Test 2 Population Health
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 A Collaboration B Communication C Cooperation D Negotiation
A Collaboration
Migrant workers and their families who reside in a specific mobile home park during the summer months would best be classified as a A Community B Group C Setting of Practice D Target Population
A Community
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 A Community forums B Focus groups C Key informants D Surveys
A Community forums
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: A Evaluation phase B Implementation phase C Needs assessment D Problem analysis
A Evaluation phase
The nurse engaging in formative program evaluation would most likely A Conduct medical record audits for quality assurance B Make a home visit before a client is discharged from the program C Participate in new client evaluation D Write policy for risk management
A Conduct medical record audits for quality assurance
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 A Efficiency B Progress C Relevance D Sustainability
A Efficiency
The major sources of information for program evaluation are A Community indicators B Media reports C Program clients D Program providers E Program records
A, C, E
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 A Adapting and coping responses B Intellectual capacity C Socioeconomic status D Spiritual awareness
A Adapting and coping responses
A nurse coordinating care for undocumented minority workers with a high incidence of 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 A Advocacy and case management B Advocacy and continuity of care C Care management and case management D Care management and continuity of care
A Advocacy and case management
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
The nurse in community health identifies an elder abuse problem because of caregiver stress among families in the local community resulting from lack of caregiver support services. The next step in the community-oriented nursing process would be to: A Analyze the community problem B Establish priorities C Establish goals and objectives D Identify intervention activities
A Analyze the community problem
The public health nurse is most likely to use what types of surveillance systems? A Active B Passive C Sentinel D Syndronic
A B
A nurse is collecting data to identify health needs in the local community. Which of the following are examples of secondary data the nurse should review? A Birth statistics B Previous health survey results C Windshield survey D Community forum E Health records
A B E
Identification of the discrepancies between the quality standards of the agency and the actual practice of the health care professionals is part of the interpretation component of quality assurance programs. Other factors addressed during this stage are (select all) A Choices of possible courses of action B Follow up evaluation C Strengths and weaknesses D Taking action
A C
What terms are used to describe healthy families? A Families with strengths B Dysfunctional C Functional families D Resilient families E Resistant families
A C D
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? A Bed wetting episodes B Desire to return to school C Fantasies of denial D Increased playfulness with peers E Thumb sucking
A C E
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
The most important causes of preventable disease, disability, and death among children are A Injuries and accidents B Maintaining a healthful diet C Physical exercise D Cardiovascular health
A Injuries and accidents
A nurse is conducting a community assessment. Which of the following data collection methods is the nurse using when having direct conversations with individual members of the community? A Key informant interviews B Participant observation C Focus groups D Health surveys
A Key informant interviews
The patient self determination act of 1991 requires that providers receiving Medicare and Medicaid funds gives clients written information regarding A Legal options for treatment choices in the event the person becomes incapacitated B Patient rights C The cost of services D Patient privacy
A Legal options for treatment options in the event the person becomes incapacitated
The hospital infection control practitioner reports new cases of TB 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
An underlying current throughout the special population groups with health disparities is A Poverty B Aging C Minority groups D Children
A Poverty
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 to achieve continuous quality improvement B quality assurance to achieve continuous quality improvement C Risk management to achieve quality D Continuous quality improvement to achieve total quality management
A Total quality management to achieve continuous quality improvement
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
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) A Risk analysis B Data mapping C Provision of illness care D Epidemiologic investigation of unexpected illnesses E Counseling and education
A, B, D
Which of the following best supports the concept of community-oriented nursing practice? (Select all that apply) A Direct nursing care of individuals with 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, C, D
A nurse is preparing to conduct a windshield survey. Which of the following data should the nurse collect as a component of this assessment? A Ethnicity of community members B Individuals who hold power within the community C Natural community boundaries D Prevalence of disease E Presence of public protection
A, C, E
A home health nurse is discussing portals of entry with a group of newly hired assistive personnel. Which of the following are portals of entry the nurse should discuss? A Respiratory secretions B Skin C Genitourinary tract D Saliva E Mucous membranes
B C E
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
What are the core competencies of the nurse participating in surveillance and investigation activities? A Basic patient assessment skills B Effective communication skills C Ability to collaborate with community partners D Advance practice nurse with secondary science degree E Leadership and systems thinking
B C E
Consumers and providers of healthcare have vested interest in the quality of the healthcare system because quality healthcare A Decreases safety B Increases safety, reduces, cost, increases patient confidence C Always causes an increase in cost D Decreases confidence in the care provieded
B Increases safety, reduces cost, increases patient confidence
Describe how community agencies like ARC and Medical Reserve Corps work together to prepare for, respond to, and recovery from disasters
ARC prepares workers and volunteers by teaching CPR and holding education sessions on what to do for attacks, respond by opening up shelters to the community, and recover by providing assistance to rebuilding
Give an example of how each of these four steps of the nursing process is used in community oriented nursing practice
Assessment: the nurse uses the community assessment process of gathering relevant data/generating missing data through methods such as windshield surveys, information interviewing, participant observation, secondary analyses of existing data, development of a composite database, and interpreting the composite database to identify community strengths and problems Planning: the nurse prioritizes among a community's health problems, establishes goals and objectives, and plans intervention activities to accomplish objectives. Interventions: the nurse is involved in activities aimed at attaining goals/objectives. Nurses may be acting in content focused roles like change agent and change partner, develop strategies in partnership Evaluation: the nurse appraises the accomplishment of objectives and effects of interventions. The nurse looks as results particularly in relationship to the community and the nurse's ideas about health. Outcomes are considered in terms of effectiveness and in terms of appropriate or inappropriate interventions
When acting as a mediator, the nurse advocate would: A Choose a new health plan for a client with limited funds B Assist new parents in communicating with their health plan regarding well-baby coverage C Provide health education to teens who need knowledge about sexually transmitted diseases D Set up a doctor's appointment for an illiterate adult
B Assist new parents in communicating with their health plan regarding well baby coverage
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 A Behavioral issue B Policy issue C Health risk issue D Social issue E Nursing issue
B C D
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 anyways" 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 purposes of disease surveillance in public health? 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 C E
Which of the following statements accurately describe the stress reaction phases a community may experience during a disaster response? A Disillusionment and reconstruction is most associated with response efforts B During the heroic phase, there is overwhelming need for people to do whatever they can to help others survive the disaster C In the Honeymoon phase, survivors may be rejoicing in that their lives and the lives of loved ones have been spared D Disillusionment is the longest phase in the stress reaction process E The disillusionment phase occurs after time elapses and people begin to notice that additional help and reinforcement may not be immediately forthcoming
B C E
Which of the following statements are true regarding the health related vulnerabilities of men? A More males die at birth B Fewer health services are offered to men C Men often put work ahead of their health needs D More males die from suicide E Men often incur more work related injuries than women
B C E
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: A Care management B Case management C Continuity of care D Disease management
B Case management
A nurse in community health is invited to work with a coalition of churches to address safety concerns for the 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: A Change agent B Change partner C Group leader D Data collector
B Change partner
A community health nurse is determining available and needed supplies in the event of a bioterrorism attack. The nurse should be aware that community members exposed to anthrax will need access to which of the following medications? A metronidazole (flagyl) B ciprofloxacin (Cipro) C Zanamivir (Relenza) D Fluconazole (Difulcan)
B Ciprofloxacin
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: A Community B Community as client C Individual as client D Partnership
B Community as client
A nurse is completing a needs assessment and beginning analysis of data. Which of the following actions should the nurse take first? A Determine health patterns within collected data B Compile collected data into a database C Ensure data collection is complete D Identify health needs of the local community
B Compile collected data into a data base
One specific approach to quality assurance is the use of total quality management. The 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
Family health can be defined as a dynamic, changing, relative state of well being that includes biological, psychological, sociological, cultural, and spiritual factors of a family system. This family health approach would best include which of the following underlying principles? A Assessment of the individual's health does not determine the overall family system's health B Family functioning affects the health of the 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 D E
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 A Data gathering B Data generation C Data interpretation D Problem identification
B Data generation
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 A Anger B Delayed stress reaction C Inability to concentrate D Insomnia
B Delayed stress reaction
The community health nurse is aware that African American adults are more likely to be admitted to the hospital for which of the following conditions A Newly diagnosed HIV infection B Diabetic patient with lower extremity wound C Testicular cancer D Psychiatric disorders
B Diabetic patient with lower extremity wound
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? A Anxiety B Effects of stress on individuals C Sense of urgency D Scapegoating and blaming
B Effects of stress on individuals
A major evaluation source for a nurse to use to determine the effectiveness of a teen driver safety program is A CDC reports B Epidemiologic data C Recent census data D Voter registration records
B Epidemiologic data
A newly hired public health nurse is familiarizing himself with the levels of disaster management. Which of the following actions is a component of disaster prevention? A Outlining specific roles of community agencies B Identifying community vulnerabilities C Prioritizing care of individuals D Providing stress counseling
B Identifying community vulnerabilities
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 A Environmental hazards are minimal B Individuals must ultimately recover on their own C The government provides economic support D Religious organizations must bear the burden of the community
B Individuals must ultimately recover on their own
Nurses often participate on field assessment teams (surveillance) during a disaster response. These assessments are crucial to best help A Encourage good intentions of those giving aid B Match available resources to the population's emergency needs C Separate casualties and allocate treatment D Provide compassion and dignity
B Match available resources to the population's emergency needs
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 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 B Quality Assurance C Risk management D Total quality management
B Quality assurance
A community is experiencing the honeymoon phase following a disaster-what is most likely to occur in the community A First responders work tirelessly to save others B Survivors share their stories C Medical personnel experience exhaustion D Community organizations reubild the community
B Survivors share their story
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
Which of the following examples best illustrates partnership for health? Explain your answer A. Telling interagency council members that teen pregnancy is the major health problem in their service area B. Helping a rural community council survey area water supplies C. Developing a volunteer program for local health and welfare agencies D. Helping a high school counselor and school nurse determine students' health education needs
B. Helping a rural community council survey area water supplies
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 A Negotiating B Cooperation C Assertiveness D Aggressiveness
C Assertiveness
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 school nurse is working with the Parent Teacher Organization 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 A Asthma B Attention deficit disorder C Childhood obesity D Poisoning
C Childhood obesity
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
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
A community health nurse is educating the public on the agents of bioterrorism. Which of the following are Category A biological agents? A Hantavirus B Typhus C Plague D Tularemia E Botulism
C D E
A particular chronic health problem that adversely affects the aging experience for which it is difficult to estimate the number of individuals affected or the associated cost to manage is A Iatrogenic drug reactions B Immobility C Incontinence D Intellectual impairment
C Incontinence
A nurse is preparing a community health program on communicable diseases. When discussing modes of transmission, the nurse should include which of the following as an airborne illness? A Cholera B Malaria C Influenza D Salmonellosis
C Influenza
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 A Conduct a survey to determine how many children the fathers have B Determine whether the fathers benefitted from this type of program before C Meet with community members to form a planning body D Provide the fathers with community resources
C Meet with community members to form a planning body
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
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? A Assessment protocol for excellence in public health (APEXPH) B Health evaluation data information system (HEDIS) C Mobilizing for Action Through Planning and Partnership (MAPP) D Planning Approach to Community Health (PATCH)
C Mobilizing for action through planning and partnership (MAPP)
A community health nurse involved in care management would most likely: A Develop, conduct, and evaluate health teaching programs in primary care B Manage the staff at a free clinic C Monitor the health status, resources, and outcomes for an aggregate D Provide immunizations for migrant workers
C Monitor the health status, resources, and outcomes for an aggregate
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's 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
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
Elderly clients should be assessed for signs of abuse. The illegal use of a person for another person's profit is known as A Neglect B INcompetence C Exploitation D Self determination
C exploitation
List 5 general areas of risk for case managers
Liability for managing care, negligent referrals, experimental treatment and technology, confidentiality, fraud and abuse
Identify the activities used in case management
Case finding, screening, intake assessment, identification of problems, advocacy of client interests, arrangement for service delivery, monitoring, reassessment, and evaluation
Identify the eight items in which teamwork and collaboration demand knowledge and skills
Clients Heath STatus Resources Treatments Community providers Clients and families complex needs Intrapersonal, interpersonal, medical, nursing, and social dimensions Team member and leadership skills
List six common tools used for needs assessment
Community forums, focus groups, key informants, indicators approach, surveys of existing community agencies, surveys
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
Contemporary family function
What is a continuous source outbreak?
Continuous source outbreak is when a disease is spread for a specific incubation period
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: A Community B Community client C Community health D Community partnerships
D Community partnerships
A 3 year smoking cessation program for teens has just concluded. The type of evaluation the staff will conduct is A A formative evaluation B An informal evaluation C An ongoing evaluation D A summative evaluation
D A summative evaluation
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 A Justice B Veracity C Deontology D Beneficence
D Beneficence
Which of the following social science theories is used by public health nursing to describe how environments and systems outside 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 system theory
A nurse is planning a community health program. Which of the following should the nurse include as part of the evaluation plan? A Determine availability of resources to initiate the plan B Gain approval for the program from local leaders C Establish a timeline for implementation of interventions D Compare program impact to similar programs
D Compare program impact to similar programs
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 the 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
The nurse in community health is meeting with staff to systematically plan for a new outreach program. Doing so helps them to A Assess the needs of potential outreach clients B Recognize the special needs of vulnerable people in the area C Identify how the problems of similar programs will not be repeated D Identify the resources and activities that will help them meet their program objectives
D Identify the resources and activities that will help them meet their program objectives
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
A disease outbreak of severe acute respiratory syndrome has occurred and has spread over several countries outside the united states. The level of occurrence is said to be A Hyperendemic B Sporadic C Epidemic D Pandemic
D Pandemic
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: A ARC disaster training B Community preparedness C Personal preparedness D Professional preparedness
D Professional preparedness
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
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: A Intercessor B Mediator C Obstructer D Promoter
D Promoter
In the event of a disaster, shelters are generally the responsibility of which of the following entities? A Centers for Disease Control and Prevention B Federal Emergency Management Agency C Public Health service D Red Cross Chapter
D Red Cross Chapter
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
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 A Behavior modification techniques B Effects on the environment C Laws regarding tobacco sales to minors D Social skills instruction to resist pressure to smoke
D 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: A Partnership B Process C Status D Structure
D Structure
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 programs A Efficiency B Impact C Relevance D Sustainability
D Sustainability
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
The major factor that has increased Florida's vulnerability to natural disasters in recent decades has been: A El Nino B Geography C Trade winds D Urbanization
D Urbanization
To maintain effective disaster preparedness, nurses working in the community can play a critical role in providing an updated record of: A Immunizations B Active TB cases C WIC enrollees D Vulnerable populations
D 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: A Composite database B Participant observation C Secondary Analysis D Windshield survey
D Windshield survey
Many families have financial resources that allow them to maintain themselves but limit the quantity 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 D Women, Infants, and Children
D Women, Infants, and Children
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 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: A Community cost concerns B Community conflict-resolution skills C Community satisfaction D Community weakness in quality of services E Community weaknesses in quantity of services
D, E
Describe six steps of program evaluation
Engage stakeholders, describe the program, focus on the evaluation design, gather credible evidence, justify conclusions, and ensure use and share lessons learned
True of false: the timing of a disaster does not influence the types of injuries that will occur
False
Identify three activities used by the nurse in the advocacy process
Informing, supporting, affirming
Name the program evaluation sources
Interview, observation, attitude scale, patient satisfaction
Discuss types of disasters (natural or human made) and the effects they have on the community
Natural are worse for communities because they aren't as prepared for them and don't have time to evacuate, human made can have serious effects because they are hard to determine at first as many biological terrorist attacks have symptoms of the flu
By what dimensions would a nurse describe community?
People, place, function
Describe the disaster management phases and give examples of the nurses role in each phase
Prevent: mitigate risks and minimize chances of disaster-hold education sessions Preparedness-personal preparation, professional preparation, community preparation Response-volunteering in triage, connecting people with resources they need, clinics Recovery-longest phase, most chance for disease outbreaks to occur, rebuilding the community
Describe the types of program evaluation measures
Program records and community indices serve as major sources of information for program evaluation Setting goals and writing objectives to meet the goals are necessary to evaluate program outcomes
Define public health surveillance and describe the different type of surveillance systems
Public health surveillance allows for nurses to monitor disease trends, improve morbidity and mortality rates, prevent and recover from outbreak Passive: when nurses report incidences of diseases to state health department Active: when members of health department look at hospitals for trends of diseases Sentinel: monitoring of commonly occuring disease trends Special: combination of active, passive, and sentinel
List the seven aspects of program evaluation
Relevance, adequacy, progress, efficiency, effectiveness, impact, sustainability
What is the community health nurse's roles in surveillance and outbreak?
Report cases of disease to health department, aid in providing immunizations in clinics, recognize early symptoms in patients, home visits
Consider the previous statement and the activity in which the nurse in involved. For each activity, define the target of service and unit of service
Target of service is junior high school students, unit of service is aggregate Target of service is families with children, unit of service is family Target of service is children on playground, unit of service is individual child Target of service is teachers, unit of service is aggregate
In a routine day, a nurse A. Conducts a scoliosis screening clinic at a junior high school B. Makes a home visit to the parents of a child with high absenteeism rate C. Bandages a child injured on the playground D Plans a first aid course for teachers Which of these activities exemplify community oriented nursing practice
The scoliosis screening visit, home visit to parents with child of high absenteeism rate, and planning a first aid course.
What is the role of the CQI team when an incident report is generated?
They can resolve the issue while the care is still being given and encourage the care team to look for improvements before the patient is discharged
In treating a worker injured at a construction site, the nurse interviews the worker, the foreman, and several of the co-workers. Does this exemplify community oriented nursing practice? Why or why not?
Yes, if target of service is the entire workforce and not just the injured individual. The goal might be to establish and maintain adherence to safety regulations
How does continuous quality improvement differ from quality assurance and total quality mangement
continuous quality improvement focuses on what is being done as the patient is receiving care-they want the best EBP being used for the patient and can change practice as it is occuring, quality assurance is looking at how the hospital performed for standards of excellence, and total quality management is a patient oriented philosophy to mitigate health care issues before they occur
Name 3 ethical and legal issues common to performing advocacy and case management activities
informed consent, conflict of allegiance between employer, payer, client, competition for scarce resources, abandonment, negligence, fraud, abuse, and referral kickbacks
