Public Health Nursing Ch 17
When applying the integrative model for community health promotion, a nurse assesses the neighborhood for accessibility and adequacy of care to provide treatment for medical conditions. What client system does this describe? a. Individual b. Family c. Aggregate d. Community
ANS: D The community focus includes the nurse assessing the community for accessibility and adequacy of care to provide treatment for medical conditions. This is the broadest client system as the nurse is examining the neighborhood. Individual focus is looking at individuals, family focuses on families, and aggregates focuses on populations. DIF: Cognitive level: Applying REF: p. 390 TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care
A PHN collaborates with a physician's clinic to increase the number of infants and toddlers who receive lead screening. According to the integrative model, what client system and focus of care are being addressed? a. Aggregate level health promotion b. Aggregate level illness prevention c. Family level illness care d. Individual level health promotion
ANS: A Each succeeding level of the client system is more complex. In this situation, the PHN is working with an aggregate of infants and toddlers. The focus of care being addressed is health promotion, focusing on positive measures such as education for healthy living and promotion of favorable environmental conditions as well as periodic examinations, including well-child developmental assessment and health education. Illness prevention is linked to the negative view of the absence of disease. Illness care is the care provision of someone with the disease. DIF: Cognitive level: Applying REF: p. 388 & p. 390 (Table 17-1) TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care
A public health nurse (PHN) collaborates with local community leaders to develop a local campaign educating about the importance of wearing a seat belt. Which of the following client systems of the integrative model does this describe? a. Community b. Aggregate c. Family d. Individual
ANS: A Interventions to initiate or maintain healthy lifestyles must be multifocal. At the broadest level of care (community), nurses work with community leaders, other community residents, and health professionals to plan programs to promote optimal health for the community and its people. The community is the environment for the aggregate and is the system being applied. DIF: Cognitive level: Applying REF: p. 388 TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care
A nurse is educating the community about modifiable behaviors. Which of the following is the nurse most likely to discuss? a. Smoking, poor diet, and alcohol consumption b. Cancer, emphysema, and cardiovascular disease c. Age and gender d. Genetic abnormalities
ANS: A Modifiable behaviors remain the major contributors to deaths in the United States. Tobacco use, poor diet, physical inactivity, and alcohol consumption are examples of modifiable behaviors. Cancer, emphysema, cardiovascular disease, gender, age, and genetic abnormalities are not modifiable behaviors. DIF: Cognitive level: Applying REF: p. 378 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
The National Prevention Strategy provides: a. recommendations on what can be done to improve population health. b. assistance in interpreting Healthy People 2020. c. a basis for public health nursing practice. d. health risk appraisal instruments.
ANS: A The National Prevention Strategy offers recommendations on what can be done to improve population health in specified contexts and across goal areas. This document does not assist in interpreting Healthy People 2020, providing a basis for public health nursing practice, or providing health risk appraisal instruments. DIF: Cognitive level: Understanding REF: p. 382 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
A 5-feet, 6-inch, 25-year-old woman who weighs 120 pounds runs 5 miles a day because it improves her mood and energy level. Which of the following best describes this example? a. Health promotion b. Illness prevention c. Health maintenance d. Health protection
ANS: A The woman is exercising to improve and promote her health. Health promotion is directed toward achieving a greater level of health. Illness prevention is a behavior directed toward reducing the threat of illness. Health maintenance focuses on maintaining health. Health protection strategies include environmental measures to improve health and quality of life. DIF: Cognitive level: Applying REF: p. 379 & p. 381 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
A nurse is performing interventions at the individual level of care. Which of the following is the nurse most likely completing? (Select all that apply.) a. Teaching well-balanced nutrition to a mother with a malnourished child b. Providing a parent age-specific information for immunizations c. Assessing the community for other cases of malnutrition d. Assessing other families on the same street for similar problems e. Planning a social marketing campaign about seat belt safety
ANS: A, B Teaching well-balanced nutrition and age-specific information about immunizations are the only interventions that focus on individuals. The other examples relate to families and the community. DIF: Cognitive level: Applying REF: pp. 387-388 & p. 390 (Table 17-1) TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
A nurse is using Anderson and McFarlane's model to complete a community health assessment. Which of the following information about the community would the nurse be collecting? a. Resources available to promote health b. Interactions among subsystems c. Physical environment d. Demographics
ANS: B A community health assessment must include information about the subsystems and interactions of the total community with the systems external to it. This model does not address the resources available to promote health, physical environment, or demographics. DIF: Cognitive level: Analyzing REF: p. 383 TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care
According to Leavell and Clark, primary prevention consists of: a. health promotion and rehabilitation. b. health promotion and specific protection. c. early diagnosis and prompt treatment. d. health maintenance and early diagnosis.
ANS: B Leavell and Clark stated that primary prevention includes health promotion and specific protection from disease. Tertiary prevention addresses rehabilitation and the return of people with chronic illness to maximal ability to function. Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Primary prevention attempts to promote health and provide specific protection from disease. DIF: Cognitive level: Understanding REF: p. 381 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
A nurse provides a screening for school-aged children to screen for hearing deficits. Which of the following is being demonstrated by the nurse? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion
ANS: B Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Primary prevention attempts to promote health and provide specific protection from disease. Tertiary prevention addresses rehabilitation and the return of people with chronic illness to maximal ability to function. Health promotion activities are interventions focused on improving one's health. DIF: Cognitive level: Applying REF: p. 381 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
A nurse is using the HBM when developing health programs in the community. Which of the following is the nurse most likely involved in? a. Conducting group risk appraisal and risk reduction b. Considering the factors that will motivate the participants to change their health behaviors c. Completing a community wellness inventory d. Considering legislative changes that are necessary to improve environmental living conditions and sanitation
ANS: B The HBM can assist with planning programs to increase an individual's motivation to take positive health action. The model contains six components that attempt to determine what motivates an individual to adopt a health behavior. Conducting a group risk appraisal and risk reduction, completing a community wellness inventory, and considering legislative changes do not address an individual's motivation to adopt a health behavior. DIF: Cognitive level: Applying REF: p. 384 TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance
The biomedical model defines health as the: a. avoidance of illness. b. absence of disease. c. promotion of healthy behaviors. d. protection from illness and disease states.
ANS: B The biomedical model defines health as the absence of disease. It does not explain why populations remain healthy or how health is enhanced. DIF: Cognitive level: Remembering REF: p. 381 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
A nurse provides counseling to an obese client about the importance of good nutrition and regular exercise with the intention of helping the client avoid future chronic diseases associated with obesity. What client system and focus of care are being applied in this situation? a. Family level health promotion b. Individual level illness prevention c. Aggregate level illness prevention d. Individual level health promotion
ANS: B The simplest level of the client system is the individual. The focus of care is illness prevention, directed at disease or disability prevention. Health promotion focuses on positive measures of health. The family level and aggregate level both focus on inclusion of more than one person. DIF: Cognitive level: Applying REF: p. 390 TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care
A 5-feet, 6-inch, 25-year-old female who weighs 120 pounds walks 5 miles a day because she has a long family history of early death from heart attacks and is refraining from a sedentary lifestyle. Which of the following best describes this example? a. Health promotion b. Illness prevention c. Health maintenance d. Health protection
ANS: B The woman is exercising to prevent an illness that runs in her family. Illness prevention is a behavior directed toward reducing the threat of illness. Health promotion focuses on positive measures such as education for healthy living and promotion of favorable environmental conditions. Health maintenance focuses on maintaining health. Health protection strategies include environmental measures to improve health and quality of life. DIF: Cognitive level: Applying REF: p. 381 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
Which community-based programs resulted in equally favorable health risk changes for both control and treatment groups? (Select all that apply.) a. Framingham Heart Study b. Stanford Five-City Heart Disease Prevention Program c. North Karelia Study d. Minnesota Heart Health Program e. Dutch Heart Health Community Intervention
ANS: B, C, D, E The Stanford Five-City Heart Disease Prevention Program, North Karelia Study, Minnesota Heart Health Program, and Dutch Heart Health Community Intervention provided beginning scientific evidence for the implementation of community-level risk reduction programs, although the results were modest and often not statistically significant. The Framingham Heart Study identified factors contributing to the development of CHD and high blood pressure. DIF: Cognitive level: Understanding REF: p. 384 TOP: Nursing process: Evaluation MSC: NCLEX: Safe and Effective Care Environment: Management of Care
Which of the following describes one advantage of the Health Belief Model (HBM)? a. It is one of the most recently developed models based on evidence-based practice principles. b. It can reduce the incidence of diseases and disabilities. c. It can assist with planning programs to increase an individual's motivation to take positive health action. d. It promotes individual's participation in community-based screening programs.
ANS: C It can assist with planning programs to increase an individual's motivation to take positive health action. This theory was one of the first theories of health behavior, which began in the 1950s. The model contains six components that attempt to determine what motivates an individual to adopt a health behavior. There is nothing to support that the use of this model will reduce the incidence of diseases and disabilities. It focuses on motivation of changing health behaviors, not participating in screening programs. DIF: Cognitive level: Understanding REF: p. 384 TOP: Nursing process: Evaluation MSC: NCLEX: Health Promotion and Maintenance
A client wears a seat belt whenever riding in an automobile. Which of the following best describes the client's behavior? a. Illness prevention b. Health promotion c. Specific protection d. Health protection
ANS: C Specific protection includes measures to reduce the threat of specific diseases or injury, such as hygiene, immunizations, use of seat belts, and the elimination of workplace hazards. Illness prevention is a behavior directed toward reducing the threat of illness. Health promotion focuses on positive measures such as education for healthy living and promotion of favorable environmental conditions. Health protection strategies include environmental measures to improve health and quality of life. DIF: Cognitive level: Applying REF: p. 381 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
The Framingham Heart Study was successful in: a. providing information on the effectiveness of risk-reduction interventions. b. documenting the relationship between social variables and heart disease. c. identifying factors contributing to the development of coronary heart disease (CHD). d. demonstrating the effects of mass media in modifying high-risk behavior.
ANS: C The Framingham Heart Study identified factors contributing to the development of CHD and high blood pressure. By collecting periodic health assessments and morbidity and mortality data, major risk factors associated with CHD mortality were identified. The investigators used health risk appraisals to relate the risk factors in well individuals to the probability of future cardiovascular disease. This study did not provide information on the effectiveness of risk-reduction interventions, document the relationship between social variables and heart disease, or identify factors contributing to the development of heart disease. DIF: Cognitive level: Understanding REF: pp. 383-384 TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care
A nurse using the integrative model for community health promotion. Which of the following best describes how the nurse would apply the dimension of client system? a. Concentrating on individual health behaviors b. Studying client-centered initiatives c. Providing multidimensional nursing care among various levels of clients d. Focusing on disease-oriented care
ANS: C The client system is multidimensional with nursing and health care targeting the multiple levels of clients. When the individual is the client, the environment includes the family, the broader aggregate, and the community of which the individual is a part. The nurse and health care provider are concerned with how these environments affect the individuals' health. The focus for care is on health promotion, illness prevention, and illness care. DIF: Cognitive level: Applying REF: pp. 387-388 TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care
The health-oriented perspective views: a. health as the absence of disease. b. human lifestyle based on one's prescribed regime. c. humans as complex and interconnected with the environment. d. community education as the role of the registered nurse.
ANS: C The health-oriented perspective includes the view that humans are complex and interconnected with others and the environment. Health behavior within this perspective involves a holistic view of lifestyle and interaction with the environment and not simply compliance with a prescribed regimen. DIF: Cognitive level: Understanding REF: p. 381 TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care
A nurse is utilizing a disease-oriented approach when providing care to a client. Which of the following interventions will the nurse most likely provide? a. Promotion of a greater level of positive health b. Education about common disease processes c. Acute care management of chronic disease d. Education about medication compliance
ANS: D A disease-oriented approach assumes that humans are composed of organ systems and cells; in this instance, health care focuses on identifying what is not working properly with a given system and repairing it. In this context, health behavior begins with patient compliance with health professionals' recommendations. This approach does not promote a greater level of positive health as this would be related to health promotion. This approach does not provide education about common disease processes or acute care management of chronic disease. DIF: Cognitive level: Applying REF: pp. 381-382 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
Which of the following statements is correct? a. Genes, biology, and health behavioral choices account for 75% of population health. b. Medical care accounts for 25% of population health. c. Physical and social environments account for 75% of population health. d. Genes, biology, and health behavioral choices account for 25% of population health.
ANS: D Genes, biology, and health behavioral choices account for 25% of population health and social determinants of health, including medical care; the physical and social environment account for the remaining 75%. DIF: Cognitive level: Understanding REF: p. 380 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
A community is searching for additional funding so that a bike trail can be built in the community. Which of the following best describes this example? a. Health promotion b. Illness prevention c. Specific protection d. Health protection
ANS: D Health protection strategies include environmental measures to improve health and quality of life. Health promotion is directed toward achieving a greater level of health. Illness prevention is a behavior directed toward reducing the threat of illness. Specific protection includes measures to reduce the threat of specific diseases or injury, such as hygiene, immunizations, use of seat belts, and the elimination of workplace hazards. DIF: Cognitive level: Applying REF: p. 379 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
