Chap. 1: Introduction to Community Health Nursing

Which of the following is most accurate about the concept of community? A) A community is a collection of people who share some important features of their lives. B) Community members live in the same geographic location. C) Community members are biologically related. D) A community is made up of people who do not necessarily interact with one another and do not necessarily share a sense of belonging to that group.

A) A community is a collection of people who share some important features of their lives. Feedback: The broad definition of a community is a collection of people who share some important features of their lives. Community members may not live in the same geographic location as in a common-interest community or a community of solution. A population is made up of people who do not necessarily interact with one another and do not necessarily share a sense of belonging to that group.

Which are characteristics of an effective community health nurse? Select all that apply. A) Is particularly concerned with healthy environments B) Optimal use of resources is a primary concern C) Views a population as the client D) Sees primary prevention as the priority in selecting community health activities E) Focuses upon select groups or populations

A) Is particularly concerned with healthy environments B) Optimal use of resources is a primary concern C) Views a population as the client D) Sees primary prevention as the priority in selecting community health activities Explanation: The community health nurse views the population as the client while applying the concept of primary prevention when formulating health related activities. Healthy environments and the optimal utilization of available resources are primary concerns of the community health nurse. Focusing on select groups or populations does not reflect the greatest good for all.

The nurse is working with a community of solution. Which of the following would the nurse expect to find? A) A health problem affecting the group B) Common goal binding members together C) Sharing of a similar goal D) Locational boundaries

A) A health problem affecting the group Feedback: A community of solution involves a group of people coming together to solve a problem that affects them. A common-interest community involves a collection of people widely scattered geographically who have an interest or goal that binds the members together. A geographical community is one defined by its geographical or locational boundaries.

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

A) Assess the groups' relationships looking for a common need. Feedback: 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.

Which of the following activities would be associated with a community health nurse? Select all that apply. A) Examining infants in a city well-baby clinic B) Caring for elderly stroke victims in their homes C) Providing emergency care in an acute care facility D) Carrying out epidemiologic research E) Participating in health policy analysis

A) Examining infants in a city well-baby clinic B) Caring for elderly stroke victims in their home D) Carrying out epidemiologic research E) Participating in health policy analysis Feedback: 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 rang 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 associated with a community health nurse.

A group of community health nursing students design a health education program for a group of pregnant teens that includes teaching nutrition during pregnancy, demonstrating helpful exercises, and discussing their concerns. This is an example of which of the following? A) Health promotion B) Treatment of disorders C) Rehabilitation D) Evaluation

A) Health promotion Feedback: The student nurses are engaging in health promotion activities. Health promotion incorporates all efforts that seek to move people closer to optimal well-being or to higher levels of wellness. Treatment of disorders would include direct care for issues involving the group, such as complications that might arise in this population. Rehabilitation would involve activities to minimize disability or restore or preserve function. Evaluation would involve an analysis of the effectiveness of these activities.

The nurse is addressing quality of life for a specific client. On which activities should the nurse focus? Select all that apply. A) high-risk behaviors B) communication skills C) ethnic background D) educational experiences E) lifestyle choices

A) High-risk behaviors E) Lifestyle choices Explanation: Community health practitioners place a strong emphasis on the capacity to develop a person's potential to lead a fulfilling and productive life—one that can be measured in terms of quality of life. Today, our health is greatly affected by the lifestyles we lead and the risk behaviors in which we engage. Ethnic background, educational experiences, and communication skills are not lifestyle behaviors.

Which of the following would be crucial for the community health nurse to address as the priority when dealing with policy makers about the development of community health programs? A) Research-based best practices B) Population's make up C) Amount of services to be provided D) Scarcity of the available resources

A) Research-based best practices Feedback: Decisions for programs or services are often made on the basis of cost-effectiveness or cost-benefit. Therefore, community health nurses must provide policy makers with information about best practices, grounded in research. Although population make up, amount of services to be provided, and scarcity of resources are factors that may need to be considered, the community health nurse must demonstrate evidence-based practice.

The community health nurse is developing a plan of primary prevention activities. Which of the following might the nurse include? Select all that apply. A) Teaching about safe-sex practices to high school students B) Encouraging older adults to install safety devices in the bathroom C) Providing regular immunization programs for communicable diseases D) Participating in cholesterol screening programs at health fairs E) Providing skin testing for tuberculosis for children over 1 year of age F) Working with a group testing water samples for contamination

A) Teaching about safe-sex practices to high school students B) Encouraging older adults to install safety devices in the bathroom C) Providing regular immunization programs for communicable diseases Feedback: Primary prevention activities are those taken to keep illness or injuries from occurring. These include teaching about safe-sex practices, encouraging older adults to use safety devices in the bathroom, and providing regular immunization programs for communicable diseases. Cholesterol screening programs, skin tests for tuberculosis, and working with a group testing water samples for contamination are examples of secondary prevention activities.

When gathering information for a public forum on the improvement of the quality of life for the older adult, the nurse initially refers to: A) the Community Health Status Indicators Project. B) Centers for Disease Control and Prevention (CDC). C) the Morbidity and Mortality Weekly Report. D) Healthy People 2020's Leading Health Indicators.

A) The Community Health Status Indicators Project. Explanation: The Community Health Status Indicators Project provides county-level reports related to such things as infectious and chronic diseases, health related quality of life, behavioral risk factors, vulnerable populations, causes of death, births, and summary measures of health and health disparities. Healthy People 2020 identifies goals and objectives for the nation's health. The MMWR identifies current data on death rates nationwide. CDC provides educational materials that could be utilized for education purposes.

When discussing the concept of the health continuum with a class, the nurse educator would be certain to include which statement in the description? A) Wellness is a relative concept, not an absolute, and illness is a state of being relatively unhealthy. B) A client's placement on the health continuum is static throughout time. C) Health is best described as cyclic. D) The health continuum can only be applied to individuals.

A) Wellness is a relative concept, not an absolute, and illness is a state of being relatively unhealthy. Feedback: Wellness is a relative concept, not an absolute, and illness is a state of being relatively unhealthy. The continuum can change. Because health involves a range of degrees from optimal health at one end to total disability or death at the other, it is often described as a continuum. The health continuum applies not only to individuals but also to families and communities.

A group of students are reviewing material for a test on populations, communities, and aggregates. Which of the following indicates that the students understand these concepts? A) Members of a population share a sense of belonging. B) Communities and populations are types of aggregates. C) Individuals of a community are loosely connected. D) Members of an aggregate share a strong bond.

B) Communities and populations are types of aggregates. Feedback: An aggregate refers to a mass of grouping of distinct individuals who are considered as a whole and who are loosely associated with one another. Communities and populations are types of aggregates. A population is made up of people who do not necessarily interact with one another and do not necessarily share a sense of belonging to the group. A community is a collection of people who chose to interact with one another because of common interests, characteristics, or goals, which form the basis for a sense of unity or belonging.

Which of the following statements about health promotion and disease prevention is the most accurate? 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. Feedback: 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 one of the following statements 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. Feedback: 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.

Which of the following statements would best describe the difference between public health nursing and community health nursing? A) Public health nursing is focused on the private aspects of health, and community health nursing is focused on the public aspects of health. B) In our textbook, the term community health practice refers to a focus on specific, designated communities and is a part of the larger public health effort. C) Public health nursing and community health nursing relate to the very same types of services and perspectives. D) Both public health nursing and community health nursing are practiced exclusively within institutions.

B) In our textbook, the term community health practice refers to a focus on specific, designated communities and is a part of the larger public health effort. Feedback: In this textbook, community health practice refers to a focus on specific, designated communities. It is a part of the larger public health effort and recognizes the fundamental concepts and principles of public health as its birthright and foundation for practice. Public health nursing is focused on the public aspects of health. Public health nursing and community health nursing have distinctive types of services and perspectives. Neither public health nursing nor community health nursing is practiced exclusively within institutions.

After discussing the leading health indicators with a class, which condition if stated by the class as one of these indicators suggests that the class has understood the information? A) Cardiac disease B) Mental health C) Sedentary lifestyle D) Maternal health care

B) Mental health Feedback: Mental health is a leading health indicator. Other leading health indicators include physical activity, overweight and obesity, tobacco use, substance use, responsible sexual behavior, injury and violence, environmental quality, immunization, and access to health care.

Which nursing activity is specific to community health nursing? A) Doing an in home assessment of a motor impaired client in order to best identify safety needs. B) Planning a public awareness seminar to focus on the effects of secondhand smoke. C) Organizing a prenatal care clinic in an Hispanic neighborhood that has staff that can communicate with clients in their native language. D) Attending a seminar on the specific health-related beliefs of the Asiand and Mid Eastern immigrate.

B) Planning a public awareness seminar to focus on the effects of secondhand smoke. Explanation: A nurse entering the field of community focuses on the effects community behaviors have on the health of the individual community member, such as the effect on secondhand smoke. The other answer options identify populations at risk and aggregates, which are public health related.

After a class that described the differences between acute care nursing and community health nursing, which statement by the class about community health nurses indicates successful teaching? A) Use a reactive approach. B) Seek out potential health problems. C) Concentrate on the illness end of the continuum. D) Emphasize curative care.

B) Seek out potential health problems. Feedback: Community health nurses, in contrast to acute care nurses, seek out potential health problems, identifying high-risk groups and instituting preventive programs; use a proactive approach; concentrate on the wellness end of the health continuum; and put less emphasis on curative care.

A community health nurse is preparing a presentation for a group of nursing students about community health nursing. Which of the following descriptions about community health nursing would the nurse most likely include in the presentation? A) Focusing on addressing continuous needs B) Working with the client as an equal partner C) Engaging in tertiary prevention as the priority D) Encouraging clients to reach out to the nurse

B) Working with the client as an equal partner Feedback: 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. The community health nurse engages in primary prevention as the priority, having the obligation to actively reach out to all who might benefit from a specific activity or service.

While interviewing a client, which of the following statements would a nurse identify as reflecting an objective dimension of health? A) "I'm feeling better since I started taking that medication." B) "Life is pretty good right now, except for an occasional upset stomach." C) "I'm able to wash myself in the mornings with just a bit of help." D) "Sometimes when I wake up, I don't even want to face the day."

C) "I'm able to wash myself in the mornings with just a bit of help." Feedback: The objective dimension of health involves one's ability to function in daily activities. The statement about being able to care for one's self is an example. The statements of feeling better with medication, life being pretty good, and not wanting to face the day are examples of the subjective dimension of health, which involves how people feel.

A community health nurse is involved in a project to evaluate the health of a city. Which of the following findings would suggest that the city would most likely need additional programs? A) Citizens are actively involved in the city's department of recreation and after-school programs. B) The construction of affordable organized housing developments and communities is nearing completion. C) Approximately one third of the people are recently unemployed due to closure of the automotive factory. D) Several new recreational facilities for adults and children have been created at several locations.

C) Approximately one third of the people are recently unemployed due to closure of the automotive factory. Feedback: A healthy city is one in which there is continual creation and improvement the physical and social environments with expansion of community resources so that people can mutually support one another. It is characterized by the meeting of basic needs for all of the city's people. This would include food, water, shelter, income, safety, and work. Loss of employment of one third of the city's workforce would be a threat to the health of the city and necessitate intervention. Active involvement in the city's functioning, affordable housing, and recreational facilities are suggestive of a healthy city.

A community health nurse is working with other members of a team that will be implementing a citywide immunization program. The nurse is coordinating the services and addressing the needs of the population groups to ensure which of the following? A) Involvement of the community B) Client participation C) Continuity of service D) Plan for follow-up

C) Continuity of service Feedback: Working in cooperation with other team members and coordinating services and addressing the needs of population groups are essential to interprofessional collaboration. In doing so, the community health nurse is preventing fragmentation and gaps thereby ensuring continuity of service. Involvement of the community and client participation are important but these help to ensure that the clients are viewed as equal partners of the health care team. A plan for follow-up may or may not be appropriate. In addition, it is the only aspect that may be addressed with the program.

When working in the community, the community health nurse adopts the teaching plan to ensure that the population understands the basic information provided to address which of the following? A) Self-care B) Health disparities C) Health literacy D) Episodic needs

C) Health literacy Feedback: Consumers are often intimated by health professionals and are uninformed about health and health care affecting the quality of care. Adopting a teaching plan to ensure that the population understands the basic information addresses health literacy, the ability to read, understand, and use health care information appropriately. Doing so helps to ensure that the teaching plan will be effective. Self-care refers to the process of taking responsibility for developing one's own health potential by actively participating in promoting one's own health. Health disparities reflect differences in all aspects of health care related to vulnerable populations. Episodic needs are one-time specific negative health events that arise and are not an expected part of life.

Which of the following would a community health nurse identify as a community of common interest? A) The global community B) Small rural town in a northern state C) National professional organization D) Counties addressing water pollution

C) National professional organization Feedback: A common-interest community shares a common interest or goal that binds the members together. Membership in a national professional organization is one example. The global community and a small rural town in a northern state would be examples of a geographic community. Counties addressing a water pollution problem would be an example of a community of solution.

Which individual would most likely have the greatest degree of wellness? A) the 45-year-old client who was diagnosed with cancer and states, "it was inevitable; both my mother and twin sister developed this form of cancer." B) the teenage football player who is diagnosed with acute depression after fracturing a femur and being told he can no longer play football. C) the 70-year-old client who is being treated for cardiovascular disease and kidney failure and who self-describes as "happy to be alive." D) the new mother who misses her recently delivered twins since developing pneumonia while recovering from a caesarian section.

C) The 70-year-old client who is being treated for cardiovascular disease and kidney failure and who self-describes as "happy to be alive." Explanation: Wellness is a relative concept, not an absolute; the individual's perception of wellness has great influence on his or her state on wellness. Wellness runs on a continuum. A football player with an injury, a new mother with pneumonia, and an adult diagnosed with cancer are acute. Thus, at this time, they would be considered mildly well and need to recover.

A community health nurse involved in assessing health needs will find with task easiest in a specific: A) economic level. B) ethnic community. C) geographic area. D) age group.

C) geographic area. Explanation: A community demarcated by geographic boundaries, such as a city or county, becomes a clear target for the analysis of health needs. Assessing age groups, ethnic community, and economic levels is important, however will require more research and analysis of available data to get information on the specific groups.

After teaching a group of nursing students about the similarities and differences between public health and community health, which of the following statements by a nursing student would indicate knowledge of 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) "Public health nursing is focused on the health of individuals." D) "Community health nursing can shape the quality of community health services and improve the health of the general public."

D) "Community health nursing can shape the quality of community health services and improve the health of the general public." Feedback: 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 term health can be described in many different ways. A community health nurse would view health as which of the following? 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 Feedback: 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 nurse is presenting a workshop at an urban community center for women who have recently experienced a mastectomy. In which type of community is the nurse addressing health needs? A) Urban B) Gender specific C) Global D) Common interest

D) Common interest Explanation: A common-interest community can be identified by a common interest or goal. A collection of people, even if they are widely scattered geographically, can have an interest or goal that binds the members together. A global community is a large-scale view of the world. Urban community would include the entire city area. Gender specific is not applicable to a community, it would be population based.

Which group is most likely to meet the criteria of a common interest community? A) the members of a high school debate team B) the people living within an urban community 1 square mile in area C) young college-educated adults 20 to 35 years of age D) homosexual couples wanting to adopt a child

D) Homosexual couples wanting to adopt a child Explanation: The function of any community includes its members' collective sense of belonging and their shared identity and values. People living within 1 square mile is a geographic community. People within an age group and members of a team do not fall into the three types of communities.

Which health promotion activity is directed toward a community health issue that has not improved over the last decade? A) having info concering the improtance of childhood immunizations printed in a variety of languages. B) arranging for volunteers to staff a clinic that manages the health issues of homeless men. C) applying for a grant to help pay for well-baby visists for newborns of newly immigrated families. D) providing a workshop on healthy eating and increased physical activity for low-income families at the local daycare center.

D) Providing a workshop on healthy eating and increased physical activity for low-income families at the local daycare center. Explanation: Although our life expectancy has improved and childhood immunization rates have risen, with advancement toward reducing racial and ethnic disparities, our rates of obesity and diabetes have risen well beyond baseline levels from the previous decade. Grant application and arranging for volunteers are not a direct health promotion activity.

A community health nurse works to ensure the greatest good for the greatest number of people by applying which of the following? A) Secondary prevention activities B) Autonomy C) Justice D) Utilitarianism

D) Utilitarianism Feedback: The ethical theory of utilitarianism promotes the greatest good for the greatest number. Primary prevention activities, not secondary prevention, are the priority. Autonomy refers to the freedom of choice. Justice involves treating people fairly.

The nurse is providing education on the importance of medication compliance to individuals newly diagnosed with tuberculosis. This is an example of: A) core public health functions. B) surveillance and assessment. C) primary prevention. D) tertiary prevention.

D) tertiary prevention. Explanation: Tertiary prevention attempts to reduce the extent and severity of a health problem to the lowest possible level. Medication compliance is an example of this. Secondary prevention would include skin or blood testing for TB. Primary prevention would include education to the general population regarding prevention of TB. Surveillance and assessment provides identification and tracking of TB cases and core public health functions include assessment, policy development, and assurance.