Chapter 18: Community as Client: Assessment and Analysis (Stanhope: Public Health Nursing, 8th Ed)

The main characteristics of partnership are: a. Awareness, flexibility, and distribution of power b. Rights, responsibilities, and consensus c. Commitment, participation, and articulation d. Collaboration, advocacy, and utility

ANS: A The main characteristics of partnership are being informed, flexibility, and negotiated distribution of power.

A nurse may define a community as a(n) (select all that apply): a. Social group determined by geographic boundaries b. Group of people who share common values and interests c. Group of people defined by their interactions d. Individual with a specific health concern

ANS: A, B, C Community can be defined as many things, including a social group determined by geographical boundaries, a group of people who share common values and interests, and a group of people defined by their interactions.

A group of nursing students forms a student nursing association to provide support while they are enrolled in a nursing program. This is known as a community of: a. Place b. Special interest c. Problem ecology d. Function

ANS: B A community of special interest brings members together with common concerns and interests.

A public health nurse is collecting data about the biological aspects of community health. What data will the nurse collect? a. Race/ethnicity b. Traditional morbidity and mortality rates c. Policy making and social change d. Homicide rates

ANS: B Biological community health is often measured by traditional morbidity and mortality rates, which can be found in The Morbidity and Mortality Weekly Report.

A nurse cares for the community as the client when focusing on: a. Providing care for aggregates living in the community b. The collective good of the population c. The provision of care for families in the home setting d. Providing health education in the community

ANS: B The community is considered the client when the nursing focus is on the collective good of the population. Providing education is one way the nurse can care for the community as the client; however, the focus of nursing care is larger in scope than only education.

Which characteristic is an indicator of community health structure? a. Infant mortality rate b. Effective communication c. Crime rate d. Emergency room utilization

ANS: D The structure of the community is defined in terms of services and resources.

A nurse schedules an appointment with a physician who has a practice in the community to learn more about the communitys beliefs regarding childhood immunizations. This is known as: a. Informant interview b. Participant observation c. Secondary analysis d. Windshield survey

ANS: A An informant interview is a method of community data collection that involves directed conversation with selected community members.

Which nursing diagnosis is written at the community-level? a. Risk of hypertension related to poor diet and sedentary lifestyle b. Risk of obesity among school-age children related to lack of opportunities to engage in physical activity c. Risk of ineffective health maintenance among individuals who do not have access to a primary care provider d. Ineffective coping related to multiple stressors as evidenced by client crying and stating she has no support system

ANS: B There are three parts: risk of, among, and related to. The risk of identifies a specific problem or health risk faced by the community. Among identifies the specific community client with whom the nurse will be working in relation to the identified problem or risk. Related to describes characteristics of the community.

Which method of data collection is being used as a nurse gathers information about the condition of homes, size of lots, neighborhood hangouts, road conditions, and modes of transportation? a. Participant observation b. Windshield survey c. Survey d. Informant interviews

ANS: B Windshield surveys are the motorized equivalent of simple observation.

Which data would be useful for a nurse to collect when assessing safety in a community? Select all that apply. a. Number of billboards in the area b. Interviews with health care providers who are familiar with the community c. Observation of community members d. Nurses own observations

ANS: B, C, D Other nurses, social workers, and health care providers, community members, and the nurses own observations are reliable sources of information about the safety of an area

When writing a community-level diagnosis, Among refers to the: a. Specific problem or health risk faced by the community b. Characteristics of the community c. Community client experiencing the risk or problem d. Likelihood that the problem will be solved

ANS: C Among identifies the specific community client with whom the nurse will be working to address the identified problem.

A nurse surveys the school nurses in a community to determine their roles in the schools because this data is not available. The nurse is engaging in the process of data: a. Collection b. Gathering c. Generation d. Interpretation

ANS: C Data generation is the process of developing data that do not already exist by interacting with community members or groups. This data includes information about a communitys knowledge and beliefs, values and sentiments, goals and perceived needs, norms, problem-solving processes, power, leadership, and influence structures.

What are the critical attributes in the definition of community? a. Families, groups, and health organizations b. Health needs, geographical boundaries, and target population c. People, place, and functions d. Populations and health resources

ANS: C The people are community members or residents; place refers to geographic and time dimensions; and function refers to the aims and activities of the community.

Change for the community as client must often occur at several levels because: a. Health problems caused by lifestyle are multidimensional. b. Most individuals can change their habits alone. c. Aggregates are responsible for social change. d. Geographic areas often have health risks that the nurse must identify.

ANS: A Because health problems caused by lifestyle cannot be solved simply by asking individuals to choose healthy habits, change for the community client must often take place at several levels.

After identifying the boundaries of a community, what is the next step the nurse should take in completing a community assessment? a. Gather relevant existing data and generating missing data. b. Plan interventions that benefit the entire community. c. Formulate nursing diagnoses. d. Evaluate the interventions that were used.

ANS: A Community assessment includes gathering relevant existing data and generating missing data.

When completing a community assessment, the nurse will: a. Identify community needs and clarify problems. b. Determine the weaknesses of a community. c. Perform the core functions of public health nursing. d. Assess individual needs within a community.

ANS: A In a community assessment, one of the core functions is a logical, systematic approach to identifying community needs, clarifying problems, and identifying community strengths and resources.

When a nurse focuses intervention strategies on the structural dimension of community health, they are directed toward: a. Health services b. Primary prevention c. Health promotion d. Secondary prevention

ANS: A Intervention strategies include service use patterns, treatment data from various health agencies, and provider/client ratios.

Which characteristic is an indicator of community health process? a. Participation and community action b. Live birth rate c. Racial distribution d. Socioeconomic levels

ANS: A Participation and community action are indicators of community health process.

A nurse who uses such data as minutes from a community meeting is using: a. Secondary analysis b. Informant interviews c. A survey d. A windshield survey

ANS: A The data is secondary because it is collected by someone else.

To effectively complete the evaluation phase, the nurse must have: a. Demonstrated the ability to improve the health of the participants b. Developed measureable objectives and goals before implementation c. Encouraged full participation by community members d. Improved the health of the population through the program

ANS: B Evaluation begins in the planning phase, when goals and measurable objectives are established and goal-attaining activities are identified. After implementing the intervention, only the meeting of objectives and effects of the intervening activities have to be assessed.

When conducting informant interviews in a small community, the nurse would most likely contact: a. The state department of health for death records b. A local priest for congregation information c. Surrounding communities for crime comparison d. The Centers for Disease Control and Prevention (CDC) for illnesses in the area

ANS: B Informant interviews are methods of directly collecting data. County health department nurses and church officials are often good key informants.

A community that has residents who are very involved in its activities and encourage activities that promote the health of the community displays which condition of community competence? a. Commitment b. Participation c. Articulateness d. Effective communication

ANS: B Participation is an essential condition of community competence defined by active, community-oriented involvement.

A nurse collects data about seat belt usage by interviewing key informants and observing behaviors in the community. What type of data is being collected? a. Quantitative b. Qualitative c. Focus-groups d. Survey

ANS: B Qualitative data is collected through interviews and observation.

To analyze the problem of increased adolescent alcohol use in the community, a nurse brings together several groups of people to address the issue. These groups come together at the same time to work on identifying potential causes of the problem, but do not interact during the process. Which model is the nurse applying? a. Delphi technique b. Program planning model c. Community-as-partner model d. Community empowerment model

ANS: B The program planning model is known as the nominal group process. It makes the most of the contributions by various groups with diverse interests, skills, and knowledge. These groups work in the presence of one another but do not interact.

Which data source provides information about the function of the community? a. Maps b. Census data c. State departments, business and labor, local library d. Civic groups

ANS: C Function relates to production, distribution, and consumption of goods and services.

A community that demonstrates commitment would most likely support the development of a: a. Community club to facilitate community involvement b. Childrens recreation program c. Curb-side recycling program and community-based education about recycling d. Cooperative agreement with a neighboring city to share needed services

ANS: C The commitment condition of community competence defined by Cottrell refers to the affective and cognitive attachment to a community, that is worthy of substantial effort to sustain and enhance. Creating a recycling program as well as associated education enhances both the cognitive and affective domains of the community.

A nurse who reads the local community newspaper is using which method to gather data about the community? a. Informant interview b. Survey c. Participant observation d. Windshield survey

ANS: C The nurse is deliberately sharing in the life of the community.

A collection of individuals who have in common one or more personal or environmental characteristics is the definition of a(n): a. Community b. Group c. Family d. Aggregate

ANS: D An aggregate is a collection of individuals who have one or more personal or environmental characteristics in common.

What intervention would be the most appropriate for the nurse to use when trying to develop community partnerships? a. Involve only the community residents. b. Use nurses as the source of information and leadership. c. Rely on the power of local officials. d. Include a variety of disciplines.

ANS: D Community partnerships occur when community residents and health workers come from a variety of disciplines.

A nurse plans on implementing a community-wide influenza immunization program. Which factor should the nurse consider when implementing this program? a. The number of community members who have already received the immunization b. The existence of formal groups in the community c. Public policy that mandates influenza immunization for certain populations d. The communitys readiness to participate in the program

ANS: D The factors that influence implementation in the community are the nurses chosen roles, the type of health problem selected as the focus for intervention, the communitys readiness to take part in problem solving, and characteristics of the social change process.

A nurse is trying to increase participation in a free colorectal screening program for middle-aged adults who lack health insurance. Which implementation mechanism would be most effective? a. Small interacting groups b. Health policy c. Lay advisors d. Mass media

ANS: D The mass media (newspapers, television, and radio) represent an impersonal and formal type of communication and are useful in providing information quickly to a large number of people.