Test 1
6. Primary health care seeks to provide affordable social, biomedical, and health services that are relevant and acceptable in terms of the individual's health, needs, and concerns. Which principle does is this model of primary health care incorporate? a. Appropriate technology b. Community participation c. Equity d. Multisectoral participation
a
6. The WHO initiative Health for All in the 21st Century can best be described as which of the following? a. Social justice initiative b. Primary care initiative c. National initiative d. Environmental initiative
a
9. If the community is where nurses practice and apply the nursing process, and the community is the client in that practice, then nurses will want to analyze and synthesize information about: a. boundaries, parts, and dynamic processes. b. community health status and structure. c. community problems and problem correlates. d. role of the nurse and lay advisers.
A
9. A PHN employed by the state's department of health is working on a team to develop local health policy. The nurse recognizes that policy development focuses on the level of the larger society and adopts strategies that require political actions such as lobbying and testifying. The reason that action in the policy arena comes most easily and naturally to nurses is the fact that the policy process is very similar to which of the following? a. Citizen action committee b. Nursing diagnosis c. Nursing process d. Socratic method
c
7. A Public Health Service nurse employed by the Indian Health Service is working with a client diagnosed with cancer. The client uses sweat lodges to "cure the disease." The nurse is integrating client care with knowledge of which cultural organizing factor? a. Biological variations b. Communication c. Environmental control d. Space
c
7. Changes to Title XIX of Medicaid in 1989 ensured adequate access to health care providers by which mechanism? a. Adding coverage for the medically indigent b. Including the costs of periodic screening for those younger than age 21 years c. Reimbursing for treatment by pediatric and family nurse practitioners d. Reimbursing for skilled and intermediate nursing home care
c
8. A community-based hospice nurse has an Asian client with terminal-stage cancer. The client complains of continuous pain and receives no relief from the prescribed opioid medication. The nurse contacts the client's provider to discuss replacing this medication with another pain-reducing drug. What is this action an example of? a. Cultural accommodation b. Cultural assessment c. Cultural brokering d. Cultural repatterning
c
8. A nurse is leading an effort to get desperately needed medical supplies and equipment to an impoverished and war-torn country. Materiel is being gathered according to the recipient country's stated needs. Before shipping the equipment, what would the nurse do? a. Consult with the country's leaders on what they are able to sustain. b. Determine if any prohibitions exist on delivery of medical goods. c. Enlist the help of an NGO to provide security services for the delivery. d. Provide funding to keep the medical equipment in working order.
c
8. A nurse seeks the best resource that provides a broad vision of the goals and objectives of many health care stakeholders in our nation and identifies the current national health policy for the United States. What is the best source for this information? a. American Public Health Association's guidelines b. Website of the Centers for Disease Control and Prevention c. Healthy People initiatives d. Pan American Health Organization's mission statement
c
5. A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. Which core public health function does this represent? a. Assessment b. Assurance c. Policy development d. Research
a
5. Bruising and swelling on a client's face and torso are noticed by a nurse during a prenatal examination. The client's exchange-student husband, who speaks for the client, tells the nurse his wife deserved the bruises. The client looks at the floor and shakes her head in agreement. The nursing student leaves the examination room angry and confused, experiencing what can best be described as: a. culture shock. b. prejudice. c. ignorance. d. racism.
a
5. Nurses working with communities to implement the CHPM are most effective when they do which of the following? a. Begin where the community is and then work to facilitate implementation of all nine steps. b. Serve in the role of expert resource, spearheading the community's work. c. Teach basic community and public health concepts before teaching the Health Communities Model. d. Work with community leaders to begin with step one and progress through step nine of the model.
a
1. Primary health care (PHC) differs from primary care in which of the following ways? a. PHC encourages community participation. b. PHC focuses on prevention and cure. c. PHC is defined more narrowly. d. PHC is the primary method of health care delivery in the United States.
a
1. The Healthy Communities and Cities (HCC) movement can best be described as which of the following? a. International movement of communities and cities focused on mobilizing local resources to improve the health of the community. b. Movement that began in the United States that targets health promotion in community practice. c. Movement that focuses on the effective development and use of public policy as the primary means for improving health. d. Program that uses the principles of primary, secondary, and tertiary prevention to mobilize citizens to improve the health of their communities.
a
10. After hearing about home radon exposure on the news, a man and his wife contact the public health department to inquire about whether or not they should have their home tested. Which stage of the transtheoretical model (TTM) are the man and his wife at in regards to the process of change? a. Preparation b. Contemplation c. Action d. Pre-contemplation
a
2. Recent trends indicate that which of the following carries the highest portion of third-party health care financing? a. Combined public sources b. Consumer premiums c. Medicare d. Private health insurers
a
2. The community-oriented nurse best exemplifies the application of feminist ethics when the nurse does which of the following? a. Design health care programs that incorporate social justice, respect and equity, and address social and political power. b. Design health care programs for women that respect their dignity and autonomy. c. Ensure that male providers do not use sexist terms with clients, families, and coworkers d. Participate in political action that focuses on women's rights and status in the community.
a
2. The relationship between nursing practice, health policy, and politics can best be described as nursing: a. advocacy. b. policy process. c. process. d. profession.
a
3. A nurse is conducting a diabetes self-management group-education session for recent immigrants. When participants are asked to remove their shoes, two male clients look at the floor and leave their shoes and socks on their feet. What action by the nurse is best? a. Clarify that no one has to remove his or her shoes and continue the education. b. Explain that everyone must learn to do foot inspection to manage their diabetes. c. Slowly repeat the instructions for all participants to remove their shoes. d. Stop the group session, pull the two gentlemen aside, and apologize to them.
a
4. A nurse in a nurse-managed health center providing a tertiary prevention intervention to a population of women who are HIV positive will most likely do which of the following? a. Educate about self-care and the women's rights as employees. b. Establish a partnership with a community to initiate a community health center. c. Help identify new cases and ensure that clients receive proper treatment. d. Teach how to lobby state legislators.
a
4. A nurse who is ethnocentric in interacting with a client of a different culture. Which statement is most likely true about this nurse? a. Most likely has little experience and is uncomfortable with people from other cultures. b. Is appreciative of and inquisitive about the client's cultural beliefs. c. Accommodates the client's cultural beliefs when planning care. d. Imposes the nurse's value system on the client for best care outcomes.
a
5. Several community-oriented nurses want to explore the problem of obesity in school-age children and assess their community school district's health status related to that problem. When gathering information at a national level, where would the nurses begin their search? a. Centers for Disease Control and Prevention b. Centers for Medicaid and Medicare Services c. Health Resources and Services Administration d. National Institute of Nursing Research
a
5. The community practice nurse is preparing to initiate a community partnership with a neighborhood watch association to address teenager street vandalism. The nurse meets with a local pastor who makes introductions between the nurse and the neighborhood residents who will partner together. The role of the pastor in this example is: a. gatekeeper. b. community health worker (CHW). c. professional service provider. d. stakeholder.
a
6. A PHN in a maternal-child health clinic encounters a client from Ethiopia. The clinic typically sees Hispanic clients. Which assessment should the nurse conduct first? a. General cultural assessment b. Head-to-toe assessment c. In-depth cultural assessment d. Nonverbal communication assessment
a
6. A community health nurse directly contacts a mammography clinic to arrange an appointment for a migrant worker with limited English language skills. The nurse communicates with the client through an interpreter to ensure that the appointment is scheduled to meet her needs and that the client understands the procedure to be performed. The role played by the nurse in this encounter with a member of a vulnerable population can best be described as: a. advocacy. b. empowerment. c. partnership. d. social justice.
a
6. A family with a small child lives in a home on a Brownfield site. What action does the public health nurse take when conducting a home visit? a. Assess the child for meeting developmental milestones. b. Have the parent complete a 3-day food diary. c. Request the child's immunization records. d. Watch the child during therapeutic play.
a
6. During the Depression, which of the following created a negative effect on public health nursing? a. Decrease in focus on the community as the unit of service. b. Increase in the scope of fundamental services. c. Increase in field experience requirements for public health. d. Decrease in the need for training and supervision.
a
6. The state public health agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored eldercare programs. Which public health core function does the nurse apply in this situation? a. Assurance b. Policy development c. Primary prevention d. Public transportation
a
7. A factor that strongly influences the success of a PHC system is: a. participation of the community members in the design, implementation, and evaluation of the initiative. b. assurance of access to care for every woman and child from pregnancy through childhood. c. each entity's sense of urgency regarding the evaluation of indicators. d. cure orientation of the private sector of health care delivery in the United States.
a
7. A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing what type of care? a. Community-oriented b. Community-based c. Secondary care d. Tertiary care
a
7. A rural community health nurse has made sure that CHWs are involved in the health department's migrant worker outreach program. The nurse believes this intervention strategy is important because the nurse knows that such individuals can be: a. influential with their insider status to engage community members. b. medical professionals within the migrant community. c. natural healers within their community. d. translators to help overcome language barriers.
a
7. One step in the ethical decision-making framework is to place an ethical issue within a meaningful context. What is the rationale for this step? a. Multiple factors affect the formulation and justification of ethical issues and dilemmas. b. The nature of ethical issues and dilemmas determine the specific ethical approach used. c. People cannot make sound ethical decisions if they cannot identify ethical issues and dilemmas. d. Professionals cannot avoid choice and action in applied ethics.
a
7. The local public health nurse (PHN) participates in a town board's community assessment process, which identifies teenage pregnancy as a community concern for action. Based on the Healthy People in Healthy Communities MAP-IT model, a logical next step would be: a. coalition building. b. evaluation of outcomes. c. health-risk assessment. d. wellness appraisal.
a
8. A community-oriented nurse conducts home visits to new parents to assess the health status of the infant, the parent-child relationship, the parents' knowledge regarding the care of the infant, and the need for health department and social services referrals. This can best be described as an example of which type of care? a. Clinical community health practice b. Community-based practice c. Population-focused practice d. Public health nursing
a
8. A shift in general approach from a more reactionary, acute care orientation toward a proactive, primary prevention orientation is necessary to achieve not only a more cost-effective, but also necessary to avoid the need for other less desirable approaches that may compromise access and quality such as: a. rationing of health care. b. secondary prevention. c. managed care expansion. d. regulatory program mandates.
a
8. How does virtue ethics differ from other ethical theories or principles? a. It focuses on character development. b. It views consequences as natural occurrences. c. It is core to developing distributive justice. d. It works from the principle of egalitarianism.
a
8. In the community-based participatory research (CBPR) approach, the use of lay community members to promote health within the community is an effective intervention because community members: a. are best at determining the health needs and planning interventions for their community. b. create a passive partnership with community leaders and public health nurses. c. provide oversight and funding decisions for the health-promotion activities. d. relieve local service providers of mundane tasks.
a
9. At the request of a local housing authority, a PHN conducted a survey at a public housing facility to determine the need for a nurse-managed clinic. When residents and community leaders were asked what services were most needed from the clinic, they listed well-child screening, parenting education, and medication management. The PHN, the local health department, and the community members collaborated in all phases of the project from planning to evaluation to establish a community nursing center at the site. This example best illustrates the application of population-focused community model at which level? a. Aggregate client system level b. Environmental level c. Family client system level d. Individual client system level
a
9. The nurse is educating an immigrant client regarding the prenatal services available through the maternal-child health clinic. The client is interested in confirming her pregnancy at this visit but does not see the need for ongoing visits because childbirth is viewed as a natural process in her culture. The nurse negotiates with the client to structure a strategy to achieve a healthy pregnancy outcome that uses the clinic's resources in a manner that is satisfactory to the client. This is an example of which of the following? a. Cultural accommodation b. Cultural brokering c. Cultural preservation d. Cultural repatterning
a
MULTIPLE RESPONSE 1. The aspects of the locality development model or bottom-up approach that have been integrated can best be described as which of the following? (Select all that apply.) a. Emphasizing consensus and cooperation b. Building a sense of community c. Using a rational-empirical approach d. Producing fundamental social change e. Rational-empirical problem solving by outside experts
a, b
MULTIPLE RESPONSE 1. Which of the following are recommendations of the 1850 Shattuck Report that represented major innovations in public health? (Select all that apply.) a. Establishment of state health departments and local health boards in every town b. Promotion of environmental sanitation and collection of vital statistics c. Steps to decrease preventable disease and control smoking and alcohol use d. Targeting of efforts solely on environmental hazards e. Provision of supplemental food to low-income persons
a, b, c
MULTIPLE RESPONSE 2. Benefits of an electronic health record in the public health system include: (Select all that apply.) a. 24-hour availability of health records. b. ease of referral coordination. c. reduction in medication errors. d. increased privacy. e. consistently reliable internet resources.
a, b, c
MULTIPLE RESPONSE 1. Which of the following are important concepts related community-as-client nursing? (Select all that apply.) a. Change for the benefit of the community-client must often occur at several levels. b. Changes in the health of individuals will affect the health of their communities. c. The idea of providing health-related care within the community is not new. d. The impact of the environment on health has long been established. e. Direct hands-on nursing care delivered to individuals or families in community settings is important.
a, b, c, d
MULTIPLE RESPONSE 1. State and federal statutes and regulations affect the health care specialties of home health and hospice practice. A primary motivator for nurses to become knowledgeable about these statutes and regulations is their impact on nursing practice in which of the areas below? (Select all that apply.) a. Documentation of client status and progress b. Documentation of services c. Living wills and advance directives d. Resident's rights in long-term care facilities e. Right to death with dignity
a, b, c, d, e
MULTIPLE RESPONSE 1. The factors that are frequently cited as having caused the increases in total and per capita health care spending in the United States are well exemplified by which of the following health care events? (Select all that apply.) a. Development of the drug sildenafil b. Increase in hip and knee replacement surgeries c. Increased incidence of ischemic heart disease d. Mandated 2-day maternity hospital stays e. Medicare Part D prescription drug plan
a, b, c, d, e
MULTIPLE RESPONSE 1. The nursing student learning about cultural variations would need to study which of the following topics? (Select all that apply.) 1. Biological variations 2. Personal space 3. Time perception 4. Social organizations 5. Communication patterns
a, b, c, d, e
MULTIPLE RESPONSE 1. The role of the nurse who wants to become more active in environmental health could include which of the following? (Select all that apply.) a. Assessing farmworkers for pesticide exposure and providing pesticide risk education b. Conducting epidemiologic investigations as a public health nurse (PHN) c. Developing corporate policy to protect workers from unsafe levels of toxic agents d. Organizing the local community to encourage landlords to remove lead-based paint e. Working as a skilled risk communicator for a local chemical manufacturer
a, b, c, d, e
MULTIPLE RESPONSE 2. A new nurse asks the mentor what an MSDS is for. What responses by the mentor are most accurate? (Select all that apply.) a. Contains information on chemical products. b. Describes any special precautions using chemicals requires. c. Details the health risks associated with the products. d. Explains the manufacturing precautions taken. e. Must be written by the product manufacturer.
a, b, c, e
MULTIPLE RESPONSE 3. Which are major accomplishments of the National Organization for Public Health Nursing (NOPHN)? (Select all that apply.) a. Collaborated to secure health insurance reimbursement for nursing services, such as postdischarge nursing care at home b. Established public health nursing programs for military outposts in World War I c. Provided matching funds to establish maternal and child health divisions in state health departments d. Responded to the 1918 worldwide influenza pandemic in the United States e. Supported nurse employment through increased grants-in-aid for state programs of home medical care
a, b, d
MULTIPLE RESPONSE 2. Which of the following factors assisted community-oriented nursing pioneers, such as Lillian Wald, in developing approaches and programs to solve the health care and social problems of her times? (Select all that apply.) a. Community health's focus on teaching and prevention b. Establishment of settlement houses c. Establishment of the town and country nursing services in large cities d. Lack of public interest in limiting disease e. Middle and upper class fear of diseases
a, b, e
MULTIPLE RESPONSE 1. Which of the following groupings of health care trends will have the greatest influence on the health care transformation process? (Select all that apply.) a. Aging of the population and medical technology advances b. Funding levels, political structure, and professional licensure requirements c. Longevity, population diversity, and funding sources d. Managed care, workforce shortages, and level of education of the population
a, c
MULTIPLE RESPONSE 3. The most important features of the Affordable Health Care for America Act of 2010 that the community-oriented nurse needs to understand include which of the following? (Select all that apply.) a. Transforms the health care system from a sick care system to health care system. b. Uses piecemeal approach to strengthen the safety net. c. Replaces the rational equitable health care system. d. Provides insurance reform. e. Increases access to affordable health care insurance.
a, d, e
1. A nurse practitioner is seeking support from a community health and hospital system to open a nurse-managed and nurse-staffed clinic. The nurse provides data demonstrating the role of the clinic in reducing non-urgent emergency department visits and in improving access to services for clients with chronic illness, management of caseloads, and service flow. This best demonstrates application of the techniques of: a. business cycle modeling. b. cost-effectiveness analysis. c. cost-benefit analysis. d. indirect reimbursement methods.
b
1. Health policy can best be defined as a set course of action to do which of the following? a. Administer public health programs for disaster preparedness, response, and recovery. b. Obtain a desired health outcome for an individual, family, group, community, or society. c. Support publicly funded health care programs at the local, state, and national levels. d. Support health care development and research to improve the health status of citizens.
b
1. The population group that is likely to be the most vulnerable is which of the following? a. Children with a family history of sickle cell disease b. Homeless pregnant teens in a substance abuse program c. Native Americans at risk for diabetes d. Overweight children
b
1. What was one of Mary Breckenridge's innovative contributions to health care in the United States? a. Establishing the Federal Emergency Relief Administration b. Introducing the first nurse-midwifery training c. Introducing the nursing process d. Establishing occupational health nursing
b
1. Which of the following community health improvement projects uses the health-oriented perspective? a. Health-promotion project aimed at monitoring an adolescent's compliance with an asthma treatment regimen b. Project to improve well-being in residents of an assisted-living facility through yoga and relaxation programs c. Project aimed at teaching clients with diabetes how to maintain glucose control by using a sliding scale for dosing insulin d. Program aimed at improving school performance by teaching high school teachers how to detect drug abuse and screen students for drug use
b
2. A community-oriented nurse wants to begin a program to reduce health inequality. What action by the nurse would be most successful? a. Conduct research on the prominent causes of inequity within the community. b. Gather a group of acute and community health care providers to brainstorm solutions. c. Invite a cross section of health professionals and lay people to join the action team. d. Use a successful model and divide the tasks among volunteers in the community.
b
2. A new group of migrant farmworkers has arrived in a community. What action by the public health nurse is most important prior to scheduling clinic services? a. Consult the public health staff regarding their schedule for large open time blocks. b. Learn about the farmworkers' concept of time and their work schedule. c. Review written materials about the farmworkers' culture of origin. d. Visit the farmworker camp and tell the camp leaders when clinic services will be available.
b
2. An occupational health nurse is conducting employee toxic exposure histories at a dog food manufacturing plant. Using the I PREPARE model, what question does the nurse ask? a. Do you eat your lunch inside or outside the building? b. Does your job include soldering any metals? c. Have you ever served in the military? d. What is the intensity of your exposure to chemicals?
b
2. The most important contribution made by Florence Nightingale to community-oriented nursing was which of the following? a. Developing the settlement house concept to improve urban health standards b. Expanding the role of nursing to include health-promotion practices c. Founding the first district nursing association in England d. Introducing professional schools of nursing in the United States
b
3. A college health nurse is working to improve environmental air quality on campus. Using the precautionary principal, what action does the nurse take? a. Develop a bike-rental program for students, staff, and faculty. b. Install "smart thermostats" and motion-generated lights in buildings. c. Make the entire campus a smoke-free zone. d. Raise the parking fees to discourage people from driving to campus.
b
3. A nurse new to community-oriented nursing expresses concern about traveling to a specific area of town. What response by the nursing manager is best? a. "Don't worry, I've gone there many times myself." b. "It is safe during the daytime but expect people loitering around." c. "Someone needs to go to that community, so don't stereotype them." d. "We can arrange another nurse to go with you."
b
3. The HCC model process relies on a problem-solving approach to achieve goals. The best example of this approach is which of the following? a. Community activists lobbying their state legislature to mandate increased primary care access b. Community-oriented nurses using the nine-step Community Health Promotion Model (CHPM) to encourage and empower community members to take responsibility for change c. Health care professionals working independently to determine priorities for their community and then educating their community about these health-promotion needs d. Teachers using health-promotion curricula to reduce teenage smoking in their community
b
3. The Social Security Act of 1935 was designed to prevent the reoccurrence of the problems of the depression. Title VI of this act provided funding for expanded opportunities for health protection and promotion. The most relevant strategy of Title VI of the Social Security Act (1935) related to public health nursing was funding which of the following? a. The Frontier Nursing Service b. Employment and education of nurses c. Research and investigation of disease d. The district nursing model
b
3. The levels of government responsible for carrying out the five government health care functions of direct services, financing, information, policy setting, and public protection are: a. federal and state. b. federal, state, and local. c. all, but primarily state and local. d. all, but primarily federal and state.
b
4. The agency that assumes the responsibility for regulating health care and overseeing the health status of Americans is which of the following? a. Department of Homeland Security b. U.S. Department of Health and Human Services c. Local Health Department d. State Department of Health
b
4. The community-oriented nurse who uses the principle of justice would demonstrate that ethical principle best when doing which of the following? a. Learns disaster triage and volunteers for service during local catastrophes. b. Has a permanent "navigation booth" to help people learn how to contact elected officials. c. Takes continuing education on emerging trends in health care such as pharmacogenomics. d. Takes the lead on a committee reviewing and revising nursing home standards.
b
5. A community health nurse manager has integrated exposure history elements into the assessment practices of the health department that are relevant to the urban industrial community served. This strategy indicates that the nurse manager is aware of the relationship between: a. community strengths and weaknesses. b. environment and human health/disease. c. toxicology studies and the environment. d. federal and state environmental regulations.
b
5. A community-oriented nurse using the principles for effective advocacy would do which of the following? a. Share data on a caseload medically indigent with philanthropic organizations. b. Follow the clients' wishes and directions tenaciously in all related activities. c. Monitor spending allocated by the state or local authorities for proper disbursement. d. Use the opinions and ideas of key community leaders first to drive policy creation and program development.
b
6. A nurse studying health care economics asks why businesses would want to spend money on employee health care, such as insurance premiums. What answer by the professor is best? a. Cost-utility analyses indicate businesses get a positive rebound on cost. b. Investing in human capital is good for the company and the economy. c. They can deduct losses such as insurance coverage from their taxes. d. This benefit carries a net-positive value for the business.
b
6. The health policy-making body of the World Health Organization (WHO) released a policy statement on nursing and midwifery in 2013. What is important for nurses to understand about WHO policy statements? Such statements: a. apply only to underdeveloped countries. b. are guides for in-country initiatives and priorities. c. carry the weight of international law. d. provide mandates for in-country legislatures.
b
7. A public health nurse (PHN) has identified a need to make amendments to an existing health-related law. The nurse knows the amendment of any existing laws would ultimately be decided by which of the following? a. Executive branch of government b. Legislative branch of government c. Local representative d. Senate hearings
b
7. Health problems exist throughout the world. In the United States, a current health concern is the appearance of new viral strains such as Hantavirus in the Southwest. This is an example of the difference in health care concerns between countries such as: a. United States and Canada. b. Sweden and Indonesia. c. Australia and Japan. d. Bangladesh and Zaire.
b
7. Monitoring and public reporting of air quality in a local community to assist individuals with asthma or other respiratory conditions best illustrates the application of: a. compliance and enforcement. b. environmental epidemiology. c. secondary prevention. d. toxicology.
b
7. The Association of Community Health Nurse Educators has called for increased graduate programs to educate Public Health Nursing leaders, educators, and researchers in such areas as: a. immigrant and migrant health. b. natural and human-made disasters. c. automobile safety for children. d. student health.
b
7. The nurse knows the Ottawa Charter identified the most effective health-promotion action as: a. creating supportive environments. b. developing health-promoting public policy. c. reorienting health services. d. strengthening community action.
b
9. An unemployed individual with acquired immune deficiency syndrome (AIDS) develops recurrent opportunistic infections that require repeated visits to the health clinic and the purchase of various medications to combat the infections and treat their associated side effects. This best demonstrates how health status can be related to: a. barriers to access. b. chronic stress. c. cumulative risk. d. socially based inequity.
b
9. Nurses consider opportunities for population-focused practice that result from the rapid transformation of health care delivery from a medical model to a health promotion/disease prevention model. Which is an example of such opportunity? a. Operator of a nurse practitioner-run urgent care center in a major retail location b. Director of clinical services providing a wide range of services to populations seen by the system c. Clinical director of a home health agency d. School nurse position in the local high school
b
9. There is strong evidence to suggest that poverty can be directly related to poor health outcomes. Poorer health outcomes lead to reduced educational outcomes for children; poor nutrition; low productivity in the adult workforce; and unstable economic growth in the population, community, and nation. These concepts reflect the human capital approach of the branch of economics known as: a. effectiveness and efficiency. b. macroeconomics. c. microeconomics. d. supply and demand.
b
MULTIPLE RESPONSE 1. A nurse in Mexico collaborates with the health committee that operates a village-based health post. They intended to discuss the planning for next year's health promotion initiative and evaluate the recent family planning program. This best demonstrates the aim of the Declaration of Alma-Alta to emphasize which of the following? (Select all that apply.) a. Availability of chemotherapeutic agents b. Development of maternal and child health programs c. Involvement and training of community health workers d. Organized approach to health education e. Promotion and acceptance of traditional medicine
b, c, d, e
MULTIPLE RESPONSE 1. Public health nursing specialists are interested in which of the following topic(s)? (Select all that apply.) a. Educational materials for individuals with HIV/AIDS b. Evaluation of an outreach program for at-risk pregnant teenagers c. Community subpopulations with high rates of type 2 diabetes d. New technologies to monitor diabetes e. Prevalence of hypertension among various age, race, and gender groups
b, c, e
MULTIPLE RESPONSE 1. A community-based HIV/AIDS clinic would be concerned about which aspects of the Public Health Code of Ethics? (Select all that apply.) a. Autonomy of the professional b. Confidentiality, when possible c. Funding d. Advocacy for disenfranchised persons e. Respect of only community rights
b, d
MULTIPLE RESPONSE 1. Vulnerable population groups are those that, in comparison with the population as a whole, have which of the following characteristics? (Select all that apply.) a. Better access to health care services but poor health outcomes b. Greater likelihood of exposure to risk factors c. Multiple risk factors but equal health outcomes d. No difference in access or outcomes d. Worse health outcomes despite access
b, d
3. What is the major barrier to achieving the "Health for All in the 21st Century in the United States? a. Global indicators are not applicable to the United States. b. Healthy People 2020 is not consistent with the Declaration of Alma-Ata. c. Primary Health Care is not the primary delivery method for health care in the United States. d. The U.S public health system is not structured to provide PHC.
c
1. Which action by the community-oriented nurse best illustrates a partnership for health? a. Assisting a school nurse in conducting vision screening of elementary school children b. Developing a volunteer program for teaching parenting skills c. Helping a group of citizens collect relevant health data and develop interventions related to potential environmental hazards d. Informing a neighborhood council that smoking is its major community health problem
c
2. A nurse has been newly appointed as commissioner of the state health department services. The programs the nurse will oversee will most likely include which of the following? a. Administration of Medicare reimbursement rates and eligibility determination b. Programs involving the local community, including sanitation and communicable disease contact tracing c. Disaster response, health care financing and administration of programs such as Medicaid, and establishment of health codes d. Monitoring drugs and over-the-counter products available for sale and use by consumers.
c
2. A registered nurse is seeking a position as a public health nurse. In reviewing the job description, the nurse would expect to find a description of a position that focused on which functions? a. Monitoring pregnant teenagers for symptoms of complications of pregnancy b. Offering free hypertension screening and treatment referral at local health fairs to low-income, uninsured, community members c. Partnering with local seasonal farmworkers to design a program aimed at preventing illness and injury, and advocating for this population with local political and community leaders d. Preventing injury among a population of elderly residents in an assisted living facility and treating residents' chronic illnesses
c
2. A rural county public health nurse is in the first phase of a community assessment to determine the health status characteristics of the local county. This initial data gathering should most likely begin with which agency? a. County public health department b. National Centers for Disease Control and Prevention c. State vital statistics bureau d. U.S. Census Bureau
c
2. A state health department nurse with budgetary responsibility for a population health framework would allocate priority funding to which activity? a. Chronic disease surveillance and treatment programs b. Pediatric and adolescent primary care and nutrition programs c. Promoting healthy lifestyles or improvement of social and physical environments d. Well and sick child clinics
c
3. A nurse takes a new position as a community health nurse. Her first assignment is to perform an assessment of the community's migrant farmworker population. What is the most appropriate step for the nurse to take first? a. Begin the community assessment using a survey tool proven effective in previous assessments. b. Perform a literature review to study assessment data for similar populations. c. Enroll in a college course to learn community research, measurement, and analysis techniques. d. Form a relationship with the farmworkers' community leaders and other key informants.
c
3. In evaluation of a program to prevent teen pregnancy, analysis of the net direct and indirect costs, the improvements in the community attributable to the program (such as lower high school dropout rates), and the costs that would result if the program were not implemented (such as the cost of care for low-birth-weight infants) is an example of which of the following? a. Cost-benefit analysis b. Cost-efficiency analysis c. Cost-effectiveness analysis d. Economic growth predictions
c
3. The nurse knows that which of the following is one of the primary contributors to vulnerability? a. Gender b. Race and ethnicity c. Resource limitations d. Urban or rural residency
c
4. A community-oriented nurse wants to design the most effective intervention to reduce Coronary Heart Disease (CHD) morbidity and mortality in a rural area. The program approach should incorporate which strategies? a. Aggregate primary prevention b. Individual level primary, secondary, and tertiary prevention c. Multilevel intervention with a focus on primary, secondary, and tertiary prevention d. Promotion of optimal health for the individual, family, aggregate, and total community
c
4. A terrorist bombing at a local church has sent many victims to the local emergency department and resulted in several deaths. Following the event, an emergency department nurse seeks out other nurses who are having difficulty performing their jobs to speak about the event. The nurse is demonstrating the disaster response strategy of: a. allaying public concern and fear. b. assisting victims to think positively and to move to the future. c. identifying feelings that individuals may be experiencing. d. preparing personnel to be effective in a disaster.
c
4. The primary impetus for the school nurse program established by Lilian Wald was to work with children in the schools and make home visits for the purpose of: a. enforcing the department of health's rules and regulations. b. excluding infectious children from the school environment. c. providing and obtaining medical treatment for absent students. d. providing shoes and clothing for students.
c
4. The role and goals of the community health nursing practice can best be described as: a. community-based interventions aimed at promoting, preserving, and maintaining the health of populations residing in institutional facilities such as nursing homes. b. education of nurses and other staff working in community-based and community-oriented settings to improve the overall effectiveness of their programs to meet client needs. c. population-level strategies aimed at promoting, preserving, and maintaining the health of populations through the delivery of personal health care services to individuals, families, and groups in an effort to improve the health of the community as a whole. d. activities targeted at improving the health status of clients served by community-based health service agencies such as hospice and home health agencies.
c
4. What entity governs nursing practice? a. Boards of nursing established by the U.S. Department of Health and Human Services. b. Nurse practice acts promulgated by federal and state legislative boards. c. Nurse practice acts created by state legislatures and operationalized by state boards of nursing. d. Nurse practice acts written by the states in conformity with broad federal guidelines.
c
4. What impact will the baby boomer generation have on the future of health care? a. Decrease in demand because they are a healthier group of older adults. b. Decrease in demand because they are less likely to use preventive care. c. Increase in demand because of increased life expectancy. d. Increase in demand because of rates of acute health problems.
c
4. Which is an example of tertiary prevention related to HCC? a. Assessing the need for programs to treat alcohol addiction b. Assessing the strengths of local schools' adolescent pregnancy prevention programs c. Initiating an evaluation of a program to address endemic hepatitis A in a community d. Organizing a community forum to explore health-promotion priorities
c
5. A small business employer desires to control company benefit expenditures by turning health care decision-making control over to the employees. Which insurance reform mechanism best addresses the shifting of responsibility, knowledge, and decision-making involvement to the individual receiving care? a. Health spending account b. Managed care c. Medical savings account (MSA) d. Prospective payment
c
5. After performing an assessment of a client seeking treatment for hypertension at the local free clinic, the nurse informs the client that the family's children may qualify for enrollment in the state children's health insurance program. The nurse provides the enrollment forms and reviews them with the client, emphasizing how to apply for the benefits. This best exemplifies which principle for intervening with vulnerable populations? a. Carrying out primary prevention b. Setting family-centered, culturally sensitive goals c. Trying to minimize the "hassle factor" d. Using the MAP-IT approach
c
5. Categorical Congressional funding has had which effect on health care? a. Positive by adoption of 2-year associate degree nursing programs b. Negative leading to exclusion of home-based care from health insurance coverage c. Negative as the national preference service model neglects emerging problems d. Positive due to the sharp rise in hospital-based care and technological resources
c
5. Commitment to which of the following best demonstrates nursing's advocacy role in primary health care initiatives in developed countries? a. Equality of health care b. Higher education for nurses c. Provision of direct client care d. Quality of care
c
5. In the disease-oriented perspective, health behavior is based on client: a. access to care. b. adjustment of lifestyle. c. compliance with a prescribed regimen. d. response to treatment.
c
5. What is the major factor driving current discussions about a Medicare shortfall in the middle of the twenty-first century? a. Diversity of the U.S. health care workforce b. Longevity of the U.S. population c. Percentage of elderly in the U.S. population d. Percentage of foreign-born in the U.S. population
c
6. A child learns at a school safety presentation the importance of wearing a bicycle helmet and requests a helmet for a birthday gift. The parent purchases a helmet like the ones worn by the child's peers. Which of the following statements best describes the relationship of healthy or risky behaviors to lifestyle choices? a. The family is responsible for the health behaviors of children. b. The individual is responsible for health behaviors. c. There is multilevel responsibility for health behaviors. d. The community has a sense of responsibility for health behaviors.
c
6. The local nurse-managed community health center initiative is providing community-based primary and preventive care as well as specialty care, community screenings, local health assessments, health education, and health care coordination, targeted to medically uninsured individuals regardless of ability to pay. What system does this best describe? a. Managed care b. Primary care c. Primary health care d. Private health care
c
6. The most important aspect of the nursing community assessment phase can best be described as: a. analyzing and synthesizing data. b. collecting and gathering data. c. formulating a community nursing diagnosis. d. identifying problem correlates.
c
9. A nurse expands a community exercise program to include a senior exercise program targeted at strength and balance training in response to the HCC initiative to address the needs of free-living elders in the local community. The nurse is most likely applying the Ottawa Charter for Health Promotion priority health-promotion activity of: a. developing personal skills. b. establishing health-promoting public policy. c. reorienting health services. d. strengthening community.
c
9. The United States is engaged in a formal agreement with Indonesia to provide economic incentives and assistance in national defense in return for the protection of U.S. private investments in that region. Which bilateral organization is most likely involved in this agreement? a. Carnegie Foundation b. United Nations c. U.S. Agency for International Development d. U.S. Department of Defense
c
1. A public health nurse has been recruited to lead a community environmental lead exposure reduction program. What action by this nurse is best? a. Advocate for funding at the state and federal levels. b. Create a multidisciplinary team to work on different aspects of the problem. c. Determine how other cities and counties have managed this problem. d. Research the number of houses likely to contain lead-based paint.
d
1. In 1988, the Institute of Medicine (IOM) published a report on the future of public health and its mission that defined public health as: a. what public-private partnerships do to treat vulnerable populations. b. what the government does to ensure that vital programs are in place. c. what the U.S. Public Health Service does to prevent disease, promote health, and deliver services. d. what society does collectively to ensure the conditions in which people can be healthy.
d
1. A low-vision client with very early dementia takes pride in her independence. The client, who lives alone in an apartment, tells her nurse she has always enjoyed using scented candles. Which is the most appropriate intervention for the nurse? a. Leave the matches and candles accessible to the client. b. Maintain the client's dignity by stating that she is capable of using them for now. c. Counsel the client of the dangers of her using candles and matches. d. Collaborates with the client to give the candles and matches to a family member who brings them during visits.
d
1. A nurse asks a couple who are new parents for their baby's full name. The parents reply that in their culture they are only supposed to give the baby its first name. What response by the nurse is most appropriate? a. Tell the couple that they are the child's parents and it is up to them to name their baby. b. Explain that the Bureau of Vital Statistics has a deadline for completing the birth certificate. c. Give the couple the paperwork and ask when the baby will have a name. d. Express interest and ask the couple to share how their new baby will receive its name.
d
1. What is a potential, unanticipated public health issue arising from international trade agreements? a. Decrease in illegal immigration across borders seeking health care. b. Decrease in contagious diseases a result of economic development. c. Improved nutrition as a result of increased amounts of healthy foods. d. Increase in foodborne disease when sanitary conditions differ between countries.
d
2. A nurse has decided to use a bottom-up approach of HCC to meet Healthy People 2020 goals for elders in the community setting. Which would be the most appropriate intervention? a. Design and implement a health-promotion activity that can be scheduled at a senior center. b. Organize a meeting of local politicians, clinicians, and community members to prioritize needs for elderly clients with diabetes. c. Recruit the mayor and city council to designate an annual Elder Health day. d. Include community members in multisectoral meetings to choose, design, and implement a culturally appropriate health-promotion activity for older adults.
d
2. An effective community-oriented diabetes program should include which of the following? a. Access to a certified diabetes educator to teach the client self-management strategies. b. Care that incorporates the American Diabetes Association treatment guidelines. c. Availability of a primary care provider, medication and supplies, and nutritionist. d. Self-management education and family education, access to affordable clinical care, medication, and testing supplies.
d
3. A public health nurse leader is encountering barriers when trying to shift the public health agency's efforts to a population-focused practice. Which of the following is most likely to be the rationale for the lack of support? a. Colleagues' push for nurses to focus on population initiatives. b. Costs associated with staff training and revision of documents. c. Lack of support from the agency's funding sources. d. Opinions that nursing should focus on direct client care and services.
d
3. The Framingham Heart Study and the Alameda County study are historically important to the development of public health multilevel interventions. Which statement best describes the contribution made by these studies? a. Both focus on urban health risks and interventions to reduce the impact of those risks on the local population. b. Both are longitudinal studies that can help community-oriented nurses design interventions to reduce cardiac morbidity and mortality. c. Both studies show that young men who cease smoking reduce their risk of coronary disease, even if they develop moderate obesity as they become middle-aged. d. Both studies examined personal and environmental factors that influence long-term health outcomes and demonstrate the need for individual and community level interventions.
d
3. The nurse analyzing data from reports of the global burden of disease would learn about which of the following topics? a. Costs to the world of treating communicable disease in less-developed countries. b. Economic cost of preventable early deaths. c. Impact of disability on the international economic forecast. d. Years in lost contribution to economic growth.
d
4. A public health nurse leader is working with community leaders and interested citizens to improve access to services for the underserved by planning an expansion of the local community health clinic. This is an example of which type of community partnership model? a. Coalition b. Democratic c. Passive d. Community member-professional
d
4. Campaigns to decrease the inequitable burden of environmental risks on the poor and people of color in the United States strive to apply which ethical principle? a. Societal justice b. Nonmaleficence c. Beneficence d. Environmental justice
d
6. One seminal event that significantly shifted nursing's focus to ethical decision making was the emergence of the field of bioethics. In conjunction with bioethics, what other event occurred to shape this agenda? a. Adopting the ANA's Code for Professional Nurses b. Adopting the American Public Health Association's Public Health Code of Ethics c. Promoting the International Council of Nurses' Code of Ethics for Nursing d. Returning ethics courses to nursing programs in institutions of higher education
d
7. A nurse uses the social-ecological model to guide care is planning an interpersonal level program for community-dwelling elders who frequent a community senior center. What program will the nurse plan? a. Bus transportation to the center b. Telehealth visits c. Volunteer opportunities d. Weekly social events
d
8. A new nurse is starting a job in public health working with vulnerable populations. What advice by the nurse manager would be most beneficial? a. "Be mindful of your documentation; we don't want reimbursement issues." b. "I'd encourage you to attend county board meetings." c. "It's important for you to get out there and network." d. "The first thing you need to do is to establish trust with clients."
d
8. The collaborative partnership best practice of "identifying specific community and system changes to be sought to effect widespread behavior change and community health improvement" would best apply to which concept of the Ottawa Charter for Health Promotion strategic framework? a. Creating supportive environments b. Establishing health-promoting public policy c. Reorienting health services d. Strengthening community action
d
8. The public health nurse is planning community programs. Which program would the nurse plan to incorporate utilitarianism? a. Ensuring vaccinations in poorer neighborhoods b. Providing vaccinations to low-income senior centers c. Using stakeholders to determine priority areas for vaccinations d. Widespread influenza vaccination events
d
8. When applying the nursing process to environmental health, which action would the nurse take? a. Conduct an assessment focused on a client's presenting problem. b. Coordinate interventions with the primary care provider of record. c. Examine criteria that are limited to the client's immediate responses. d. Include outcome measures to mitigate and eliminate the contributing factors.
d
9. Caring and the ethic of care were developed in the mid-1980s and early 1990s in response to and the desire of nurses to do which of the following? a. Apply gender-related voices to moral judgment. b. Apply principles of utilitarianism. c. Differentiate distributive justice from beneficence. d. Differentiate nursing practice from medical practice.
d
