health nurse? A. Organize the data. B. Analyze the data. C. Interpret and disseminate the data. D. Determine if surveillance is appropriate.

D. Determine if surveillance is appropriate.

The family systems theory encourages nurses to view both the individual clients as participating members of a whole family. What is the major weakness of the systems framework? A. Views families from both a subsystem and a suprasystem approach B. Defines the direction of interactions C. Views the family as an agent of change D. Focuses on the interaction of the family with other systems

D. Focuses on the interaction of the family with other systems

A public health nurse employed by the Department of Health is working on a team developing local health policy. The nurse recognizes which of the following about policy development? A. It is based on Socratic method. B. It is important that the policy has been approved by the American Nurses Association. C. It is primarily up to politicians to plan for health care. D. It is very similar to the nursing process.

D. It is very similar to the nursing process.

A parent with two school-age children has just finished a family health assessment questionnaire. The parent asks the nurse why one of the questions asks whether there is a neighborhood playground. The nurse's best response would be: A. "Don't worry about it. We are going to talk about all this anyway." B. "It's important to good health to have adequate recreation resources." C. "We want to be able to report any dangerous playground equipment to the city." D. "We want to know what kind of neighborhood you're in so we can assess income."

B. "It's important to good health to have adequate recreation resources."

A nurse demonstrates cultural competence by using statements such as: A. "I know how you feel." B. "Tell me about your health care beliefs." C. "Let me show you the way you should do this." D. "You can do things in a more modern way now."

B. "Tell me about your health care beliefs."

During a family nursing assessment, a parent questions whether God is punishing the family, because one of the children has just been diagnosed with leukemia. The most facilitative response by the nurse would be: A. "God is loving and doesn't punish people." B. "Tell me more about your family's spiritual beliefs." C. "That is not part of my religious belief system, so I don't know." D. "Why do you think your family needed to be punished?"

B. "Tell me more about your family's spiritual beliefs."

Nurses in community health often use epidemiology because in the community it is often difficult to control the environment. Which of the following statements demonstrates an epidemiologic strategy for monitoring disease trends? A. A nurse in community health conducts an education class for clients newly diagnosed with diabetes. B. A nurse in community health investigates a breakout of whooping cough in a local middle school. C. A nurse in community health organizes a health fair at the community health center. D. A nurse in community health participates on a county school board that addresses student health issues.

B. A nurse in community health investigates a breakout of whooping cough in a local middle school.

Evidence-based public health utilizes which of the following guidelines? (Select all that apply.) A. Decision making for the community served B. Application of program planning frameworks C. Judicious use of the Internet for use of evidence D. Conducting evaluations E. Disseminating what has been learned

B. Application of program planning frameworks D. Conducting evaluations E. Disseminating what has been learned

When final health care-related regulations are published, they often lead to changes in practice. After a period of draft review, public comment/hearing, further study if necessary, and then final redrafting, the regulations at both federal and state levels carry the weight of law and are published in the: A. ANA Code of Conduct. B. Code of Regulations. C. Patient Safety Act of 1997. D. Interstate Nurse Licensure Compact.

B. Code of Regulations.

A community-based HIV/AIDS clinic would be concerned about which aspects of the Public Health Code of Ethics? (Select all that apply.) A. Autonomy of the professional B. Confidentiality when possible C. Funding D. Promoting advocacy for disenfranchised persons E. Respecting only community rights

B. Confidentiality when possible D. Promoting advocacy for disenfranchised persons

Nurses should review which of the following reports to determine what pollutants have been found in the drinking water of a community? A. Point source report B. Consumer confidence report C. Material Safety Data Sheet D. Environmental standards report

B. Consumer confidence report

The community health nurse is aware that African-American adults are more likely to be admitted to the hospital for which of the following conditions? A. Newly diagnosed HIV infection B. Diabetic patient with lower extremity wound C. Testicular cancer D. Psychiatric disorders

B. Diabetic patient with lower extremity wound

Which of the following statements accurately describe the stress reaction phases a community may experience during a disaster response? (Select all that apply.) A. Disillusionment and reconstruction is most associated with response efforts. B. During the Heroic phase, there is overwhelming need for people to do whatever they can to help others survive the disaster. C. In the Honeymoon phase, survivors may be rejoicing in that their lives and the lives of loved ones have been spared. D. Disillusionment is the longest phase in the stress reaction process. E. The Disillusionment phase occurs after time elapses and people begin to notice that additional help and reinforcement may not be immediately forthcoming.

B. During the Heroic phase, there is overwhelming need for people to do whatever they can to help others survive the disaster. C. In the Honeymoon phase, survivors may be rejoicing in that their lives and the lives of loved ones have been spared. E. The Disillusionment phase occurs after time elapses and people begin to notice that additional help and reinforcement may not be immediately forthcoming.

What are the core competencies of the nurse participating in surveillance and investigation activities? (Select all that apply.) A. Basic patient assessment skills B. Effective communication skills C. Ability to collaborate with community partners D. Advanced practice nurse with secondary science degree E. Leadership and systems thinking

B. Effective communication skills C. Ability to collaborate with community partners E. Leadership and systems thinking

Following the attacks of 9/11, a nurse practitioner in a family clinic used opportunities at the clinic staff meetings to speak about her own feelings of loss and guilt. This strategy indicates that the nurse was aware of what phenomenon related to disasters? A. Anxiety B. Effects of stress on individuals C. Sense of urgency D. Scapegoating and blaming

B. Effects of stress on individuals

A community-oriented nurse convenes a support group for teenage mothers. The nurse understands that this strategy fosters cohesiveness among members and allows the members to learn from one another. What other benefit specific to group teaching will be achieved? A. Cultural sensitivity B. Efficiency in client service C. Learning of new skills D. Distraction-free surroundings

B. Efficiency in client service

Family health can be defined as a dynamic, changing, relative state of well-being that includes the biological, psychological, sociological, cultural, and spiritual factors of a family system. This family health approach would best include which of the following underlying principles? (Select all that apply.) A. Assessment of the individual's health does not determine the overall family system's health. B. Family functioning affects the health of individuals. C. Family system assessment specifically addresses the individual's health. D. The individual's health affects family functioning. E. Simultaneous assessment of individual family members and the family system as a whole is important to family health.

B. Family functioning affects the health of individuals. D. The individual's health affects family functioning. E. Simultaneous assessment of individual family members and the family system as a whole is important to family health.

Which of the following statements are true regarding the health-related vulnerabilities of men? (Select all that apply.) A. More males die at birth. B. Fewer health services are offered to men. C. Men often put work ahead of their health needs. D. More males die from suicide. E. Men often incur more work related injuries than women.

B. Fewer health services are offered to men. C. Men often put work ahead of their health needs. E. Men often incur more work related injuries than women.

The historical figure whose work in providing care to poor people, primary prevention, and environmental health established that individual as nursing's first moral leader and community-oriented nurse was: A. Sister Mary Augustine. B. Florence Nightingale. C. William Rathbone. D. Lillian Wald.

B. Florence Nightingale.

The primary reasons for delay, difficulty, or failure to access care include which of the following factors? (Select all that apply.) A. The increase in safety net providers B. Inability to afford health care and a variety of insurance-related reasons C. Lack of transportation D. Refusal of services by providers E. Resolved nursing shortage

B. Inability to afford health care and a variety of insurance-related reasons C. Lack of transportation D. Refusal of services by providers

Primary care refers to personal health care for the most common needs of members of a community. Which of the following statements also differentiates primary care from primary health care? (Select all that apply.) A. Primary care consists of a multidisciplinary team. B. Primary care is provided within the context of family and community. C. Primary care encourages self-care and self-management. D. Primary care provides first-contact, continuous, comprehensive, and coordinated care. E. Primary care provides preventive, curative, and rehabilitative services.

B. Primary care is provided within the context of family and community. D. Primary care provides first-contact, continuous, comprehensive, and coordinated care.

What are the purposes of disease surveillance in public health? (Select all that apply.) A. Tries to identify terrorist attacks before they occur B. Provides a means for nurses to monitor disease trends C. Generates knowledge about disease or outbreak patterns D. Allows the nurse to advocate for policy changes E. Reduces morbidity and mortality and improves health through disease trend monitoring

B. Provides a means for nurses to monitor disease trends C. Generates knowledge about disease or outbreak patterns E. Reduces morbidity and mortality and improves health through disease trend monitoring

What is the purpose of using an algorithm in the surveillance process? A. Tells the nurse who to call in the event of an outbreak B. Provides the nurse with a step by step plan to identify events needing investigation C. Provides the nurse with a system for telephone triage in an outbreak D. It is a visual reminder of the epidemiologic triangle

B. Provides the nurse with a step by step plan to identify events needing investigation

A nurse who questions whether a particular activity in her job description is within her scope of practice would look to which government jurisdiction or agency to seek the clarification? A. Federal system B. State system C. Department of Labor D. U.S. Department of Health and Human Services

B. State system

A home health nurse receives a referral to educate an older adult client with diabetes in proper foot care. The nurse's assessment of the client determines that the client has poor eyesight that may affect the client's ability to learn and perform certain skills. Which educational principle is being examined? A. Cognitive domain B. Events of instruction C. Principles of effective instruction D. Psychomotor domain

D. Psychomotor domain

In the event of a disaster, shelters are generally the responsibility of which of the following entities? A. Centers for Disease Control & Prevention (CDC) B. Federal Emergency Management Agency (FEMA) C. Public Health Service (PHS) D. Red Cross chapter

D. Red Cross chapter

The federal act that grants authority to the Environmental Protection Agency (EPA) which controls the generation, transportation, treatment, storage, and disposal of hazardous waste and ultimately called for the phaseout of land disposal of hazardous waste under a later amendment was the: A. Emergency Planning and Community Right-to-Know Act (EPCRA). B. National Environmental Policy Act (NEPA). C. Pollution Prevention Act (PPA). D. Resource Conservation and Recovery Act (RCRA).

D. Resource Conservation and Recovery Act (RCRA).

A nurse works in a free clinic for uninsured low-wage employees in the community. The free clinic setting operates in a primary health care (PHC) strategy. The nurse would most likely focus on: A. Incidence of the disease. B. Physician orders for the individual. C. Pathophysiology of the disease. D. Self-care/management.

D. Self-care/management.

The federal agency most responsible for improving the health status of the American people is the: A. Office of Health Preparedness. B. Office of Global Affairs. C. Food and Drug Administration. D. U.S. Department of Health and Human Services.

D. U.S. Department of Health and Human Services.

A nurse doing a family assessment asks the client, "Have any of your blood relatives had mental illness?" The nurse is asking this question to: A. determine whether the family is stable. B. assess for biological risk factors. C. decide whether this family member needs medication. D. demonstrate open-mindedness about mental illness.

B. assess for biological risk factors.

When a community health nurse uses evidence-based practice (EBP) to evaluate effectiveness, accessibility, and quality of personal and population-based services, the nurse is addressing the core public health function of: A. assessment. B. assurance. C. policy development. D. research.

B. assurance.

A nursing student prepares a treatment plan for a client that draws upon the student's understanding of pathophysiology and nursing practice theory learned in the student's coursework. This application of new information used in a different way demonstrates the educational principle of: A. affective domain. B. cognitive domain. C. events of instruction. D. principles of effective education.

B. cognitive domain.

The concept of managed care is most often associated with processes such as utilization management, disease prevention, health promotion, wellness, and: A. ambulatory payment classes (APCs). B. consumer education. C. retrospective payment. D. third-party payer.

B. consumer education.

A family nurse is working with a married couple that has decided to remain child-free. The nurse recognizes this decision as a: A. biological necessity. B. contemporary family function. C. religious belief decision. D. threat to family survival.

B. contemporary family function.

Four months after the disaster of 9/11 at the Pentagon, a local EMS worker complained of extreme exhaustion. The veteran EMS worker also stated that the pace of work at the squad was too slow. The occupational health nurse that is assessing the EMS worker recognizes the symptoms of: A. anger. B. delayed stress reaction. C. inability to concentrate. D. insomnia.

B. delayed stress reaction.

The monitoring and public reporting of air quality in a local community to alert individuals with asthma or other respiratory conditions would illustrate: A. compliance and enforcement. B. environmental epidemiology. C. secondary prevention. D. toxicology.

B. environmental epidemiology.

A mother brings her child to the nurse's office a few days before the first day of class for the new school year. The mother wants the child to begin school but says, "I'm going to take care of the immunizations tomorrow." The most important action the nurse should take is to: A. conduct a physical exam to determine whether the child is healthy. B. explain to the parent that all required immunizations must be given before the child will be allowed to enter school. C. let the child begin school but ensure that the school keeps the child separated from the other children. D. make sure the child does have an appointment for tomorrow.

B. explain to the parent that all required immunizations must be given before the child will be allowed to enter school.

A business executive develops symptoms of the flu 1 day after returning by air from a cross-Atlantic business trip that ran for 2 consecutive stressful 10-hour days. This individual's development of flu symptoms illustrates the relationship between: A. host and agent. B. host, agent, and environment. C. risk and causality. D. morbidity and disease.

B. host, agent, and environment.

The aging population is expected to affect health services more than will any other demographic factor. Another demographic population factor that affects health care costs can be related to: A. consumer demand. B. illnesses such as AIDS. C. marketing practices for new drugs. D. technology advancement.

B. illnesses such as AIDS.

The recovery phase of a disaster can take a very long time. Nurses need to be aware that despite effective disaster preparedness and response efforts: A. environmental hazards are minimal. B. individuals must ultimately recover on their own. C. the government provides economic support. D. religious organizations must bear the burden of the community.

B. individuals must ultimately recover on their own.

Nurses often participate on field assessment teams (surveillance) during a disaster response. These assessments are crucial to best help: A. encourage good intentions of those giving aid. B. match available resources to the population's emergency needs. C. separate casualties and allocate treatment. D. provide compassion and dignity.

B. match available resources to the population's emergency needs.

The problem of the working poor and uninsured places a major burden on the current health care system that affects those families and the community in general. Nurses in community health see this as a major: (select all that apply) A. behavioral issue. B. policy issue. C. health risk issue. D. social issue. E. nursing issue.

B. policy issue. C. health risk issue. D. social issue.

Of the four major factors that affect health care—personal behavior/lifestyle, environmental factors (physical, social, economic), human biology, and the health care system—medical services are said to have the least effect. Yet, the U.S. health care system remains reactionary with high-cost, high-technology, and disease-specific "sickness care." This statement supports the need for increased investment in: A. managed care. B. primary prevention. C. secondary prevention. D. tertiary prevention.

B. primary prevention.

When health care providers in the community refuse to accept Medicare clients, this implies reduced access to care, potential decreases in acceptable quality of services offered, and a form of health care rationing. Health care rationing becomes a public health and nursing issue because: A. Medicare reimbursement needs to be higher. B. proactive primary prevention orientation is cost effective. C. public health systems and nurses must ensure that essential clinical services are available. D. sufficient resources are available in the public health system to meet the unmet need.

B. proactive primary prevention orientation is cost effective.

One of the basic concepts in epidemiology is the concept of risk. Risk refers to the: A. prevalence of an event occurring. B. probability that an event will occur within a specified time period. C. population most likely to develop a disease. D. rate of development of new cases.

B. probability that an event will occur within a specified time period.

A nurse in community health is working with a single parent of three children, ages 4, 6, and 8. The 6-year-old has cerebral palsy. The 4-year-old has asthma. The maternal grandmother lives with the family and has diabetes. The nurse understands the importance of working within the context of the existing family structure and community resources because families are: A. resistive to outside intervention or involvement. B. responsible for providing/managing the care of their members. C. unable to manage the stress of complex health needs. D. restricted in their ability to identify interventions.

B. responsible for providing/managing the care of their members.

A nurse is concerned about the accuracy of the PPD test in identifying cases of TB exposure for follow-up chest x-ray. The nurse's concern is addressing the validity measure of: A. reliability. B. sensitivity. C. specificity. D. variation.

B. sensitivity.

Politics is simply described as: A. the ability to fund a special project. B. the art of influencing others. C. business conducted in the senate. D. interaction between the policymakers and the public.

B. the art of influencing others.

A public health nurse has identified the need to make amendments in an existing law concerning the TB health assessment of individuals sentenced to serve jail terms on weekends only, based on the current criminal justice system practices and potential health risk to the free-living community. To raise this concern, the nurse has several paths to follow, but the amendment of any existing laws would ultimately be decided by: A. the executive branch of the government. B. the legislative branch of the government. C. local representatives. D. senate hearings.

B. the legislative branch of the government.

Many families have financial resources that allow them to maintain themselves but limit the quality of their purchasing power. Food high in fat and calories may be affordable, whereas fresh fruits and vegetables may not be affordable. A federal program that attempts to promote healthier diets for vulnerable populations is: A. Medicaid B. Medicare C. Supplemental Security Income (SSI) D. Women, Infants, and Children (WIC)

D. Women, Infants, and Children (WIC)

Caring and the ethic of care is a core value of nursing in community health. This ethical view was developed in the mid-1980s and early 1990s in response to the technical advances in health care science and the desire of nurses to: A. apply gender-related voices to moral judgment. B. apply principles of utilitarianism. C. differentiate distributive justice from beneficence. D. differentiate nursing practice from medical practice.

D. differentiate nursing practice from medical practice.

In caring for a young adult from West Africa, the community nurse is introduced to another individual who is referred to as "auntie." A culturally competent nurse who is aware of the basic organizing factor of culture related to social organization would: A. assess the competence of the "auntie" to care for the young adult. B. assume that the "auntie" is related to one of the young adult's parents. C. declare that the young adult is capable of making personal health decisions. D. find out who is considered to be a member of the family.

D. find out who is considered to be a member of the family.

When applying the nursing process to environmental health, the community health nurse would: A. conduct a focused assessment on the presenting problem. B. coordinate interventions with the physician only. C. examine criteria that include only the client's immediate response. D. include outcome measures that mitigate and eliminate the environmental factors.

D. include outcome measures that mitigate and eliminate the environmental factors.

In applying Ethical Principles for Effective Advocacy, the ethical principle that empowers the client (groups or communities) to make knowledgeable decisions is: A. act impartially and offer frank, independent advice. B. act in accordance with the client's wishes and instructions. C. act in the client's best interest. D. keep the client properly informed.

D. keep the client properly informed.

A disease outbreak of severe acute respiratory syndrome has occurred and has spread over several countries outside the United States. This level of occurrence is said to be: A. hyperendemic. B. sporadic. C. epidemic. D. pandemic.

D. pandemic.

The most significant commonalities between the ANA's Scope and Standards of Public Health Nursing Practice and the Public Health Code of Ethics assert that advocacy is conducted in the: A. assertiveness arena. B. education arena. C. litigation arena. D. policy arena.

D. policy arena.

A nurse educator who teaches at the local community college takes the time to read and understand her community's disaster plans and participates in community mock disasters as a leader of the triage team. The best description of the nurse's activities would be: A. ARC disaster training. B. community preparedness. C. personal preparedness. D. professional preparedness.

D. professional preparedness.

Nursing interventions and approaches for helping individuals and families to assume an active role in their care should focus on empowerment rather than on enabling. The underlying principle to empowerment is: A. client dominance. B. decreased competence. C. professional dominance. D. professional-client partnership.

D. professional-client partnership.

One reason that nursing may be slow in developing evidence-based practice (EBP) in the community setting may be the lack of understanding about the links between EBP and: A. evidence gathering. B. research design. C. research funding. D. research use.

D. research use.

A nurse in community health decides to form a contract with a family. The contract states that the family will designate one night as a family night. The nurse is most likely using the contract to: A. make sure the family does what is expected. B. encourage the family to put plans in writing. C. let the family know that this is a legal agreement. D. shift the responsibility so that it becomes a shared effort.

D. shift the responsibility so that it becomes a shared effort.

The school nurse is interested in providing an antismoking program in a local middle school and is aware that programs are more effective for this age group when they focus on short-term versus long-term effects of smoking. Besides including health risks and cosmetic effects, the nurse should also consider: A. behavior modification techniques. B. effects on the environment. C. laws regarding tobacco sales to minors. D. social skills instruction to resist pressure to smoke.

D. social skills instruction to resist pressure to smoke.

A nurse in community health seeks to determine whether the visit with an older adult Asian woman is successful. The nurse has not encountered many clients from this culture. An effective way to judge whether a cultural encounter has been effective would include the nurse's sense that the visit was successful, the nurse and client experience little or no stress, and: A. the client says "thank you." B. the client nods frequently. C. the client's family does not complain. D. tasks are done efficiently.

D. tasks are done efficiently.

A nurse in community health is conducting a parenting class for prospective parents that will focus on the development of new skills, identification of needed resources, planning, and other preparations for the arrival of a newborn. This intervention is addressing a potential risk associated with: A. biology. B. behavior. C. environment. D. transitions.

D. transitions.

The major factor that has increased Florida's vulnerability to natural disasters in recent decades has been: A. El Niño. B. geography. C. trade winds. D. urbanization.

D. urbanization.

To maintain effective disaster preparedness, nurses working in the community can play a critical role in providing an updated record of: A. immunizations. B. active tuberculosis (TB) cases. C. WIC enrollees. D. vulnerable populations.

D. vulnerable populations.

The public health nurse is most likely to use what types of surveillance systems? (Select 2 that apply.) A. Active B. Passive C. Sentinel D. Syndronic

A. Active B. Passive

The Clean Air Act of 1970 was amended in 1990 to meet unaddressed or insufficiently addressed problems that included which of the following? (Select all that apply.) A. Addressing acid rain B. Addressing excessive noise and heat or cold extremes C. Addressing ground-level ozone D. Addressing stratospheric ozone depletion E. Tracking 75,000 industrial chemicals

A. Addressing acid rain C. Addressing ground-level ozone D. Addressing stratospheric ozone depletion

Finding resources to implement evidence-based practice (EBP) in community health will continue to be a challenge because of the emphasis on quality care, equal distribution of health care resources, and cost control. Which of the following would demonstrate a creative strategy to implementing EBP? A. Adopting quality indicators for evaluating websites claiming to contain EBP B. Avoiding the issue of community politics C. Creating the role of a knowledge manager D. Making decisions on behalf of the community

A. Adopting quality indicators for evaluating websites claiming to contain EBP

A nurse in community health in California has been working with a 6-year-old child that was rescued from a mudslide. The nurse will observe the child for which of the following stress effects? (Select all that apply.) A. Bed-wetting episodes B. Desire to return to school C. Fantasies of denial D. Increased playfulness with peers E. Thumb sucking

A. Bed-wetting episodes C. Fantasies of denial E. Thumb sucking

Which of the following factors have had an impact on the complex relationship among nursing practice, health policy, and politics? (Select all that apply.) A. Categorical funding B. Death penalty C. Head Start D. Health fairs E. Statutory authority for the profession

A. Categorical funding C. Head Start E. Statutory authority for the profession

Several community-oriented nurses want to explore the problem of obesity in school-age children and assess their community school district health status related to that problem. When gathering information at a national level, they would begin with the: A. Centers for Disease Control and Prevention (CDC). B. Centers for Medicare and Medicaid Services (CMS). C. Health Resources and Services Administration (HRSA). D. National Institute of Nursing Research (NINR).

A. Centers for Disease Control and Prevention (CDC).

A nurse exclaims proudly to other nurses at the agency, "The care I provide is the same for everyone. I treat everyone the same." In fact, this nurse is demonstrating what inhibitor to developing cultural competence? A. Cultural blindness B. Cultural competence C. Cultural conflict D. Culture shock

A. Cultural blindness

A nurse in community health that administers a local WIC program for women, infants, and children is participating in a federal-state collaborative program that receives oversight from the: A. Department of Agriculture (DOA). B. Department of Defense (DOD). C. Department of Health and Human Services (DHHS). D. Department of Labor (DOL).

A. Department of Agriculture (DOA).

There are many barriers that affect the actual implementation of evidence-based practice (EBP) in a nursing environment. Which statements reflect the most significant concerns of nurses in the community-focused setting? (Select all that apply.) A. EBP requires compliance by the client. B. EBP requires little support. C. EBP demands change. D. EBP questions long-standing nursing practice. E. Lack of resources

A. EBP requires compliance by the client. D. EBP questions long-standing nursing practice. E. Lack of resources

Which of the following statements best explains the need for geologists, meteorologists, and chemists on the multidisciplinary team in environmental health? A. Earth sciences explain how pollutants travel in air, water, and soil. B. Earth sciences help us understand the strength of the association between exposures and health effects in human populations. C. Earth scientists study the negative effects of chemical exposure. D. Earth scientists work with the community to coordinate services to meet the community's needs.

A. Earth sciences explain how pollutants travel in air, water, and soil.

What terms are used to describe healthy families? (Select all that apply.) A. Families with strengths B. Dysfunctional C. Functional families D. Resilient families E. Resistant families

A. Families with strengths C. Functional families D. Resilient families

Which of the following barriers are specific to the educator? (Select all that apply.) A. Fear of public speaking B. Low literacy C. Limited experience with the topic D. Lack of motivation E. Lack of experience with gaining participation

A. Fear of public speaking C. Limited experience with the topic E. Lack of experience with gaining participation

What are some of the effects of technology in the area of home health care? (Select all that apply.) A. High technology equipment increases expense. B. Technology decreases legal liability. C. Technology has the potential for increased privacy. D. Technology quickly becomes outdated when newer developments occur. E. There is inconsistent quality of resources available on the Internet.

A. High technology equipment increases expense. D. Technology quickly becomes outdated when newer developments occur. E. There is inconsistent quality of resources available on the Internet.

What are some examples of programs which may be provided at the local health department level? (Select all that apply.) A. Immunization clinics B. Health education C. Family planning services D. Licensing of health care professionals E. Quality and safety data

A. Immunization clinics B. Health education C. Family planning services

Which of the following factors has influenced the implementation of evidence-based practice in health care? (Select all that apply.) A. Increased expectations of consumers B. Advances in technology C. Nursing shortages D. Increases in lawsuits E. Implementation of electronic health records

A. Increased expectations of consumers B. Advances in technology D. Increases in lawsuits

Which educational method has been shown to be most effective in fostering treatment adherence? A. Internet based education B. In-person counseling C. Telephone counseling D. Self-directed learning

A. Internet based education

The hospital infection control practitioner reports new cases of tuberculosis to the public health department. Of what type of surveillance system is this an example? A. Passive B. Active C. Sentinel D. Special

A. Passive

Implementing a community-level program, such as walking for exercise, to assist citizens in improving health behaviors is an example of which level of prevention? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Disease promotion

A. Primary prevention

Which of the following domains are used in evaluating the strength of evidence? (Select all that apply.) A. Quality B. Quantity C. Cost effectiveness D. Consistency E. Usefulness

A. Quality B. Quantity D. Consistency

A nurse in community health integrates new slides into a presentation that will be given to a local elementary school group regarding the techniques of proper hand washing. The new slides will repeat essential points during the presentation. This demonstrates the nurse's understanding of what principle? A. Repetition B. Integration C. Participation D. Sequencing

A. Repetition

A nurse is conducting an in-service education session on the Centers for Disease Control and Prevention's (CDC's) updates for preventive services for a group of nurses in community health. The nurse would demonstrate the best understanding of the educational process by integrating which planning strategies? (Select all that apply.) A. Use of films B. Small group interaction C. Use of games D. Session timing E. Session space

A. Use of films B. Small group interaction C. Use of games D. Session timing E. Session space

When applying evidence-based practice (EBP), community-oriented nurses are primarily obligated to ensure that evidence applied to practice is: A. acceptable to the community. B. contains cost and reduces legal liability. C. applied as a universal remedy. D. limited to research findings.

A. acceptable to the community.

The later years of life for many older adults mark a period of abruptly changing social dynamics over which the older adult has very little control. The nurse should understand that this phenomenon of later life challenges: A. adapting and coping responses. B. intellectual capacity. C. socioeconomic status. D. spiritual awareness.

A. adapting and coping responses.

When a community health nurse evaluates the completeness and accuracy of information made available to community residents regarding the impact of rezoning land parcels for industrial use, the nurse is: A. advocating for ethical choices. B. communicating risk. C. controlling environmental damage. D. volunteering for service on state boards.

A. advocating for ethical choices.

In applying the developmental theory, a family nurse determines the developmental stage of the family based on: A. age of the eldest child. B. family strengths. C. individual growth patterns. D. overall tasks of the family.

A. age of the eldest child.

A nurse in community health is planning to begin a class to help mothers returning to work better cope with the stresses of multiple roles. The nurse would most likely use: Which of the following barriers are specific to the educator? (Select all that apply.) A. an andragogical approach. B. a behavioral approach. C. an operational approach. D. a pedagogical approach.

A. an andragogical approach.

A neighborhood association group has asked the local nurse in community health for a class on environmental hazards. The nurse in community health has seen good information in the community health text and thinks about getting permission to copy some of the information. The most important thing the nurse should do before using copies of this material is to: A. assess the literacy level of the group. B. see how many plan to attend. C. see whether the group is ready to learn. D. secure a good space for a group meeting.

A. assess the literacy level of the group.

The ethical question, "Are persons assigned to develop community knowledge adequately prepared to collect data on groups and populations?" is based on an ethical tenet that supports the community-oriented core function of: A. assessment. B. assurance. C. policy development. D. compliance.

A. assessment.

A community-based hospice nurse has an Asian male client with terminal stage cancer. The client complains that he is in continuous pain and receives no relief from the codeine prescribed by his primary care practitioner (PCP). The nurse contacts the client's PCP to discuss replacing the prescription of codeine with another pain-reducing non-codeine-based drug. The nurse is demonstrating knowledge of the cultural organizing factor of: A. biological variance. B. communication. C. space. D. time perception.

A. biological variance.

Virtue ethics is distinctly different from moral justification via theories or principles because the emphasis of virtue ethics is practical reasoning applied to: A. character development. B. consequentialism. C. distributive justice. D. egalitarianism.

A. character development.

Health care costs are influenced by factors related to demographic changes, new technology, resource intensity, and: A. chronic illness. B. market practices. C. nursing shortages. D. professional competition.

A. chronic illness.

Which of the following tools are used in analytic epidemiology? (Select all that apply.) A. cohort study B. case-control study C. cross-sectional study D. clinical trials E. community trials

A. cohort study B. case-control study C. cross-sectional study

Nurses in community health who understand the basis of their own behaviors and how those behaviors help or hinder the delivery of competent care to persons from cultures other than their own are demonstrating the cultural competence development process construct of: A. cultural awareness. B. cultural desire. C. cultural encounter. D. cultural skill.

A. cultural awareness.

A breast cancer screening program screened 8000 women and discovered 35 women previously diagnosed with breast cancer and 20 women with no history of breast cancer diagnosed as a result of the screening. The prevalence proportion would reflect: A. current and past breast cancer events in this population of women. B. newly diagnosed cases of breast cancer in this population of women. C. past breast cancer events in this population of women. D. the population of women that had no evidence of breast cancer.

A. current and past breast cancer events in this population of women.

A nurse overhears the doctor saying, "Let's not give him codeine; he is Asian." The nurse reflects on the comment and determines that the: (select all that apply) A. doctor is culturally competent. B. doctor is prejudiced. C. doctor should have called an interpreter. D. doctor's ability to assess pain based on culture may be limited. E. doctor is planning care based on racial enzymatic differences.

A. doctor is culturally competent. E. doctor is planning care based on racial enzymatic differences.

The nurse in community health uses information about family structure, household composition, marriage, divorce, birth, death, adoption, and other family life events to forecast and predict stresses and developmental changes experienced by families and identify possible solutions to family challenges. This best describes the study of: A. family demographics. B. family functions. C. family health. D. family resilience.

A. family demographics.

The family nurse conducts the family nursing assessment with the family as a unit. Using a systematic process, family problems are identified and family strengths are emphasized as building blocks for interventions. Which of the following best completes the statement to demonstrate the importance of assessment to outcomes? Integrating the extended families: A. fosters equal family and provider commitment to success. B. facilitates outcomes-oriented family nursing research. C. decreases the need for nurse contact and intervention. D. removes barriers to needed services to achieve success.

A. fosters equal family and provider commitment to success.

A nurse who speaks only English has just gotten a new client for an intake interview. The client is a refugee who has very limited English proficiency (LEP). The nurse should: A. get an interpreter. B. see whether another nurse, more comfortable with refugees, will work with the client. C. see what helpful information is on the Internet. D. try to communicate with hand gestures.

A. get an interpreter.

The most important causes of preventable disease, disability, and death among children are: A. injuries and accidents. B. maintaining a healthful diet. C. physical activity. D. cardiovascular health.

A. injuries and accidents.

The Patient Self-Determination Act of 1991 requires that providers receiving Medicare and Medicaid funds give clients written information regarding: A. legal options for treatment choices in the event the person becomes incapacitated. B. patient rights. C. the cost of services. D. patient privacy.

A. legal options for treatment choices in the event the person becomes incapacitated.

Ethical decision making is conducted in a generic framework. One step of ethical decision making is to place an ethical issue or dilemma within a meaningful context. The rationale for this step is: A. multiple factors affect the formulation and justification of ethical issues and dilemmas. B. the nature of ethical issues and dilemmas determines the specific ethical approach used. C. people cannot make sound ethical decisions if they cannot identify ethical issues and dilemmas. D. professional persons cannot avoid choice and action in applied ethics.

A. multiple factors affect the formulation and justification of ethical issues and dilemmas.

Provision 3 of the Code of Ethics for Nurses states, "The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient." In applying this provision to practice, the public health nurse understands that: A. patient means the recipient of nursing care. B. the profession's integrity is at stake. C. rights of the individual supersede. D. this applies only to nursing in community health.

A. patient means the recipient of nursing care.

An underlying current throughout the special population groups with health disparities is: A. poverty. B. aging. C. minority groups. D. children.

A. poverty.

Clinical medicine and epidemiology differ from each other in the major aspect of: A. practice focus. B. health monitoring. C. determinants of health and disease. D. evaluation of interventions.

A. practice focus.

When applying the nursing process to environmental health, the community health nurse would examine criteria that include the immediate and long-term responses of the client to the planned interventions. Another important factor to consider in the evaluation process would be: A. recidivism of the problem for the client. B. consideration of community policy and laws. C. relationship between the disease and the environmental factors. D. coordination of actions to meet the client's needs.

A. recidivism of the problem for the client.

Twenty people attended a church picnic the previous weekend. By Monday, four individuals exhibited symptoms of food poisoning. On Tuesday, the nurse in community health records the addition of two new cases. The incidence rate would be: A. two new cases divided by 16 at risk. B. two new cases divided by 20. C. six cases divided by 20. D. four cases divided by 16.

A. two new cases divided by 16 at risk.