Evolve questions - Exam 2

The major sources of information for program evaluation are: (select all that apply) - community indicators. - media reports. - program clients. - program providers. - program records

- community indicators - program clients - program records

Which of the following tools are used in analytic epidemiology? (Select all that apply.)

-Cohort study -Case-control study -Cross-sectional study

Which of the following statements are true regarding the health-related vulnerabilities of men? (Select all that apply.)

-Fewer health services are emphasized for men. -Men are less likely to be honest about their symptoms. -Men do not participate in health care at the same level as women.

Analytic epidemiology differs from descriptive epidemiology because it searches for:

"why" of disease patterns.

Nurses in community health often use epidemiology because in the community it is often difficult to control the environment. Which of the following statements demonstrates an epidemiologic strategy for monitoring disease trends?

A nurse in community health investigates a breakout of whooping cough in a local middle school.

The public health nurse is most likely to use what types of surveillance systems? (Select 2 that apply.) A. Active B. Passive C. Sentinel D. Syndronic

A. Active B. Passive

Which of the following best supports the concept of community-oriented nursing practice? Select all that apply. A. Direct nursing care of individuals with tuberculosis (TB) B. Hospice home care for a terminally ill individual and family C. Nursing interventions to stop elder abuse D. Nutrition education programs for teenagers and their families E. Wound care for a homebound individual

A. Direct nursing care of individuals with tuberculosis (TB) C. Nursing interventions to stop elder abuse D. Nutrition education programs for teenagers and their families Community-oriented nursing has often been considered unique because of its target of practice. Independent of the location of practice, if the target of practice is the community as a whole, the practice is community oriented. If the target of practice is the individual or family, the practice is not community oriented even when individuals or families are living in the community. Community-oriented nursing interventions should result in changes that are intended to affect the whole community.

What terms are used to describe healthy families? (Select all that apply.) A. Families with strengths B. Dysfunctional C. Functional families D. Resilient families E. Resistant families

A. Families with strengths C. Functional families D. Resilient families

The hospital infection control practitioner reports new cases of tuberculosis to the public health department. Of what type of surveillance system is this an example? A. Passive B. Active C. Sentinel D. Special

A. Passive

In applying the developmental theory, a family nurse determines the developmental stage of the family based on: A. age of the eldest child. B. family strengths. C. individual growth patterns. D. overall tasks of the family.

A. age of the eldest child.

A government agency is conducting an audit of all active clients in the local hospice program to ensure that hospice criteria for care are being applied appropriately. The type of tool being used in this specific approach to quality assurance is: A. concurrent audit. B. outcome audit. C. retrospective audit. D. peer review.

A. concurrent audit.

The nurse in community health uses information about family structure, household composition, marriage, divorce, birth, death, adoption, and other family life events to forecast and predict stresses and developmental changes experienced by families and identify possible solutions to family challenges. This best describes the study of: A. family demographics. B. family functions. C. family health. D. family resilience.

A. family demographics.

The family nurse conducts the family nursing assessment with the family as a unit. Using a systematic process, family problems are identified and family strengths are emphasized as building blocks for interventions. Which of the following best completes the statement to demonstrate the importance of assessment to outcomes? Integrating the extended families: A. fosters equal family and provider commitment to success. B. facilitates outcomes-oriented family nursing research. C. decreases the need for nurse contact and intervention. D. removes barriers to needed services to achieve success.

A. fosters equal family and provider commitment to success.

The Omaha System is a client classification system developed by the Visiting Nurses Association of Omaha, Nebraska, that has the potential to improve the delivery of care by: A. improving the description of care. B. minimizing the assessment required. C. predicting the outcome. D. decreasing the communication needs.

A. improving the description of care.

A traditional quality assurance program goal is to identify problems between the provider and client. Other goals of a traditional QA program are: (Select all that apply.) A. intervention in problem cases. B. peer review of all cases that are problematic. C. provide feedback regarding interactions between client and provider. D. provide documentation of interactions between client and provider.

A. intervention in problem cases. C. provide feedback regarding interactions between client and provider.

Given recent vaccine shortages for the flu, the local nurses in community health form a group to evaluate the process of scheduling and operating flu vaccination clinics in the community and review the community's complaints from the previous season. The activity best represents the principle of: A. total quality management (TQM) to achieve continuous quality improvement (CQI). B. quality assurance (QA) to achieve continuous quality improvement (CQI). C. risk management to achieve quality. D. continuous quality improvement (CQI) to achieve total quality management (TQM).

A. total quality management (TQM) to achieve continuous quality improvement (CQI).

What are the purposes of disease surveillance in public health? (Select all that apply.) A. Tries to identify terrorist attacks before they occur B. Provides a means for nurses to monitor disease trends C. Generates knowledge about disease or outbreak patterns D. Allows the nurse to advocate for policy changes E. Reduces morbidity and mortality and improves health through disease trend monitoring

B. Provides a means for nurses to monitor disease trends C. Generates knowledge about disease or outbreak patterns E. Reduces morbidity and mortality and improves health through disease trend monitoring

The deliberate release of viruses, bacteria or other germs with the intent of causing illness or death is: A. event outbreak. B. chemical terrorism. C. biological terrorism. D. surveillance.

C. biological terrorism.

A disease outbreak of severe acute respiratory syndrome has occurred and has spread over several countries outside the United States. This level of occurrence is said to be: A. hyperendemic. B. sporadic. C. epidemic. D. pandemic.

D. pandemic.

A general approach to quality improvement where a qualified agent designates formal recognition to individuals or institutions that have met minimum standards of performance is best described as: A. accreditation. B. charter. C. credentialing. D. licensing.

C. credentialing.

The later years of life for many older adults mark a period of abruptly changing social dynamics over which the older adult has very little control. The nurse should understand that this phenomenon of later life challenges:

Adapting and coping responses

The nurse in community health identifies an elder abuse problem because of caregiver stress among families in the local community due to lack of caregiver support services. The next step in the community-oriented nursing process would be to: Analyze the community problem Establish priorities Establish goals and objectives Identify intervention activities

Analyze the community problem Following the identification of the community problem(s), the planning phase of the community-oriented nursing process should begin with an analysis of the problem to seek clarification on the nature of the problem, its origins and effects, intervention points, interested parties/change agents, direct and indirect contributing factors, outcomes of the problem, and relationships between problems.

A parent with two school-age children has just finished a family health assessment questionnaire. The parent asks the nurse why one of the questions asks whether there is a neighborhood playground. The nurse's best response would be: A. "Don't worry about it. We are going to talk about all this anyway." B. "It's important to good health to have adequate recreation resources." C. "We want to be able to report any dangerous playground equipment to the city." D. "We want to know what kind of neighborhood you're in so we can assess income."

B. "It's important to good health to have adequate recreation resources."

During a family nursing assessment, a parent questions whether God is punishing the family, because one of the children has just been diagnosed with leukemia. The most facilitative response by the nurse would be: A. "God is loving and doesn't punish people." B. "Tell me more about your family's spiritual beliefs." C. "That is not part of my religious belief system, so I don't know." D. "Why do you think your family needed to be punished?"

B. "Tell me more about your family's spiritual beliefs."

What are the core competencies of the nurse participating in surveillance and investigation activities? (Select all that apply.) A. Basic patient assessment skills B. Effective communication skills C. Ability to collaborate with community partners D. Advanced practice nurse with secondary science degree E. Leadership and systems thinking

B. Effective communication skills C. Ability to collaborate with community partners E. Leadership and systems thinking

Family health can be defined as a dynamic, changing, relative state of well-being that includes the biological, psychological, sociological, cultural, and spiritual factors of a family system. This family health approach would best include which of the following underlying principles? (Select all that apply.) A. Assessment of the individual's health does not determine the overall family system's health. B. Family functioning affects the health of individuals. C. Family system assessment specifically addresses the individual's health. D. The individual's health affects family functioning. E. Simultaneous assessment of individual family members and the family system as a whole is important to family health.

B. Family functioning affects the health of individuals. D. The individual's health affects family functioning. E. Simultaneous assessment of individual family members and the family system as a whole is important to family health.

What is the purpose of using an algorithm in the surveillance process? A. Tells the nurse who to call in the event of an outbreak B. Provides the nurse with a step by step plan to identify events needing investigation C. Provides the nurse with a system for telephone triage in an outbreak D. It is a visual reminder of the epidemiologic triangle

B. Provides the nurse with a step by step plan to identify events needing investigation

A nurse doing a family assessment asks the client, "Have any of your blood relatives had mental illness?" The nurse is asking this question to: A. determine whether the family is stable. B. assess for biological risk factors. C. decide whether this family member needs medication. D. demonstrate open-mindedness about mental illness.

B. assess for biological risk factors.

A family nurse is working with a married couple that has decided to remain child-free. The nurse recognizes this decision as a: A. biological necessity. B. contemporary family function. C. religious belief decision. D. threat to family survival.

B. contemporary family function.

One specific approach to quality assurance is the use of Total Quality Management (TQM). A district public health department uses this approach and gives much attention to ensuring that studies are used to improve processes, remove management by objectives, and promote self-improvement. The major TQM guideline that would summarize these efforts would be: A. create, publish, and distribute aims and purposes. B. creating a strong customer-oriented philosophy that is process-driven. C. eliminate barriers to pride of work/performance. D. understand the purpose of inspection.

B. creating a strong customer-oriented philosophy that is process-driven.

The problem of the working poor and uninsured places a major burden on the current health care system that affects those families and the community in general. Nurses in community health see this as a major: (select all that apply) A. behavioral issue. B. policy issue. C. health risk issue. D. social issue. E. nursing issue.

B. policy issue. C. health risk issue. D. social issue.

A state health department wants to ensure that the local health departments are delivering quality client care and can demonstrate the degree of excellence attained. The principle that is best defined by this statement is: A. continuous quality improvement (CQI). B. quality assurance (QA). C. risk management. D. total quality management (TQM).

B. quality assurance (QA).

A nurse in community health is working with a single parent of three children, ages 4, 6, and 8. The 6-year-old has cerebral palsy. The 4-year-old has asthma. The maternal grandmother lives with the family and has diabetes. The nurse understands the importance of working within the context of the existing family structure and community resources because families are: A. resistive to outside intervention or involvement. B. responsible for providing/managing the care of their members. C. unable to manage the stress of complex health needs. D. restricted in their ability to identify interventions.

B. responsible for providing/managing the care of their members.

A nurse in community health in California has been working with a 6-year-old child that was rescued from a mudslide. The nurse will observe the child for which of the following stress effects? (Select all that apply.)

Bed-wetting episodes Fantasies of denial Thumb sucking

An elementary classroom of 28 students has had 13 children who have developed chicken pox over the last 3 weeks. What is the pattern of occurrence? A. Common source outbreak B. Point source outbreak C. Continuous source D. Mixed outbreak

C. Continuous source

The current-day definition of family refers to two or more individuals who depend on one another for emotional, physical, and/or financial support. Which of the following is the most important principle to support this broader definition? A. Families are defined by genetic ties. B. Family names are needed to confer status. C. Members of a family are self-defined. D. Traditional family functions have been redefined.

C. Members of a family are self-defined.

Which of the following systems of surveillance is used to monitor trends in commonly occurring diseases? A. Active B. Passive C. Sentinel D. Syndronic

C. Sentinel

A nurse in community health is conducting an assessment on a family of four. During the course of the assessment, the nurse collects information about previous generations of the family and siblings. The results are used to create a diagram for the family that displays the family unit across generations. Further discussions occur regarding the patterns of health and illness that relate to biological health risks. The diagram is called: A. an ecomap. B. a family plan. C. a genogram. D. a risk plot.

C. a genogram.

One member of an older couple has just retired. This is considered a: A. developmental stage that will help the family with stress reduction. B. nonnormative event that will have psychological impact on the family. C. normative event and can increase the family's risk for illness. D. normative event and will have little effect on the family' well-being.

C. normative event and can increase the family's risk for illness.

The general approach to quality improvement known as licensure that grants control over who can enter into and who exists in a profession can best be described as a contract between the: A. consumers and the profession. B. legislature and the state board. C. profession and the state. D. public and the professional associations.

C. profession and the state.

A nurse in community health is invited to work with a coalition of churches to address safety concerns for children in the local community. The nurse provides training in problem-solving skills, manages conflict, facilitates the process, and provides expertise in interpreting data. This nurse has chosen the implementation role of: Change agent Change partner Group leader Data collector

Change partner Content-focused roles often are considered change agent roles, whereas process roles are change partner roles. Change partner roles include enabler-catalyst, teacher of problem-solving skills, and activist advocate.

A school nurse is working with the Parent Teacher Organization (PTO) to improve the health status of preschool students in a lower socioeconomic urban community. Given the demographics of the community, the nurse is aware that this population is at greatest risk for:

Childhood obesity

Migrant workers and their families who reside in a specific mobile home park during the summer months would best be classified as a: Community Group Setting of practice Target population

Community In most definitions the concept of community includes people, place/time, and function.

A nurse in community health contacts three individuals who have had sexual encounters with an individual recently diagnosed with syphilis. The concept basic to community-oriented nursing practice that is best described by this intervention is: Community Community as client Individual as client Partnership

Community as client. When the community is the client, the results of nursing interventions should produce changes that affect the community as a whole, such as reducing the spread of sexually transmitted diseases (STDs).

A Hispanic outreach program works with the nurse in community health to train Hispanic health care workers in providing basic services and education within the local Hispanic community. The concept basic to community-oriented nursing practice that is best described by this intervention is: Community Community client Community health Community partnerships

Community partnerships Partnerships for health mean the active participation and involvement of the community or its representatives in healthful change. It involves the informed, flexible, and negotiated distribution or redistribution of power among all participants in the process of change for improved community health.

A nurse performing home hospice case management notes the increasing number of hospice clients that lack caregivers in the home environment. The nurse identifies the potential need for a hospice house facility to meet the needs of these clients. The case management process frequently reveals such larger picture issues as: (select all that apply)

Community weaknesses in quality of services Community weaknesses in quantity of services Case management activities with individual clients and families will reveal the larger picture of health services and health status of a community. Through a nurse's case management activities, general community weaknesses in quality and quantity of services often are discovered.

Which of the following social science theories is used by public health nursing to describe how environments and systems outside of the family influence the development of a child over time? A. Life cycle theory B. Family developmental theory C. Family systems theory D. Bioecological systems theory

D. Bioecological systems theory

According to the Minnesota Model of Public Health interventions, what is the first step of surveillance for the public health nurse? A. Organize the data. B. Analyze the data. C. Interpret and disseminate the data. D. Determine if surveillance is appropriate.

D. Determine if surveillance is appropriate.

The family systems theory encourages nurses to view both the individual clients as participating members of a whole family. What is the major weakness of the systems framework? A. Views families from both a subsystem and a suprasystem approach B. Defines the direction of interactions C. Views the family as an agent of change D. Focuses on the interaction of the family with other systems

D. Focuses on the interaction of the family with other systems

Many families have financial resources that allow them to maintain themselves but limit the quality of their purchasing power. Food high in fat and calories may be affordable, whereas fresh fruits and vegetables may not be affordable. A federal program that attempts to promote healthier diets for vulnerable populations is: A. Medicaid B. Medicare C. Supplemental Security Income (SSI) D. Women, Infants, and Children (WIC)

D. Women, Infants, and Children (WIC)

A multidisciplinary quality assurance team has reviewed an organization's stated philosophy and objectives and developed a conceptual model for appraisal that integrates peer review and client satisfaction. The quality assurance program component that should be addressed next would be: A. action. B. process. C. structure. D. outcome.

D. outcome.

Nursing interventions and approaches for helping individuals and families to assume an active role in their care should focus on empowerment rather than on enabling. The underlying principle to empowerment is: A. client dominance. B. decreased competence. C. professional dominance. D. professional-client partnership.

D. professional-client partnership.

The purpose of record keeping in public health agencies is to maintain complete information on clients served and the extent and quality of service provided to those clients. The records also provide information for education and research. Another important use of the records is to: A. determine raises for personnel. B. explain cost overruns. C. foster independence in clinical practice. D. resolve legal issues in malpractice suits.

D. resolve legal issues in malpractice suits.

A nurse in community health decides to form a contract with a family. The contract states that the family will designate one night as a family night. The nurse is most likely using the contract to: A. make sure the family does what is expected. B. encourage the family to put plans in writing. C. let the family know that this is a legal agreement. D. shift the responsibility so that it becomes a shared effort.

D. shift the responsibility so that it becomes a shared effort.

A nurse in community health is conducting a parenting class for prospective parents that will focus on the development of new skills, identification of needed resources, planning, and other preparations for the arrival of a newborn. This intervention is addressing a potential risk associated with: A. biology. B. behavior. C. environment. D. transitions.

D. transitions.

While conducting a community health assessment, a nurse in community health meets with local religious leaders to understand the values, norms, perceived needs, and influence structures within the community. This process of data collection can best be described as: Data gathering Data generation Data interpretation Problem identification

Data generation Data generation in a community health assessment is the process of developing data that do not already exist through interaction with community members, individuals, families, and groups, such as community knowledge and beliefs, values, goals, perceived needs, norms, problem-solving processes, power, leadership, and influence structures. This activity parallels the assessment phase of the nursing process.

Four months after the disaster of 9/11 at the Pentagon, a local EMS worker complained of extreme exhaustion. The veteran EMS worker also stated that the pace of work at the squad was too slow. The occupational health nurse that is assessing the EMS worker recognizes the symptoms of:

Delayed stress reaction

Which of the following statements accurately describe the stress reaction phases a community may experience during a disaster response? (Select all that apply.)

During the Heroic phase, there is overwhelming need for people to do whatever they can to help others survive the disaster. In the Honeymoon phase, survivors may be rejoicing in that their lives and the lives of loved ones have been spared. The Disillusionment phase occurs after time elapses and people begin to notice that additional help and reinforcement may not be immediately forthcoming.

Following the attacks of 9/11, a nurse practitioner in a family clinic used opportunities at the clinic staff meetings to speak about her own feelings of loss and guilt. This strategy indicates that the nurse was aware of what phenomenon related to disasters?

Effects of stress on individuals

The nurse in community health defines goals and measurable objectives during the planning phase of a community health intervention. This also marks the beginning of the: Evaluation phase Implementation phase Needs assessment Problem analysis

Evaluation phase Evaluation begins in the planning phase, when goals and measurable objectives are established and goal-attaining activities are identified. After implementing the intervention, only the accomplishment of objectives and the effects of the intervention activities have to be assessed. The nurse will evaluate whether the objectives were met and whether the intervention activities were effective.

Elderly clients should be assessed for signs of abuse. The illegal use of a person for another person's profit is known as:

Exploitation

The recovery phase of a disaster can take a very long time. Nurses need to be aware that despite effective disaster preparedness and response efforts:

Individuals must ultimately recover on their own

The most important causes of preventable disease, disability, and death among children are:

Injuries and accidents

The Patient Self-Determination Act of 1991 requires that providers receiving Medicare and Medicaid funds give clients written information regarding:

Legal options for treatment choices in the event the person becomes incapacitated

Nurses often participate on field assessment teams (surveillance) during a disaster response. These assessments are crucial to best help:

Match available resources to the population's emergency needs

A nurse in community health is participating in a community service board strategic team that is currently assessing the community's strengths, the local public mental health system, the community's mental health status, and other variables. This best describes what strategic program planning model used today in the public health arena? - Assessment Protocol for Excellence in Public Health (APEXPH) - Health Evaluation Data Information System (HEDIS) - Mobilizing for Action Through Planning and Partnership (MAPP) - Planning Approach to Community Health (PATCH)

Mobilizing for Action Through Planning and Partnership (MAPP)

The community health nurse is aware that lesbian, gay, bisexual, and transgender (LGBT) adults are more likely to experience which of the following conditions?

Poor mental health

An underlying current throughout the special population groups with health disparities is:

Poverty

A nurse educator who teaches at the local community college takes the time to read and understand her community's disaster plans and participates in community mock disasters as a leader of the triage team. The best description of the nurse's activities would be:

Professional preparedness

In the event of a disaster, shelters are generally the responsibility of which of the following entities?

Red Cross Chapter

A nurse functioning in the role of a case manager performs which of the following functions in the care delivery process? (Select all that apply.)

Risk analysis Data mapping Epidemiologic investigation of unexpected illnesses The case manager is the architect for the target group's health in the care management delivery process. The building blocks used by the manager include risk analysis, data mapping, data monitoring, epidemiologic investigation of unexpected illnesses, multidisciplinary development of action plans and programs, and identifying case management triggers or events that promote earlier referrals of high-risk clients when prevention can have dramatic results. The case manager builds on the basic functions of the traditional role and adapts new competencies for managing the transition from one part of the system to another or to home.

The school nurse is interested in providing an antismoking program in a local middle school and is aware that programs are more effective for this age group when they focus on short-term versus long-term effects of smoking. Besides including health risks and cosmetic effects, the nurse should also consider:

Social skills instruction to resist pressure to smoke

The nurse in community health reviews the monthly and year-to-date health service use report for the local community to monitor trends as correlates of the community's health. The nurse is viewing community health through the dimension of: Partnership Process Status Structure

Structure Community health has three dimensions: status, structure, and process. The dimension of structure would define the community's health in terms of community characteristics such as services and resources.

The major factor that has increased Florida's vulnerability to natural disasters in recent decades has been:

Urbanization

To maintain effective disaster preparedness, nurses working in the community can play a critical role in providing an updated record of:

Vulnerable populations

Two nurses in community health schedule a day to ride through a low-income community to better understand the community and its boundaries, trends, rhythm, stability, and changes that can affect the health of that community. This direct data collection method is often referred to as: Composite database Participant observation Secondary analysis Windshield survey

Windshield survey Five useful methods of data collection are informant interviews, participation observation, windshield survey, secondary analysis of existing data, and surveys. Windshield surveys are the motorized equivalent of simple observation. While driving a car or riding public transportation, the nurse can observe many dimensions of a community's life and environment through the windshield.

A 3-year smoking cessation program for teens has just concluded. The type of evaluation the staff will conduct is: - a formative evaluation. - an informal evaluation. - an ongoing evaluation. - a summative evaluation

a summative evaluation

A nurse coordinating care for undocumented minority workers with a high incidence of tuberculosis (TB) conducts a presentation before the local community health board to focus attention on the magnitude of the problem and its potential impact on the local community. The presentation stimulates the community to explore innovative solutions to increase screening for and treatment of TB cases. This scenario is an example of the relationship between:

advocacy and case management. Clients are a part of larger systems: the family, the work environment, and the community. Each system interacts with the client to shape available options through resources, needs, and desires. The practice of advocacy may entail the ability to focus attention on the magnitude of problems caused by diseases affecting a segment of the population. Advocacy often stimulates a community's self-determination to find innovative actions to correct gaps in service.

A parent involved in conflict resolution with her teenager says, "I know that some of your friends stay out until midnight, but I think it is best if you are in at 10 o'clock." This statement, a behavior seen in conflict situations, is an example of:

assertiveness. Assertiveness is the ability to present one's own needs and is a behavior often seen in conflict situations. Negotiating is a strategic process used to move conflicting parties toward an outcome. Cooperation is the ability to understand and meet the needs of others. Aggressiveness is a behavior which may be exhibited in a conflict situation.

When acting as a mediator, the nurse advocate would:

assist new parents in communicating with their health plan regarding well-baby coverage. Mediation is an activity in which a third party attempts to provide assistance to those who may be experiencing a conflict in obtaining what they desire. The goal of the nurse advocate as mediator is to help parties understand each other on many levels so that agreement on an action is possible.

A case manager is concerned that some of the clients at the neighborhood clinic are getting fewer services because of their financial situations. The case manager is confronting the ethical principle of:

beneficence. Beneficence can be influenced when excessive attention to cost supersedes or impairs the nurse's duty to provide measures to improve health or relieve suffering. Justice, as an ethical principle for case managers, considers equal distribution of health care with reasonable quality. Veracity, or truth telling, is absolutely necessary to the practice of advocacy and building a trusting relationship with a client. Deontology is not an ethical principle that applies to this situation.

A community health nurse is working with an uninsured family with two children. The nurse assists the parents in applying for SCHIP benefits and securing an appointment for the children with a community pediatrician that participates in SCHIP. The intervention can best be described as:

case management. Case management is identified as one of the 17 interventions in the scope of practice in community health nursing. Case management is defined as the ability to optimize self-care capabilities of individuals and families and the capacity of systems and communities to coordinate and provide services. Case management, in contrast to the definition of care management, refers to activities implemented with individual clients in a system. Care management includes the concept of disease management.

In case management, it is unlikely that any single professional has the expertise, knowledge, or skills required to achieve success. The synergy produced by all involved parties (client, providers, payers, family/significant others, and community organizations) can result in successful outcomes. This statement relates to the sequential process of:

collaboration. Collaboration is achieved through a developmental process that occurs in a sequence, yet it is reciprocal between those involved. Teamwork and collaboration require extensive skill sets to achieve successful outcomes. No single professional has the expertise required in all aspects. It requires the synergy of all parties involved. The goal of communication in the collaborative development process is to promote respect for, understanding of, and the accuracy of all team members' points of view. Cooperation is the ability to understand and meet the needs of others. Negotiation generally occurs in a situation involving conflict.

A nurse in community health seeks a low-cost evaluation method to learn the perspectives of the largest number of persons regarding a proposed local safe haven program for unwanted infants. The best evaluation method to meet the criteria would be: - community forums. - focus groups. - key informants. - surveys.

community forums

The nurse engaging in formative program evaluation would most likely: - conduct medical record audits for quality assurance. - make a home visit before a client is discharged from the program. - participate in new client evaluation. - write policy for risk management.

conduct medical record audits for quality assurance.

A breast cancer screening program screened 8000 women and discovered 35 women previously diagnosed with breast cancer and 20 women with no history of breast cancer diagnosed as a result of the screening. The prevalence proportion would reflect:

current and past breast cancer events in this population of women.

A particular chronic health problem that is a serious public health challenge and results in health complications that double medical costs is:

diabetes

Local officials have requested a program evaluation of a comprehensive teen sex education program offered in the local schools in preparation for potential budget discussions. A nurse in community health conducts a program evaluation and determines that the teen pregnancy rate has gradually declined over the years that the program has been in place. The community is measuring the program's: - efficiency. - progress. - relevance. - sustainability

efficiency

A major evaluation source for a nurse to use to determine the effectiveness of a teen driver safety program is: - Centers for Disease Control and Prevention (CDC) reports. - epidemiologic data. - recent census data. - voter registration records

epidemiologic data

A business executive develops symptoms of the flu 1 day after returning by air from a cross-Atlantic business trip that ran for 2 consecutive stressful 10-hour days. This individual's development of flu symptoms illustrates the relationship between:

host, agent, and environment.

The nurse in community health is meeting with staff to systematically plan for a new outreach program. Doing so helps them to - assess the needs of potential outreach clients. - recognize the special needs of vulnerable people in the area. - identify how the problems of similar programs will not be repeated. - identify the resources and activities that will help them meet their program objectives.

identify the resources and activities that will help them meet their program objectives.

A nurse in community health has determined that there is a need for a program for teenage fathers who want to learn about child care. The next step in the program management process would be to: -conduct a survey to determine how many children the fathers have. -determine whether the fathers have benefited from this type of program before. -meet with community members to form a planning body. -provide the fathers with community resources.

meet with community members to form a planning body.

A community health nurse involved in care management would most likely:

monitor the health status, resources, and outcomes for an aggregate. Care management is an enduring process in which a care manager establishes systems and monitors the health status, resources, and outcomes for an aggregate or a targeted segment of the population or a group. Care management strategies include use management, critical paths, disease management, demand management, and case management.

Clinical medicine and epidemiology differ from each other in the major aspect of:

practice focus.

One of the basic concepts in epidemiology is the concept of risk. Risk refers to the:

probability that an event will occur within a specified time period.

A nurse working with a Hispanic client explains the referral options available for the client to receive a mammogram. One option is free and has limited Spanish language resources. The other option has a nominal fee and comprehensive Spanish language resources. The nurse supports the client's decision to choose the provider that the client feels would best meet her needs. This advocacy role is best described as:

promoter. The nurse advocate makes the client's rights the priority. The goal of promoter for the client's autonomy and self-determination may result in a high degree of client independence in decision making. Mediation is an activity in which a third party attempts to provide assistance to those who may be experiencing a conflict in obtaining what they desire. The nurse advocate does not exhibit roles of intercessor or obstructer in this situation.

A nurse in community health who teaches a client with asthma to recognize and avoid exposure to asthma triggers and assists the family in implementing specific protection strategies such as removing carpets and avoiding pets is intervening at the level of:

secondary prevention.

A nurse is concerned about the accuracy of the PPD test in identifying cases of TB exposure for follow-up chest x-ray. The nurse's concern is addressing the validity measure of:

sensitivity.

A nurse in community health becomes aware that a teen smoking cessation program offered at the health department is a demonstration project. In evaluating this program, the nurse would be concerned with the program's: - efficiency. - impact. - relevance. - sustainability.

sustainability

Twenty people attended a church picnic the previous weekend. By Monday, four individuals exhibited symptoms of food poisoning. On Tuesday, the nurse in community health records the addition of two new cases. The incidence rate would be:

two new cases divided by 16 at risk.