Test Bank for Community and Public Health Nursing, 10th Edition (Chapters 1-30)

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COMMUNITY AND PUBLIC HEALTH NURSING 10THEDITION RECTOR TEST BANKChapter 1 The Journey Begins: Introduction1.After teaching a group of nursing students about the similarities and differences betweenpublic health and community health, which of the following statements by a nursing studentwould indicate knowledge of the similarities and differences between public health andcommunity health?A)<Community health nursing is defined asnursing care that is provided in a community setting, rather thanan institutional setting.=B)<Public health nursing is defined as nursing care that is provided in an institutionalsetting.=C)<Public health nursing is focused on thehealth of individuals.=D)<Community health nursing can shape the quality of community health services andimprove the health of the general public.=Ans:DFeedback:Operating within an environment of rapid change and increasingly complex challenges,this nursing specialty holds the potential to shape the quality of community health services andimprove the health of the generalpublic.2.Which of the following statements would bestdescribe the difference between public health nursing and community health nursing?A)Public health nursing is focused on the private aspects of health, and community healthnursing is focused on the public aspects ofhealth.B)In our textbook, the term community health practice refers to a focus on specific,designated communities and is a part of thelarger public health effort.C)Public health nursing and community health nursing relate to the very same types ofservices and perspectives.D)Both public health nursing and community health nursing are practiced exclusivelywithin institutions.Ans:BFeedback:

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In this textbook, community health practice refers to a focus on specific, designatedcommunities. It is a part of the larger public health effort and recognizes the fundamentalconcepts and principles of public health as its birthright and foundation for practice. Publichealth nursing is focused on the public aspects of health. Public health nursing and communityhealth nursing have distinctive types of services and perspectives. Neither public health nursingnor community health nursing is practiced exclusively withininstitutions.3.Which of the following is most accurate aboutthe concept of community?A)A community is a collection of people whoshare some important features of their lives.B)Community members live in the samegeographic location.C)Community members are biologically related.D)A community is made up of people who do not necessarily interact with one another anddo not necessarily share a sense of belongingto that group.Ans:AFeedback:The broad definition of a community is a collection of people who share some importantfeatures of their lives. Community members may not live in the same geographic location as in acommon-interest community or a community of solution. A population is made up of peoplewho do not necessarily interact with one another and do not necessarily share a sense ofbelonging to thatgroup.4.A group of students are reviewing material for a test on populations, communities, andaggregates. Which of the following indicatesthat the students understand these concepts?A)Members of a population share a sense ofbelonging.B)Communities and populations are types ofaggregates.C)Individuals of a community are looselyconnected.D)Members of an aggregate share a strong bond.Ans:BFeedback:An aggregate refers to a mass of grouping of distinct individuals who are considered as awhole and who are loosely associated with one another. Communities and populations are typesof aggregates. A population is made up of people who do not necessarily interact with oneanother and do not necessarily share a sense of belonging to the group. A community is a

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collection of people who chose to interact with one another because of common interests,characteristics, or goals, which form the basis for a sense of unity orbelonging.5.Which of the following would a community health nurse identify as a community ofcommon interest?A)The global communityB)Small rural town in a northern stateC)National professional organizationD)Counties addressing water pollutionAns:CFeedback:A common-interest community shares a common interest or goal that binds the memberstogether. Membership in a national professional organization is one example. The globalcommunity and a small rural town in a northern state would be examples of a geographiccommunity. Counties addressing a water pollution problem would be an exampleof a community of solution.6.The nurse is working with a community of solution. Which of the following would thenurse expect to find?A)A health problem affecting the groupB)Common goal binding members togetherC)Sharing of a similar goalD)Locational boundariesAns:AFeedback:A community of solution involves a group of people coming together to solve a problemthat affects them. A common-interest community involves a collection of people widelyscattered geographically who have an interest or goal that binds the members together. Ageographical community is one defined by its geographical or locationalboundaries.7.Which one of the following statements made by a student would the nurse educatorrecognize as evidence that a studentunderstands the health continuum?A)The distinction between health and illness iswell demarcated.B)Illness refers to a state of being relativelyunhealthy.C)The term health is limited to reflect anindividual's state.D)Treatment of acute conditions reflects thecurrent focus of health care.Ans:B

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Feedback:Although society typically depicts an absolute line of difference between being eitherwell or ill, health is considered a relative term. Thus, illness is viewed as a state of beingrelatively unhealthy. Health is typically described as a continuum that involves a range ofdegrees from optimal health at one end to total disability or death at the other. The line ofdemarcation is not clear. Health applies to individuals, families, and communities.Traditionally, most health care has focused on the treatment of acute and chronic conditions atthe illness end of the continuum, but this emphasis is shifting to focus on the wellnessend.8.When discussing the concept of the health continuum with a class, the nurse educatorwould be certain to include which statementin the description?A)Wellness is a relative concept, not an absolute, and illness is a state of beingrelatively unhealthy.B)A client's placement on the health continuumis static throughout time.C)Health is best described as cyclic.D)The health continuum can only be applied toindividuals.Ans:AFeedback:Wellness is a relative concept, not an absolute, and illness is a state of being relativelyunhealthy. The continuum can change. Because health involves a range of degrees from optimalhealth at one end to total disability or death at the other, it is often described as a continuum. Thehealth continuum applies not only to individuals butalso to families and communities.9.After discussing the leading health indicators with a class, which condition if stated bythe class as one of these indicators suggests thatthe class has understood the information?A)Cardiac diseaseB)Mental healthC)Sedentary lifestyleD)Maternal health careAns:BFeedback:Mental health is a leading health indicator. Other leading health indicators includephysical activity, overweight and obesity, tobacco use, substance use, responsible sexualbehavior, injury and violence, environmental quality, immunization, and access to healthcare.

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10.Which of the following statements abouthealth promotion and disease prevention is the most accurate?A)Health promotion and disease prevention include all efforts that seek to move peoplecloser to optimal well-being or higher levelsof wellness.B)Disease prevention differs from health promotion in that disease prevention istargeted toward a specific disease or diseases.C)Health promotion can be described in terms ofprimary, secondary, and tertiary prevention.D)The goal of disease prevention is to raise levels of wellness for individuals, families,populations, and communities.Ans:BFeedback:Health promotion includes all efforts that seek to move people closer to optimal well-being or higher levels of wellness. The goal of health promotion is to raise levels of wellness forindividuals, families, populations, and communities. Disease prevention is targeted toward aspecific disease or diseases and consists of primary, secondary, and tertiaryprevention.11.A group of community health nursing students design a health education program for agroup of pregnant teens that includes teaching nutrition during pregnancy, demonstrating helpfulexercises, and discussing their concerns. This is an exampleof which of the following?A)Health promotionB)Treatment of disordersC)RehabilitationD)EvaluationAns:AFeedback:The student nurses are engaging in health promotion activities. Health promotionincorporates all efforts that seek to move people closer to optimal well-being or to higher levelsof wellness. Treatment of disorders would include direct care for issues involving the group,such as complications that might arise in this population.Rehabilitation would involve activities to minimize disability or restore or preserve function.Evaluation would involve an analysis of the effectiveness of theseactivities.12.plan of primary prevention activities. Which of the following might the nurse include?Select all that apply.A)Teaching about safe-sex practices to high

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school studentsB)Encouraging older adults to install safetydevices in the bathroomC)Providing regular immunization programs forcommunicable diseasesD)Participating in cholesterol screeningprograms at health fairsE)Providing skin testing for tuberculosis forchildren over 1 year of ageF)Working with a group testing water samplesfor contaminationAns:A, B, CFeedback:Primary prevention activities are those taken to keep illness or injuries from occurring.These include teaching about safe-sex practices, encouraging older adults to use safety devices inthe bathroom, and providing regular immunization programs for communicable diseases.Cholesterol screening programs, skin tests for tuberculosis, and working with a group testingwater samples for contamination are examples of secondary prevention activities.13.A community health nurse is preparing a presentation for a group of nursing studentsabout community health nursing. Which of the following descriptions about community healthnursing would the nurse most likelyinclude in the presentation?A)Focusing on addressing continuous needsB)Working with the client as an equal partnerC)Engaging in tertiary prevention as the priorityD)Encouraging clients to reach out to the nurseAns:BFeedback:The community health nurse works with the client as an equal partner, encouragingautonomy. At any time, the nurse deals with continuous and episodic needs simultaneously.Primary prevention is the priority for community health nurses. The community health nurseengages in primary prevention as the priority, having the obligation to actively reach out to allwho might benefit from a specific activity orservice.14.A community health nurse is working with other members of a team that will beimplementing a citywide immunization program. The nurse is coordinating the services andaddressing the needs of the population groups to ensure which of thefollowing?A)Involvement of the communityB)Client participationC)Continuity of serviceD)Plan for follow-upAns:CFeedback:

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Working in cooperation with other team members and coordinating services andaddressing the needs of population groups are essential to interprofessional collaboration. Indoing so, the community health nurse is preventing fragmentation and gaps thereby ensuringcontinuity of service. Involvement of the community and client participation are important butthese help to ensure that the clients are viewed as equal partners of the health care team. A planfor follow-up may or may not be appropriate. In addition, it is the only aspect that may beaddressed with theprogram.15.A community health nurse works to ensure the greatest good for the greatest number ofpeople by applying which of the following?A)Secondary prevention activitiesB)AutonomyC)JusticeD)UtilitarianismAns:DFeedback:The ethical theory of utilitarianism promotes the greatest good for the greatest number.Primary prevention activities, not secondary prevention, are the priority. Autonomy refers to thefreedom of choice. Justice involvestreating people fairly.16.When working in the community, the community health nurse adopts the teaching plan toensure that the population understands the basic information provided to addresswhich of the following?A)Self-careB)Health disparitiesC)Health literacyD)Episodic needsAns:CFeedback:Consumers are often intimated by health professionals and are uninformed about healthand health care affecting the quality of care.Adopting a teaching plan to ensure that the population understands the basic informationaddresses health literacy, the ability to read, understand, and use health care informationappropriately. Doing so helps to ensure that the teaching plan will be effective. Self-care refers tothe process of taking responsibility for developing one's own health potential by activelyparticipating in promoting one's own health. Health disparities reflect differences in all aspects ofhealth care related to vulnerable populations. Episodic needs are one-timespecific negative health events that arise and are not an expected part of life.

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17.Which of the following would be crucial for the community health nurse to address as thepriority when dealing with policy makers about the development of community healthprograms?A)Research-based best practicesB)Population's make upC)Amount of services to be providedD)Scarcity of the available resourcesAns:AFeedback:Decisions for programs or services are often made on the basis of cost-effectiveness orcost3benefit. Therefore, community health nurses must provide policy makers with informationabout best practices, grounded in research. Although population make up, amount of services tobe provided, and scarcity of resources are factors that may need to be considered, the communityhealth nursemust demonstrate evidence-based practice.18.After a class that described the differences between acute care nursing and communityhealth nursing, which statement by the class about community health nurses indicatessuccessful teaching?A)Use a reactive approach.B)Seek out potential health problems.C)Concentrate on the illness end of thecontinuum.D)Emphasize curative care.Ans:BFeedback:Community health nurses, in contrast to acute care nurses, seek out potential healthproblems, identifying high-risk groups and instituting preventive programs; use a proactiveapproach; concentrate on the wellness end of the health continuum; and putless emphasis on curative care.19.Which of the following activities would be associated with a community health nurse?Select all that apply.A)Examining infants in a city well-baby clinicB)Caring for elderly stroke victims in theirhomesC)Providing emergency care in an acute carefacilityD)Carrying out epidemiologic researchE)Participating in health policy analysisAns:A, B, D, EFeedback:Community health nurses work in every conceivable kind of community agency, from astate public health department to a community-based advocacy group. Their duties rang fromexamining infants in a well- baby clinic or teaching elderly stroke victims in their homes to

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carrying out epidemiologic research or engaging in health policy analysis and decision making.Providing care in an acute care facility would not be an activityassociated with a community health nurse.20.The term health can be described in many different ways. A community health nursewould view health as which of the following?A)The absence of diseaseB)The potential to lead a productive lifeC)An environment free of toxinsD)A holistic state of well-beingAns:DFeedback:Community health nurses view health as a holistic state of well-being, which includessoundness of mind, body, and spirit. Along with this foundational view is the emphasis onwellness, which includes the definition of health as well as the capacity to develop a person'spotential to lead a fulfilling and productive life. Health is more than just the absence of disease oran environment free oftoxins.21.While interviewing a client, which of the following statements would a nurse identify asreflecting an objective dimension ofhealth?A)<I'm feelingbetter since I started taking thatmedication.=B)<Life is pretty good right now, except for anoccasional upset stomach.=C)<I'm able to wash myself in the mornings withjust a bit of help.=D)<Sometimes when I wake up, I don't evenwant to face the day.=Ans:CFeedback:The objective dimension of health involves one's ability to function in daily activities.The statement about being able to care for one's self is an example. The statements of feelingbetter with medication, life being pretty good, and not wanting to face the day are examples ofthe subjective dimension ofhealth, which involves how people feel.22.When employing a population-oriented focus, the community health nurse would dowhichof the following?A)Assess the groups' relationships looking for acommon need.B)Consider the members individually for

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similarities.C)Focus on the geographical area of thepopulation.D)Promote the groups' dependency forimproving health.Ans:AFeedback:A population-oriented focus requires the assessment of relationships, considering thegroups or communities in relationship to the rest of the community to discover common needs orrisks for a common health problem. The nurse does not consider the groups or communitiesseparately but rather in context. The population may or may not be delineated by thegeographical area. The community health nurse encourages individuals' participation to promotetheir autonomy ratherthan permitting dependency.23.A community health nurse is involved in a project to evaluate the health of a city. Whichof the following findings would suggest that the city would most likely need additionalprograms?A)Citizens are actively involved in the city's department of recreation and after-schoolprograms.B)The construction of affordable organizedhousing developments and communities is nearing completion.C)Approximately one third of the people are recently unemployed due to closure of theautomotive factory.D)Several new recreational facilities for adults and children have been created at severallocations.Ans:CFeedback:A healthy city is one in which there is continual creation and improvement the physicaland social environments with expansion of community resources so that people can mutuallysupport one another. It is characterized by the meeting of basic needs for all of the city's people.This would include food, water, shelter, income, safety, and work. Loss of employment of onethird of the city's workforce would be a threat to the health of the city and necessitateintervention. Active involvement in the city's functioning, affordable housing, and recreationalfacilitiesare suggestive of a healthy city.Chapter 2 Public Health Nursing in the Community1.A community health nurse is engaging in assurance activities. Which of the followingwould best explain these activities?

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A)Gathering and analyzing information that willaffect the health of the people to be servedB)Providing leadership in facilitating community groups toward meeting their needs, ofteninvolving changes in andadditions to existing lawsC)Being involved in activities to make certain that necessary services are being provided tothe communityD)Accessing relevant data that enable identification of strengths, weaknesses, andneeds within the communityAns:CFeedback:Assurance activities are those activities that make certain that services are provided andinclude focusing on the availability of necessary health services throughout the community,maintaining the ability of public health agencies and private providers to manage day-to-dayoperations as well as the capacity to respond to critical situations and emergencies. Assessmentinvolves gathering and analyzing information that will affect the health of those to be served andaccessing relevant data to enable the nurse to identify strengths, weaknesses, and needs. Policydevelopment involves providing leadership infacilitating community groups.2.When fulfilling the function of assessment, which of the following would be mostimportant for the community health nurse todo?A)Secure the trust of the clientsB)Gather appropriate informationC)Interact with key community leadersD)Use a variety of assessment toolsAns:AFeedback:Although securing and maintaining the trust of others is pivotal to all nursing practice, itis even more critical when working in the community. Trust can afford a nurse access to clientpopulations that are difficult to engage, to agencies, and to health care providers. As difficult asit may be for the nurse to gain the trust and respect of the community, if it is ever lost, theseattributes can be difficult if not impossible to regain. Gathering information, interacting with keycommunity leaders, and using a variety of assessment tools are important, but they can onlyoccurafter trust is established.

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3.The community health nurse is engaging in the core function of policy development.With which of the activities would the nurse mostlikely be involved?A)Monitoring health status to identifycommunity health problemsB)Empowering communities about importanthealth issuesC)Linking individuals to needed personal healthservicesD)Ensuring a competent health care workforceis availableAns:BFeedback:With policy development, the community health nurse would be involved in informing,educating, and empowering people about health issues. Monitoring health status is associatedwith the assessment function.Linking individuals to needed personal health services and ensuring a competent public healthand personal health care workforce areassociated with assurance.4.A community health nurse is collaborating with local community leaders to prepare acommunity disaster plan. Which function isthe nurse fulfilling?A)ResearchB)AssuranceC)Policy developmentD)AssessmentAns:BFeedback:Community health nurses perform the assurance function at the community level whenthey collaborate with community leaders in the preparation of a community disaster plan.Research is demonstrated by gaining new insights and innovative solutions to health problems.Policy development would involve client information, education and empowerment,mobilization of community partnerships, and the development of plans and policies to supportcommunity health efforts. Assessment involves monitoring health status for community healthproblems and diagnosing and investigating health problems and hazards in thecommunity.5.A community health nurse has collected data for several months on the birth weights ofnewborns to mothers who smoked throughout their pregnancy. This nurse is acting in whichrole?A)CollaboratorB)ManagerC)ResearcherD)Clinician

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Ans:CFeedback:The nurse is assuming the role of a researcher, that is, engaging in systematicinvestigation that includes data collection. In the collaborator role, the nurse would work withnumerous members of the health team, working jointly with others in a common endeavor. In themanager role, the nurse exercises administrative direction toward the accomplishment ofspecified goals. In the clinician role, the nurse ensures the provision of health care services toindividuals,families, groups, and populations.6.A nurse in community health nursing setting works with police officers, social workers,health educators, and other nurses to promote the health of clients. The nurse is acting inwhich role?A)ClinicianB)EducatorC)ResearcherD)CollaboratorAns:DFeedback:The nurse is assuming the role of collaborator. In this role, the community health nurseworks jointly with many individuals to benefit client care. In the clinician role, the nurse ensuresthe provision of health care services to individuals, families, groups, and populations. As aneducator, the nurse is the health teacher and provides information to community clients. In theresearcher role, the community health nurse engages in systematic investigation, collection, andanalysis of data for solving problems andenhancing community health practice.7.A community health nurse is interviewing for employment. The interviewer describessome of the typical activities that the nurse would be involved in, such as making home visits tofamilies, holding immunization clinics for infants and children, and setting up flu-shot clinics forelders. The interviewer isdescribing which role?A)EducatorB)AdvocateC)ClinicianD)ManagerAns:CFeedback:The interviewer is describing direct care activities associated with the clinician role. Asan educator, the nurse is the health teacher and provides information to community clients. In theadvocate role, the nurse pleads for the clients' cause or acts on their behalf. In the manager role,the nurse exercises administrative direction toward theaccomplishment of specified goals.

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8.A community health nurse is reviewing his or her schedule for the day. Included in his orher activities are planning client care, leading a staff conference, and supervising a new staffmember. This nurse is fulfilling which role?A)AdvocateB)ManagerC)CollaboratorD)ResearcherAns:BFeedback:When functioning in the manager role, the nurse exercises administrative directiontoward the accomplishment of specified goals. Overseeing client care as a case manager,supervising ancillary staff, managing caseloads, running clinics, or conducting community healthneeds assessment projects are examples of activities associated with the manager role. In theadvocate role, the nurse pleads for the clients' cause or acts on their behalf. In the collaboratorrole, the nurse would work with numerous members of the health team, working jointly withothers in a common endeavor. In the researcher role, the community health nurse engages insystematic investigation, collection, and analysis of data for solving problems and enhancingcommunity health practice.9.While providing care to a family at a local center, the community health nurse contactsthe local department of social services to help the family attain assistance with health insurancecoverage. The nurse also gives the family a list of pharmacies where they can get theirprescriptions filled. The nurse is actingin which role?A)EducatorB)LeaderC)ClinicianD)AdvocateAns:DFeedback:The nurse is acting in the role of advocate, by pleading their cause and acting on theirbehalf. The nurse acts as an advocate by showing clients what services are available, the ones towhich they are entitled, and how to obtain them. As an educator, the nurse is the health teacherand provides information to community clients. As a leader, the nurse directs, influences, orpersuades others to effect change that will positively impact people's health and move themtoward a goal. In the clinician role, the nurse ensures the provision of health care services toindividuals, families, groups, and populations.

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10.Which of the following best exemplifies the attributes of a community health nurse in theresearcher role?A)Gaining the trust and respect of the staffmembersB)Interpreting abstract ideas so others canunderstandC)Implementing a staff development programfor a techniqueD)Evaluating the correlation between variablesin specific health conditionsAns:DFeedback:Attributes of a researcher include a spirit of inquiry, careful observation, analytic skills,such as evaluating the possible cause and effect of a situation, and tenacity. Gaining the trust andrespect of staff, interpreting abstract ideas, and implementing a staff development program areexamples of the managementskills used in the role of manager.11.Which of the following statements about therole of educator within the framework of public health nursing functions is true?A)The educator role has the potential for finding greater receptivity and providing higher-yieldresults.B)People are unable to recognize the value ofhealth and are not well motivated to achieve higher levels of wellness.C)It is only possible for a nurse to reach alimited number of persons.D)The public's higher level of healthconsciousness hinders the educator's role.Ans:AFeedback:The educator role has the potential for finding greater receptivity and providing higher-yield results. People are recognizing the value of health and are increasingly motivated toachieve higher levels of wellness. With an emphasis on populations and aggregates, theeducational efforts of community health nursing are appropriately targeted to reach many people.One factor that enhances the educator role is the public's higher level ofhealth consciousness.12.Which of the following statements about theimportance of the role of collaborator is true?A)Community health nurses frequently practicein isolation.

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B)Successful community health practice depends on multidisciplinary collegiality andleadership.C)Community health nurses must assert themselves as the most powerful person on thehealth care team to ensure each clientreceives services that are necessary.D)It is best for community health nurses to focus on what they, as nurses, can do for theirclients.Ans:BFeedback:Community health nurses seldom practice in isolation. As collaborators, nurses workjointly with others in a common endeavor, cooperating as partners. Successful community healthpractice depends on multidisciplinary collegiality and leadership. The community health nurse'scollaborator role requires skills in communicating, in interpreting the nurse's unique contributionto the team, and in acting assertively as an equalpartner.13.Which of the following statements about the community health nurse's selection andpractice of each role is true?A)Within a given time, a community healthnurse may practice multiple roles.B)The knowledge that vulnerable populations need someone to guide them through thecomplexities of the health care system and thenurse can serve as an advocate for themC)The researcher role for community healthnurses involves only the use of quantitative statistics.D)The leadership role consists solely ofmanaging staff.Ans:BFeedback:Community health nurses wear many hats while conducting day-to-day practice. At anygiven time, however, one role is primary.They need someone to guide them through the complexities of the system and assure thesatisfaction of their needs. This is particularly true for minorities and disadvantaged groups.Although research technically involves a complex set of activities conducted by persons withhighly developed and specialized skills, research also means applying that technical study toreal-practice situations. As leaders, community health nurses seek to initiate changes thatpositivelyaffect people's health.

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14.A community health nurse is involved in education, screening, referral, and support forthe individuals of a specific religious congregation. The nurse is practicing in whichsetting?A)Occupational health nursingB)Faith community nursingC)School nursingD)Residential institution nursingAns:BFeedback:In faith community nursing, the practice focal point is the faith community and thereligious belief system provided by the philosophical framework. It may be called church-basedhealth promotion, parish nursing, or primary care parish nursing practice. Occupational healthnursing occurs in business and industry settings. School nursing, as the name implies, involvespracticing in the school system, including from preschools to colleges and universities.Residential institution nursing occurs in any facility where the clients reside such as a halfwayhouse or continuing carecenter.15.Which of the following differentiates the home setting for community health nursingfrom other settings?A)The nurse acts primarily as an educator.B)The client is viewed within his or herenvironment.C)Technologically advanced care is limited.D)The home is being used less frequently today.Ans:BFeedback:In the home, unlike most other health care settings, clients are on their own <turf,= suchthat the client is the host, comfortable and secure in familiar surroundings, and the nurse is aguest. Although education may be a major component of care in the home, all community healthnursing roles are performed to varying degrees. In addition, technologically advanced care in thehome is increasing in demand, with the home being the most frequently used setting forcommunity health nursing.16.After teaching a group of students about the various settings for community healthnursing, the instructor determines that this teaching was successful when the students identifywhich of the following as an exampleof ambulatory service setting?A)Local preschoolB)Halfway houseC)Continuing care centerD)Family planning clinicAns:D

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Feedback:Ambulatory service setting includes a variety of venues for community health nursing inwhich clients come for day or evening services that do not include overnight stays. One exampleis a family planning clinic. A local preschool would be an example of a school setting. Ahalfway house and continuing care center are examples ofresidential institutions.17.After teaching a group of students about the changing roles of the community healthnurse in the occupational setting, the instructor determines that the students need additionalteaching when they state which of thefollowing?A)Occupational health nurses are increasingtheir role as employee advocates.B)Health education is a key function of theoccupational health nurse.C)There is a greater emphasis on theoccupational health nurse's role as a clinician.D)Collaboration with other health care providersfosters the offering of better services.Ans:CFeedback:The clinician role was primary for many years, as nurses continued to care for sick orinjured employees at work. However, recognition of the need to protect employees' safety and,later, to prevent their illness led to the inclusion of health education in the occupational healthnurse role. Occupational health nurses also act as employee advocates, assuring appropriate jobassignments for workers and adequate treatment for job- related illness or injury. Theycollaborate with other health care providers and company management to offer better services totheir clients. They act as leaders and managers in developing new health services in the worksetting, endorsing programs such ashypertension screening and weight control.18.A community health nurse is working as a lobbyist for health legislation for AIDSresearch at the state capital. This nurse ispracticing in which setting?A)Faith communityB)Ambulatory serviceC)Residential institutionD)Community at largeAns:DFeedback:The community at large is not confined to a specific philosophy, location, or building. Itserves as the setting for practice of a nurse who serves on health care planning committees,lobbies for health legislation at the state capital, runs for a school board position, or assists with

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flood relief in another state or country. Faith community nursing focuses on activities involvingthe faith community and religious belief system.Ambulatory service settings include a variety of venues in which clients come for day or eveningservices that do not include overnight stays. Residential institutions include anyfacility where clients reside.19.Which of the following is included in themost accurate description of school nursing?A)This is one community health setting wherethe role is static.B)The primary role of school nurses is clinician.C)The practice of school nurses is widening.D)School nurses rarely act as advocates.Ans:CFeedback:School nurses, whose primary role initially was that of clinician, are widening theirpractice to include more health education, interprofessional collaboration, and clientadvocacy.20.A community health nurse is assuming the role of a manager. Which function would bemost important for the nurse to address first?A)PlanningB)OrganizingC)LeadingD)ControllingAns:AFeedback:The management process incorporates a series of problem-solving activities or function:planning, organizing, leading, and controlling and evaluating. Although these activities occursimultaneously, they are sequential withplanning being the first activity.21.A nursing student is interviewing a community health nurse about the various roles thenurse assumes and the skills and behaviors necessary to perform each role. Which of thefollowing would the community health nurse identify as being essential to therole of an advocate? Select all that apply.A)AssertivenessB)Ability to planC)Ability to negotiateD)Risk takingE)Holistic viewF)Questioning attitudeAns:A, C, DFeedback:

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As an advocate, the community health nurse must be assertive, willing to take risks, beable to communicate and negotiate well, and be able to identify resources and obtain results. Theability to plan is associated with the manager role. A holistic view is critical to the communityhealth nurse acting as a clinician. A questioning attitude is necessaryfor the role as a researcher.22.A community health nurse works in a busy community health nursing practice. Today,the nurse is devoting the day to the educator role. With which of the following activities wouldthe nurse be involved? Select all that apply.A)Planning seven home visits todayB)Working on a new curriculum for high-riskteensC)Meeting with colleagues to discussorganizational changes in the officeD)Ordering pamphlets over the Internet to beused in a parenting classE)Tabulating data from surveys distributed toelders during a flu-shot clinicF)Going to social services to speak up for afamily in his or her caseloadAns:B, DFeedback:In the educator role, the nurse would work on a new curriculum for high-risk teens andorder pamphlets for use in a parenting class. Planning seven home visits would be part of theclinician role. Meeting with colleagues to discuss organizational changes would be part of themanager role. Tabulating data from surveys would be part of the researcher role. Speaking up fora family in the nurse's caseload would be an example of the advocaterole.23.A community health nurse is devoting the day to being a manager. Which activitieswould the nurse expect to perform? Which of the following activities are part of this role?Select all that apply.A)Orienting three new community health nursesin the agencyB)Attending a strategy meeting for a newservice the community will be offeringC)Working with a team to direct a smokingcessation program in public areasD)Investigating an outbreak of Salmonella in thecommunityE)Tabulating the findings of exploringimmunization practices among teensF)Reviewing the staff evaluations to assist withplanning future in-servicesAns:A, B, F

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Feedback:As a manager, a community health nurse would be involved in orienting new nurses inthe agency, attending meetings for new services to be offered, and reviewing staff evaluations.Working with a team to direct a smoking cessation program in public areas exemplifies theleadership role. Investigating an outbreak of Salmonella and tabulating the findings ofimmunization practices depict theresearcher role.24.Of all the nursing roles assumed by community health nurses, which role must beassumed in every situation?A)ResearcherB)ManagerC)LeaderD)ClinicianAns:BFeedback:The type and number of roles that are practiced vary with each set of clients and eachspecific situation, but the nurse should be able to successfully function in each of these roles asthe particular situation demands. The role of manager is one that the nurse must play in everysituation, because it involves assessing clients' needs, planning and organizing to meet thoseneeds, directing and leading clients to achieve results, and controlling and evaluating theprogress to ensure that the goals and clients' needs aremet.25.Which of the following are core values ofprofessional behavior that are unique to public health nursing? Select all that apply.A)Community/population as clientB)PreventionC)RehabilitationD)PartnershipE)Healthy environmentF)DiversityAns:A, B, D, E, FFeedback:Core values of professional behavior emphasize community/population as client,prevention, partnership, healthy environment, and diversity. Rehabilitation is not populationcentered.Chapter 3 History and Evolution of Public Health Nursing1.A group of students are reviewing the various historical events associated with theevolution of community health nursing in preparation for a test. They identify the time from1970 to the present as the era known as community health nursing based on the understandingthat which of the following influences

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contributed most to this change?A)The settings and the nurses delivering healthcare in the communityB)Decisions made by the American NursesAssociationC)Decisions made by physicians in a variety ofcommunity settingsD)The demand to eliminate the word <public=from health servicesAns:AFeedback:The numbers, increasing variety of settings, and many nurses coming to work in thecommunity settings since the 1970s have contributed most significantly to the change. As aresult, professional associations supported the broader term of community health nursing.Physician decisions played no role in the change. The term public healthnursing still remains.2.Before the mid-1800s, early home care nursing was best recognized by which of thefollowing?A)Technical advances with the IndustrialRevolution making major changesB)Care provided by family members, friends,and religious groups in the homeC)Accomplishments stemming from the work ofFlorence NightingaleD)Formal organization of visiting nursing toprovide care to the sick poorAns:BFeedback:Before the mid-1800s, early home care was characterized by care of the sick in the homeby family members, friends, and religious groups. Technical advances came after 1850, as didthe work of Florence Nightingale and the formal organization of visiting nurses toprovide care to the sick poor.3.Community health nursing has a long history of contributing to the health of populations.Which of the following forms of service would the nurse identify as being mostrecent?A)Voluntary home nursing care for the sick poorvia district nursingB)Care provided termed public health nursingC)Lay and religious groups providing care to thesick poor in their homesD)Focus on populations with community healthnursing seen as a specialty fieldAns:D

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Feedback:The four stages of community health nursing followed from lay and religious groupsproviding care in the early years before 1850,the more specialized <health nurses= or districtnursing after the mid-1800s, concern for the health of the general public from 1900s to 1970, andfinally community health nursing as a specialty with a focus onpopulations since 1970.4.Which factor was the most significant featureassociated with district nursing?A)Caring for the sickB)Teaching hygiene and cleanlinessC)Preventing illnessD)Gathering statistical dataAns:BFeedback:Although district nurses primarily cared for the sick, they also taught cleanliness andwholesome living to their clients. This early emphasis on prevention and health became one ofthe distinguishing features of district nursing and later of public health nursing.Preventing illness and gathering statistical data were key contributions of Florence Nightingaleduring the Crimean War of theearly 1850s.5.In their early stages, district nursing wassponsored by which of the following?A)Religious organizationsB)Private philanthropyC)ContributionsD)Public fundingAns:AFeedback:Early district nursing services were founded by religious organizations that served astheir sponsors. Later sponsorship shifted to private philanthropy. Funding came fromcontributions and fees charged to clients on an ability-to-pay basis. Finally, visiting nursingbegan to be supported by public money.6.Which of the following would characterize the public health stage of community healthnursing?A)Voluntary health agencies emphasizingdisease preventionB)Family considered as the primary unit of careC)Service provision to the sick poor populationD)Primary health care as the key to health for all

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Ans:BFeedback:The public health nursing stage was characterized by service to the public, with thefamily targeted as a primary unit of care. Official health agencies, which placed a greateremphasis on disease prevention and health promotion, provided the chief institutional base.Primary health care as the key to health for all characterizes thecommunity health nursing stage.7.At which time did the focus of district nursing broadened to include the health andwelfare ofthe general public?A)Beginning of 20th centuryB)In the late 19th centuryC)Prior to the 1850sD)By the early 1970sAns:AFeedback:The focus of district nursing broadened to include the health and welfare of the generalpublic by the beginning of the 20th century or the early 1900s. In the late 19th century, districtnurses were ill-prepared to cope with their clients' multiple health and social problems resultingfrom widespread immigration and filled tenement housing that led to inadequate sanitation,unsafe and unhealthy working condition, and barriers adding to poverty and disease. Districtnursing did not develop until after 1850. Theearly 1970s is associated with the emergence of community health nursing.8.A student is planning a presentation about the evolution of public health nursing. As partof the presentation, the student would identify which person as being the first one to use theterm <public health nursing=?A)Jessie SleetB)Lillian WaldC)Lina RogersD)Margaret SangerAns:BFeedback:Lillian Wald, a leading figure in the expansion of district nursing, was the first to use theterm <public health nursing= todescribe the specialty. Jessie Sleet was credited as being the firstBlack public health nurse. Lina Rogers was credited with being the first school nurse. MargaretSanger was the nurse who opened the first birth control clinic in America that eventually resultedin the formation of the International PlannedParenthood Federation.

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9.Which of the following are important contributions made by Lillian Wald to theprofession of public health nursing? Select allthat apply.A)Demonstrating the effectiveness of placing school nurses in public schools to reduceabsenteeism and improve follow-up ofproblems identified in school childrenB)Promoting the use of birth controlC)Convincing the Metropolitan Life Company that nurse intervention could reduce deathratesD)Providing rural <frontier nursing= to servemountain families in KentuckyE)Founding the National Organization forPublic Health Nursing (NOPHN)Ans:A, C, EFeedback:Lillian Wald contributed to the profession of public health nursing by demonstrating theeffectiveness of placing school nurses in public schools to reduce absenteeism and improvefollow-up of problems identified in school children, convincing the Metropolitan Life Companythat nurse intervention could reduce death rates, and Founding the National Organization forPublic Health Nursing(NOPHN).10.After a class discussion about the contributions of Lillian Wald to the advancement ofcommunity health nursing, which of the following if stated by the classindicates that the discussion was effective?A)Establishment of family-centered nursing and outreach services in New York City at theturnof the 20th centuryB)Use of clean and safe nursing care practices tosoldiers during the Crimean War in the 1850sC)Assistance to high-risk populations experiencing tropical diseases in CentralAmerica and the Caribbean in the late 1800sD)Creation of home nursing services in London, marking the beginning of district nursinginthe 1860sAns:AFeedback:Lillian Wald worked with immigrant families in the Lower East Side of New York City,providing home visits, a neighborhood center, and general sanitation improvement for families

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and health care services to children in schools. Florence Nightingale was responsible forproviding clean and safe nursing care practices to soldiers during the Crimean War. MarySeacole helped high-risk populations who experienced tropical diseases in Central America andthe Caribbean. William Rathbone was responsible for establishing avisiting nurse service for the sick in London.11.A group of nursing students are studying for an examination on influential nursingleaders involved in the advancement of community health nursing. The students demonstrate thatthey are prepared for the examination when they identify which person as the firstcommunity health nurse in the United States?A)Frances RootB)Mary RobinsonC)Mary SeacoleD)Reba ThelinAns:AFeedback:In the United States, Frances Root was the first community health nurse who was hiredby the Women's Branch of the New York Mission in 1877. Mary Robinson was the nurse whocared for William Rathbone's wife and was hired by Rathbone to visit the sick poor in theirhomes in England. Mary Seacole, the <Black Nightingale,= practiced Creole or Afro-Caribbeanmedicine in Jamaica and helped populations who experienced tropical diseases in CentralAmerica, Panama, and the Caribbean. Reba Thelin was a nurse hired by Johns HopkinsHospital to visit the homes of tuberculosis clients in 1903.12.Which of the following nurses openly defied a law that she saw as unjust and eventuallyresulted in the formation of The InternationalPlanned Parenthood Federation?A)Lillian WaldB)Florence NightingaleC)Margaret SangerD)Mary BrewsterAns:CFeedback:Margaret Sanger openly defied a law that she saw as unjust (the Comstock Act thatprohibited the provision of any information on contraception to women). This defianceeventually resulted in the formation of The International Planned Parenthood Federation. Duringthe same period that Lillian Wald and her contemporaries were working to alleviate the sufferingcaused by disease and poverty, Margaret Sanger began a different battle.

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Florence Nightingale wrote a series of papers on the need for <home missioners= and <healthvisitors= and endorsed the view that prevention was better than cure. Mary Brewster was a nurseand a friend of Lillian Wald who both together started the HenryStreet Settlement.13.The community health nurse is preparing a presentation for a group of nursing studentsabout the societal influences on the development of community health nursing. Which factorsshould the nurse include that have influenced the growth of communityhealth nursing? Select all that apply.A)Advances in the technologyB)The recognition that one single agent could beconsidered a cause of illnessC)Access to education being limited to theprivileged fewD)Continued increase in the number of women entering nursing because it is recognized asachoice career for women and not menE)Consumer demand for quality servicescoupled with community health nurses provision of holistic careAns:A, EFeedback:Many factors have influenced the growth of community health nursing, includingadvances in technology, progress in causal thinking (relating disease or illness to its cause andrecognition that many factors might contribute to a disease or health disorder), and the consumermovement with consumers demanding quality services. Education is now widely available and isconsidered a basic right and necessity for a vital society.Changing demographics and the role of women have influenced community health nursing;however, the number of womenentering nursing has decreased.14.Which of the following actions by the community health nurse exemplifies the societalinfluence of causality on the practiceof community health nursing?A)Using computer-based education programsfor client education

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B)Engaging in video conferencing to shareresearch findingsC)Identifying multiple factors associated withpromoting wellnessD)Developing a plan to address the rapidincrease in older adult populationAns:CFeedback:Causal thinking relates disease or illness to its cause and includes areas such asepidemiology; interactions among an agent, host, and environment; and recognition of multiplefactors contributing to a disease, health disorder, or wellness. Using computer- based educationprograms and engaging in video conferencing are examples reflecting the advancement oftechnology. Developing a plan to address the rapid increase in the older adult populationinvolves application of the change in demographics affecting communityhealth nursing.15.A community health nurse who is teaching a group of nursing students about the varioussocietal influences on community health nursing is explaining the effects of the consumermovement. Which of the following student responses would lead the community health nurse todetermine that the teachingwas successful?A)Individuals are considered passive membersof the health care team.B)Consumers are demanding more coordinatedcomprehensive care.C)People are expecting community healthnurses to develop new programs.D)Consumers are identifying a greater need forcare by a variety of care providers.Ans:BFeedback:The consumer movement has led to changes in community health nursing. Consumers aredemanding more humane, personalized health care, seeking more comprehensive coordinatedcare. They are viewed as active members of the health care team. The need to develop newprograms is a response to the economic forces that have affected the practice of communityhealth nursing.Consumers desire more coordinated care, notcare from a variety of care providers.

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16.Which of the following most accurately reflects the response of community healthnursing to economic forces?A)Decreased competition with other communityhealth service providersB)Reduction in available programs and servicesC)Development of new services for generatingrevenueD)Switch to a more illness-oriented philosophyfor serviceAns:CFeedback:Economic forces have led community health nursing to respond by developing newrevenue-generating services to augment depleted budgets. Other responses include directlycompeting with other community health service providers and developing new programs andservice emphases. Although some public health agencies have been drawn into more illness-oriented services, community health nursing continues to be resourceful in finding ways to fosterthecommunity's optimal health.17.A prospective nursing student is interested in working in community health nursing aftergraduation. Which type of education would bemost appropriate for this student to choose?A)Diploma programB)Associate degreeC)Baccalaureate degreeD)Graduate degreeAns:CFeedback:Community health nursing is a challenging specialty in nursing. The demands of this typeof nursing require additional courses in liberal arts and science, along with courses in communityhealth nursing practice as a student. The minimum preparation for community health nurses inmany states is a baccalaureate degree. The diploma and associate degree level prepares studentsfor basic nursing practice. Students can build on this basic knowledge by entering a BSNcompletion program, which will prepare them to enter the specialty of community healthnursing. In order to stay current and to build skills in this specialty, advanced courses or agraduate (masters) degree is needed.

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18.A community health nurse desires to attain a tenure-track position at a local university toteach community health nursing. Which of thefollowing would this nurse need?A)CertificationB)Master's degreeC)Doctoral degreeD)Nurse practitioner licenseAns:CFeedback:A doctoral degree would be the required education needed to obtain a tenure-trackteaching position at a university. Certification provides additional education for specializationand may result in a promotion or higher salary accompanied by additional responsibilities andopportunities. A master's degree can lead to management positions, private community healthownership, agency teaching, or research positions. Nurse practitioners can run well-child clinicsand direct a school-based clinic if a school nurse. Advanced practice can open doors intoleadership positions in community healthnursing.Chapter 4 Evidence-Based Practice and Ethics in Community/Public Health1.A nursing instructor is preparing a teaching plan for a class comparing evidence-basedpractice and critical thinking. Which of thefollowing would the instructor include?A)Evidence-based practice and critical thinkingare polar opposites.B)Both involve problem clarification of centralconcepts.C)Interpretation of accumulated evidence isunique to evidence-based practice.D)Problem exploration is unique to evidence-based practice.Ans:BFeedback:Evidence-based practice and critical thinking share commonalities including exploring aproblem, addressing a purpose or goal, making assumptions, clarifying the problem aroundcentral concepts or indicators, accessing data, interpreting accumulated evidence, usingreasoning, processing, defining, planning and documenting, acting on the problem, andevaluating, adjusting, generalizing, and applying to a broader problem set. In addition, criticalthinking is an important component of evidence-basedpractice.2.According to the Institute of Medicine's landmark report, The Future of Nursing,nurses should: Select all that apply.

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