Community Health Exam 1

The public health nurse is working with a specific population and is preparing to participate in a descriptive epidemiology study. Which of the statements apply to descriptive epidemiology? (Select all that apply.) A. Descriptive epidemiology seeks to answer questions about the amount of disease in a given population. B. Descriptive epidemiology seeks to answer questions about the cause of disease in a given population. C. Descriptive epidemiology seeks to answer questions about the cure for disease in a given population. D. Descriptive epidemiology seeks to answer questions about the distribution of disease in a given population.

A and D -The study of the amount and distribution of disease constitutes descriptive epidemiology. Patterns identified through descriptive epidemiology may indicate possible causes. When these possible causes are investigated with different and more advanced epidemiologic methods, this is analytic epidemiology.

The steps in the community assessment process for community health nurses are: (Select all that apply.) A. writing a community diagnosis. B. evaluating the outcomes. C. collecting assessment data. D. identifying the cause of the problem. E. planning community interventions.

A, B, C, and E -The steps of the community assessment process for community health nurses are collecting the assessment data, synthesizing assessment data into diagnostic statements about the community's health, planning interventions, and evaluating the outcomes. Identifying the cause of the problem helps with planning the interventions.

When nonindustrial cultures adopt Western customs and transition into urban environments, Western diseases begin to appear. Epidemiologic studies suggest that common risk factors that contribute these health conditions include: (Select all that apply.) A. changes in diet. B. environmental alterations. C. economic changes. D. increased population density. E. occupational hazards.

A, B, D, and E -Epidemiologic studies suggest that common risk factors that contribute to chronic health conditions are changes in diet (e.g., increases in refined sugar and fats and lack of fiber), environmental alterations (e.g., use of motorized transportation and climate-controlled living and work sites), and occupational hazards. An increase in population and population density also increase mental and behavioral disorders. Economic improvements in nonindustrialized communities would decrease the risk of disease. Economic changes in nonindustrialized communities are not listed as a common risk factor that contributes to chronic health conditions.

A variety of health indicators are used by health providers, policy makers, and community health nurses to measure the health of the community. Indicators that illustrate the health status of a community and may be useful in analyzing health patterns over time include: (Select all that apply.) A. morbidity. B. mortality. C. birth rates. D. life expectancy. E. cancer incidence rates.

A, B, D, and E Some of the more commonly reported health indicators used by health providers, policy makers, and community health nurses to measure the health of the community are life expectancy, infant mortality, age-adjusted death rates, and cancer incidence rates. Birth rates do not provide relative data to measure the health of a community.

While caring for a client from an Asian culture, the community health nurse might expect which of the following behaviors? (Select all that apply.) A. The client is quiet and compliant, asking few questions. B. The client asks many questions related to the health problem and the nurse's instructions. C. The client may avert his or her eyes during the conversation. D. Folk healers and complementary health care providers may also be present. E. The client may provide the nurse with the answers he or she thinks the nurse wants to hear.

A, B, and E

Nurses' involvement in policy can be achieved by all of the following: (Select all that apply.) A. conducting and supporting health policy research. B. avoiding discussions that involve health policy that may be controversial. C. working with health care professionals to influence change in the quality of health care. D. writing letters to educate legislators about health care issues. E. monitoring the quality ratings of health care organizations and suggesting changes that would improve care.

A, C, D, and E -Nurses can support and use nursing research that demonstrates positive clinical and economic outcomes. This would serve to validate the importance of nursing within the health system. External strategies that nurses can use to influence private health policy include participation in discussion regarding quality and managed care. Nurses should work cooperatively with other health professions to influence managed care organizations to improve quality of care. Nurses should monitor the quality ratings of health care organizations and suggest changes that would improve care. Writing letters to legislators is a direct way to communicate opinions and concerns. Avoiding controversial discussions on health policy, however, will not foster positive changes.

Cost containment incentives include which of the following? (Select all that apply.) A. Capitated reimbursement B. Limited access to care C. Fee-for-service billing D. Health care rationing E. Carve-out services

A, C, and D -Economic or cost-containment incentives can be divided into the following broad categories: capitated reimbursement, access limitation, and rationing. Fee-for-service billing has a potential for overuse. Carve-out services are services provided within a standard benefit package but delivered exclusively by a designated provider or group, such as mental health services or dialysis services.

Using theory to guide community health nursing practice serves to: (Select all that apply.) A. guide data collection and interpretation in a clear and organized manner. B. provide uniformity in community health nursing practice. C. improve community health nursing practice. D. validate traditional community health nursing beliefs. E. focus the student on factors that are critical to understanding the situation.

A, C, and E -Theory-based practice guides data collection and interpretation in a clear and organized manner. Although using theory makes it easier to plan standardized care for aggregates, the goal of theory is to improve nursing practice, thereby ensuring quality care. Through the process of integrating theory and practice, the student can focus on factors that are critical to understanding the situation. The lack of uniformity in theory definitions reflects the evolution of thought and the individual differences in the understanding of relationships among theory, practice, and research.

Provisions of the Patient Protection and Affordable Care act include: (Select all that apply.) A. mandating that all citizens obtain health insurance. B. reducing Medicaid eligibility. C. subsidizing insurance premiums for all citizens. D. prohibiting denial of coverage for preexisting conditions. E. establishing health insurance exchanges.

A, D, and E -The Patient Protection and Affordable Care Act provisions include mandating that all citizens obtain health insurance, expanding Medicaid eligibility, subsidizing insurance premiums for low income purchasers, prohibiting denial of coverage for preexisting conditions, and establishing health insurance exchanges.

Which of the following minority groups has a 35% higher mortality rate from cancer than nonminority groups? A. African Americans B. Asians C. Latin Americans D. Italian Americans

A. African Americans

Which of the following "determinants of health" would include predisposition to prostate cancer and a history of depression? A. Biology B. Behaviors C. Social environment D. Physical environment

A. Biology -Biology refers to an individual's genetic makeup, family history, and physical and mental health problems experienced over the course of life. Behaviors are the individual's responses to internal stimuli and external conditions. Social environment includes interactions and relationships with family, friends, coworkers, and others in the community. The physical environment refers to the things that can be experienced with the senses. Biology is an individual's genetic makeup, family history, and any physical and mental health problems developed in the course of life.

In comparing ancient aggregates to those in the present time, the groups are similar in that: A. Communities of people continue to live in close proximity in which disease or illness can be easily spread. B. People domesticate animals, so they live in close proximity to their herds C. All countries now have elaborate water systems in order to prevent cross-contamination of water supplies D. Communities or aggregates are not affected by size, density, and relationship to the environment

A. Communities of people continue to live in close proximity in which disease and illness can be easily spread -Aggregates continue to live in close, such as schools, college dorms, nursing homes, etc., in which disease or illness can be easily spread. The growing population of world cities is also resulting in overcrowding, which contributes to the spread of disease and illness.

The community health nurse is caring for a client who abstains from eating any form of meat. This dietary preference is commonly practiced by which of the following religions? A. Hinduism B. Mormonism C. Judaism D. Islam

A. Hinduism

Which of the following statements describes the social construct paradigm for disability (as opposed to the medical model)? A. It focuses on the modification of attitudinal, architectural, sensory, and economic barriers in the environment. B. It discourages full citizenship for people with disabilities. C. Health professionals prescribe interventions to remedy functional limitations of the ill person. D. It focuses on problems and solutions related to the individual.

A. It focuses on the modification of attitudinal, architectural, sensory, and economic barriers in the environment. -This is the only statement that reflects the social construct paradigm, which implies that disability stems from the failure of a structured social environment to adjust to the needs and aspirations of disabled citizens rather than from the inability of a disabled individual to adapt to the demands of society. The other options are characteristics of the medical model.

Decisions on public policy are made by which part of the federal government? A. Legislative, executive, or judicial branches of the government B. Only the executive branch (president, governor, mayor) C. Supreme Court D. House of Representatives and Senate

A. Legislative, executive, or judicial branches of the government

Enacted in 1965 as part of the Social Security Act, __________ was intended to provide health care to the population of U.S. citizens 65 years of age and older. A. Medicare B. Medicaid C. Social Security D. Blue Cross/Blue Shield

A. Medicare

A community health nurse participating in planning programs for the coming year considers incidence rates to better understand the needs of the community. Which statement below is the most accurate explanation of incidence rates? A. New cases of a disease or condition in a community over a period of time are included in incidence rates. B. The number of all cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time is included in incidence rates. C. Incidence rate refers to the number of new cases of a disease in those exposed to the disease. D. The term incidence rate refers to the percentage of deaths in a specific period of time from a specific cause.

A. New cases of a disease or condition in a community over a period of time are included in incidence rates. -Incidence rates describe the occurrence of new cases of a disease or condition in a community during a period of time relative to the size of the population at risk for that disease or condition during that same time period. In calculating this rate, the numerator is the number of new cases during the specific period of time, and the denominator consists only of those who are at risk for developing the disease or condition during the specific period of time. A prevalence rate is the number of all cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time. Attack rates document the number of new cases of a disease in those exposed to the disease. The percentage of deaths in a specific period of time from a specific cause refers to the mortality rate.

Which of the following theories is based on the assumption that individual needs and related activities are the focus of nursing care? A. Orem's self-care deficit theory B. The health belief model C. Milio's framework D. Critical social theory

A. Orem's self-care deficit theory -Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing interventions required to assist clients to obtain optimal health. The health belief model (HBM) evolved from the premise that the world of the perceiver determines action. Milio's framework for prevention (1976) provides a complement to the HBM and a mechanism for directing attention upstream and examining opportunities for nursing intervention at the population level. Critical social theory uses societal awareness to expose social inequalities that keep people from reaching their full potential.

Through epidemiologic investigations, effective prevention measures are often identified. When the nurse is engaged in providing prevention for the community before disease has developed, the prevention activities meet the definition for what level of prevention? A. Primary B. Secondary C. Tertiary D. Pathogenic

A. Primary -Primary prevention occurs when intervention activities take place before disease development. Immunization is an example of primary prevention that provides specific protection. Secondary prevention occurs after pathogenesis, namely screening and physical examinations that are aimed at early diagnosis. Tertiary prevention focuses on rehabilitation and limitation of disability. Pathogenic does not describe a type of prevention.

The percentage of deaths resulting from a specific cause provides the nurse with information about areas in which public health programs might make significant contributions in reducing deaths. Select the statistic often used for this purpose. A. Proportionate mortality rate B. Crude death rate C. Age-adjusted death rate D. Standardized mortality rate

A. Proportionate mortality rate -Proportionate mortality rate is calculated using the number of deaths resulting from a specific cause in a specific time period as the numerator and the total number of deaths in the same time period as the denominator. In crude death rates, the numerator is the number of deaths, and the denominator is the average population size or the population size at midyear multiplied by a constant. Age adjustment or standardization reduces bias when there is a difference between the age distributions of two populations.

Early public health nurse Lillian Wald and her associates were successful in addressing health and disease in the immigrant community by: A. supporting political activities to improve social and environmental conditions of immigrant families. B. administering bedside nursing care to immigrants and their families. C. teaching the immigrant family members to provide health care in the home. D. obtaining and administering medications to the immigrants and their family members.

A. Supporting political activities to improve social and environmental conditions of immigrant families These early public health nurses saw that neither administering bedside clinical nursing, including obtaining and administering medication, nor teaching family members to deliver care in the home adequately addressed the true determinants of health and disease. They resolved that collective political activity should focus on advancing the health of aggregates and improving social and environmental conditions by addressing the social and environmental determinants of health. Wald and her colleagues (1971) impacted the health of the community by organizing the community, establishing school nursing, and taking impoverished mothers to testify in Washington, DC.

One dimension of a community, which looks at personal characteristics and risks of a group, is called: A. aggregate of people. B. location in space and time. C. social system. D. census tract.

A. aggregate of people. -An aggregate is a community composed of people who share common characteristics. An aggregate of people describes the "who" of a community, including personal characteristics and risks. Location in space and time looks at the geographical location of a community. Social system is the relationships that community members form with each other. Census tracts facilitate the organization of resident information in specific community geographic locales.

A microscopic approach to the community health problem of childhood obesity would focus on: A. asking an obese child and his or her parent(s) to complete a 24-hour food diary. B. analyzing aggregate Body Mass Indexes (BMIs) of school-age children in a school. C. advocating for a change in health policy related to school lunches. D. exploring changing cultural changes and societal values related to activity.

A. asking an obese child and his or her parent(s) to complete a 24-hour food diary. -A microscopic approach to the conceptualization of the problem of childhood obesity focuses on the individual child. A macroscopic approach focuses on the societal factors that influence health status. Analyzing aggregate BMIs, advocating a change in school lunches, and exploring societal and cultural values related to activity are examples of a macroscopic approach to the community health problem of childhood obesity.

Political action committees (PAC) are formed by professional organizations, business, or labor groups for the purpose of: A. attracting candidates who are sympathetic to particular health care issues. B. lobbying legislation about health policies. C. being an advocate for health care reform. D. providing financing to professional organizations.

A. attracting candidates who are sympathetic to particular health care issues. -PACs are nonpartisan entities that promote the election of candidates believed to be sympathetic to their interests. The purpose of specific PACs could be to promote certain health care issues or health care reform or to obtain financing for certain professional organizations.

The phrase "All Chinese people like rice" is an example of: A. cultural stereotyping. B. culture-bound syndrome. C. cultural imposition. D. ethnocentrism.

A. cultural stereotyping. -The tendency to view individuals of common cultural backgrounds similarly and according to a preconceived notion of how they behave is called cultural stereotyping. Culture-bound syndrome is a condition that is culturally defined. Cultural imposition is a person's tendency to impose his or her own beliefs, values, and patterns of behavior on individuals from another culture. Ethnocentrism is a person's tendency to view his or her own way of life as the most desirable, acceptable, or best and tendency to act in a superior manner toward individuals from another culture.

When making health-related decisions, clients from different cultural backgrounds depend on relationships. One type of relationship involves the client seeking assistance from other members of the family and allowing a relative to make decisions about important health-related issues. This relationship is a(n): A. lineal relationship. B. collateral relationship. C. cultural relationship. D. individual relationship.

A. lineal relationship. -Lineal relationships involve a client seeking assistance from another family member and allowing a relative to make important decisions related to health matters. A collateral relationship's focus is primarily on group goals, and family orientation is important. A cultural relationship is characterized by tolerance and respect. Individual relationships refer to personal autonomy and independence. Individual goals dominate, and group goals become secondary.

Modern community health nursing requires the nurse to __________, which empowers people to understand and address their health issues and disease. A. practice from a population focus B. adopt a medical model of care C. return to earlier models of prevention D. focus on the individual and family

A. practice from a population focus -

The use of theory in population-focused community health nursing encourages which of the following? (Select all that apply.) A. A reactive approach to care B. A proactive approach to care C. Development of population-focused programs D. Development of individual-focused health protocols for community use

B and C -Theory assists the community health nurse in applying upstream thinking, including a proactive approach to population-focused care. A reactive or individual approach prevents progress toward "big picture" initiatives and population-based programs.

Lillian Wald and Mary Brewster's Henry Street Settlement was a model of modern health care. Which of the following services was provided to people living in the Lower East Side of New York City by the Henry Street Settlement nurses? (Select all that apply.) A. Emergency care and first aid B. Home visits to ill mothers and children C. School health services D. Industrial health services to local workers E. Support programs for immigrants

B, C, D, and E -The Henry Street Settlement was a model comprehensive health care center that provided many services, including home visits to mothers and children, support services for immigrants, the first school health and industrial health programs, and many other services. Emergency care and first aid were not provided services.

Public health efforts focus on prevention and promotion of population health. The local level of the health care system provides direct services to community members through community and personal health services. An example of a health service that targets the larger community, rather than individuals, is: (Select all that apply.) A. providing well-infant care. B. a mobile immunization clinic. C. condemning or repairing unsafe housing. D. encouraging family planning. E. airing a weekly public service announcement to remind women to do breast self-examination.

B, C, and E A mobile immunization clinic, repairing unsafe housing, and airing weekly public service announcements all target the larger population of a community. Providing well-infant care and encouraging family planning target individuals.

Which of the following is an example of a modifiable risk factor? (Select all that apply.) A. Air pollution B. Cigarette smoking C. Gender D. Sexual practices E. Diet

B, D, and E -Modifiable risk factors are those aspects of a person's health risk over which he or she has control. Examples include smoking, leading a sedentary or active lifestyle, the type and amount of food eaten, and the type of activities in which he or she engages. Gender is not changeable. Air pollution can contribute to some disease processes, but it is not considered to be a direct risk factor.

Disease prevention activities protect people from disease and the effects of disease. An example of primary disease prevention is: A. teaching people with diabetes how to prevent complications. B. administering vaccines to children before kindergarten. C. checking the skin of farm workers for signs of skin cancer. D. identifying and testing individuals exposed to someone with tuberculosis.

B. Administering vaccines to children before kindergarten Primary prevention activities prevent a problem before it occurs; an immunization is given to prevent a disease before it occurs. Secondary prevention refers to early detection and prompt intervention during the period of early disease pathogenesis, such as checking the skin for signs of skin cancer or identifying and treating individuals who have been exposed to contagious diseases. Aims of tertiary prevention are to keep health problems from getting worse, reduce the effects of disease and injury, and restore individuals to their optimal level of functioning. Examples of tertiary prevention include teaching prevention of complications from disease or referring a patient with a stroke for rehabilitation.

The nurse working in the community is aware that there are different models for studying the epidemiology of a health condition in a population. One model of investigation of the interrelationships and characteristics of disease is the epidemiologic triangle. This model analyzes what three elements? A. Incidence, prevalence, and etiology B. Agent, host, and environment C. Person, place, and time D. Virus, bacteria, and fungus

B. Agent, host, and environment -The epidemiologic triangle considers the extent of the host's exposure to the agent, the virulence of the agent, and the host's genetic or immunologic susceptibility to the agent. Environmental conditions at the time of exposure are also considered. Examination of these three elements allows assessment of the problem, determination of protective factors, and evaluation of the vulnerability of the host to disease. The person-place-time model organized epidemiologists' investigations of the disease pattern in the community. Answers A and D do not represent an epidemiologic model.

The nurse who was responsible for organizing relief efforts for soldiers during the U.S. Civil War and who was the founder of the American Red Cross was: A. Lavinia Dock. B. Clara Barton. C. Sojourner Truth. D. Margaret Sanger.

B. Clara Barton. -Clara Barton was responsible for organizing relief efforts during the U.S. Civil War. In 1882, she successfully persuaded Congress to ratify the Treaty of Geneva, which allowed the Red Cross to perform humanitarian efforts in times of peace. Lavinia Dock was a writer and political activist. Sojourner Truth was an advocate for abolishing slavery and supporting women's rights. Margaret Sanger was an American birth control activist, sex educator, and nurse.

What is the process used when conceptual differences, which impact the provision of health care, exist between the client and the nurse? A. Cultural diversity B. Cultural negotiation C. Cultural competence D. Cultural imposition

B. Cultural negotiation -Cultural negotiation refers to the process in which messages, instructions, and belief systems are manipulated, linked, or processed between the professional and lay models of health problems and preferred treatment. In each act, the nurse gives attention to eliciting the client's views regarding a health-related experience (e.g., pregnancy, complications of pregnancy, or illness of an infant). Cultural diversity is a multifaceted and complex concept that refers to the differences among people, especially those related to values, attitudes, beliefs, norms, behaviors, customs, and ways of living. Cultural competence is respecting and understanding the values and beliefs of a certain cultural group so that one can function effectively in caring for members of that cultural group. Cultural imposition is a person's tendency to impose his or her own beliefs, values, and patterns of behavior on individuals from another culture.

A smoking cessation class stresses increased lung function, money saved that is not spent on cigarettes, and smelling clean and fresh as benefits to quitting smoking. These support which of the following concepts? A. Perceived barriers B. Decisional balance C. Precontemplation D. Contemplation

B. Decisional balance -In the transtheoretical model, "decisional balance" describes weighing the benefits of a behavior change against the cost of behavior change. Perceived barriers to action are one's beliefs regarding the tangible and psychological costs of an advised action and include perceived unavailability, inconvenience, expense, difficulty, or time regarding health behaviors. In the precontemplation stage of change, the individual has no intention to take an action toward changing a behavior in the next 6 months. In the contemplation stage, the individual has some intention to take action toward behavior change in the next 6 months.

A major limitation of the health belief model is that the burden of action related to health behaviors is exclusively on the aggregate. A. True B. False

B. False -A major limitation of the health belief model is that the burden of responsibility for health behaviors is on the individual client.

Mary is a nursing student doing her senior project in community health. Part of her assignment is to conduct an activity that illustrates "social health" within a group in her community. The most appropriate activity for Mary to organize would be a: A. neighborhood block party. B. food bank in a local church. C. community yard sale. D. school fundraiser for the school band.

B. Food bank in a local church Social health is a positive interaction among groups with an emphasis on health promotion and illness prevention. The correct choice is a food bank in a local church because a food program alleviates problems with hunger and nutrition that affect health. The other options do not relate to health.

Every 10 years, the U.S. Department of Health and Human Services publishes a national prevention initiative titled Healthy People. One of the new objectives for Healthy People 2020 is to: A. achieve access to preventive services of all Americans. B. improve the nation's ability to prevent, prepare for, respond to, and recover from a major health incident. C. reduce health disparities among Americans D. increase independence of older Americans.

B. Improve the nation's ability to prevent, prepare for, respond to, and recover from a major health incident One of the new objectives for Healthy People 2020 focuses on preparedness for major health incidents. Achieving access to preventive services of all Americans and reducing health disparities among Americans were goals of Healthy People 2000, and increasing the independence of older Americans was a goal of the original 1979 Healthy People version.

A community nurse is reviewing health statistics to gain a better understanding of a population's health needs. Crude rates are available for several health occurrences. What statement accurately describes crude rates? A. In calculating a crude rate, the numerator is the size of the population at risk. B. In calculating a crude rate, the average population size may be used as denominator. C. The denominator in a crude rate represents the population at risk for the event. D. Crude rates are used frequently because they avoid bias in interpretation.

B. In calculating a crude rate, the average population size may be used as denominator. -Crude rates are calculated by using the number of events as the numerator. The denominator used may be the average population size or the population size at midyear and not the population at risk. Crude rates are subject to certain biases in interpretation.

A community health nurse is caring for a client who often stares at the floor while the nurse is talking. This client is likely to be of what ethnic group? A. Latin Americans B. Native Americans C. African American D. European

B. Native Americans

According to the ICF (International Classification of Functioning, Disability, and Health), which of the following would be classified as a disability? A. Detached retina B. Need to use a powered wheelchair C. Spinal cord injury D. Amputation

B. Need to use a powered wheelchair -A disability involves any restriction or lack of ability (resulting from an impairment) to perform an activity in a normal manner or within the normal range. Using a powered wheelchair is the only option that fits this description. The other options would be classified as impairments.

In which of the following historical ages would people have had an increased risk for contracting salmonella, anthrax, Q fever, or tuberculosis from the proximity of domesticated animals and herds? A. Hunting and gathering stage B. Settled village stage C. Preindustrial cities stage D. Industrial cities stage

B. Settled village stage During the settled village stage of the Mesolithic period and Neolithic period, people became sedentary, formed villages, and domesticated herds of animals. They lived in close proximity to the animals and contracted diseases such as salmonella, anthrax, Q fever, and so forth because of cross-contamination of water and food supply. In the hunting and gathering stage, groups may have avoided many contagious diseases because the scattered aggregates were small, nomadic, and separated from other aggregates. In the preindustrial stage, large urban centers formed to support the expanding population. In the industrial cities stage, there was an increase in respiratory diseases such as tuberculosis, pneumonia, and bronchitis and in epidemics of infectious diseases such as diphtheria, smallpox, typhoid fever, typhus, measles, malaria, and yellow fever.

A community health nurse explores a group of teenagers' beliefs about the seriousness of eating disorders and their related susceptibility. The nurse is applying principles from which theory? A. Orem's self-care deficit theory B. The health belief model C. Milio's framework D. Critical social theory

B. The health belief model -The health belief model (HBM) offers indicators of the perceived seriousness, perceived susceptibility, and cues to action related to specific health behaviors. Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing interventions required to assist clients to obtain optimal health. Milio's framework for prevention (1976) provides a complement to the HBM and a mechanism for directing attention upstream and examining opportunities for nursing intervention at the population level. Critical social theory uses societal awareness to expose social inequalities that keep people from reaching their full potential.

Infectious diseases continue to result in death in many non-Western world countries because: A. Migratory patterns of people from Western world countries increase the incidence of infections disease in non-Western world countries B. The incidence of infectious disease is higher among low-income aggregates such as those found in non-Western world countries C. Infectious diseases rarely develop when countries adopt Western customs and health promotion D. Western diseases rarely emerge when cultures transition into urban environments

B. The incidence of infectious disease is higher among low-income aggregates such as those found in non-Western world countries -Incidence of infectious disease is higher in non-Western world countries where many people live in poverty and crowded living situations. These communities also tend to have higher populations of non-white people. Infectious diseases typically not seen in the US are found in these populations

Which of the following sources of information about a community's health would give the community health nurse information about births, deaths, and marriages and aid in providing indicators of population growth or reduction? A. Census tracts B. Vital statistics C. National Health Survey data D. Needs assessment

B. Vital statistics -The official registration records of births, deaths, marriages, divorces, and adoptions form the basis of data in vital statistics. When compared with previous years, vital statistics provide indicators of population growth or reduction. Census tracts facilitate the organization of resident information in specific community geographic locales. National Health Survey Data describes health trends in a national sample. A needs assessment is completed by the community health nurse to gain understanding of the community's perspective on health status, the services used or required, and concerns.

Which of the following groups is an example of a community of solution? A group: A. that lives within a specific geographic location. B. concerned with reducing teenage suicides. C. with the same ethnic background. D. in which all members enjoy hiking.

B. concerned with reducing teenage suicides. -A community of solution forms when a common problem unites individuals. The group members may have little in common other than the desire to address the problems that bring them together. A geographic community is a group that lives within a specific geographic location. Other types of communities may be defined by members of the same ethnic background or members that share the same interests, such as hiking.

Nurses can help parents and family members adjust to a child with a disability by: A. withholding some noncritical information about the condition to decrease the impact. B. establishing a partnership between the parent and health care team. C. making decisions on behalf of the child and the family. D. teaching the family to avoid social networks and support groups to refrain from co-dependency.

B. establishing a partnership between the parent and health care team. -Nurses can help the parents and family members adjust to a child with a disability by providing information about the child's condition, providing sources of emotional support from social networks and support groups, empowering and enabling the parent for decision making on behalf of the child, and establishing a partnership between the parent and health care team.

A risk factor refers to a(n): A. probability that a specific event will occur in a given time frame. B. exposure that is associated with a disease. C. systematic way of distinguishing the risks posed by potentially harmful exposures. D. proactive process in which individuals participate in behaviors that enable them to react to actual or potential threats to their health.

B. exposure that is associated with a disease. -A risk factor is an exposure that is associated with incidence of a disease. Risk is the probability that a specific event will occur in a given time frame. A risk assessment is a systematic way of distinguishing the risks posed by potentially harmful exposures. A risk reduction is a proactive process in which individuals participate in behaviors that enable them to react to actual or potential threats to their health.

In a managed care organization, physicians are responsible for the approval or referral of some services. In this position, they are referred to as: A. enforcers. B. gatekeepers. C. carriers. D. distributors.

B. gatekeepers. -Some services may only be accessed on approval or referral from physicians who are called gatekeepers (the primary care providers). The other options do not pertain to the referral or approval of services by a physician.

Receiving immunizations, regular health screenings, and physical exams is an example of: A. health promotion. B. health protection. C. secondary prevention. D. health maintenance.

B. health protection. -Health protection refers to behaviors in which the individual engages with the intent to prevent disease, detect disease in early stages, or maximize health. Immunizations and physical examinations are examples. Green and Kreuter (1991) define health promotion as "any combination of health education and related organizational, economic, and environmental supports for behavior of individuals, groups, or communities conducive to health." Secondary prevention refers to early detection and prompt intervention during the period of early disease pathogenesis, such as checking the skin for signs of skin cancer or identifying and treating individuals who have been exposed to contagious diseases. Health maintenance occurs when the individual has changed overt behavior for more than 6 months and strives to prevent relapse.

Epidemiologic data can be useful in the planning phase of the community assessment process because they: A. help discover the patterns of health and illness distribution in a population. B. help construct benchmarks to gauge achievement of program objectives. C. identify the aggregate at risk. D. explain the nature of the health problem.

B. help construct benchmarks to gauge achievement of program objectives. -Inherent in the planning phase of the nursing process is a plan for the intervention and its evaluation. Epidemiologic data can be useful as a basis for determining success. By comparing baseline data, national and local data, and other relevant indicators, the nurse can construct benchmarks to gauge achievement of program objectives. The other options are useful in the assessment phase of the nursing process.

During the Renaissance period, much was learned about health and disease. The Elizabethan Poor Law was enacted during this time to: A. govern personal and community hygiene such as contagion, disinfection, and sanitation. B. make local parishes responsible for caring for the poor in the community. C. enforce hygienic codes from Leviticus and establish leper houses. D. legislate social reform, addressing issues such as child welfare and factory management.

B. make local parishes responsible for caring for the poor in the community. -Under the Elizabethan Poor Law, parishes established workhouses to employ the poor. Orphaned and indigent children were considered wards of the parish and were often forced to work long hours and live in substandard housing that negatively affected their health. The Minoans created laws that governed personal and community hygiene. In the Middle Ages, the church enforced hygienic codes from Leviticus and established leper houses. Social reform was legislated by the General Board of Health for England in 1848.

According to the health belief model, the inconvenience of driving to a gym to exercise is an example of a: A. perceived susceptibility. B. perceived barrier. C. perceived benefit. D. cue to action.

B. perceived barrier. -Perceived barriers to action are one's beliefs regarding the tangible and psychological costs of an advised action and include perceived unavailability, inconvenience, expense, difficulty, or time regarding health behaviors. Perceived susceptibility is one's belief regarding the chance of getting a given condition. Perceived benefit is one's belief in the ability of an advised action to reduce the health risk or seriousness of a given condition. Cues to action are strategies or conditions in one's environment that activate readiness to take action.

Groups such as professional organizations, nonprofit health care organizations, and corporations that sponsor health care are/is called: A. the public sector. B. the private sector. C. stakeholders. D. field experts.

B. the private sector. -The private sector includes professional organizations, nonprofit organizations, and corporations that deliver, insure, or fund health care services outside direct government control. The public sector is concerned with providing government services. A stakeholder is one who can affect or be affected by the actions of an organization as a whole. An expert is one who has extensive knowledge or skill in a particular field.

While caring for a client from a different culture, the community health nurse must assess the client's health-related beliefs. All of the following questions would be appropriate and would elicit the desired information except: A. "Are there certain foods you eat when you are sick?" B. "When do you know you are sick enough to visit a health care provider?" C. "Is it OK if I speak in English?" D. "What does health mean to you?"

C. "Is it OK if I speak in English?"

In which era were people with mental disabilities labeled as "feebleminded" because they could not reach the minimum educational level? A. Biblical times B. 18th century C. 19th century D. 20th century

C. 19th century -During the 19th century, the Industrial Revolution stimulated a societal need for increased education. Those who could not reach the minimum education level were labeled as "feebleminded." In Biblical times, people with disabilities were often viewed as unclean or sinful. In the 18th and 19th centuries, people saw disability as an irreparable condition caused by supernatural agency. Special interest groups for people with disabilities began to develop in the 20th century.

It has been estimated that individual behaviors and environmental factors are responsible for what percentage of all premature deaths in the United States? A. 20% B. 40% C. 50% D. 70%

C. 50% According to Orleans and Cassidy (2011), 50% of all premature deaths in the United States are a result of individual behaviors and environmental factors. According to Mokdad, Marks, Stroup, and Gerberding (2004), tobacco use leads the list of "actual causes of death" at almost 20% of annual deaths in the United States.

Which of the following is the correct process a bill must take before final approval by the president? A. A bill must succeed through one of the two legislative bodies, the House of Representatives and the Senate, and then be submitted for final approval by the president. B. A bill must go through discussion by the Supreme Court and then be submitted for final approval by the president. C. A bill must succeed through the two legislative bodies, the House of Representatives and the Senate, and then be submitted for final approval by the president. D. A bill must be approved by the House and Senate and then go before a committee before being submitted for final approval by the president.

C. A bill must succeed through the two legislative bodies, the House of Representatives and the Senate, and then be submitted for final approval by the president.

The landmark civil rights legislation that uses the authority of the federal government to guarantee equal opportunities for people with disabilities related to employment, transportation, public accommodations, public services, and telecommunications is the: A. Individuals with Disabilities Education Act (IDEA). B. Ticket to Work and Work Incentives Improvement Act (TWWIIA). C. Americans with Disabilities Act (ADA). D. Civil Rights Act.

C. Americans with Disabilities Act (ADA). -The ADA is landmark civil rights legislation that provides a clear and comprehensive mandate against discrimination toward people with disabilities in everyday activities. The IDEA addresses the educational needs of children with disabilities. The TWWIIA reduced people with disabilities' disincentives to work by increasing access to vocational services and provided new methods for retaining health insurance after returning to work. The Civil Rights Act prohibits discrimination based on race, ethnicity, religion, and sex.

Which of the following is an example of "community health nursing" rather than "community-based nursing"? A. An RN assisting a doctor in a pediatrician's office B. An RN visiting a home-bound patient to monitor for congestive heart failure C. An RN reviewing school clinic records to determine which children are not up to date on their immunizations D. An RN dispensing medications in a nursing home

C. An RN reviewing school clinic records to determine which children are not up to date on their immunizations "Community health nursing" focuses on groups of people, with the primary responsibility being the population as a whole (as with a school). Care typically focuses on health promotion and illness prevention, such as the nurse who reviews school clinic records to determine which children are not up to date on their immunizations. "Community-based nursing" is setting specific and emphasizes care to individuals, often in homes and ambulatory clinics, and typically addresses acute and chronic health conditions. The other options are examples of nurses providing care to individuals.

Which of the following prospective payment methods determined the amount of reimbursement that health care providers would receive for specific illnesses from Medicare? A. Current procedural terminology codes B. Actuarial classifications C. Diagnostic-related groups D. Medigap insurance

C. Diagnostic-related groups -For determination of the prospective amount, Medicare depended on the diagnostic-related groups to calculate the reimbursement. Physician services are coded according to current procedural terminology codes. Actuarial classifications ensured that adequate premiums were charged by private health insurers for the projected health care needs of those enrolled. Medigap insurance is a privately purchased individual or group health insurance plan designed to supplement Medicare coverage.

Which of the following nurse leaders formulated the first theory-based conceptual model for nursing care? A. Nancy Milio B. Lillian Wald C. Florence Nightingale D. Dorthea Orem

C. Florence Nightingale -Most nursing scholars identify Florence Nightingale as the first nurse theorist. Lillian Wald helped establish community health nursing in the United States. Nancy Milio created the framework for prevention theory. Dorthea Orem conceptualized the self-deficit theory.

Which of the following methods of gathering data is most effective for remote and vulnerable segments of a community and for those communities with underdeveloped opinions? A. Interviewing community informants B. Community forum C. Focus groups D. Telephone surveys

C. Focus groups -Focus groups are effective for remote and vulnerable segments of a community and for those with underdeveloped opinions. These sessions can produce greater interaction and expression of ideas than surveys and may provide more insight into an aggregate's opinions. The community health nurse may gather some data by interviewing key informants in the community. Informants may be knowledgeable residents, elected officials, or health care providers. A community forum may be held to discuss selected questions. A telephone survey may be useful for selected questions.

Edwin Chadwick's Report on an Inquiry into the Sanitary Conditions of the Laboring Population of Great Britain greatly contributed to the development of the: A. National Organization for Public Health Nursing. B. American Medical Association. C. General Board of Health for England. D. National Institute.

C. General Board of Health for England. -Chadwick's report was published in 1842 and began a move toward legislation resulting in social reform. The General Board of Health for England was established in 1848 as a result of this social reform. The National Organization for Public Health Nursing was formed as an organization for public health nurses. The American Medical Association was formed as an organization for physicians in the mid-1800s. The National Institute is a scientific organization based in Washington, DC.

A person who acts as a representative for another person or organization before the legislature is called a(n): A. advocate. B. policy maker. C. lobbyist. D. field expert.

C. lobbyist. -A lobbyist is a person, who voluntarily or for a fee, represents him- or herself, or another individual, organization, or entity for the purpose of influencing policy or legislation. An advocate is a person who supports a cause or policy. A policy maker is one who creates policies. An expert is one who has extensive knowledge or skill in a particular field.

Identify the etiologic or causal statement component of the following community diagnosis: "There is an increased risk for undetected testicular cancer among young men related to insufficient knowledge about the disease and the methods for preventing and detecting it at an early stage as demonstrated by high rates of late initiation of treatment." A. Risk for undetected testicular cancer B. Young men C. Insufficient knowledge about the disease and methods of prevention D. High rates of late initiation of treatment

C. Insufficient knowledge about the disease and methods of prevention -The "related to" phrase describes the cause of the health problem and directs the focus of the intervention. "Risk for undetected testicular cancer" is the identified problem. "Young men" is the identified aggregate. "Insufficient knowledge" is the "related to" phrase.

Lemuel Shattuck, a Boston bookseller with an interest in public health, published the 1850 book Report of the Massachusetts Sanitary Commission. Which of the following was NOT a recommendation of the report? A. Keeping a record of vital statistics B. Developing well-infant and well-child care programs C. Introducing modern family planning methods in the United States D. Beginning a system of vaccination and health education

C. Introducing modern family planning methods in the United States -Shattuck recommended major health reform that included keeping vital statistics; providing environmental control; food, drug, and communicable disease control; well-infant, well-child, and school-age child health programs; mental health care; vaccination; and health promotion. His recommendations were not implemented until nearly 19 years later, when a state board of health was formed in Massachusetts. Modern family planning methods were not introduced until the 20th century.

Which of the following statements is NOT true about the "thinking upstream" model of community health nursing practice? A. It is a conceptual model to assist the nurse in community health planning. B. It helps to focus the time, energy, and programmatic resources available to community health nursing clients. C. It focuses the nurse on short-term, individual-based nursing interventions. D. It focuses the nurse on long-term, "bigger picture" issues related to community health practice, such as social justice or power.

C. It focuses the nurse on short-term, individual-based nursing interventions. -The upstream model uses the analogy of a river flowing upstream toward the bigger picture to focus community health nursing practice. This differentiates population-focused and individual-focused nursing interventions. The community health nurse needs to have a "critical eye" for the bigger picture to focus time, energy, and resources and provide quality care.

Which of the following statements is true concerning the Individuals with Disabilities Education Act (IDEA)? A. It is designed to ensure a free, appropriate public education in the most restrictive setting. B. An IEP (Individualized Education Program) for a child is developed solely by the school professionals. C. It provides federal funding through state-administered programs from preschool through secondary education for children with disabilities. D. It removes guidelines that typically result in the termination of Medicaid and Medicare benefits for people with disabilities who return to work.

C. It provides federal funding through state-administered programs from preschool through secondary education for children with disabilities. -This is the only true statement regarding IDEA. IDEA ensures free appropriate public education in the least restrictive setting. The IEP is developed by parents, student, and professionals. The other option concerns the TWWIIA.

In the 1850s, a researcher studied a cholera epidemic among people living in different sections of London. The researcher who used epidemiologic methods to study the epidemic and used rates as an epidemiologic tool was: A. Joseph Lister. B. William Farr. C. John Snow. D. Edward Jenner.

C. John Snow. -John Snow is recognized as the researcher who applied epidemiologic methods in the investigation of a cholera epidemic in London in the 1850s. Joseph Lister is considered the pioneer of antiseptic surgery. William Farr was a 19th century British epidemiologist who is regarded as a founder of medical statistics. Edward Jenner developed the smallpox vaccine.

Currently, the state with the highest rate of adult smoking is: A. Tennessee. B. Indiana. C. Kentucky. D. Ohio.

C. Kentucky.

The belief that health deficits result from an imbalance between the population's health needs and its health-sustaining resources is the premise of which theory? A. Orem's self-care deficit theory B. The health belief model C. Milio's framework D. Critical social theory

C. Milio's framework -Milio's theory demonstrates upstream conceptualization of understanding the community's health needs and resources; this theory complements the health belief model (HBM). The HBM offers indicators of the perceived seriousness, perceived susceptibility, and cues to action related to specific health behaviors. Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing interventions required to assist clients to obtain optimal health. Critical social theory exposes people to inequities to help them reach their full potential.

A man has been smoking for 20 of his 40 years. He smokes a pack of cigarettes daily and states, "My dad smoked two packs a day and lived to be almost 90. Besides, I'm going to die from something anyway, so why quit"? He is in which "stage of change" in the transtheoretical model? A. Contemplation B. Maintenance C. Precontemplation D. Preparation

C. Precontemplation -In the precontemplation stage of change, the individual has no intention to take an action toward changing a behavior in the next 6 months. In the contemplation stage, the individual has some intention to take action toward behavior change in the next 6 months. In the maintenance stage, the individual has changed overt behavior for more than 6 months. In the preparation stage, the individual intends to take action within the next month and has taken steps toward behavior change.

Which of the following entities strives to improve the health of all the public by promoting healthy lifestyles, preventing disease and injury, and protecting the health of communities? A. Managed care organizations (MCOs) B. Medicare C. Public health system D. Affordable Care Act

C. Public Health System The Public health system strives to improve the health of entire populations by promoting healthy lifestyles, preventing disease and injury, and protecting the health of communities. Although MCOs and government financing entities (Medicare and Medicaid) focus on the health of their clients, they do not focus on the community and population in general. The focus of the Affordable Care Act is to mandate health insurance for individuals.

The health literature accessed by the community health nurse often addresses the probability of an adverse event. What term refers to the likelihood that healthy people exposed to a specific factor will experience a specific health condition? A. Prevalence B. Rates C. Risk D. Incidence

C. Risk -The term risk refers to the probability of an adverse event. Prevalence is the number of all cases of a specific disease or condition in a population. Rates are arithmetic expressions that help practitioners consider a count of an event relative to the size of the population from which it is extracted. Incidence describes the occurrence of new cases of a disease or condition in a community over a period of time.

When writing a community diagnosis, the community health nurse notes that the "among" phrase: A. presents a synthesis of all assessment data. B. provides the supporting data. C. specifies the aggregate that will benefit from the nurse's plan. D. describes the cause of the health problem and directs focus of interventions.

C. specifies the aggregate that will benefit from the nurse's plan. -The "among" phrase specifies the aggregate that will be the beneficiary of the nurse's action plan. The identification of the health problem represents a synthesis of all assessment data. The "related to" phrase describes the cause of the health problem and directs the focus of the intervention. The health indicators are the supporting data. The "related to" phrase describes the cause of the health problem and directs the focus of the intervention.

Jennifer is a community health nurse in a large metropolitan area. According to the American Nurses Association's Code of Ethics (2001), community health nurses must align themselves with public health programs that promote and preserve the health of populations by influencing: A. socioeconomic issues. B. psychosocial issues. C. sociocultural issues. D. developmental issues.

C. Sociocultural Issues The Code of Ethics of the American Nurses Association (2001) promotes social reform by focusing on health policy and legislation to positively affect accessibility, quality, and cost of health care. Community health nurses must align themselves with public health programs that promote and preserve the health of populations by influencing sociocultural issues, such as human rights, homelessness, violence, and stigma of illness. Directing care toward socioeconomic issues, psychosocial issues, or developmental issues focuses on individuals, families, or groups, which in turn contributes to the health of the total population.

Which act, established in the 1940s, provided grants to states for the purpose of new construction of health care institutions? A. The McCarren-Ferguson Act B. The Health Amendments Act C. The Hill-Burton Act D. The Tax Equity and Fiscal Responsibility Act

C. The Hill-Burton Act -The Hill-Burton Act of 1946 provided grants to states for the construction of new hospitals, targeting low income and rural areas. The McCarren-Ferguson Act gave states the right to regulate health insurance plans. The Health Amendments Act authorizes funds for registered nurse education in administration, supervision, or teaching. The Tax Equity and Fiscal Responsibility Act established the prospective payment system for Medicare.

When chronic disease became a more important cause of death in developed countries, different epidemiologic models were developed to study the many factors involved in the development of these health conditions. Which of the following is an example of such a model? A. Person-place-time model B. Epidemiologic triangle C. Web of causation D. Wheel model

C. Web of causation -Chronic disease is marked by a complexity of relationships among causal factors. The web of causation model illustrates the interrelationships. The person-place-time model organized epidemiologists' investigations of the disease pattern in the community. The epidemiologic triangle considers the extent of the host's exposure to the agent, the virulence of the agent, and the host's genetic or immunological susceptibility to the agent. The wheel model is an example of a model that stresses the multiplicity of host and environmental interactions.

A 22-year-old college student explains to the nurse at the health clinic that she drinks four to five beers when she goes out with friends on Saturday nights. Otherwise, she rarely drinks during the week because of her classes, studying, and part-time job. This would be considered: A. age- and circumstance-appropriate behavior. B. alcoholism. C. binge drinking. D. excessive drinking.

C. binge drinking. -Binge drinking is defined as drinking five or more drinks on a single occasion for men and four or more for women. Excessive drinking is drinking more than two drinks per day on average for men or more than one drink per day for women. This is considered binge drinking, which is not age- or circumstance-appropriate behavior. Alcoholism is an addiction to alcohol.

A community health nurse is caring for a family that includes the husband, wife, children, and other blood relatives. This type of family is called a(n): A. nuclear family. B. communal family. C. extended family. D. nuclear dyad.

C. extended family.

During World War II, faced with a decrease in the number of workers, employers added a health insurance plan to employee's benefits. These plans were called: A. health maintenance organizations. B. prospective payment plans. C. indemnity plans. D. cafeteria plans.

C. indemnity plans. -During World War II, employers began to add health insurance to employees' benefits rather than increasing the wages. This type of health insurance was called an indemnity plan. A health maintenance organization is a managed care plan that acts as an insurer and sometimes a provider for a fixed prepaid premium. Prospective payment is payment for health care providers based on the disease or injury that is treated. Cafeteria plans are customizable health care plans.

Which of the following would be considered a long-term disabling condition in which the person must learn to incorporate the modifications required for living into daily living and identity? A. A sprained ankle requiring the use of crutches B. A total knee replacement surgery requiring the use of a walker after surgery C. A car accident with a broken arm requiring surgery D. A cardiovascular accident (CVA) with paralysis to the right side of the body

D. A cardiovascular accident (CVA) with paralysis to the right side of the body -Those with a temporary disability have a very different experience from those who are permanently disabled. Although they may experience the frustrations of the disability, they do not fully enter the world of people with disabilities because they know they will soon reenter society as able bodied. In contrast, those who develop a permanent disability (e.g., as in a CVA) must learn to incorporate the modifications required for living into their daily living and identity.

An epidemic is occurring in a public health nurse's community, and the nurse is working with the epidemiologist and other health professionals seeking to identify the causative agent. What phrase best describes such efforts? A. Cohort study B. Descriptive epidemiology C. Point prevalence study D. Analytic epidemiology

D. Analytic epidemiology -Analytic epidemiology may be defined as close examination of identified possible causes of disease using advanced epidemiologic methods. Cohort studies obtain information about the cause of disease by establishing a relationship between the presumed causal factors and the effect. The study of the amount and distribution of disease constitutes descriptive epidemiology. When prevalence rates describe the number of people with the disease at a specific point in time, they are sometimes called point prevalences.

One of the first health insurance companies established in the 1930s to provide health care to subscribers was: A. Aetna Insurance. B. Woodmen of the World. C. Humana Health Maintenance Organization. D. Blue Cross and Blue Shield.

D. Blue Cross and Blue Shield. -During the 1930s, in an effort to provide care and avoid bankruptcy, health care providers began to establish health insurance plans. One of the most recognizable of these is Blue Cross and Blue Shield. The other options were all created later.

The first visiting nurse in the United States was: A. Lillian Wald. B. Mary Brewster. C. Florence Nightingale. D. Francis Root.

D. Francis Root. -Francis Root was an 1877 graduate nurse sent by the Women's Board of the New York City Mission to provide care to sick individuals in their homes. This was considered an innovation in nursing care in the United States and the precursor to modern visiting nurses' associations. Lillian Wald and Mary Brewster established a district nursing service in New York City in 1893. Florence Nightingale began her work in the mid-19th century and is credited with establishing "modern nursing."

Which of the following was NOT a public health service provided by the Romans? A. A supervisor of the public baths B. Street cleaners C. Supervision of the sale of food D. Housing for the indigent population

D. Housing for the indigent population -Public health services provided by the Romans included a water board to maintain the aqueducts, a supervisor of the public baths, street cleaners, and supervision of the sale of food. Housing for the indigent population was not a public service provided by the Romans; in fact, inhabitants of the Roman slums did not share in public health amenities, and their health suffered accordingly.

Almost 13% of residents in the United States were born in other countries. More than half (53.1%) of these individuals were born in: A. Asia. B. Europe. C. Africa. D. Latin America.

D. Latin America.

What is the most common chemical dependence in the United States? A. Alcohol B. Cocaine C. Marijuana D. Nicotine

D. Nicotine -Nicotine addiction is the most common form of chemical dependence in the United States. Smokers who try to quit experience withdrawal symptoms, including anxiety, irritability, and difficulty concentrating. Alcohol use is very common in our society, but it is not the most common form of chemical dependence. Cocaine and marijuana are not the most common forms of chemical dependence in the United States.

Access to health care is determined by the circumstances of the individual that obstruct the means to obtain desired health care. Which of the following is NOT a barrier to access to health care? A. Preexisting conditions B. Nonparticipating physician C. Inability to communicate D. Personal avoidance of a health problem

D. Personal avoidance of a health problem -Any condition that prevents an individual from seeking desired health care presents a barrier. Chosen avoidance is not a barrier.

Which of the following "determinants of health" refers to factors that are experienced with the senses-things that can be seen, touched, heard, and smelled? A. Biology B. Behaviors C. Social environment D. Physical environment

D. Physical environment -The physical environment refers to the things that can be experienced with the senses. The physical environment can affect health negatively or positively. Biology is an individual's genetic makeup, family history, and any physical and mental health problems developed in the course of life. Behaviors are the individual's responses to internal stimuli and external conditions. Social environment includes interactions and relationships with family, friends, coworkers, and others in the community.

A community health nurse is reviewing the results of SIPP (Survey of Income and Program Participation) used by the U.S. Census Bureau to collect disability data. Which of the following will the nurse find classified as an instrumental activity of daily living? A. Seeing B. Walking C. Dressing D. Preparing meals

D. Preparing meals

What discovery by Edward Jenner resulted in one of the greatest medical advances of the 18th century? A. The benefits of isolation in the control of communicable disease such as bubonic plague B. The discovery that cholera was transmissible through contaminated water C. The identification of modern epidemiologic principles, such as agent-host-environment D. The development of the smallpox vaccination that resulted in immunity after inoculation with the cowpox virus

D. The development of the smallpox vaccination that resulted in immunity after inoculation with the cowpox virus -Edward Jenner's observation of a decline in the incidence of smallpox among people who worked with cows lead to his investigation of the connection between cowpox and smallpox and the development of the smallpox vaccination that prevented the disease in humans. At the time, the incidence of smallpox among the general population was 95%, and the death rate was 10%. Isolation and other epidemiologic principles were not recognized as beneficial in controlling communicable disease until modern times. John Snow demonstrated in 1854 that cholera was transmissible through contaminated water.

A major cause for the rise in health care costs is: A. an increase in the specialization of physicians. B. a decrease in nonprofit hospitals. C. a shortage in the number of primary care physicians. D. a demand for complex and advanced services.

D. a demand for complex and advanced services. -The spiraling health care costs have been fueled by the presence of technological advances, society's sense of entitlement to these therapies, a guaranteed payer, and the prevailing medical orientation toward curative measures. The number of physicians or hospitals is not a primary contributor to rising health care costs.

The community health nurse is teaching a prenatal class and includes the societal cost of fetal alcohol syndrome in one of the educational sessions. The nurse is demonstrating an understanding of: A. Orem's self-care deficit theory. B. the health belief model. C. Milio's framework. D. critical theoretical perspective.

D. critical theoretical perspective. -Critical theoretical perspective exposes people to inequities to help them reach their full potential. Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing interventions required to assist clients to obtain optimal health. The health belief model (HBM) evolved from the premise that the world of the perceiver determines action. Milio's framework for prevention (1976) provides a complement to the HBM and a mechanism for directing attention upstream and examining opportunities for nursing intervention at the population level.

A community health nurse in the assessment phase of the nursing process conducted research to identify the distribution pattern of breast cancer within a population and the associated risk factors. This is called: A. statistical analysis. B. needs assessment. C. census collection. D. epidemiology.

D. epidemiology. -Epidemiology involves the analysis of data to discover the patterns of health and illness distribution in a population. It also involves conducting research to explain the nature of health problems and identify aggregates at increased risk. Statistical analysis is a general term for the analysis of data. A needs assessment is completed by the community health nurse to gain understanding of the community's perspective on health status, the services used or required, and concerns. Census information is collected every 10 years by the U.S. Census Bureau to describe the population characteristics of the nation.

A statement of a decision regarding a goal in health care and a plan for achieving that goal is called: A. nursing policy. B. fiscal policy. C. social policy. D. health policy.

D. health policy. -Health policy is a statement of a decision regarding a goal in health care and a plan for achieving that goal. Nursing policy specifies nursing leadership that influences and shapes health policy and nursing practice. Fiscal policy is related to finance. Social policy is policy associated with individuals and communities.

The Health Resources and Services Administration (HRSA) assists nursing workforce development by: A. establishing schools of nursing. B. supporting organizations with a political agenda for health care. C. providing federal funds to promote health care reform. D. providing grants to provide for education and recruitment.

D. providing grants to provide for education and recruitment. -The nursing workforce development programs administered by the HRSA through Title VIII provide federal support for nurses' workforce development. The HRSA does not establish nursing schools but provides federal funding for nursing education at the undergraduate and graduate levels and favors institutions that educate nurses for practice in rural and medically underserved communities. The other options do not assist nursing workforce development.

One of the first steps in community assessment may involve the community health nurse driving or walking through an area and making observations about such things as environmental layout and location of agencies, hospitals, industries, and so forth. This is called a(n): A. census survey. B. needs survey. C. informant survey. D. windshield survey.

D. windshield survey. -Community health nurses often perform a windshield surveys by driving or walking through an area and making organized observations to help gain an understanding of the environmental layout, including geographic features and the location of agencies, services, businesses, and industries and to locate possible areas of environmental concern through sight, sense, and sound. A needs assessment is completed by the community health nurse to gain understanding of the community's perspective on health status, the services used or required, and concerns. Census information is collected every 10 years by the U.S. Census Bureau to describe the population characteristics of the nation. To conduct an informant survey, the community health nurse may gather data by interviewing key informants in the community. Informants may be knowledgeable residents, elected officials, or health care providers.