Community Exam 1 Practice Questions

Which level of prevention is illustrated when a public health nurse offers cholesterol and blood glucose screenings in a community center? a. primary b. tertiary c. secondary d. quaternary

c. secondary Cholesterol and blood glucose screenings are an example of secondary prevention. Primary prevention promotes health and protects against threats to health. Tertiary prevention tries to limit the damaging effects of a health problem. Quaternary is not a level of prevention.

Which is considered a determinant of health? a. height b. beliefs c. attitude d. genetics

d. genetics An example of a determinant of health is genetics, which influences health status across the life cycle. Height, beliefs, and attitude are not determinants of health.

Which factors affect prevalence rates? Select all that apply. a. location b. duration c. incidence d. mortality e. chronicity

b. duration c. incidence Prevalence rates are determined by the duration of the illness and the number of people who experience a condition (incidence). Location, mortality, and chronicity do not affect prevalence, morbidity, or mortality.

Which type of evaluation involves reflecting on each previous stage to determine the plan's strengths and weaknesses? a. process b. product c. predictive d. summative

a. process Process evaluation involves reflecting on each previous stage to determine the plan's strengths and weaknesses. Product evaluation allows one to evaluate both positive and negative aspects of each experience honestly and comprehensively and to evaluate whether the desired outcomes were achieved. Predictive is not a type of evaluation. Summative evaluation is another term for product evaluation and looks at outcomes.

what are the three levels of practice of the intervention wheel? a. educator, family, healer b. community, systems, and individual c. community, nutritionist, and physician d. nursing, family, and interprofessional team

b. community, systems, and individual The Intervention Wheel is a model that encompasses community, systems, and individuals. The three levels of practice of the Intervention Wheel do not include the educator, family, healers, nutritionist, physician, or nursing.

which statement is true regarding community health nursing and community-based nursing? a. all services in community health nursing are direct b. services in community-based nursing are largely indirect c. the primary patient in community health nursing is the community d. the primary patients in community health nursing are individuals and the family unit

c. the primary patient in community health nursing is the community The primary patient in community health nursing is the community. Services in community health nursing can be either direct or indirect, and services in community-based nursing are largely direct. The primary patient in community health nursing is the community, not individuals and families.

During the needs assessment, which type of need reflects the population's wants and preferences? a. relative need b. perceived need c. expressed need d. normative need

b. perceived need The perceived need is expressed by the audience and includes the population's wants and preferences. The relative need is the gap showing health disparities between the advantaged and disadvantaged populations. The expressed need or the need expressed by the behavior is the demand for services and the market behavior of the targeted population. The normative need is the lack, deficit, or inadequacy as determined by expert health professionals.

What best describes the nurse analyzing statistical data to identify the aggregates at increased risk for suicide? a. survey b. epidemiology c. community forum d. needs assessment

b. epidemiology The nurse is participating in epidemiology, which involves conducting research to explain the nature of health problems and identify the aggregates at increased risk. A survey is a general method of collecting information. A community forum is an opportunity to gather data by inviting community members to discuss specific questions. A needs assessment is a series of steps to gather subjective data directly from an aggregate.

During which step of the health planning model should the nurse consider the process, product, appropriateness, and effectiveness of the plan, objectives, and outcomes? a. planning b. evaluation c. assessment d. intervention

b. evaluation During the evaluation step, the nurse considers the process, product, appropriateness, and effectiveness of the plan, objectives, and outcomes of the intervention. During the planning step, the nurse identifies mutual goals and objectives. During the assessment step, the nurse identifies and prioritizes health needs and problems. During the intervention step, the nurse implements at least one level of planned intervention.

The nurse on a college campus is providing a presentation to a group of female students about the importance of annual pelvic examinations and Pap smears. Which type of prevention is the nurse providing this student population? a. primary b. secondary c. tertiary d. quaternary

b. secondary Secondary prevention includes performing self-examinations and undergoing screening for cancers. Primary prevention involves promoting healthy lifestyles to prevent illness. Tertiary prevention includes providing support services for the patient who has a cancer diagnosis to prevent complications. There are only three levels of prevention: primary, secondary, and tertiary.

What will the public health nurse use to measure the effect of interventions on population health? a. intermediate goals b. delegated functions c. community forum minutes d. outcome health status indicators

d. outcome health status indicators The nurse should use meaningful, measurable outcome health status indicators to measure the effect of the interventions on population health. Intermediate goals are useful for behavior change that occurs in very small steps. Delegated functions ensure that necessary action steps take place. Community forum minutes do not offer measurable indicators.

According to the Institute of Medicine (IOM), what is the definition of public health? a. public health is what communities use to determine the medical and clinical needs of the people b. public health is the state of health, wellness, and illness within a certain region and population of people c. public health is the measure of how many people within a community are living without any diseases d. public health is what society does collectively to ensure conditions exist in which people can be healthy

d. public health is what society does collectively to ensure conditions exist in which people can be healthy The IOM defines public health as "what we, as a society, do collectively to assure the conditions in which people can be healthy." According to the National Academies of Medicine, public health is not limited to just the state of health, wellness, and illness, nor is it narrowed down to how many people do not have a disease or the types of medical and clinical needs of a community.

Which services should the new public health nurse review when assessing communication parameters that affect community security? a. police protection b. after-school programs c. rape treatment centers d. radio and television services

d. radio and television services Radio and television services are communication parameters that affect community security. Police departments and rape treatment centers are public services. After-school programs are a part of education.

What dimension of a community describes people who share common characteristics? a. survey b. census c. aggregate d. social system

c. aggregate Many dimensions describe the nature of community. An aggregate is a community composed of people who have common characteristics. A survey is a method of making organized observations. Census tracts subdivide larger communities. A community is a complex social system with various subsystems.

Which interventions by the population health nurse best illustrate primary prevention at the individual level? Select all that apply. a. developing customized smoking cessation materials b. providing bike safety education to the parents of school-age children c. meeting with the community partners to build walking paths in the neighborhood d. conducting handwashing seminars at daycare centers to prevent disease e. using social media to spread awareness about nationally recommended childhood vaccinations

a. developing customized smoking cessation materials b. providing bike safety education to the parents of school-age children The individual level of prevention includes developing customized smoking cessation materials and providing bike safety education to the parents of school-age children because these programs target the behaviors of individual people. Meeting with community partners to build walking paths in the neighborhood and conducting handwashing seminars at daycare centers to prevent disease transmission illustrate the community level because these efforts affect specific populations or communities of people. Using social media to spread awareness about nationally recommended childhood vaccinations is primary prevention at the systems level because it applies to all children in the nation, a larger group than a community.

Which strategies best illustrate primary prevention? Select all that apply. a. immunizing against pneumonia b. teaching healthy nutrition habits c. teaching heart failure management d. coordinating smoking cessation programs e. encouraging exercise to promote a healthy body weight

a. immunizing against pneumonia b. teaching healthy nutrition habits d. coordinating smoking cessation programs e. encouraging exercise to promote a healthy body weight Primary prevention strategies are aimed at preventing the occurrence of disease, as illustrated by immunizing against pneumonia, teaching healthy nutrition habits, coordinating smoking cessation programs, and encouraging exercise to promote a healthy body weight. Teaching heart failure management is a tertiary prevention strategy because it is aimed at limiting disability and rehabilitating from disease.

Which action will the nurse take when using upstream thinking? a. modification of environmental factors b. increasing compliance with treatment c. improving care in the critical care units d. increasing access to prescribed treatment

a. modification of environmental factors The nurse using upstream thinking takes actions that focus on modifying economic, political, and environmental factors that are precursors to poor health. Increased compliance with treatment is not an action associated with upstream thinking. Health care that takes place in critical care units, emergency departments, and other settings that focus on illness care is considered downstream thinking. Increasing access to prescribed treatment is not an action of upstream thinking.

A public health group is preparing a report on age-specific recommendations for prenatal care to reduce infant mortality. Which data will the group use to determine possible outcomes? Select all that apply. a. risk factors b. prevalence rates c. cause and effect d. standardization of rates e. disparities within groups

a. risk factors d. standardization of rates e. disparities within groups When establishing possible outcomes within age-specific group, it is important to include possible risk factors as well as disparities within subgroups. Likewise, the group must be adjusted for bias and differences within each age group when compared with the group as a whole, which would include standardization of rates. Prevalence would not be used, but mortality would. Cause-and-effect relationships could be helpful, but it is difficult to determine in this particular cohort and is typically correlated to chronic disease.

The student nurse is interning at the Henry Street House. The student should anticipate working with programs that address which health factors? Select all that apply. a. social b. genetic c. industry d. economic e. environmental

a. social d. economic e. environmental The Henry Street Settlement adopted the philosophy of meeting the health needs of the population, including the social, economic, and environmental determinants of health. Genetic and industrial needs were not a priority for Lillian Wald and the nurses of the Henry Street Settlement.

The nurse is looking at the multicausal view of obesity in the community. Which factors should the nurse consider in the analysis? Select all that apply. a. stress b. career c. housing d. literacy e. nutrition

a. stress d. literacy e. nutrition Stress levels, literacy rates, and nutrition are all factors in the development of obesity in the community. Increased stress can alter hormone secretion and increase the desire to overeat. Poor literacy means that individuals may not be able to read nutrition labels or understand which foods are healthy to eat and which should be avoided. Understanding and following the general principles of nutrition can also have an effect on weight gain. A person's career or housing situation is unlikely to have a direct effect on obesity.

Which describes the concept of upstream thinking? a. the variable precedes the health problem b. it applies to a broad concept with multiple variables c. it takes a microscopic approach to health assessment d. lack of motivation is the variable that affects health

a. the variable precedes the health problem The concept of upstream thinking emphasizes that specific variables precede or play a role in the development of health problems. A broad concept with multiple variables describes a macroscopic health situation, whereas upstream is a more specific concept. A microscopic approach to a health assessment focuses on an individual and is considered downstream. Upstream thinking is not associated with the concept that a patient's lack of motivation is the variable that affects health.

Which ancient law is reflected when the nurse helps a local church establish a health center to serve the poor members of the community? a. sanitary revolution b. hippocratic treatise c. elizabethan poor law d. berlin public health law

c. elizabethan poor law Elizabethan Poor Law shifted responsibility for providing relief to the poor to the churches; this became the prototype for later laws. The Sanitary Revolution attempted to study public health problems, but it did not specifically address caring for the poor. A treatise by Hippocrates discussed the balance between humans and their environment. Public health laws were submitted to the Berlin Society of Physicians and Surgeons to promote health to its citizens. This did not address caring for the poor.

What is an example of a macroscopic approach to nursing interventions in community health nursing problems? a. screening a patient for a breast cancer tumor marker b. providing care during a home visit for a newborn infant c. improving living conditions in a low-income community d. educating a patient on resources in the community for diabetic care

c. improving living conditions in a low-income community Nursing interventions applied to the community are examples of a macroscopic approach. Improving living conditions in a low-income community is a macroscopic approach. Applying nursing interventions to an individual is a microscopic approach to community health nursing problems. Screening a patient, providing infant care, and educating a patient are microscopic approaches.

Which statement best describes the health condition of nomadic populations? a. rodent infestation increases the transmission of infectious diseases b. there are frequent epidemics because of the spread of populations throughout the world c. contamination of the water supply is a common cause of the spread of waterborne diseases such as cholera d. contagious diseases are rare because these groups tend to be smaller and separated from other communities

d. contagious diseases are rare because these groups tend to be smaller and separated from other communities Nomadic populations are in the Hunting and Gathering Stage. They tend to be small and avoid other groups, minimizing the risk for contagious diseases. Rodent infestations were a major issue in the Preindustrial Cities stage, when people lived close together and had frequent close contact with others. Contamination of the water supply is more common in the Settled Villages stage, when stationary communities had to find ways to manage their waste. Exploration and imperialism spread through the world in the Industrial Cities stage, leading to the introduction and spread of infectious diseases into different populations.

Which intervention would be most effective at increasing the number of children who wear a helmet when riding bicycles in the local community? a. offer a helmet discount program at the local department store b. leave pamphlets in the urgent care and pediatric clinic about bike safety c. provide follow-up care at home after a child is injured while riding a bike d. have a small team of nurses visit the homes of local families to discuss bike safety

d. have a small team of nurses visit the homes of local families to discuss bike safety Having a small team of nurses visit the homes of local families to discuss bike safety with families would likely be the most effective way to increase the rate of helmet use. Depending on the findings of the home visitors, offering a bike helmet discount program may be effective, but the main reason children are failing to wear helmets when riding bicycles may be lack of awareness of the dangers rather than the cost of helmets. Pamphlets do not tend to be an effective way to change health practices in a community. Follow-up care at the home of an injured child may be a benefit to those families specifically but would not help address the behavior or need for change within the community.

Which describes the Intervention Wheel? a. nurse and provider focused b. based on eight assumptions c. made up of four levels of practice d. made up of three distinct elements

d. made up of three distinct elements The Intervention Wheel is population based and has three distinct elements (it is population based, it contains three levels of practice, and it defines 17 public health interventions). It is population based; it is not systems or family based.

The nurse completed an educational session with patients at a community center about type 2 diabetes mellitus prevention. Which action should the nurse perform to evaluate the effectiveness of the session? a. administer questionnaires b. assess blood glucose levels c. perform hemoglobin A1C testing d. provide pamphlets and brochures

a. administer questionnaires Questionnaires would provide immediate feedback to the nurse regarding patient understanding of the information provided. Assessing the blood glucose and hemoglobin A1C levels at this point would not provide information as to how much learning occurred. Pamphlets and brochures provide information, but they do not assess learning.

Which type of factor includes the positive or negative effects of adopting new behavior, including social support? a. enabling b. regulating c. reinforcing d. predisposing

a. enabling Reinforcing factors are the positive or negative effects of adopting new behavior, including social support. Enabling factors are the environment or community of an individual that facilitates or presents obstacles to change. Regulating is not a type of behavior change factor. Predisposing factors are the knowledge, attitudes, behavior, beliefs, and values before intervention that affect willingness to change.

Which is an objective of Healthy People 2020? a. reduce meningococcal infections b. reduce tuberculosis (TB) treatment completion rate c. increase invasive pneumococcal infections d. decrease the proportion of adults with TB who have been tested for HIV

a. reduce meningococcal infections Healthy People 2020 is a list of objectives to improve the health of the U.S. population. One objective included in the list is reducing meningococcal infections. Increasing, rather than decreasing, the proportion of adults with TB who have been tested for HIV, and increasing TB treatment completion rate are also objectives listed in Healthy People 2020. Decreasing, not increasing, invasive pneumococcal infections is also an objective.

What is the best source of information for the nurse who wants to find data on a population's ability to read and understand health information? a. almanac b. school districts c. census documents d. local health department

b. school districts School districts provide information on education relevant to socioeconomic status, access to health care, and the ability to read and understand health information. The almanac provides information on climate relevant to the influence of nature on health problems and access to care. Census documents are the best source of information for the nurse who wants to find data on population size. The local health department provides information on water, sewage, housing, and other environmental factors that may influence health.

Which characteristic reflects an organization in community health nursing practice? a. interdependent collective with common interests, problems, and needs b. large, unorganized group with common interests, problems, and needs c. aggregate of people in a common location with organized social systems d. organized group in a common location with shared governance and goals

d. organized group in a common location with shared governance and goals An organization is an organized group in a common location with shared governance and goals. A group is an interdependent collective with common interests, problems, and needs. A population group is a large, unorganized group with common interests, problems, and needs. A community is an aggregate of people in a common location with organized social systems.

The community health nurse is running a weight-loss group for obese employees at a local factory. Which system level and level of prevention does this address? a. tertiary prevention for the subsystem b. tertiary prevention for the supra-system c. primary prevention for the aggregate system d. secondary prevention for the aggregate system

d. secondary prevention for the aggregate system A weight-loss group for obese employees at a local factory addresses secondary prevention (treatment of disease) for the aggregate system (group of employees). Tertiary prevention aims to reduce long-term damage or disability. The subsystem would be the individuals, not the group. The suprasystem would be a community. Primary prevention would intervene before obesity was diagnosed.

A community nurse wishes to start a home visiting nurse service to look in on students who are frequently kept home from school because of illness. Which benefits should the nurse include in the presentation to local officials? Select all that apply. a. decreased hospitalization b. increased healthcare costs c. increased attendance at schools d. increased specialization of nurses e. decreased satisfaction with the healthcare system

a. decreased hospitalization c. increased attendance at schools Home health visiting would likely decrease hospitalization and increase school attendance because of early intervention by educated nurses. It would also cause decreased, not increased, healthcare costs. Both specialized and general nurses participate in home health care. It would likely increase satisfaction with the healthcare system rather than decrease satisfaction.

In which aspects of health care will the public health nurse directly participate? Select all that apply. a. epidemiology b. research development c. community assessment d. emergency preparedness e. chronic disease management

a. epidemiology c. community assessment d. emergency preparedness The roles of the public health nurse include community assessment, epidemiology, and emergency preparedness. Research and chronic diseases are not identified roles but are matters in which public health nurses may become indirectly engaged.

Which item will the nurse focus on when using a downstream approach for childhood obesity? a. lifestyle changes b. health policy changes c. school lunch program modifications d. healthier choices in vending machines at school

a. lifestyle changes The nurse using a downstream focus on childhood obesity will concentrate on lifestyle changes. Health policy changes, school lunch program modifications, and healthier choices in vending machines at school reflect an upstream focus.

Which factors are associated with "person" in the person-place-time research model? Select all that apply. a. male b. spot map c. non-hispanic d. HIV diagnosis e. beach vacationers f. minimum wage worker

a. male c. non-hispanic d. HIV diagnosis f. minimum wage worker When using the person-place-time model in epidemiology, "person" factors include demographics (age, race, socioeconomic status, etc.), health status (good, poor, etc.), and disease (HIV, autoimmune disorders, etc.). Spot maps are used when investigating trends in location or places. "Beach vacationers" would be a factor used to study trends in time or place. Timing would be used for seasonal studies and place would be important in geographical studies.

Which is the best example of Hygeia intervention for influenza infection in the community? a. promotion of influenza vaccination b. increased availability of antiviral medications c. use of OTC medications to reduce symptoms d. creation of several small flu clinics to reduce stress on the emergency room

a. promotion of influenza vaccination Hygeia promotes prevention, not curation, of the selected disease state. Hygeia for influenza would involve an increase in rate of influenza vaccination to prevent future cases of the flu. Increased availability of antiviral medications, use of over-the-counter medications, and the creation of flu clinics all focus on treating or curing the disease, not preventing it.

The results of epidemiologic studies guide tertiary-level prevention activities resulting in which patient outcomes? Select all that apply. a. reducing mortality b. managing chronic diseases c. limiting debilitating events d. improving the quality of life e. screening for chronic diseases

a. reducing mortality b. managing chronic diseases c. limiting debilitating events d. improving the quality of life Reducing mortality, limiting debilitating events, managing chronic diseases, and improving the quality of life are related to tertiary-level prevention activities that are guided by epidemiological studies. Screening for chronic diseases is related to secondary prevention activities.

A community health nurse is providing dietary instruction for a patient newly diagnosed with hypertension. The patient asks the nurse, "Can I really do this?" Based on the patient's statement, which component of the Health Belief Model does this patient's statement reflect? a. self-efficacy b. cues to action c. perceived barriers d. perceived severity

a. self-efficacy The component of the Health Belief Model the patient's statement reflects is self-efficacy, or one's belief in his or her ability to do something. Cues to action include a patient questioning what might motivate taking action. A patient's question that is representative of a perceived barrier is, "If I do what is suggested, will it be unpleasant or costly?" An example of a statement regarding perceived severity is, "If something does happen to me, will it be a big problem?"

The nurse has identified potential barriers to smoking cessation by the patient. Using the Health Belief Model (HBM), which should the nurse recognize as the motivator for the patient to stop smoking? a. peer pressure b. perceived benefits c. perceived seriousness d. knowledge about the disease

b. perceived benefits The likelihood that the patient will stop smoking is his or her perceived benefit of preventative action minus the barriers to preventative action. Peer pressure is a modifying factor identified in the HBM. Perceived seriousness is identified as an individual perception, not a likelihood of action. Knowledge about the disease is a structural variable that can be modified.

Which statement accurately describes a microscopic approach to community health nursing problems? <p>Which statement accurately describes a microscopic approach to community health nursing problems? a. social or political action may be involved b. environmental precursors of illness are emphasized c. an individual's illness of lifestyle pattern is emphasized d. interfamily and intercommunity themes in health and illness

c. an individual's illness of lifestyle pattern is emphasized A microscopic approach to community health nursing problems emphasizes an individual's illness or lifestyle pattern. A macroscopic approach to community health nursing problems may involve social or political action; emphasize social, economic, and environmental precursors of illness; and examine interfamily and intercommunity themes in health and illness.

The public health nurse is using the epidemiologic triangle model (i.e., agent, host, environment) to identify causation, transmission, and risks related to infectious diseases. Which factor represents the host? a. climate b. bacteria c. diet and exercise d. working conditions

c. diet and exercise Diet and exercise is an example of the host factor of the epidemiologic triad. Climate is an example of environmental factors. Bacteria are an example of an agent factor. Working conditions are environmental.

Which should the nurse apply to interventions in a health planning project? Select all that apply. a. use only existing resources b. implement all planned interventions c. identify goals of the interventions that are measurable d. consider interventions at each system level where appropriate e. select and validate the interventions with the highest probability of success

c. identify goals of the interventions that are measurable d. consider interventions at each system level where appropriate e. select and validate the interventions with the highest probability of success The nurse should identify goals of the interventions that are measurable, consider interventions at each system level where appropriate, and select and validate the intervention(s) with the highest probability of success. Interventions may use existing resources, or they may require the development of new resources. If an intervention was not implemented, the nurse should provide reasons, but he or she does not have to implement all of the interventions.

A nurse is studying prostate cancer rates in the community. Which statistic would be most concerning? a. a prevalence of 942 per 100,000 men b. a mortality rate of 810.7 per 100,000 men c. an increase in incidence proportion from 52.7% to 63.4% d. an increase in incidence rate from 92.6 per 100,000 men last year to 207.8 per 100,000 men this year

d. an increase in incidence rate from 92.6 per 100,000 men last year to 207.8 per 100,000 men this year The increase in the incidence rate is the rate or number of new cases of prostate cancer. In this situation, the incidence more than doubled, which is concerning. The prevalence and mortality rate are isolated statistics and do not indicate trends that might be concerning. The incidence proportion is the risk for developing prostate cancer. The jump from 52.7% to 63.4% is an increase, but it is only an increase in risk, not in actual cases.

Which nursing theories are based on society as a focus of change? Select all that apply. a. adaptation model b. health belief model c. self-care deficit model d. critical social theory perspective e. milo's framework for prevention

d. critical social theory perspective e. milo's framework for prevention The critical social theory perspective and Milo's framework for prevention view society as the focus of change. The adaptation model considers the goal of nursing to be promoting adaptation. The Health Belief Model and Orem's self-care deficit theory are both focused on the individual as the locus of change.

Which statement demonstrates understanding of the Health Belief Model (HBM)? a. it is the health professional's responsibility to reduce health care barriers b. the primary focus of nursing practice is on self-care needs and activities c. the model challenges nursing to examine the root cause of health behaviors d. it promotes behavioral change by altering the patient's perspectives

d. it promotes behavioral change by altering the patient's perspectives The HBM can help promote behavioral change in a patient by altering his or her perspective. This model focuses on the nurse's ability to focus on interventions designed to modify the patient's perception of health. The HBM does not challenge nursing to examine the root causes of health behaviors; it places the burden of action on the patient.

The nurse is caring for a patient after a global outbreak of influenza type A. This is an example of which type of disease outbreak? a. endemic b. infection c. epidemic d. pandemic

d. pandemic A pandemic occurs when a disease affects a large proportion of the population or in the case of a global epidemic, as with seasonal influenza type A. An endemic disease is something that is always present in a given population, such as a cold or pneumonia. An infection is not a type of outbreak; rather, it occurs any time a foreign pathogen takes over the body's defense system. An epidemic occurs when there is an outbreak of a disease that is not always present but can flare up occasionally.

The development and building of bathhouses and sewer systems was first observed in which society? a. ancient rome b. ancient greece c. the renaissance d. prerecorded historic times

a. ancient rome The ancient Romans were the first society to construct aqueducts, bathhouses, and sewer systems to improve access to clean water and dispose of waste appropriately. However, people living in the slums did not have access to such amenities. Ancient Greeks were aware of the importance of exercise, rest, and nutrition, but were not able to construct sewage systems or bathhouses. The Renaissance had such systems in place, but was not the first society to do so. There was no system to manage waste or clean water during prerecorded historic times.

Which reflects an upstream approach that the unit manager can use to address nursing medication errors? a. assess the process of the workflow b. provide individual safety education c. examine the behavior of the nurse d. discuss workplace safety with the staff

a. assess the process of the workflow Assessing the process of the workflow is an upstream focus. An upstream focus allows the nurse manager to examine the system changes that are needed and evaluate the system level factors that may have led to the error or the workplace structure that may have perpetuated the errors. A downstream approach focuses on the individual behavior, attempts to change individual behavior, and provides reeducation to prevent further errors.

Which factors contributed to the reduction of communicable disease mortality in the mid-1900s? Select all that apply. a. improved housing b. nutrition education c. improved sanitation d. reduced infrastructure e. increased job openings f. immunization campaigns

a. improved housing b. nutrition education c. improved sanitation f. immunization campaigns The mid-1900s saw a decrease in communicable disease mortality, in part as a result of immunization campaigns, nutrition education, improved sanitation, and better housing. Increased job openings and reduced infrastructure did not contribute to a decrease in communicable disease mortality.

The nurse is reviewing the macroscopic approach to community health nursing problems. Which factor should the nurse include in the practice? Select all that apply. a. interfamily themes in health b. modification of social barriers c. changing a patient's belief system d. environmental precursors of illness e. examining a family's response to illness

a. interfamily themes in health b. modification of social barriers d. environmental precursors of illness The practice of a macroscopic approach to community health nursing includes interfamily themes in health, modification of social barriers, and environmental precursors of illness. Changing a patient's belief system and examining a family's response to illness are examples of a microscopic nursing approach to community health nursing problems.

A patient asks about tuberculosis while a nurse is administering a tuberculosis test. The nurse explains which scientist discovered the bacteria that causes the disease? a. robert koch b. joseph lister c. louis pasteur d. edwin chadwick

a. robert koch Robert Koch discovered the bacteria that caused both cholera and tuberculosis in 1882. Joseph Lister suggested the concept that there was something small that originated outside the body that would get in and cause a disease. Louis Pasteur first proposed the theory of the existence of germs after experimenting with wine production. Edwin Chadwick called attention to the health disparities disproportionately affecting the poor.

When determining causality, the nurse must establish which criteria? Select all that apply. a. specificity b. biological plausibility c. primary prevention d. strength of association e. dose-exposure relationship f. variability of other correlational studies

a. specificity b. biological plausibility d. strength of association When establishing causality, there are six criteria that should be investigated to establish cause-and-effect relationship: specificity, biological plausibility, strength of association, dose-response relationship, temporally correct relationship, and consistency with other studies. Primary intervention is a goal of epidemiology to reduce or increase disease rates. Dose-response relationship, not dose-exposure, is used to establish causality. Consistency, not variability, is used when establishing causality.

Why is it beneficial to analyze health data by time, place, and person? Select all that apply. a. the epidemiologist can become very familiar with the data b. the epidemiologist can analyze how a disease is transmitted c. the epidemiologist can identify areas that have a high rate of disease d. the epidemiologist can create tables, graphs, and maps for easy communication e. the epidemiologist can identify the extent and pattern of the problem being investigated

a. the epidemiologist can become very familiar with the data c. the epidemiologist can identify areas that have a high rate of disease d. the epidemiologist can create tables, graphs, and maps for easy communication e. the epidemiologist can identify the extent and pattern of the problem being investigated There are several reasons why an epidemiologist investigates a disease by time, place, and person. These reasons include becoming familiar with the data, identifying areas or groups that have a high rate of disease, creating tables and graphs that can communicate data, and learning the extent and pattern of the health problem being investigated. An epidemiologist does not analyze these data to analyze how a disease is transmitted.

Which describes the approach the nurse will take when using critical interactionism to address violence in the workplace? a. integrate a macroscopic approach b. implement the health belief model c. integrate upstream and downstream focus d. implement milo's framework for prevention

c. integrate upstream and downstream focus The nurse using critical interaction to address violence in the workplace allows the use of both the upstream and downstream approaches. A macroscopic approach entails the use of upstream thinking, which is a broad scope that incorporates many variables that precede or play a role in understanding health problems. The Health Belief Model is a downstream approach. Milio's framework for prevention focuses on an upstream approach.

Which statement by the nurse assisting with a community assessment project indicates understanding of identifying key informants for data collection? a. healthcare providers are typically not good key informants because their focus is too narrow b. key informants are people who have high positions within community associations or organizations c. leaders within church congregations are good options when it comes to selecting key informants d. key informants should be people from outside the community because they can give a more objective point of view

c. leaders within church congregations are good options when it comes to selecting key informants Key informants are generally viewed as community leaders and usually have a long history within the community. Leaders within church congregations are often consulted as key informants in community assessment. Healthcare providers can be good key informants, particularly local health department nurses. Key informants do not necessarily have to hold formal positions within the community. Key informants should be members of the community; the nurse's goal is not to obtain objective, outside points of view.

The public health nurse is determining the origin of an outbreak of food poisoning in the community. Which type of incidence rate would the nurse report? a. attack b. mortality c. morbidity d. prevalence

a. attack The public health nurse would determine the attack rate for an outbreak of food poisoning in the community. Mortality is the death rate. Morbidity is the rate for illnesses, but it does not report the incidence of food poisoning. Prevalence is the number of current cases, not new cases, of a disease.

What major feature of a community is defined by the interrelationships of aggregates fulfilling community functions? a. social system b. location in time c. location in space d. personal characteristics

a. social system A social system is defined by the interrelationships of aggregates fulfilling community functions. Location in time and space is defined by the physical location frequently delineated by boundaries and influenced by the passage of time. Personal characteristics are a defining feature of aggregates.

The community health nurse is working with men in recovery from substance abuse who are transitioning from group to independent living. Which element is the system? a. the group of men b. the individual men c. the men's healthcare teams d. the group living organization

a. the group of men In this example, the group of men is the system. The individual men are the subsystem. The healthcare providers and/or group living organization make up the suprasystem.

The nurse is discussing the use of microscopic and macroscopic approaches for health promotion with a colleague. Which statement made by the nurse reflects a microscopic approach? <p>The nurse is discussing the use of microscopic and macroscopic approaches for health promotion with a colleague. Which statement made by the nurse reflects a microscopic approach? a. I will work to identify the barriers of care in the community b. I will be assessing the family's response to the patient's illness c. I am going to assess the pattern of illness in the patient's family d. I am politically focused on the sanitation problem in the neighborhood

b. I will be assessing the family's response to the patient's illness The statement made by the nurse that reflects a microscopic approach is "I will be assessing the family's response to the patient's illness." A microscopic approach is focused on the individual and sometimes family responses to health and illness. Identifying barriers in a community is a macroscopic approach. Assessing the pattern of illness in a patient's family is a macroscopic approach. A political approach to an issue is a macroscopic approach.

Which are core functions of public health? Select all that apply. a. research b. assurance c. counseling d. assessment e. social marketing f. policy development

b. assurance d. assessment f. policy development The core functions of public health are assurance, assessment, and policy development. Research, counseling, social marketing, and policy development are important functions of public health, but they are not defined as core functions.

What is the best source of information for the nurse who wants to find data on how topography influences the health of a population? a. almanac b. school districts c. chamber of commerce d. employment commission

c. chamber of commerce The chamber of commerce provides information on how topography influences the health of a population. The almanac provides information on climate relevant to the influence of nature on health problems and access to care. School districts provide information on education relevant to socioeconomic status, access to health care, and the ability to read and understand health information. The employment commission provides information on how industry and manufacturing may influence health.

Which is the primary goal of the Healthy People 2020 program? a. improve fitness level of older adults b. improve access to preventative services c. increase the quality and years of healthy life d. decrease chronic health conditions in U.S. population

c. increase the quality and years of healthy life The primary goal of the Healthy People 2020 program is to increase the quality and years of healthy life. Improving the fitness level of older adults is not the primary goal of the Healthy People 2020 program. Improving access to preventative services is only a small focus of the Healthy People 2020 program, not the primary goal. The Healthy People 2020 program has an objective for older adults in managing their chronic health conditions.

During which time period were public health practices were first observed? a. the renaissance b. the classical period c. prerecorded history d. the 19th century

c. prerecorded history Public health practices were observed even during prerecorded history. Elements of medicine, isolation, and fumigation were used to manage disease and protect the community long before modern medicine. During classical times, hygiene and health preservation were important priorities for several populations. During the Renaissance, scientists described microscopic organisms, though they weren't explicitly linked with disease or infection. Many modern public health principals were developed during the 19th century.

Which tool is best for the nurse to collect needs assessment data to determine gaps in service? a. windshield survey b. small sample survey c. review of official data d. large-scale community assessment

d. large-scale community assessment The strategy chosen for collecting needs assessment data depends on the size and nature of the aggregate, the purpose for collecting information, and the resources available to the nurse. A large-scale community needs assessment can help the nurse determine gaps in service. A windshield survey is not the best choice for gathering subjective data from an aggregate. The nurse may survey a small sample of patients to measure their satisfaction with a program. A review of official data will not yield information about gaps in service.

The nurse is providing Hygeia-based home care for a refugee family new to the area. Which interventions will the nurse use? Select all that apply. a. reviewing nutritional food choices b. treating an ear infection with antibiotics c. discussing the importance of regular hygiene d. educating on the use and benefits of vaccinations e. recommending an antidiarrheal agent for ongoing diarrhea

a. reviewing nutritional food choices c. discussing the importance of regular hygiene d. educating on the use and benefits of vaccinations Hygeia focuses on health promotion as opposed to treating health problems. Reviewing nutritional food choices, discussing the importance of regular hygiene, and educating on the use of vaccinations are all examples of health promotion activities, or Hygeia. Treating an ear infection or providing an antidiarrheal agent are examples of treating a medical condition.

The nurse is sharing information with a group of colleagues about the critical theoretical perspective. Which statement should the nurse include? a. the main determinant of health is lack of available resources b. societal awareness should be used to expose social inequalities c. government and institutional policies set the range of health options d. national level policy is the most favorable way to affect societal health status

b. societal awareness should be used to expose social inequalities The critical theoretical perspective focuses on the use of societal awareness to expose social inequities. Identifying the main determinant of health associated with a lack of available resources, recognizing that government and institution policies set the range of health options, and the national level's policy on the effect on societal health status are all reflective of Milio's framework for prevention.

Which example reflects a microscopic approach to assessing community health nursing problems? a. assessing a community for cases of hepatitis b. assessing interfamily incidence of breast cancer c. examining a neighborhood fr causes of parasite infections d. examining a patient's response to a diagnosis of congestive heart failure

d. examining a patient's response to a diagnosis of congestive heart failure A microscopic approach to assessing community health nursing problems focuses on the individual patient. Examining a patient's response to a diagnosis of congestive heart failure is a microscopic approach. Assessing the community, assessing interfamily incidence of A microscopic approach to assessing community health nursing problems focuses on the individual patient. Examining a patient's response to a diagnosis of congestive heart failure is a microscopic approach. Assessing the community, assessing interfamily incidence of disease, and examining a neighborhood are macroscopic examples. disease, and examining a neighborhood are macroscopic examples.

While conducting a windshield survey, what questions should the nurse consider to assess attitudes toward health and health care? Select all that apply. a. are there any noticeable hospitals b. are there identifiable subgroups c. what are the sanitary conditions of the housing d. is there evidence of folk medicine practice e. are there observable efforts to improve the neighborhood health

d. is there evidence of folk medicine practice e. are there observable efforts to improve the neighborhood health When conducting a windshield survey to get information about attitudes toward health and health care, the nurse should take note of any evidence of folk medicine practice and any efforts to improve the neighborhood's health. Hospitals provide information about health resources. Identifiable subgroups provide information about social functioning. The sanitary condition of housing provides information about environmental conditions related to health.

What is tertiary prevention? a. detecting health problems in the early stages b. providing palliative care to promote comfort c. promoting health and protecting against threats d. limiting further negative effects from a health problem

d. limiting further negative effects from a health problem Tertiary prevention is limiting further negative effects from a health problem. Secondary prevention is detecting health problems in their early stages. Primary prevention is promoting health and protecting against any threats. Providing palliative care is not a level of prevention.

What is the best source of information for the nurse who wants to find data on how transportation affects access to services? a. library b. almanac c. school districts d. local bus and train services

d. local bus and train services Local bus and train services provide data on access to services. The library is the best source of information for the nurse who wants to find data on how local newspapers reflect the concerns and needs of a population. The almanac provides information on climate relevant to the influence of nature on health problems and access to care. School districts provide information on education relevant to socioeconomic status, access to health care, and the ability to read and understand health information.

While conducting a windshield survey, what questions should the nurse consider to assess social and economic conditions? Select all that apply. a. are there any noticeable hospitals b. are there any seasonal workers present c. what is the sanitary condition of the housing d. is there evidence of folk medicine practice e. is there any observable interest in political campaigns or issues

b. are there any seasonal workers present e. is there any observable interest in political campaigns or issues When conducting a windshield survey to get information about social and economic conditions, the nurse should take note of any seasonal workers and any interest in political campaigns or issues. Hospitals provide information about health resources. Sanitary condition of housing provides information about environmental conditions related to health. Evidence of folk medicine practice provides information about attitudes toward health and health care.

The community health nurse is working with men in recovery from substance abuse who are transitioning from group to independent living. Which element is the subsystem? <p>The community health nurse is working with men in recovery from substance abuse who are transitioning from group to independent living. Which element is the subsystem? a. the group of men b. the individual men c. the men's healthcare teams d. the group living organization

b. the individual men In this example, the individual men are the subsystem. The group of men is the system. The healthcare providers and/or group living organization make up the suprasystem.

Which interventions on the Intervention Wheel are applicable at all three levels of practice? Select all that apply. a. outreach b. case finding c. surveillance d. coalition building e. community organizing

a. outreach c. surveillance Surveillance and outreach are examples of interventions that can be applied at all three levels. All interventions of the Intervention Wheel are applicable at all three levels of practice except for case finding, coalition building, and community organizing.

Which components are included in a community diagnosis? Select all that apply. a. an etiological or causal statement b. evidence supporting the diagnosis c. the affected aggregate or community d. identification of the health problem or risk e. possible interventions for the health problem or risk f. the community's perception of the health problem or risk

a. an etiological or causal statement b. evidence supporting the diagnosis c. the affected aggregate or community d. identification of the health problem or risk A community diagnosis has four components: an etiological statement evidence that supports the diagnosis the affected aggregate and identification of the health problem or risk. Possible interventions are discussed after making the diagnosis. The community's perception of the health problem or risk is useful in prioritization of diagnoses.

During which step of the health planning model should the nurse identify mutual goals and objectives? a. planning b. evaluation c. assessment d. intervention

a. planning During the planning step, the nurse identifies mutual goals and objectives. During the evaluation step, the nurse considers the process, product, appropriateness, and effectiveness of the plan, objectives, and outcomes of the intervention. During the assessment step, the nurse identifies and prioritizes health needs and problems. During the intervention step, the nurse implements at least one level of planned intervention.

What focus can a community health nurse take to move beyond the direct care of individuals and families? a. population focus b. geographical focus c. primary prevention d. community subpopulation

a. population focus The community health nurse can take a population-focused approach to move beyond direct care to individuals and families. This approach is concerned with many distinct and overlapping community subpopulations, with the end goal of promoting healthy communities. Geographical focus refers to a physical area, not a population. Primary prevention is the prevention of problems before they occur and is included in the three levels of prevention. Focusing on community subpopulations is considered part of a population focus.

What level of prevention is reflected by administering flu vaccines to older adults in a senior center? a. primary b. tertiary c. secondary d. quaternary

a. primary Administering flu vaccines is an example of primary prevention. Primary prevention promotes health and protects against threats to health. Tertiary prevention tries to limit the damaging effects of a health problem. Secondary prevention detects and treats health problems in early stages. Quaternary is not a level of prevention.

During the needs assessment, which type of need reflects the gap showing health disparities between the advantaged and disadvantaged populations? a. relative need b. perceived need c. expressed need d. normative need

a. relative need The relative need is the gap showing health disparities between the advantaged and disadvantaged populations. The perceived need is expressed by the audience and includes the population's wants and preferences. The expressed need or the need expressed by the behavior is the demand for services and the market behavior of the targeted population. The normative need is the lack, deficit, or inadequacy as determined by expert health professionals.

Which public health elements does the Intervention Wheel identify and define? Select all that apply. a. surgery b. outreach c. advocacy d. consultation e. collaboration f. delegated functions

b. outreach c. advocacy d. consultation e. collaboration f. delegated functions The Intervention Wheel identifies and defines 17 public health elements, including consultation, delegated functions, collaboration, advocacy, and outreach. Surgery is not included in the public health elements.

The nurse understands that individuals who share risk factors for the same disease may have unique needs that constitute a form of community. Which term encompasses these risk factors that help delineate a community? a. nurse factors b. people factors c. disease factors d. treatment factors

b. people factors Many human factors help delineate a community. Health-related traits, or risk factors, are one aspect of "people factors" to be considered. People who have impaired health or a shared predisposition to disease may join together in a group, or community, to learn from and support each other. Even when these individuals are not organized, the nurse may recognize that their unique needs constitute a form of community, or aggregate. Nurse factors, disease factors, and treatment factors are not terms describing these risk factors.

Which public health intervention is the nurse using when identifying individuals with unrecognized health risk factors or asymptomatic disease conditions? a. outreach b. screening c. surveillance d. case finding

b. screening Screening is defined as Identifying individuals with unrecognized health risk factors or asymptomatic disease conditions. Outreach is locating populations of interest or populations at risk and provides information about the nature of the concern, what can be done about it, and how services can be obtained. Surveillance is describing and monitoring health events through ongoing and systematic collection, analysis, and interpretation of health data for the purpose of planning, implementing, and evaluating public health interventions. Case finding is locating individuals and families with identified risk factors and connecting them with resources.

The nurse is planning to perform a windshield survey of a community to determine the socioeconomic conditions. Which information will the nurse obtain? Select all that apply. a. presence of tourists b. age range of residents c. viable transportation d. condition of buildings e. gangs present on streets

c. viable transportation d. condition of buildings e. gangs present on streets Indications of the socioeconomic conditions in a community include viable transportation for residents, the condition of the buildings in the community, and the presence of gangs of men or women hanging out along the streets. Community vitality includes the presence of tourists and the age of the people living in the community.

Which population-focused strategies do public health nurses primarily use to practice health promotion and prevention for specific groups of people? Select all that apply. a. emphasizing all levels of prevention b. focusing only on primary prevention c. assessing the population's health status d. considering broad determinants of health e. providing direct care only to individuals and families

a. emphasizing all levels of prevention c. assessing the population's health status d. considering broad determinants of health The population-based strategies of public health nurses emphasize all levels of prevention (not just primary), are based on the assessment of the population's health status, consider the broad determinants of health, and focus on the entire population (not just individuals and families).

The nurse conducting the assessment step of a health planning project should include which characteristics of the aggregate? Select all that apply. a. health status b. family history c. suprasystem influences d. supersytem influences e. sociodemographics characteristics

a. health status c. suprasystem influences e. sociodemographics characteristics During the assessment step, the nurse conducting a health planning project should include health status, suprasystem influences, and sociodemographic characteristics of the aggregate. Family history and supersystem characteristics are not included.

which topics will the public health nurse recognize as leading health indicators identified in Healthy People 2020? select all a. oral health b. vaccine promotion c. injury and violence d. environmental quality e. reproductive and sexual health

a. oral health c. injury and violence d. environmental quality e. reproductive and sexual health The community health nurse should know that leading health indicator topics identified in Healthy People 2020 include oral health, injury and violence, environmental quality, and reproductive and sexual health. Vaccine promotion is not a leading health indicator topic of Healthy People 2020.

A nurse is developing an educational program for individuals with uncontrolled diabetes and either stage 2 or stage 3 renal disease. The goal of the program is to slow or prevent the progression of renal disease. What type of intervention does this program describe? a. primary prevention b. tertiary prevention c. secondary prevention d. Quaternary prevention

b. tertiary prevention This program reflects tertiary prevention, which aims to keep health problems from getting worse and to reduce the effects of disease or injury. Secondary prevention calls for early diagnosis and treatment to reduce the duration and severity of disease or dysfunction. In this case, the uncontrolled diabetes has likely been long-standing (not early diagnosis) because renal disease is noted. Primary prevention involves health promotion and activities that protect the patient from illness or dysfunction. Quaternary prevention includes actions taken to identify a patient at risk for overmedicalization.

How does the public health nurse establish a relationship at the systems level? a. the nurse develops relationships with patients that foster trust b. the nurse initiates a relationship with the state health department c. the nurse establishes relationships with families in the community d. the nurse creates a relationship with local organizations that support the community

b. the nurse initiates a relationship with the state health department The public health nursing process works on systems, community, and individual/family levels. To establish relationships at the systems level, the nurse will initiate a relationship with the state health department. Establishing relationships with local partners represents the community level. Establishing relationships with patients and families represents the individual level.

Which is the best source of data for the nurse researching information about morbidity and mortality trends? a. census b. vital statistics c. windshield survey d. shoe leather epidemiology

b. vital statistics The official registration records of births, deaths, marriages, divorces, and adoptions form the basis of data in vital statistics. In addition to supplying information about the number of births and deaths, registration certificates record the causes of death, which is useful in determining morbidity and mortality trends. The census provides population information for specific geographic locations. Windshield surveys and shoe leather epidemiology involve the nurse gathering observable information.

The public health nurse is working with an HIV+ patient who reports difficulty with affording medications and housing needs. Which parameters should the nurse assess in the community for available resources? Select all that apply. a. education b. recreation c. communication d. politics and government e. health and social services

c. communication d. politics and government e. health and social services The nurse can access government and politics to find resources to meet the patient's needs, such as through Medicaid, Medicare, housing, and food stamp programs. Health and social services would be accessed to meet this patient's medical needs. Education and recreation resources do not meet the patient's current health and housing needs.

While conducting a windshield survey, what questions should the nurse consider to assess environmental conditions related to health? Select all that apply. a. are there any noticeable houses b. are there family planning services c. what is the sanitary condition of the housing d. is there evidence of folk medicine practice e. is there handicapped access to buildings, sidewalks, and streets

c. what is the sanitary condition of the housing e. is there handicapped access to buildings, sidewalks, and streets When conducting a windshield survey to get information about environmental conditions related to health, the nurse should take note of the sanitary condition of housing and handicapped access to buildings, sidewalks, and streets. Hospitals and family planning services provide information about health resources. Evidence of folk medicine practice provides information about attitudes toward health and health care.

How will the community health nurse address poor attendance at a series of workshops to teach carbohydrate counting to patients with diabetes? a. cancel the workshops b. find a way to make workshops mandatory c. reschedule the workshops for a different time d. ask potential participants why they haven't attended

d. ask potential participants why they haven't attended Although implementation should follow the initial plan, the nurse should prepare for unexpected problems. If the nurse is unable to complete the intervention, the reasons for its failure should be analyzed. The nurse shouldn't cancel the workshops without first attempting to improve attendance. Making workshops mandatory is likely to be unfeasible. The nurse shouldn't reschedule the workshops unless it has been determined that this will improve attendance.

What is the best source of information for the nurse who wants to find data on how the manufacturing industry affects the health of workers? a. almanac b. school districts c. census documents d. employment commission

d. employment commission The employment commission provides information on how industry and manufacturing may influence health. The almanac provides information on climate relevant to the influence of nature on health problems and access to care. School districts provide information on education relevant to socioeconomic status, access to health care, and the ability to read and understand health information. Census documents are the best source of information for the nurse who wants to find data on population size.

What is the best source of data for the nurse seeking information on emerging health problems in the United States? a. census b. vital statistics c. community forum d. national health interview survey

d. national health interview survey The best source of data on emerging health problems in the United States is the National Health Interview Survey, compiled by the National Center for Health Statistics (NCHS). The NCHS publishes reports on the prevalence of disability, illness, and other health-related variables. Specifically, the Behavioral Risk Factor Surveillance System is the world's largest telephone survey of U.S. citizens' health behaviors and risk factors. It tracks trends by nation, state, and year, with the goal of identifying emerging health problems. The census provides population information for specific geographic locations. The official registration records of births, deaths, marriages, divorces, and adoptions form the basis of data in vital statistics. Community forums gather opinions about specific questions directly from community members.

Which format is most appropriate for the community health nurse to provide sex education to a group of adolescents? a. lectures b. written material c. one-on-one interviews d. small-group discussions

d. small-group discussions Adolescents receiving sex education are likely to be most receptive to material delivered in small-group discussions. They usually do not enjoy or engage in lectures. Written material may be ignored. One-on-one interviews about sex may be awkward and overly personal for adolescents.

What is an aggregate? a. a community of people with common characteristics b. a set of data collected about a community of patients c. a selection of people of the same gender in a particular age range d. a group of nurses and other providers engaged in research together

a. a community of people with common characteristics An aggregate is a community of people with common characteristics. It is not a set of data. A selection of people of the same gender and/or in a particular age range is an example of an aggregate, but an aggregate can be based on many other characteristics. A research team is not an example of an aggregate.

What is the best source of information for the nurse who wants to find data on climate's influence on the health of a population? a. almanac b. school districts c. census documents d. local health department

a. almanac The almanac provides information on climate relevant to the influence of nature on health problems and access to care. School districts provide information on education relevant to socioeconomic status, access to health care, and the ability to read and understand health information. Census documents are the best source of information for the nurse who wants to find data on population size. The local health department provides information on water, sewage, housing, and other environmental factors that may influence health.

While conducting a windshield survey, what questions will help the nurse get information about health resources? Select all that apply. a. are there any noticeable hospitals b. are there any family planning services c. what is the sanitary condition of the housing d. is there evidence of folk medicine practice e. is there observation of any interest in political campaigns or issues

a. are there any noticeable hospitals b. are there any family planning services When conducting a windshield survey to get information about health resources, the nurse should take note of hospitals and family planning services. Sanitary condition of housing provides information about environmental conditions related to health. Evidence of folk medicine practice provides information about attitudes toward health and health care. Interest in political campaigns or issues provides information about social and economic issues.

How does Healthy People 2020 aim to combat infectious diseases? Select all that apply. a. by increasing the proportion of sexually active persons who use condoms b. by increasing hepatitis B vaccine coverage among high-risk populations c. by increasing the number of courses of antibiotics prescribed for common colds d. by increasing sustained domestic transmission of primary and secondary syphilis e. by increasing the percentage of children who are vaccinated against seasonal influenza

a. by increasing the proportion of sexually active persons who use condoms b. by increasing hepatitis B vaccine coverage among high-risk populations e. by increasing the percentage of children who are vaccinated against seasonal influenza Healthy People 2020 aims to combat communicable and infectious diseases by increasing hepatitis B vaccine coverage among high-risk populations, increasing the proportion of sexually active persons who use condoms, and increasing the percentage of children who are vaccinated against seasonal influenza. Healthy People 2020 aims to decrease, not increase, the number of courses of antibiotics that are prescribed for common colds. Healthy People 2020 aims to decrease, not increase, sustained domestic transmission of primary and secondary syphilis.

Which occurrences would lead the public health nurse to assess the attack rate of an infection? Select all that apply. a. tuberculosis b. foodborne illnesses c. catheter-associated illnesses d. sexually transmitted infections e. community-acquired pneumonia

a. tuberculosis b. foodborne illnesses d. sexually transmitted infections The public health nurse would examine occurrences in the community to assess the attack rate of an infection. Common occurrences include tuberculosis, foodborne illnesses, and sexually transmitted infections. Catheter-associated infections are nosocomial and investigated by the hospital infection control staff. Community-acquired pneumonia is not a public health concern unless it is isolated to a specific causative organism.

Which model of epidemiology helps researchers understand how multiple causes contribute to disease and complex chronic conditions? a. wheel model b. web of causation c. person-place-time d. epidemiology triangle

a. wheel model The wheel model represents the human-environment interaction and is useful in investigating multiple causations including social, biological, and physical components of chronic conditions. The web-of-causation model illustrates the complexity of relationships among causal variables, including risk factors. The person-place-time model investigates who is affected by disease, where there is prevalence of disease, and when disease occurs. The epidemiology triangle investigates the triad of agent, host, and environment and does not take into account the social components of disease.

Which legislation requires all citizens to be covered by one or a combination of insurance programs? a. hill-burton act b. affordable care act c. national health planning and resources development act d. comprehensive health planning and public health services amendments

b. affordable care act The Affordable Care Act is a national health insurance program that requires all citizens to be covered by one or a combination of insurance programs. The Hill-Burton Act addresses the need for better hospital access. The National Health Planning and Resources Development Act combined the strengths of the Hill-Burton Act, regional medical programs, and the comprehensive health planning program to forge a new system of single-state and area-wide health planning agencies. The Comprehensive Health Planning and Public Health Services Amendments combined with the Partnership for Health Amendments of 1967 to create the Partnership for Health Program, which provided federal grants to states to establish and administer a local agency program to enact local comprehensive healthcare planning.

While conducting a windshield survey, what questions should the nurse consider to assess social functioning? Select all that apply. a. are there any noticeable hospitals b. are there identifiable subgroups c. what is the sanitary condition of the housing d. are there observable families in the neighborhoods e. is there handicapped access to buildings, sidewalks, and streets

b. are there identifiable subgroups d. are there observable families in the neighborhoods When conducting a windshield survey to get information about social functioning, the nurse should take note of any identifiable subgroups and the presence of families in the neighborhoods. Hospitals provide information about health resources. The sanitary condition of housing and handicapped access to buildings, sidewalks, and streets provide information about environmental conditions related to health.

Which resource would be the most helpful to the community nurse in researching the size, demographic characteristics, trends, migration, and density of a newly assigned population of care? a. almanac b. chamber of commerce c. employment commission d. local and state health departments

b. chamber of commerce The local chamber of commerce is the most helpful place to gather information about a location's size, demographic characteristics, trends, migration, and population density. An almanac is useful for learning about geography and industry. The employment commission is a source of information about industry. Local and state health departments are helpful for determining information about the environment and modes of communication, health professional organizations, and community services.

Which theories are based on the individual as a locus of change? Select all that apply. a. adaptation model b. health belief model c. self-care deficit model d. milo's framework for prevention e. critical social theory perspective

b. health belief model c. self-care deficit model The Health Belief Model and Orem's self-care deficit theory are both focused on the individual as the locus of change. The adaptation model considers the goal of nursing to be promoting adaptation. The critical social theory perspective and Milo's framework for prevention view society as the focus of change.

A nurse is asked to develop a quality improvement project that correlates to an objective of Mental Health Status Improvement of Healthy People 2020. Which project topics would be appropriate? select all a. researching the effect of integrative medicine on anxiety b. improving support for patients struggling with eating disorders c. reducing post-discharge suicide rates among individuals with severe mental illness d. fostering partnership between a hospital and a local school to develop programming for children with autism e. decreasing the number of re-admissions within 30 days for patients experiencing major depressive episodes

b. improving support for patients struggling with eating disorders c. reducing post-discharge suicide rates among individuals with severe mental illness e. decreasing the number of re-admissions within 30 days for patients experiencing major depressive episodes The objectives of Healthy People 2020 are aimed at eating disorders, suicide, adolescent suicide attempts, and major depressive episodes. Developing a support program for patients struggling with eating disorders, reducing post-discharge suicide rates among individuals with severe mental illness, and decreasing the number of readmissions within 30 days for patients experiencing major depressive episodes would be appropriate goals of a quality improvement project that correlates with the objectives of Healthy People 2020. Neither anxiety nor autism are specifically named in the objectives for mental health status improvement in Healthy People 2020.

Which description reflects a community in community health nursing practice? a. interdependent collective with common interests, problems, and needs b. large, unorganized group with common interests, problems, and needs c. aggregate of people in a common location with organized social systems d. organized group in a common location with shared governance and goals

c. aggregate of people in a common location with organized social systems A community is an aggregate of people in a common location with organized social systems. A group is an interdependent collective with common interests, problems, and needs. A population group is a large, unorganized group with common interests, problems, and needs. An organization is an organized group in a common location with shared governance and goals.

How is the Intervention Wheel used? a. as a source of research evidence that guides nursing practice b. as a means of providing evidence to support nursing interventions c. as a framework for community and public health nursing practices d. as a systemic analysis of the types of services patients need the most

c. as a framework for community and public health nursing practices The Intervention Wheel is used as a framework for community and public health nursing practices. It is not used as a means of providing evidence to support nursing interventions, as a systemic analysis of the types of services patients need the most, or as a source of research evidence that guides nursing practice.

Living conditions are an example of which type of determinant? a. health services b. individual behavior c. social environment d. physical environment

d. physical environment Physical environment determinants include living conditions, crowding, and pollution. Health services determinants include access to quality health care and insurance coverage. Individual behavior includes alcohol use, drug use, unprotected sex, smoking, and activity level. Discrimination, income, and gender are examples of social environment determinants.

What will the nurse do after identifying an aggregate's health needs? a. validate al interventions b. identify general objectives c. provide reasons why certain interventions will not be implemented d. select one health problem or need and then identify the ultimate goal of intervention

d. select one health problem or need and then identify the ultimate goal of intervention After identifying an aggregate's health needs, the nurse should select one health problem or need and then identify the ultimate goal of intervention. The nurse should select and validate only the intervention(s) with the highest probability of success. Measurable, not general, objectives should be identified. The nurse should provide reasons once interventions were not implemented.

What is Healthy People 2020? a. categories of disease b. a list of potential bioterrorism agents c. centers for disease control and prevention data d. a list of objectives to improve health in the unites states

d. a list of objectives to improve health in the unites states Healthy People 2020 is a list of objectives to improve health in the United States. Healthy People 2020 is a list of objectives to improve health, not a list of disease categories. A list of potential bioterrorism agents would be categorized and provided in a report from the Centers for Disease Control and Prevention (CDC). The CDC did not organize the Healthy People 2020 initiative.

Which action by the community health nurse reflects tertiary prevention for a group of school-age children? a. administering vaccinations b. screening for behavioral disorders c. delivering general healthy diet education d. explaining proper management techniques for type 1 diabetes

d. explaining proper management techniques for type 1 diabetes Explaining proper management techniques for type I diabetes is a tertiary prevention intervention to prevent irreversible damage and/or rehabilitate and restore an optimal level of functioning. Administering vaccinations is a primary prevention intervention to protect the patient from illness or dysfunction. Screening for behavioral disorders is secondary prevention to provide early diagnosis and treatment to reduce the duration and severity of disease or dysfunction. Delivering general healthy diet education is a primary prevention intervention.

Which subdivisions of larger communities are used for data collection and population assessment but may not be apparent to their residents? a. census tracts b. neighborhoods c. voting precincts d. geopolitical boundaries

a. census tracts Census tracts subdivide larger communities. The U.S. Census Bureau uses them for data collection and population assessment. Although residents may not be aware of their census tract's boundaries, census tract data help define and describe neighborhood communities. Residents are more likely to be aware of demarcations of neighborhoods, voting precincts, and geopolitical boundaries.

Which examples are outcome status indicators that can measure the effect of interventions on population health? Select all that apply. a. child regularly attends school b. well-child check-ups are up to date c. child boards the bus on time 3 days in a row d. child scores within the limits on developmental tests e. child's parents calls to make an appointment for a well-child check-up

a. child regularly attends school b. well-child check-ups are up to date d. child scores within the limits on developmental tests Examples of outcome status indicators include that the child regularly attends school, well-child check-ups are up to date, and the child falls within limits on developmental tests. The child boarding the bus on time 3 days in a row and the parent calling to make a well-child check-up appointment are examples of intermediate goals.

Which activity would help the nurse gain understanding of the environmental layout and geographic features of the community? a. conduct a windshield survey b. review most recent census data c. schedule key informant interviews with local leaders d. obtain demographic and epidemiologic data for the community

a. conduct a windshield survey Windshield surveys best help the nurse gain an understanding of the environmental layout and geographic features of a community. Census data will not provide information concerning the environmental layout and geographic features. Key informant interviews can provide information about various aspects of a community but may be biased. Demographic and epidemiological data would not provide this information.

The community health nurse wants to offer services to a grief support group. Which is the appropriate way for the nurse to gain access to the group? a. contact a group leader to set up an initial meeting b. contact a group leader to pitch an intervention plan c. attend a meeting and share a personal story of grief d. make informal introductions to members after a meeting

a. contact a group leader to set up an initial meeting The nurse should contact a group leader to set up an initial meeting. Pitching an intervention plan before even meeting with any of the group leaders or members excludes them from the planning process and may overlook their needs. Attending a meeting and sharing a personal story of grief or making informal introductions to members after a meeting are not professional ways to make an introduction.

As the nurse is researching morbidity and mortality, what statistics would be included under the mortality rate? Select all that apply. a. crude death rates b. paternal death rates c. age-specific death rates d. motor vehicle death rates e. infant and maternal death rates

a. crude death rates c. age-specific death rates e. infant and maternal death rates The mortality rate includes the crude death rate (rate of death within the general population), age-specific death rates, and infant and maternal death rates. Paternal death rates and motor vehicle death rates are not part of the mortality rates.

Which intervention by the community health nurse reflects primary prevention for a group of school-age children? a. delivery healthy diet education b. screening for behavioral disorders c. providing home delivery of medications d. explaining proper management techniques for type 1 diabetes

a. delivery healthy diet education Delivering general healthy diet education is a primary prevention intervention to protect the patient from illness or dysfunction. Screening for behavioral disorders is secondary prevention to provide early diagnosis and treatment to reduce the duration and severity of disease or dysfunction. Providing home delivery of medications and explaining proper management techniques for type I diabetes are tertiary prevention interventions to prevent irreversible damage and/or rehabilitate and restore an optimal level of functioning.

Which statements reflect the Intervention Wheel? select all a. each level of practice contributes to improving the health of the population b. some elements of the intervention wheel are more important than others c. one major public health intervention is defined with multiple levels of practice d. the model is based only on surveillance, disease investigation, outreach, and screenings

a. each level of practice contributes to improving the health of the population d. the model is based only on surveillance, disease investigation, outreach, and screenings Each intervention and level of practice of the Intervention Wheel contributes to improving population health. Three levels of practice—community, systems, and individual/family—are reflected in the Intervention Wheel. The Intervention Wheel defines 17 public health interventions and multiple levels of practice. The model is based on other concepts in addition to surveillance, disease investigation, outreach, and screenings. All elements of the wheel are of equal importance.

Which interventions are examples of upstream interventions? Select all that apply. a. establishing a healthy food bank b. increasing taxes on tobacco products c. providing education about the importance of handwashing d. planning the diet of a patient newly diagnosed with diabetes e. providing emergency care to a patient experiencing myocardial infarction

a. establishing a healthy food bank b. increasing taxes on tobacco products c. providing education about the importance of handwashing Upstream interventions use environmental, political, and economic factors to alter health. For instance, a healthy food bank improves nutrition for low-income families, increasing tobacco taxes discourages smoking, and providing education about handwashing helps prevent the spread of disease. Downstream interventions are short term and focus on individuals, such as planning a menu for a patient with diabetes and treating a patient experiencing a myocardial infarction.

Which theory specifically uses a microscopic approach to community health problems? a. health belief model b. critical interactionism c. critical social theory perspective d. milo's framework for prevention

a. health belief model The Health Belief Model specifically uses a microscopic approach to community health problems. Critical interactionism brings two theories together using an upstream and downstream approach. Critical society theory perspective and Milio's framework for prevention are macroscopic approaches to community health problems.

Which legislation addresses the need for better hospital access? a. hill-burton act b. affordable care act c. national health planning and resources development act d. comprehensive health planning and public health services amendments

a. hill-burton act The Hill-Burton Act addresses the need for better hospital access. The Affordable Care Act is a national health insurance program that requires all citizens to be covered by one or a combination of insurance programs. The National Health Planning and Resources Development Act combined the strengths of the Hill-Burton Act, regional medical programs, and the comprehensive health planning program to forge a new system of single-state and area-wide health planning agencies. The Comprehensive Health Planning and Public Health Services Amendments combined with the Partnership for Health Amendments of 1967 to create the Partnership for Health Program, which provided federal grants to states to establish and administer a local agency program to enact local comprehensive healthcare planning.

According to the epidemiological triangle, what factors interact to support the transmission of disease? Select all that apply. a. host b. agent c. immunity d. environment e. genetic makeup

a. host b. agent d. environment According to the epidemiological triangle, interactions between host, agent, and environment are responsible for the transmission of a pathogen. The wheel model looks at the multiple host and environmental interactions and includes immunity and the genetic makeup of the host.

What will the nurse focus on when using a downstream focus to address workplace violence? a. implementing programs to reduce violence b. changing policies that deal with work place violence c. targeting departments for which violence has occurred d. assessing organizational factors that promote workplace violence

a. implementing programs to reduce violence A downstream focus to change workplace violence includes implementing workplace programs to reduce violence. An upstream focus includes changing polices that deal with workplace violence, targeting departments for which violence has occurred, and assessing organization factors that promote workplace violence.

Which description reflects a group in community health nursing practice? a. interdependent collective with common interests, problems, and needs b. large, unorganized group with common interests, problems, and needs c. aggregate of people in a common location with organized social systems d. organized group in a common location with shared governance and goals

a. interdependent collective with common interests, problems, and needs A group is an interdependent collective with common interests, problems, and needs. A population group is a large, unorganized group with common interests, problems, and needs. A community is an aggregate of people in a common location with organized social systems. An organization is an organized group in a common location with shared governance and goals.

which statements are true of the Intervention Wheel? select all a. it is population based b. it has three levels of practice c. it is systems and family based d. it is dissected into levels of practice e. it identifies 15 public health interventions

a. it is population based b. it has three levels of practice d. it is dissected into levels of practice The Intervention Wheel is population based and has three levels of practice. It also is dissected into levels of practice. The Intervention Wheel identifies 17, not 15, public health interventions. It is population based; it is not systems or family based.

What is the best source of information for the nurse who wants to find data on how local newspapers reflect the concerns and needs of a population? a. library b. almanac c. school districts d. chamber of commerce

a. library The library is the best source of information for the nurse who wants to find data on how local newspapers reflect the concerns and needs of a population. The almanac provides information on climate relevant to the influence of nature on health problems and access to care. School districts provide information on education relevant to socioeconomic status, access to health care, and the ability to read and understand health information. The chamber of commerce provides information on how topography influences the health of a population.

What does the windshield survey help the nurse to assess? Select all that apply. a. locations of hospitals and clinics b. the availability of public trash receptacles c. the most common ethnicity or race in the community d. the most common health risk factors in the community e. parental concerns about children's education opportunities

a. locations of hospitals and clinics b. the availability of public trash receptacles c. the most common ethnicity or race in the community During a windshield survey, the nurse drives or walks through an area to make organized observations about the community. This is a way to form initial impressions of the community including environmental layout and indicators of social, environmental, and health conditions and resources. During such a survey, the nurse can gain understanding of elements such as locations of hospitals and clinics, availability of trash receptacles, and an impression of the most common ethnicity or race in the area. The most common health risk factors and parental concerns can be determined from more in-depth forms of data collection.

which services reflect the leading health indicators identified by Healthy People 2020 as major public health concerns? select all a. prenatal care b. cancer research c. genetic therapy d. city bus service e. gun violence prevention f. routine dental cleaning

a. prenatal care d. city bus service e. gun violence prevention f. routine dental cleaning Gun violence prevention reflects the leading health indicator of injury and violence. City bus service directly reflects the health indicator of access to health services. Prenatal care is imperative to the health indicator of maternal, infant, and child health. Routine dental cleaning reflects the indicator of oral health. Although cancer research and genetic therapy are important, they are not reflected in the 12 leading health indicator topics; rather, they address chronic illness and treatment.

The nurse is working on prioritizing health issues identified by the community assessment and has categorized health determinants of primary, secondary, and tertiary prevention from the assessment data. Which categorization is correct? a. primary prevention interventions will include educating children and young adults about making healthy food choices b. secondary prevention interventions will include monthly support groups for community members with chronic diseases c. secondary prevention interventions will include seeking legislation to require the use of bicycle helmets on all roadways d. primary prevention interventions will include modifying work expectations so that people who are injured can return to their jobs sooner

a. primary prevention interventions will include educating children and young adults about making healthy food choices Primary prevention includes strategies to lower occurrences of disease or injury by reducing risk factors. An example is educating children and young adults about making healthy food choices. Modifying work expectations is an example of secondary prevention, which involves identifying and controlling disease processes in early stages. Legislation requiring the use of bicycle helmets is an example of primary prevention. Monthly support groups for community members with chronic diseases are tertiary prevention, which offers strategies for preventing disability and helping people achieve optimal level of functioning after disease or injury is established.

The nurse using a downstream approach to address obesity will take which action? a. providing bariatric surgical nursing care b. participating in community food coalitions c. actively participating in health policy changes d. targeting corporations that profit from obesity

a. providing bariatric surgical nursing care The nurse providing bariatric nursing care is taking a downstream approach to addressing obesity. Participating in community food coalitions, actively participating in health policy changes, and targeting corporations that profit from obesity are examples of an upstream approach.

In which situation is the public health nurse assisting people in the community with primary prevention? a. providing free measles immunizations to children b. screening a group of people who have per-hypertension c. treating patients in the community who have active tuberculosis d. giving out healthy snacks and exercise plans to people who are obese

a. providing free measles immunizations to children Primary prevention promotes health and protects people against threats to health. Vaccinations and immunizations are primary prevention strategies. Treating patients in the community who have active tuberculosis is an example of tertiary prevention because the people already have the disease. Screening people who have pre-hypertension is an example of secondary prevention because the risk is already there, but actions may be taken to prevent hypertension. Giving out healthy snacks and exercise plans to people who are obese is an example of tertiary prevention because the problem (obesity) has already been identified and confirmed.

the intervention wheel bases its framework on which assumptions? select all a. public health nursing practice focuses on populations b. public health nursing practice emphasizes disease prevention c. public health nursing practice considers the determinants of health d. public health nursing practice emphasizes pharmacologic treatment e. public health nursing practice uses the nursing process at certain levels of practice

a. public health nursing practice focuses on populations b. public health nursing practice emphasizes disease prevention c. public health nursing practice considers the determinants of health The Intervention Wheel is based on 10 assumptions, including that public health nursing practice focuses on populations, that it emphasizes disease prevention, and that it considers the determinants of health. The Intervention Wheel does not assume that public health nursing practice emphasizes pharmacologic treatment or that it uses the nursing process at certain levels of practice. Rather, it uses the process at all levels of practice.

Which primary prevention measure should the community health nurse recommend to a new client with a family history of diabetes and heart disease? Select all that apply. a. regular exercise b. pharmacotherapy c. routine physical examinations d. healthy diet and nutrition e. screening for hypertension

a. regular exercise d. healthy diet and nutrition Primary prevention measures include preventative and maintenance activities that promote health, such as daily exercise and proper nutritional intake. Secondary prevention measures include screening and physical examinations to monitor health and aid in early diagnosis and interventions to provide early treatment and cure of disease. Tertiary prevention focuses on limitation of disability and the rehabilitation of patients with irreversible diseases, such as diabetes and spinal cord injury.

The nurse is attempting to understand the views of local health services by studying a small rural population group that rarely interacts with the healthcare system. Which strategy should the nurse use to obtain the most useful information? a. schedule several focus groups with group members b. hold a community forum and invite group members c. conduct key informant interviews with local leaders d. review most recent community health needs assessment

a. schedule several focus groups with group members Focus groups can be very effective at gathering community views for vulnerable or remote populations. Community forums are generally open to all populations and would not necessarily enhance the ability to obtain the viewpoint of the remote population. Key informant interviews are generally conducted with knowledgeable residents, leaders, and so on; these may not provide information reflective of the entire population. Community health needs assessments are conducted by nonprofit hospitals to support coordination with public health agencies; these would not provide the most useful information for this small rural population.

Which intervention by the community health nurse reflects secondary prevention for a group of school-age children? a. screening for behavioral disorders b. providing home delivery of medications c. delivering general healthy diet education d. explaining proper management techniques for type 1 diabetes

a. screening for behavioral disorders Screening for behavioral disorders is secondary prevention to provide early diagnosis and treatment to reduce the duration and severity of disease or dysfunction. Providing home delivery of medications is a tertiary prevention intervention. Delivering general healthy diet education is a primary prevention intervention to protect the client from illness or dysfunction. Explaining proper management techniques for type I diabetes is a tertiary prevention intervention to prevent irreversible damage and/or rehabilitate and restore an optimal level of functioning.

Which levels of practice are included in the Public Health Intervention Wheel? Select all that apply. a. systems b. community c. surveillance d. individual/family e. population-based

a. systems b. community d. individual/family The Intervention Wheel contains three important elements: It is population based, contains three levels of practice (community, systems, and individual/family), and identifies and defines 17 public health interventions. All of the intervention wheel activities are population based, but this is not a level of public health nursing practice. Surveillance is 1 of the 17 public health nursing interventions but is not a specific level of practice.

Which information would the nurse need to determine the incidence rate of measles in a community? Select all that apply. a. time frame b. number of deaths per year c. number of cases of measles d. number of susceptible people e. total number of people in the community

a. time frame c. number of cases of measles d. number of susceptible people The nurse would need to determine the time frame to study and the number of cases of measles. The nurse would need to determine the number of susceptible people because those who have been immunized would not be included. Incidence rates do not include mortality, or deaths. The total number of people is not used to determine incidence; only the number of susceptible people is used.

Which are rationales for the public health nurse to research epidemiologic rates in an area? Select all that apply. a. to track health records over time b. to develop contacts within the community c. to determine the extent of a health problem d. to obtain the number of people in a community e. to compare information among demographics and locations

a. to track health records over time c. to determine the extent of a health problem e. to compare information among demographics and locations The public health nurse researches epidemiological rates in an area to track health trends, determine the extent of health problems, and compare information among different areas and people. The nurse uses contact within the community to obtain information. A census, not epidemiological rates, would provide information about the number of people in a community.

Which strategies best illustrate secondary prevention interventions? Select all that apply. a. treatment of dental caries b. surgical removal of cancerous tumors c. providing influenza vaccines to prevent illness d. blood pressure screenings to detect heart disease e. guaiac testing to check for hidden gastrointestinal disorders

a. treatment of dental caries b. surgical removal of cancerous tumors d. blood pressure screenings to detect heart disease e. guaiac testing to check for hidden gastrointestinal disorders The treatment of dental caries, surgical removal of cancerous tumors, blood pressure screenings to detect heart disease, and guaiac testing to check for hidden gastrointestinal disorders all illustrate secondary prevention because they focus on the early detection or treatment of a disease. Providing influenza vaccines best illustrates primary prevention.

Which description of a population group in community health nursing practice is accurate? a. interdependent collective with common interests, problems, and needs b. large, unorganized group with common interests, problems, and needs c. aggregate of people in a common location with organized social systems d. organized group in a common location with shared governance and goals

b. large, unorganized group with common interests, problems, and needs A population group is a large, unorganized group with common interests, problems, and needs. A group is an interdependent collective with common interests, problems, and needs. A community is an aggregate of people in a common location with organized social systems. An organization is an organized group in a common location with shared governance and goals.

While conducting a windshield survey, what questions should the nurse consider to get information about community vitality? Select all that apply. a. are there any noticeable hospitals b. what is the sanitary condition of the housing c. are tourists or visitors to the community present d. is there evidence of folk medicine practice e. what is the age range of people living in the community

c. are tourists or visitors to the community present e. what is the age range of people living in the community When conducting a windshield survey to get information about community vitality, the nurse should take note of tourists or visitors to the community and the age range of people living in the community. Hospitals provide information about health resources. Sanitary condition of housing provides information about environmental conditions related to health. Evidence of folk medicine practice provides information about attitudes toward health and health care.

The nurse is assessing census data and identifies a district with a high number of older adults. What nursing action should occur next based on this analysis? a. host a monthly meeting offering mental health support for older adults b. conduct fundraising efforts to build a geriatric clinic within that district c. assess the availability of health resources for the older adult population in that location d. advocate for dispersing the older adult population throughout other districts to improve diversity

c. assess the availability of health resources for the older adult population in that location After assessing census data and identifying a district with a high number of older adults, the nurse's most appropriate next action is to assess the availability of health resources for the older adult population in that location. This assessment should take place before implementing a plan for building a geriatric clinic or hosting a monthly meeting offering mental health support, as these needs may already be met. Advocating to disperse the older adult population to improve diversity is unlikely to serve the needs of the population.

During which step of the health planning model should the nurse identify and prioritize health needs and problems? a. planning b. evaluation c. assessment d. intervention

c. assessment During the assessment step, the nurse identifies and prioritizes health needs and problems. During the planning step, the nurse identifies mutual goals and objectives. During the evaluation step, the nurse considers the process, product, appropriateness, and effectiveness of the plan, objectives, and outcomes of the intervention. During the intervention step, the nurse implements at least one level of planned intervention.

How does public health nursing incorporate the nursing process when identifying populations of interest at the community level? a. by identifying the health issues or problems b. by identifying the systems that require change c. by identifying the population at risk for the problem d. by identifying new patients who are at risk for a problem

c. by identifying the population at risk for the problem Identifying populations of interest at the community level is done by identifying the population at risk for the problem. Identifying the health issues or problems is part of assessing the community. Identifying the systems that require change is how the nursing process is used at the systems level. Identifying new patients at risk for a problem is how the nursing process is used at the individual level.

What is the best source of information for the nurse who wants to find data on population size? a. almanac b. school districts c. census documents d. local health department

c. census documents Census documents are the best source of information for the nurse who wants to find data on population size. The almanac provides information on climate relevant to the influence of nature on health problems and access to care. School districts provide information relevant to what influences socioeconomic status, access to health care, and the ability to read and understand health information. The local health department provides information on water, sewage, housing, and other environmental factors that may influence health.

Which examples reflect goals to measure behavior change? Select all that apply. a. child regularly attends school b. well-child check-ups are up to date c. child boards the bus 3 days in a row d. child scores within the limits on developmental tests e. child's parent calls to make an appointment for a well-child check-up

c. child boards the bus 3 days in a row e. child's parent calls to make an appointment for a well-child check-up The child boarding the bus on time 3 days in a row and the parent calling to make a well-child check-up appointment are examples of intermediate goals. Examples of outcome status indicators include that the child regularly attends school, well-child check-ups are up to date, and child scores within limits on developmental tests.

What term best describes a group of diverse parents working to prevent teenage suicide? a. aggregate b. social system c. community of solution d. geographic community

c. community of solution A community of solution may form when a common problem unites individuals. Although people may have little else in common with each other, their desire to redress a problem, such as teenage suicide, brings them together. An aggregate is a community composed of people who have common characteristics. A community is a complex social system with various subsystems. A geographic community can encompass more or less formalized areas that may be marked by official geopolitical boundaries, a geographic landmark, a particular building style, etc.

Which is an overarching goal of Healthy People 2020? Select all that apply a. measure the impact of prevention activities b. encourage collaborations across communities and sectors c. create social and physical environments that promote good health for all d. achieve health equity, eliminate disparities, and improve the health of all age groups e. promote quality of life, health development, and health behavior across all life stages f. attain high-quality, longer lives free of preventable disease, disability, injury, and premature death

c. create social and physical environments that promote good health for all d. achieve health equity, eliminate disparities, and improve the health of all age groups e. promote quality of life, health development, and health behavior across all life stages f. attain high-quality, longer lives free of preventable disease, disability, injury, and premature death The four overarching goals of Healthy People 2020 are (1) to create social and physical environments that promote good health for all; (2) achieve health equity, eliminate disparities, and improve the health of all age groups; (3) promote quality of life, health development, and health behavior across all life stages; and (4) attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. Measuring the impact of prevention activities and encouraging collaborations across communities and sectors are ways that Healthy People establishes benchmarks and monitors progress, but are not overarching goals.

The nurse's analysis of vital statistics or census data can reveal small groups of people with special needs who may be overlooked by the "Rule of Utility." What term describes these groups? a. hidden gems b. greatest good c. hidden pockets d. greatest number

c. hidden pockets Whereas most public health practitioners are attuned to the leading indicators or dominant trends in data, vital statistics or census data can suggest the existence of small hidden pockets, not hidden gems, of people with special needs. Some may view a focus on such a minority segment as insignificant and in conflict with the Rule of Utility, which posits "the greatest good for the greatest number." However, community health nursing practice combines principles of beneficence and social justice with utilitarianism, and thus, small vulnerable segments of the community are considered legitimate clients of community health nursing.

The nurse is teaching about historical influences on public health. Which statement by a student indicates the need for further education? a. clergymen often acted as doctors during the middle ages b. housing, diet, hygiene, and sleep were important to people during the middle ages c. people knew early on that rodents were transmitting the plague but did not know how to prevent it d. monasteries helped implement and enforce measures to protect the public health of the community

c. people knew early on that rodents were transmitting the plague but did not know how to prevent it For many centuries, people were unsure of the cause and transmission of the bubonic plague. They were not aware that it was the fleas on the rats that were carrying the bacteria that caused the plague. Clergymen did act as physicians and care for the royalty and nobleman of the time. In addition, monasteries helped promote activities to improve public health such as cleaning streets, disposing of refuse, and building wells. Medieval writings were found with information about basic hygiene, housing, diet, and sleep.

What describes driving or walking through an area and making organized observations to collect data? a. fact finding b. vital statistics c. windshield survey d. shoe leather epidemiology

c. windshield survey Community health nurses often perform a community windshield survey by driving or walking through an area and making organized observations. Fact finding is a general term for gathering information. The nurse can gain an understanding of the environmental layout, including geographic features and the location of agencies, services, businesses, and industries, and can locate possible areas of environmental concern through "sight, sense, and sound." The windshield survey offers the nurse an opportunity to observe people and their role in the community. Vital statistics are based on the official registration records of births, deaths, marriages, divorces, and adoptions. The nurse can establish certain hunches or hypotheses about the community's health, strengths, and potential health problems by walking through the area and observing it, called shoe leather epidemiology.

A community health nurse is driving through an area and notes that many people appear to be under the influence of alcohol or drugs, sees many dilapidated houses, and notices many mental health clinics and mostly fast-food restaurants. What type of research is the nurse conducting? a. focus group b. needs assessment c. windshield survey d. community-based intervention

c. windshield survey Community health nurses sometimes perform community windshield surveys by driving or walking through an area and making organized observations. A focus group can be effective in gathering community views, particularly for remote and vulnerable segments of a community and for those with underdeveloped opinions. A needs assessment requires data collected directly from an aggregate. The first step of a community-based intervention is compiling a range of assessment data that support the nursing diagnosis.

On completion of a community assessment, the nurse creates a list of diagnoses. Which diagnosis includes all required elements? a. potential carcinogen exposure via water source in a local middle-school population b. increased amounts of pollutants in waterways as determined by local environmental protection agency c. increased rates of communicable diseases as a result of decreasing vaccination rates as indicated in state department of health data d. increased risk of infant mortality in the local immigrant population because of lack of prenatal care as noted in hospital labor and delivery data

d. increased risk of infant mortality in the local immigrant population because of lack of prenatal care as noted in hospital labor and delivery data Community diagnoses should include four components: the disability or disease, the community or population, etiological statement, and health indicators (evidence or support for the diagnosis); the diagnosis concerning increased risk of infant mortality contains all four components. The diagnosis related to potential carcinogens does not contain evidence or support for the diagnosis. The diagnosis of increased amount of pollutants does not indicate a specific community or population. The diagnosis of increased rates of communicable diseases does not specify a community or population.

What is true of the Intervention Wheel? a. there are four interventions b. similar interventions are the same color c. all wedges of the wheel are focused on systems d. interventions are grouped with related interventions

d. interventions are grouped with related interventions There are 17 interventions in the Intervention Wheel, and they are grouped with related interventions. The Intervention Wheel has 17, not 4, interventions. Similar interventions have similar colors, but they are not the same color. Not all wedges of the wheel are focused on systems. Some are focused on the community, and others are focused on individuals.

What is the best source of information for the nurse who wants to find data on how a community's water and sewage handling affect a population's health? a. almanac b. school districts c. census documents d. local health department

d. local health department The local health department provides information on water, sewage, housing, and other environmental factors that may influence health. The almanac provides information on climate relevant to the influence of nature on health problems and access to care. School districts provide information on education relevant to socioeconomic status, access to health care, and the ability to read and understand health information. Census documents are the best source of information for the nurse who wants to find data on population size.

What is the best source of information for the nurse who wants to find data on the level of citizen activism in a community? <p>What is the best source of information for the nurse who wants to find data on the level of citizen activism in a community? a. library b. almanac c. school districts d. local representatives

d. local representatives Local representatives are the best source of information for the nurse who wants to find data on the level of citizen activism in a community. The library is the best source of information for the nurse who wants to find data on how local newspapers reflect the concerns and needs of a population. The almanac provides information on climate relevant to the influence of nature on health problems and access to care. School districts provide information on education relevant to socioeconomic status, access to health care, and the ability to read and understand health information.

The community health nurse begins to establish certain hypotheses about the community's health, strengths, and potential health problems by traveling through the area. What term describes this approach? a. fact finding b. vital statistics c. windshield survey d. shoe leather epidemiology

d. shoe leather epidemiology The community health nurse becomes familiar with the community and begins to understand its nature by traveling through the area. The nurse begins to establish certain hunches or hypotheses about the community's health, strengths, and potential health problems through this down-to-earth approach, called shoe leather epidemiology. Fact finding is a general term for gathering information. Vital statistics are based on the official registration records of births, deaths, marriages, divorces, and adoptions. Community health nurses often perform a community windshield survey by driving or walking through an area and making organized observations.