Test Bank Community Public Health Nursing Practice 5th Edition, Maurer
Chapter 1: Responsibilities for Care in Community/Public Health Nursing
1. A community/public health nurse is best defined as a nurse who
a. Applies concepts and knowledge from nursing and public health.
b. Gives care to families in the community.
c. Has a baccalaureate and previous experience in community health.
d. Is employed outside of an acute care setting.
2. The only clear distinction between a community health nurse and a public health nurse is that
a. The community health nurse gives care in community settings regardless of personal education, whereas public health nurses have specific educational preparation.
b. Community health nurse is a title that has historically been used, whereas public health nurse is the new “in” title for the role.
c. The community health nurse is employed to give care to families and groups, whereas the public health nurse works in public health departments.
d. Community health nurse is the broader term that includes public health nursing, school nursing, and home health nursing.
3. When the nurse is caring for a family or a community, it is important that the nurse provide care that is
a. Similar to that described in the textbook or procedure manual
b. Consistent with agency policies
d. Culturally congruent
4. What is the meaning of the term aggregate as used in community health?
a. A group of persons who reside in a specific geographic area
b. All the persons who live in a specific community
c. A set of persons who have some characteristic in common
d. “The public” in professional terminology
5. What is the appropriate approach for the community/public health nurse in balancing individual privacy and autonomy and the community’s needs for safety and security?
a. Fulfill agency policies first.
b. Implement professional standards of nursing practice.
c. Seek a balance between individuals’ needs and the community’s needs.
d. Remember that group needs outrank individual needs.
6. In which situation would the community/public health nurse be applying the ethical principle of doing good for the greatest number of persons with the least amount of harm?
a. Asking the agency supervisor how to approach an ethical dilemma
b. Focusing on providing basic services for everyone in the community
c. Following agency policies
d. Delivering care to families who have health insurance
7. When faced with an ethical conflict about limited resources and unlimited need, which action is the most just?
a. Giving care to clients whose needs most closely match the nurse’s abilities
b. Giving care to whichever prospective clients ask for care first
c. Working as hard as possible and not worrying about it
d. Trying to achieve the outcome of the greatest good for the greatest number of persons
8. Which document is helpful in describing competent and appropriate nursing care in the community?
a. Community Health: Standards of Nursing
b. Healthy People 2020
c. The Joint Commission: The Comprehensive Accreditation Manual
d. Public Health Nursing: Scope and Standards of Practice
9. How does a community/public health nurse provide indirect care to clients in homes, clinics, senior citizen centers, schools, prisons, homeless shelters, and other living environments?
a. Being employed in community settings such as outpatient clinics
b. Providing anticipatory guidance and health promotion activities to community members
c. Providing care in mobile vans to citizens in their own neighborhoods
d. Being involved on a political action committee to create new client services
10. How would the actions of the community/public health nurse caring for a recently discharged client in his home differ from those of the acute care nurse?
a. The community/public health nurse would assess the health and needs of all the family members.
b. The community/public health nurse would be careful to be nonjudgmental about the family’s living situation.
c. The community/public health nurse would explain why each nursing intervention was being performed.
d. The community/public health nurse would help the family understand the basis for the treatment.
Chapter 2: Origins and Future of Community/Public Health Nursing
1. With what aspect of the population being served have both nursing and public health always been most concerned?
a. Financial resources
b. Political beliefs
c. Religious faith
d. Social and physical environments
2. A community/public health nurse is working for a local health department. Which of the following would be an appropriate goal for the nurse?
a. Assessing clients in their own home environment
b. Caring for whole families, not just individuals
c. Improving health over the long term for families
d. Striving for social betterment
3. What occurred as a result of industrialization?
a. People from lower socioeconomic classes were able improve their socioeconomic positions.
b. Problems such as overcrowding and disease developed.
c. Products were individualized to meet customers’ unique needs.
d. Taxes for roads and other community services increased.
4. A district nurse in England during the 1860s was providing care for the community. With which of the following groups would the nurse most likely have interacted?
a. Church clergy
b. Business owners
d. Government officials
5. A nurse was working with William Rathbone and other social reformers to improve care in the homes of poor residents. What barrier was this nurse likely to have encountered?
a. Poor persons did not want nurses to enter their homes.
b. Providing home care to the poor was not accepted by the community.
c. Wealthy community members were reluctant to donate money for these services.
d. There were not enough nurses to provide adequate services.
6. A district nurse working with William Rathbone was visiting homes of persons suffering from contagious disease. Which of the following nursing interventions probably would have been implemented?
a. Providing information to family members without providing direct care
b. Assessing the client who was suffering from the disease
c. Donating money, food, bedding, and supplies to the families of the ill person
d. Referring the client and family to community resources
7. A public health nurse is addressing problems in the community. What would be the nurse’s primary concern?
a. Collecting and analyzing data
b. Assuring sufficient standard of living for clients
c. Providing direct care to clients living in the community
d. Assisting clients and families in adapting to their circumstances
8. Who emphasized that public health must be concerned with the standard of living of citizens?
a. C. E. A. Winslow
b. Lemuel Shattuck
c. Florence Nightingale
d. John Snow
9. Who was the first person to recognize the importance of the environment by noting that cholera rates were much higher among persons who drank water from a particular well?
a. C. E. A. Winslow
b. Edwin Chadwick
c. Lemuel Shattuck
d. John Snow
10. Which person established population-based objectives and used statistics to show that specific interventions dramatically decreased the death rate by 51%?
a. C. E. A. Winslow
b. Lemuel Shattuck
c. Florence Nightingale
d. John Snow
Chapter 3: The United States Health Care System
1. What is the main difference in the health care system in the United States between President Clinton’s vision in 1994 and today’s reality?
a. Funding is totally centralized or decentralized.
b. Oversight is a public or private responsibility.
c. Health care team leadership is shared.
d. Pharmaceuticals are purchased through a payer system.
2. A community/public health nurse is describing the American health care system to a group of immigrants. How would the nurse best describe this system?
a. As a static, complex entity that the nurse must seek to understand
b. As clearly the best in the world and envied by other countries
c. As extremely effective, especially in high-technology care
d. As being in the midst of ongoing change that offers real opportunities
3. A community/public health nursing faculty member discusses with students the significant changes in the U.S. health care system. Why is this information important to discuss with this population?
a. Helps orient students to their options for health insurance
b. Helps students understand health behaviors
c. Helps students determine where they wish to seek employment
d. Helps meet accreditation requirements for the curriculum
4. A public health nurse is examining the effectiveness of a health care system. Which of the following data would be the most appropriate for the nurse to use?
a. The number of resources expended by the system
b. The health of the population served
c. The number of noncitizens who seek health care in the system
d. The typical cost of routine primary care
5. Which of the following best describes the U.S. health care system?
a. It is a mixture of social welfare and comprehensive care.
b. It is decentralized and expensive.
c. It is highly centralized and autocratic.
d. It assures basic minimal care to everyone.
6. What are the two systems of health care that exist in the United States?
a. Federal system for military personnel and community system for others
b. Home-based care for wealthy and nursing home care for poor
c. Hospitals for acute care and outpatient clinics for chronic care
d. Private system for those who can pay and public system for some of the poor
7. In comparison with other similar industrialized countries, the U.S. health care system results in
a. Outcomes very similar to outcomes in other industrialized countries.
b. Superb outcomes, perhaps because of the advanced research and technology.
c. The highest life expectancy and lowest infant mortality.
d. The lowest life expectancy and highest infant mortality.
8. A community health nurse is caring for a client who is not a veteran and has no funds for health care. Where would this client go to receive care?
a. Local hospital
b. Privately owned, for-profit hospital
c. Proprietary hospital
d. Publicly owned hospital
9. The federal government obtains its authority to be involved in health care from the
a. Legislation that was passed giving the federal government that privilege.
b. Regulation of interstate commerce and its responsibility to provide for the general welfare.
c. Constitution, specifically allocating authority for health care to the federal government.
d. States requesting the federal government, because of its taxing ability, to accept that responsibility.
10. Which federal agency is most involved in both direct and indirect health-related responsibilities?
a. U.S. Department of Health and Human Services
b. National Health Care Service Agency
c. Public Health Service
d. Veterans Administration Medical Services Branch
Chapter 4: Financing of Health Care: Context for Community/Public Health Nursing
1. What approach have nurses historically used when providing care and paying attention to costs?
a. Giving the best possible nursing care regardless of ability to pay
b. Giving whatever care the nurse has the expertise to give
c. Giving whatever care the patient could afford
d. Giving whatever care the patient desired and for which he or she was willing to pay
2. Which of the following is true about access to care?
a. Care providers have always donated necessary services to make sure everyone received care.
b. Health care is rationed by the ability to pay.
c. Poverty-stricken patients received care from medical and nursing school students in teaching hospitals.
d. Universal access has always been a component of health care in America.
3. A nurse educator teaches community/public health nursing students about how health care is financed in the United States. Why is it important that nursing students receive this information?
a. Nurses are expected to help patients find funding sources to pay for their care.
b. Nurses have to restrict their care to services that are financially reimbursed.
c. Health care organizations must charge patients for all supplies consumed while care is given.
d. Health care organizations must notify patients of the exact cost of the nursing services rendered.
4. A nurse has chosen to provide home care services to a needy client even though there is no source of reimbursement for this care. What problem may result?
a. The nurse will be expected to provide this care to other clients.
b. The nurse may not be covered in case of a malpractice claim.
c. The agency’s clients will start demanding that the staff provide free care.
d. The agency’s clients will be at risk for being billed for the services provided.
5. A community/public health nurse is providing home care services to an elderly couple. They report that they believe they are spending more and more money on health care services and have limited funds available to meet their everyday living expenses. Which of the following offers the best explanation for their situation?
a. The proportion of the gross domestic product devoted to health care is increasing.
b. The health care costs are increasing for the elderly population.
c. The cost of living is increasing because of recent rapid inflation.
d. The cost of health care is increasing because more people are insured.
6. Which of the following was true concerning the amounts paid by private funds and governmental funds in 2009?
a. Government spent 49%, and private funding accounted for 51%.
b. Government spent 75%, whereas private funding accounted for 25%.
c. Government spent 40%, whereas private funding accounted for 60%.
d. It is unknown what proportion of funds was governmental and what proportion was private.
7. A community/public health nurse is examining how health care dollars are distributed in the United States. Which of the following information would the nurse find in the literature?
a. The majority of health care dollars are spent on health promotion activities.
b. The percentage of health care dollars spent on public health activities is increasing.
c. The percentage of health care dollars spent on health care advances is increasing.
d. The majority of health care dollars are spent on personal health care services.
8. Which component of government is primarily responsible for health research spending?
a. The federal government, through the Centers for Disease Control and Prevention
b. The federal government, through the National Institutes of Health
c. State governments, through grants to state universities and research centers
d. State governments, through local public health departments in cooperation with local researchers
9. A community/public health nurse is working with vulnerable populations in the community. Which population would be most likely to not have health insurance?
a. Elderly persons who do not qualify for Social Security
b. Homeless persons who lack a permanent address
c. Working poor persons whose jobs lack health insurance as a benefit
d. Young families who have not yet saved enough to qualify
10. Self-payment of health care costs are
a. Almost never done because that is the purpose of health insurance.
b. Frequently done because many employers do not offer a health insurance benefit.
c. Frequently done by paying for one’s own insurance to ensure coverage.
d. Usually done by paying co-payments and deductibles required by insurance.
Chapter 5: Global Health
1. A public health nurse is concerned about a recent influenza outbreak in Germany. Why would the nurse be interested in a health issue occurring outside of the United States?
a. Highly infectious diseases can circle the world quickly through worldwide travel.
b. Other nations rely on the United States for guidance to address health issues.
c. According to the World Health Organization (WHO) guidelines, nurses should assist in disease control efforts.
d. Nurses have a moral obligation to keep the public safe and healthy.
2. Which factor is primarily responsible for the differences in health care needs and health care outcomes among the various countries?
a. Economic development
b. Political system
c. Social-cultural system
d. Religious affiliation
3. A public health nurse is discussing actions that countries must take in order to reduce poverty successfully. Which of the following actions is the nurse likely to suggest?
a. Adopt a democratic government for their people.
b. Create a national health care plan.
c. Give preference to women and infants.
d. Provide predictable and sustained funding.
4. What was the primary commitment agreed upon when the United Nations Millennium Declaration was adopted?
a. Adoption of specific environmental actions
b. Elimination of poverty
c. Enforcement of maternal and infant health standards
d. Provision of safe water and sanitation
5. Which of the following efforts is being led by the World Health Organization (WHO)?
a. Establishing standards for medications and vaccines
b. Providing food for all the world’s residents
c. Eliminating polio as an infectious disease
d. Ensuring safe water for all the citizens of the world
6. A community/public health nurse has recently accepted a position with the United Nations International Children’s Fund (UNICEF). What will be the primary focus of the nurse working for this organization?
a. Building and staffing hospitals in undeveloped countries
b. Providing health education for mothers of children
c. Establishing clinics for surgical interventions for handicapped persons
d. Helping with economic development in undeveloped countries
7. A developing country has been in contact with the World Bank. What is this country accomplishing by connecting with this intergovernmental organization?
a. Ensuring that the economy is based on the U.S. dollar
b. Supporting specific projects, especially to establish new businesses
c. Requesting a loan to improve the infrastructure
d. Helping to establish a national banking system
8. Which of the following statements represents an example of the epidemiologic transition?
a. As economics improve, the life expectancy increases.
b. As education improves, the number of physicians and nurses increases.
c. As global funding increases, the incidence of communicable disease decreases.
d. As preventable diseases increase, the global infection rate decreases.
9. Which of the following is the leading contributor to illness and death in developing countries?
a. Inadequate sources of food
b. Unsafe water
c. Limited availability of immunizations and antibiotics
d. Lack of sanitary sewer systems
10. A public health nurse is investigating the health of children worldwide. Which of the following sources of data should be used to determine which country has the healthiest children?
a. Percentage of mothers who breast-feed their infants
b. Rate of immunization
c. Rate of malnutrition
d. Percentages of generalist versus specialist physicians
Chapter 6: Legal Context for Community/Public Health Nursing Practice
1. In which legislation can most public health documents be found?
a. County or district law
b. Federal acts
c. Local ordinances
d. State statutes
2. Which of the following is the name for the rules and regulations written by state boards of nursing?
a. Administrative law
b. Common law
c. Legislative law
d. Tort law
3. What are laws passed by a local government unit such as a village, town, or city called?
b. Judicial law
4. Which of the following actions should be taken by a nurse who wants to influence proposed administrative law?
a. Calling, e-mailing, faxing, or writing the leaders of the House of Representatives and Senate concerning what should be included in the administrative law
b. Writing the state legislators to suggest that appropriate legislation be introduced
c. Promising to contribute money to the legislator’s reelection campaign if the administrative law reflects the nurse’s views
d. Providing input, either verbally or in writing, to the involved agency, after notice of proposed rules is published
5. Which of the following descriptions best reflects the central purpose of laws?
a. Ensuring that the highest priority needs in society are met
b. Ensuring that ethical issues are resolved on the basis of the majority’s agreement about the conclusion represented in the law
c. Helping society maintain employment (e.g., courts, jails and prisons, police officers, attorneys)
d. Maintaining public order and communicating expectations about behavior
e. Ensuring that the desires of the majority in society become the rules
6. Who is protected by state laws when an employed nurse provides care to a client?
a. The health care provider and the client
b. The agency or hospital and the client
c. The health care provider and the agency or hospital
d. The client and the general population
7. A community/public health nurse is providing care to a client who reports that he has received a diagnosis of tuberculosis. The nurse wants to be sure that the legally safe action is chosen when care is provided to this client. With whom should the nurse consult?
a. Agency director
b. State hygienic laboratory personnel
c. Attending physician
d. State’s attorney general
8. A nurse’s action resulted in serious harm to a client. Many years later, the client brings a court case against the nurse for damages. What might prevent the case from going to court for a ruling against the nurse?
a. The client agreed to the care at the time.
b. The nurse did not know the chosen action was inappropriate.
c. The nurse thought what was being done was appropriate.
d. The time limit for suing had passed.
9. A nurse is caring for a client who is ill with a contagious infectious disease that has a high death rate. Which of the following actions should be taken by the nurse?
a. Asking the client to talk to a health care provider about disease progression
b. Reporting the disease if such reporting is required by state law
c. Determining whether the disease is easily transmitted through air or body fluids
d. Encouraging the client to stay at home and not have visitors
10. Under which of the following conditions can a nurse knowingly share confidential information about a particular client with anyone not involved in the client’s care?
a. If a client states lack of concern about publicly sharing information with anyone
b. If the client has an extremely contagious disease, in which case the nurse may tell those possibly exposed
c. If the local public health department decides to encourage the general population to take protective measures
d. If the family requests that others are informed so they may be supportive of the client
Chapter 7: Epidemiology: Unraveling the Mysteries of Disease and Health
1. Who was the first nurse epidemiologist who pioneered the use of statistics to improve public health?
a. Dorothea Dix
b. Florence Nightingale
c. Lillian Wald
d. Sue Barton
2. A nurse noted that 15 people became very ill while eating at the school banquet for the basketball team. To calculate the rate of illness, what other fact does the nurse need?
a. How many athletes were honored for being on the team
b. How many parents and family members attended the banquet
c. How many people ate at the banquet
d. How many people live in the school district
3. A rate might be accurately defined as
a. Another term for ratio.
b. A way of determining the incidence of disease in a group.
c. A way to make comparisons among equal-size populations.
d. The number of events divided by the number of persons at risk.
4. A nurse was asked whether the agency should offer additional health promotion programming for young mothers in the Two Oaks neighborhood or the Centerville neighborhood. Two Oaks is a village that has a population of 4000 persons, of whom 50 are single mothers, whereas Centerville is an urban area of 15,000 people, of whom 150 are single mothers. On the basis of this information, which of the following would be the best response by the nurse?
a. Additional programming will be helpful and appropriate in either neighborhood.
b. The nurse needs to know the total number of children in these neighborhoods before making a decision.
c. The nurse should choose to focus on single mothers in Centerville.
d. The nurse should choose to focus on single mothers in Two Oaks.
5. Assuming that City A has a murder rate of 12 per 100,000 population and City B has a murder rate of 24 per 100,000 population, which city has the more worrisome problem?
a. The answer cannot be determined from these data.
b. City A has the more worrisome problem.
c. City B has the more worrisome problem.
d. Both cities have equally worrisome problems.
6. A nurse was given the following data about the children attending school in two area communities:
School Asthmatic Children Number of Children in School Number of Persons in Community
Centerville Elementary 25 1000 15,000
Centertown Suburban Elementary 25 1000 15,000
Centerville Junior High 35 1500 15,000
Two Oaks Elementary 5 200 5000
Two Oaks Junior High 10 300 5000
Totals: 100 4000 55,000
What is the rate of asthma in the school-age population?
7. A community/public health nurse needs to conduct a descriptive study of the health needs of elderly persons attending a congregate meal at the local community center. Therefore, the nurse would
a. Divide the elderly population into two groups (healthy and unhealthy), teach courses on healthy lifestyles, and then measure any changes.
b. Use two randomly chosen groups, teach healthy lifestyles to all participants, and then determine learning through a posttest.
c. Divide the elderly population into two randomly chosen groups, teach healthy lifestyles to one group, and then determine differences in knowledge between the two groups.
d. Screen each elderly person and look for patterns in the findings related to health problems that necessitate attention.
8. A nurse was assigned to work with technology-dependent schoolchildren. What kind of study would the nurse most likely conduct to help determine the needs of these children?
a. A case-control study to compare these children with children who are not technology-dependent
b. A cross-sectional study of school-based variables affecting the children
c. A descriptive study regarding prevalence of technology dependence among the total school population
d. An analytic study to determine causes of the children’s problems
9. A school nurse was concerned about the prevalence of obesity in the elementary school classes. On the basis of the literature, the nurse decided to ask each student whether he or she ate breakfast before coming to school in the morning. Which type of study is the nurse conducting?
d. Clinical trial
10. A school nurse decided to begin a “don’t smoke, don’t start” program. To determine whether the program has any effect, an experimental trial study was planned. Which of the following actions would the nurse take?
a. Divide the students into two groups (smokers and nonsmokers), teach the course to both groups, and then observe for changes in beliefs.
b. Divide the students into two randomly chosen groups, teach the program to all students, and then determine learning and smoking behaviors through a posttest.
c. Use two randomly chosen groups, teach the program to one group, and then determine differences in knowledge and smoking behaviors between the two groups.
d. Screen each student, and look for evidence of smoking behaviors.
Chapter 8: Communicable Diseases
1. What was one of the first public health measures legislated by the U.S. federal government?
a. Funding local government provision of safe water
b. Using the power to impose quarantine
c. Requiring pasteurization of all milk
d. Regulating disposal of waste (garbage and feces)
2. What scientific criteria were developed by Jacob Henle to link an organism to its specific disease?
a. Give samples of the organism to three different researchers and see whether all three researchers can grow it successfully.
b. Grow the organism on the diseased tissue and then see whether, when spread on normal tissue, the organism continues to grow.
c. Identify microorganisms under a microscope and grow them on the tissue that the disease usually infects.
d. Identify the organism, isolate the organism, and see if the organism produces disease.
3. In what way are antibiotics important in reducing the spread of communicable diseases?
a. They help keep the environment free of the infectious agent.
b. They help the host resist the infection.
c. The kill the entire infectious agent upon contact with it.
d. They reduce the time during which the disease is contagious in the infected person.
4. Which of the following actions have had the most success in protecting the public’s health?
a. Creation of effective broad-spectrum antibiotics
b. National immunization campaigns to protect children
c. Growth of hospitals and medical and nursing schools in the twentieth century
d. Safe water and sewage systems, as well as milk pasteurization
5. Which of the following statements concerning infectious diseases in the United States today is true?
a. They account for 25% of all physician visits and are still a major cause of death.
b. They are not a community/public health problem in the United States.
c. They are a major source of morbidity in the world, but not in the United States.
d. They are rarely fatal in the United States.
6. Which of the following contributed to several measles epidemics in the 1990s?
a. People had stopped getting immunizations for measles and other diseases.
b. The measles vaccine was no longer effective against the agent because the virus had mutated.
c. The measles vaccine did not provide lifetime immunity.
d. Thousands of ineffective contaminated vaccine doses had unknowingly been injected.
7. Which of the following is the reason for mumps outbreaks among young adults?
a. People had stopped getting immunizations for mumps and other diseases.
b. The mumps vaccine is no longer effective against the agent because the virus had mutated.
c. The mumps vaccine does not provide lifetime immunity.
d. Thousands of ineffective contaminated vaccine doses had unknowingly been injected.
8. A mother wanted her child vaccinated against measles. When she read the “benefits and risks” sheet, she changed her mind. Her child was the only one in the class who did not get immunized. What is the probable risk of her child getting measles in elementary school?
a. Fairly high, as there is no way to prevent being exposed to measles during childhood
b. Fairly low, as measles usually hits in late adolescence now
c. Low, as most of the child’s playmates have been immunized
d. Very high without the protection of immunization
9. Which of the following groups is most at risk today for an outbreak of pneumococcal pneumonia?
a. Adolescents who have not yet received their booster shots
b. Persons older than 65 who live in nursing homes and other extended-care facilities
c. Elementary school children who have not been immunized
d. Young adults who have never been exposed to the agent before
10. A man had a viral upper respiratory tract infection and was seen by a family nurse practitioner (FNP). The FNP gave the man both verbal and written information about over-the-counter drugs to control symptoms. However, the patient insisted upon a prescription for an antibiotic. Which of the following would be the most appropriate response from the FNP?
a. “Antibiotics won’t be helpful in treating this infection, but they may allow bacteria that will be immune to antibiotics to develop, putting you at high risk for getting sicker.”
b. “I’ll write you a prescription for a special new research drug that works wonders with viral respiratory infections.” Then the FNP writes a prescription for a placebo.
c. “I’m the expert. I’ll decide when you need an antibiotic. And you do not need one.”
d. “Of course; I always try to meet the needs of my clients. Which antibiotic do you find works best for you?”
Chapter 9: Environmental Health Risks: At Home, at Work, and in the Community
1. Which of the following events marked the beginning of the most outstanding improvements in public health?
a. Discovery of antibiotics
b. Creation of safe water purification and sewer systems
c. Implementation of surgery as a clean procedure in the operating rooms
d. Physician education on the benefits of hand-washing between procedures
2. To what does the term environmental justice refer?
a. Applying environmental laws equally throughout the country
b. Being fair (or just) in relation to how the costs of environmental pollution cleanup are distributed
c. Putting the most environmental pollution waste in the already polluted sites (known as Superfund sites)
d. Recognizing that environmental risks are disproportionately high for low-income and minority populations who live in more highly polluted neighborhoods
3. Between what two aspects does the ecologic systems model distinguish?
a. Ecologic disasters and lifestyle behavior problems
b. Housing and school or employment hazards
c. The immediate environment and the broader environment
d. The United States and the rest of the world
4. What, in basic terms, do Barry Commoner’s laws of ecology state?
a. Everything is connected to everything else, and everything must go somewhere.
b. Long-term survival requires protection of our environment.
c. Only humans contaminate their own environment.
d. Take care of the planet; it’s the only one we’ve got.
5. Which of the following information would the nurse document when conducting an exposure assessment with a client?
a. The chemicals used at work or in hobbies
b. The substances used to clean the house or keep the yard/garden beautiful
c. The home, work site, and neighborhood
d. The environmental and psychological stress that is encountered
6. Which of the following is the most appropriate secondary prevention approach when a nurse is working in a community with known high lead levels?
a. Educating parents about avoiding purchasing toys painted with lead-based paint
b. Screening all minority children
c. Educating parents about early signs of lead poisoning
d. Screening all children who are living in poverty
7. A nurse learned that a client was taken to the hospital with carbon monoxide poisoning after neglecting to turn off the car parked in the garage. Which of the following would be the most appropriate intervention to suggest at the next nursing visit?
a. Encourage the client to leave one window open a crack, so there is always a constant supply of fresh air from outside the home.
b. Advise the client to install a carbon monoxide detector in the home.
c. Suggest that the family move to a house with a detached garage.
d. Teach the family the symptoms of breathing carbon monoxide gas so they can act quickly to get out of the house.
8. A nurse who had just undergone orientation for a staff position in the emergency department noticed a material safety data sheet attached to a solvent used to clean the skin around wounds. What is the purpose of this sheet?
a. Hospitals are now attaching such documents for emergency department nurses, who are at high risk for trauma and injury from chemicals that patients use.
b. It is part of the risk management program of hospitals that do not want to be sued by employees who misuse chemicals.
c. It is required by federal law so that employees know the potential effects of the chemicals with which they are working.
d. The sheet is the equivalent of a drug information sheet and should be given to patients who have their wounds cleaned with the solvent.
9. Which of the following actions demonstrates the occupational health nurse’s need to balance conflict between what is legal and what is ethical?
a. Ensuring the employer’s profit and keeping the employees happy
b. Fulfilling what the nurse’s supervisor wants and what the employees want
c. Encouraging primary prevention and first aid to the injured
d. Reporting health problems to employers and keeping health records confidential
10. Which of the following activities is an ergonomist most likely to perform?
a. Studying the prevention, detection, and treatment of work-related injuries
b. Designing equipment for the interface of humans, their tools, and work activities
c. Recognizing natural history of occupational disease and injuries in certain groups
d. Describing the toxic properties of chemical agents used in the employment setting
Chapter 10: Relevance of Culture and Values for Community/Public Health Nursing
1. Which of the following statistics related to diversity in the United States is accurate?
a. One per five people belongs to an ethnic or racial minority.
b. One per three people identifies with an ethnic or racial minority.
c. The percentage of people identifying with a minority group is decreasing.
d. The percentage of people identifying with a minority culture has become the majority.
2. Which of the following groups is the largest ethnic minority in the United States?
a. African Americans
b. Asian immigrants
d. American Indians/Alaskan natives
3. Which of the following is the best definition of culture?
a. An appropriate way to behave within a group
b. A choice of lifestyle behaviors by a group
c. Learned and shared beliefs, values, and lifeways of a group
d. Unconscious behaviors of a group
4. A nurse went to a convention in a large city with which the nurse was unfamiliar. The nurse was somewhat anxious about finding the convention center, but once there, the nurse relaxed and eagerly entered into interaction with other attendees. Which of the following would have been the most likely reason the nurse became comfortable?
a. Enjoyment in learning more about topics that were relevant to current practice
b. Understanding the perspective of most nurses
c. Eagerness about hearing the keynote speaker
d. Being an extrovert who loved interacting with people
5. A nurse was so angry at a family for not being home when the nurse arrived for their appointment that the nurse wanted to drop the family from the agency caseload. What would the agency supervisor need to point out to the nurse?
a. Clients can have emergencies that interfere with plans.
b. Communication about the time of the appointment may not have been clear.
c. Nurses expect promptness and compliance, but not all clients feel the same way.
d. Perhaps the nurse made an error in writing down the appointment date and time.
6. A nurse was proud of having completed a professional education program on cultural care of Hispanics. It was surprising when the Hispanic client for whom the nurse had been caring did not seem to act very “Hispanic.” Which of the following considerations is the nurse not taking?
a. The client may have been trying to demonstrate behaviors to please the nurse.
b. The client may have customs that are not identical with the Hispanic culture.
c. The client may be in too much pain to demonstrate cultural behaviors
d. The client may not have been truthful when claiming to be Hispanic.
7. Which of the following is a reason why each person is asked to report his or her race during the U.S. census?
a. Race is a biologic reality defining persons with common biologic features.
b. Race is a crucial variable, which explains the differences among different groups of people.
c. Race is a historical tradition that must be upheld.
d. Race is a way in which people identify themselves.
8. Why will the concept of ethnicity decrease in value to health professionals in the future?
a. Assessment and treatment will become more accurate according to a person’s race.
b. Ethnicity as a concept mainly helps clients have a sense of belonging and loyalty.
c. Persons from different ethnic groups are intermarrying, and their children are multiracial.
d. The concept of ethnicity is less informative than the term race.
9. What is the relationship between race and ethnicity?
a. Race is biologic, whereas ethnicity is psychologic.
b. Race is skin color, whereas ethnicity is shared beliefs.
c. Both race and ethnicity mean “visible subgroup.”
d. Race means “common physiology,” and ethnicity means “common culture.”
10. Which of the following is the best way for a nurse to determine a client’s ethnicity?
a. Analyzing the client’s actions and communication patterns
b. Closely observing behaviors and customs
c. Discussing with anthropologists how to recognize the various ethnic groups
d. Querying “How do you identify yourself?”
Chapter 11: Home Visit: Opening the Doors for Family Health
1. A senior student nurse asked the instructor, “Why do we have to make home visits? The client learned self-care in the hospital.” Which of the following statements would be the best response from the instructor?
a. “Home visits allow you to focus on the entire family and see threats to health and safety.”
b. “Making home visits will increase your marketability after you graduate.”
c. “Our State Board of Nursing requires home visits as part of community/public health education.”
d. “The national accreditation policies require that students make home visits before they graduate.”
2. It was suggested a public health department’s funding for home visits be cut because so much time and money were spent in travel and such expenses seemed inappropriate in a time of fiscal restraint. Which of the following would be the nurse’s best response to this suggestion?
a. “Research has shown home visits save far more than their cost in decreasing child abuse, drug-resistant infections, and even emergency department visits.”
b. “The public health department staff members are the most knowledgeable concerning funding needed and how best to spend the funds.”
c. “The voters agreed on the tax levy funding the department. It would not be politically wise to act against voters’ obvious desires.”
d. “With all the fear about bioterrorism, it is an inappropriate time to cut funds to the public health department.”
3. A new mother asked the community/public health nurse what a nurse visiting her at home would do differently from what the nurses in the hospital had already done. Which of the following would be the best response from the nurse?
a. “All nurses try to help people stay well, but I can also help you assess your home for any dangers to the baby.”
b. “Hospital nurses and I all try to be helpful, but I can also tell you how to obtain excellent child care.”
c. “In the hospital, you had a nurse focus on your baby and another nurse focus on your care. I’ll be focusing on both you and your baby.”
d. “The other nurses in the hospital focus on helping you and the baby get off to a great start. I’m going to repeat everything to be sure you really know it.”
4. After leaving the home of a new mother and her newborn, the student nurse asked the instructor, “What will the new mother do when we aren’t there to help?” Which of the following statements would be the best reply from the nursing instructor?
a. “I am going to ask you to come back tomorrow to help the new mother further.”
b. “Why would the new mother experience any problems?”
c. “We have to assume that the new mother will be able to manage without us.”
d. “We’ll have another nurse stop by tomorrow to help the new mother.”
5. A clinical specialist in gerontology accepted a position with the local health department as a community/public health nurse. For whom can the nurse expect to provide care?
a. To geriatric clients and the local senior citizen centers
b. To the neighborhood at highest risk in the city
c. To the neighborhood where the nurse lives
d. To wherever the nurse selects
6. A home health nurse was making an initial visit to an elderly man. As the nurse began the assessment, the wife gave all the information requested. Which of the following actions would the nurse take next?
a. Agreeing upon appropriate interventions with the family
b. Creating appropriate nursing diagnoses
c. Assessing the environment of the wider community
d. Confirming the information obtained with the client
7. As the nurse entered the house of an elderly couple and was invited to sit, three cats rubbed against the nurse’s legs. Which of the following would be the most appropriate comment for the nurse to make?
a. “Are these cats hungry? Or do they want something else?”
b. “Cats can really cause health problems. Would you like me to call the animal shelter for you?”
c. “Would you like to introduce me to your cats?”
d. “Would you please lock up your cats until we’re done?”
8. Which of the following would be the nurse’s primary goal during the first visit to home-bound clients?
a. To assess the health of all family members and the immediate environment
b. To discuss the time and financial limits to the care the nurse can give
c. To establish rapport with the clients and work with them to define mutually agreeable goals
d. To implement the nursing care plan established before hospital discharge
9. What is the most crucial aspect of the first visit to a new client?
a. Confirming that all needed assessment data are obtained
b. Creating an accurate and appropriate list of nursing diagnoses
c. Establishing a systematic evaluation plan
d. Establishing trust for a productive relationship
10. Which of the following reasons explains why new community/public health nurses are very uncomfortable with home visiting, even in nice neighborhoods?
a. Home visits are a new skill to be mastered, and learning is uncomfortable.
b. Home visits reflect a situation under the client’s control and in the client’s environment.
c. Home visits require lots of supervision, backup, and extra resources.
d. Home visits take much more time and effort than does giving care in the hospital.
Chapter 12: A Family Perspective in Community/Public Health Nursing
1. When a home health nurse visits a family for the first time, what is the nurse’s primary goal?
a. Complete physical examinations on as many family members as time allows.
b. Have the family complete as many assessment tools as time allows.
c. Make sure all records, including third-party payer information, are accurate.
d. Observe and interview the family to identify family strengths and needs.
2. After completing an assessment, the nurse discusses with the family some actions that needed to be taken and refers to the wife in the family as an incredible organizer. Which of the following goals is the nurse trying to achieve by making this statement?
a. Making the husband proud that he had married his wife
b. Making the wife feel very complimented and positive
c. Encouraging the wife to volunteer to follow through on all the needed actions
d. Reinforcing for the family some of the strengths of one of their family members
3. Upon what variable are Duvall’s developmental stages based?
a. Age of the oldest child
b. Age of the parent or parents
c. Family function
d. Family structure
4. Why would a family strenuously resist the nurse’s efforts to be helpful?
a. People have the tendency to want to stay the same.
b. The family as a system operates on the principle of equifinality.
c. The nurse crossed the family’s coping boundary.
d. The family system is trying to achieve entropy.
5. After completing an assessment and discussing the plan of care with the family, upon which member would the nurse focus effort?
a. The adult patient with the acute flare-up of chronic illness
b. The child who, being young, was energetic and enthusiastic
c. The extended family, who had to learn to become a resource
d. The spouse, who was flexible and able to cope
6. In the midst of anxiety and concern over the new diagnosis, it seems that every family member was distancing himself or herself from the rest of the family. What mechanism would the nurse recognize that the family members are using?
a. Anger reduction strategies
b. Double-bind communication
c. Circumplex modeling
7. The nurse is caring for a family who is very anxious and tense. Which of the following would be the most appropriate nursing intervention?
a. Being supportive as the family debates what should be done about the problems
b. Calmly discussing the family’s perception of their problems and coping mechanisms
c. Sharing with the family the interventions to be made and the goal of the interventions
d. Telling the family what should be done to reduce their anxiety and fearfulness
8. Which of the following would be better understood by the nurse after using a family map?
a. Recognition of the communicator and leader who speaks for the family
b. Description of the genogram or family tree of the family
c. Identification of the geographic location of neighborhood resources for the family
d. Roles and relationships within the family
9. Which of the following statements would be the most accurate description of symbolic interaction in a family?
a. “Behaviors of one person are the cause of behaviors in another family member.”
b. “Behaviors of one person are the effect of behaviors in another family member.”
c. “Behaviors of one person are both the cause and the effect of behaviors in another family member.”
d. “Behavior within the family is consistent, patterned, and repetitious.”
10. A community/public health nurse is working with a family who is having difficulty with communication. Which of the following behaviors would cause the nurse to be concerned?
a. Family members communicate through behaviors and verbal statements.
b. Family members use rules to regulate behaviors in the family.
c. Family members use double-bind messages.
d. Family members communicate through metacommunication.
Chapter 13: Family Case Management
1. Why do community/public health nurses focus on families?
a. Families will understand the higher cost of care if they are active participants.
b. Improving the health of a family improves the health of a community.
c. Nurses find such a focus much easier than trying to focus on the community.
d. Nurses allow family members to receive respite by providing this type of care.
2. A community/public health nurse is visiting a family for the first time. Which of the following should be the priority action for the nurse?
a. Assessing how the family is adjusting to the illness of the sick family member
b. Clarifying what insurance or third-party payer is reimbursing this care
c. Determining the problem or reason for the referral
d. Establishing a relationship with the family
3. What is the primary goal of case management of families?
a. To ensure the care is given in the most cost-effective manner possible
b. To coordinate all of the community agencies involved in care of the family
c. To focus on communication, counseling, and teaching
d. To work to maximize the family’s self-care capabilities
4. A community/public health nurse is conducting a family assessment. Which source of data would be most helpful?
a. Information from other cooperating health care agencies
b. Input from other professional health care providers
c. Observation and interaction with the family members
d. Review of family members’ charts and medical record data
5. A nurse met with a client before hospital discharge to make arrangements to visit the client at home. Why would the nurse visit the client’s home when the assessment could be completed while the client is still in the hospital?
a. The client may not realize all of the assistance that is needed until he or she returns home.
b. The client needed time to consider the community resources that would be used in the future.
c. The nurse wanted to include family and environmental conditions in the assessment.
d. The nurse wanted to ask the client questions in a private setting.
6. A home health nurse was making an initial visit to an elderly man. As the nurse began the assessment, the man’s wife gave all of the information requested. Which of the following actions should the nurse take next?
a. Agreeing on appropriate interventions with the family
b. Determining appropriate nursing diagnoses
c. Assessing the environment of the wider community
d. Confirming the information with the client
7. A nurse is assigned to care for a client who has just been discharged from the hospital. What should be the nurse’s priority assessment after discovering that other family members desperately need health care as well?
a. Focusing on identified problems and the person with the most problems
b. Reviewing the home and the immediate environment for external problems
c. Interviewing the family members to get an overall picture of family functioning
d. Providing care for the client who has been discharged from the hospital
8. The community/public health nurse asks a married couple to review important family events. What is the nurse accomplishing through this review?
a. Giving the family members an opportunity to emote about negative events
b. Recognizing how past events have changed their lives
c. Providing an opportunity to review how they interact with each other
d. Putting distance between past events and current reality
9. When a client’s wife asked whether the nurse would like a tour of the yard and her gardens, the nurse agreed immediately. Considering the limited time the nurse had to spend with the family, why did the nurse agree to tour the gardens?
a. Accepting the invitation encourages the wife to speak privately to the nurse.
b. Completing the environmental assessment will assist with drawing a genogram.
c. Examining of the environment helps identify potential health or safety problems.
d. Touring the grounds allows the nurse to learn more about the family.
10. A nurse asked quite a few questions about what each family member did during the day, including school, work, and recreation outside the home. What was the nurse accomplishing by asking these questions?
a. Assessing the community environment for possible community-wide problems
b. Creating a picture of the family’s relationships with outside agencies and resources
c. Looking for topics the nurse might have in common with a family member
d. Seeking an appropriate topic around which to establish rapport
Chapter 14: Multiproblem Families
1. A community/public health nurse has been having difficulty interacting with a family with multiple problems and has asked the agency supervisor for advice. Which of the following actions will most likely be suggested?
a. Exchange caseloads with another nurse at periodic intervals to obtain fresh insight.
b. Reassure the family that things will eventually be alright.
c. Help the family recognize how they are responsible for their own problems.
d. Recognize that the family has potential for improvement.
2. A home health nurse felt overwhelmed and asked to be assigned to a better neighborhood. Why would the agency supervisor decline to change the nurse’s assignment?
a. Although the nurse is just beginning to assess the families, the nurse’s continued efforts to visit and support the families will be therapeutic.
b. Lots of nurses are willing to work in nice neighborhoods; most agencies need nurses who are willing to work in poor, needy neighborhoods.
c. The nurse had signed a contract and must work where assigned, regardless of personal feelings.
d. The nurse is capable of learning about how to improve interactions with these families and will do better with experience.
3. Which of the following is the most crucial factor in how a family responds to a natural disaster that almost destroyed their house?
a. How many of the family’s relatives will allow them to move in temporarily
b. How much of house is repairable
c. How much governmental aid will be given to them to rebuild their house
d. How the family perceives the disaster and their ability to cope
4. Which of the following is the most probable reason that some families have multiple problems?
a. Presence of multiple, ongoing, intense stressors beyond their resources
b. Lack of cultural integration into mainstream society
c. Being supported by government resources for several generations
d. Being unwilling to change or consider new approaches to problems
5. Having completed an initial assessment, a nurse was overwhelmed with the current problems the family was facing. Which of the following actions should the nurse take first?
a. Arranging for tangible sources of external support
b. Helping the family explore current and alternative coping mechanisms
c. Providing information on crisis management and the health issues that the family is facing
d. Recognizing sources of family resiliency and strength
6. Which of the following would make a family with a newborn who is severely handicapped be considered a vulnerable family?
a. When all of the choices related to the situation have negative consequences
b. When there are no backup caregivers to care for the severely handicapped infant
c. When the family welcomes someone else taking responsibility for them
d. When the family has to choose a lifestyle that is dependent on others
7. Statistically, what are poverty-stricken families more likely to have demographically?
a. A female head of the family, with few social and financial resources
b. Employment outside the immediate neighborhood
c. More children than the male head of household can support
d. Ongoing predictable life events
8. In addition to having low income and few resources, how are poverty-stricken families often notably different from mainstream families?
a. Children have been removed from the household by Children’s Protective Services.
b. Many predictable life events occur for which they do not prepare.
c. The time for each developmental period is shorter, with ambiguous transitions.
d. They have relationships with controlling family members.
9. Which of the following statements is a reality regarding disturbances in family dynamics and high-risk problems in families?
a. “Chronic ongoing problems have no relationship to disturbed family dynamics.”
b. “Chronic family problems lead to difficulties in family dynamics.”
c. “Disturbances in these areas lead to the majority of problems in families.”
d. “It is impossible to state which issue leads to the other.”
10. What typically happens to the adults who grew up in maladaptive families?
a. They create very different lifestyles, as they promised themselves when very young.
b. They look back and laugh at how naive they were.
c. They repeat the multigenerational life patterns of their parent or parents.
d. They attempt to change, but some behaviors consistent with their parents’ behaviors remain.
Chapter 15: Community Assessment
1. Which of the following would be the best way to determine the health of a community?
a. Ask a firefighter which neighborhoods have the fewest fires.
b. Ask a realtor which neighborhoods have the most expensive houses.
c. Ask people living in the neighborhood if they are happy with where they live.
d. Ask the police department which neighborhoods have the lowest crime rates.
2. Which of the following characteristics would be most indicative of a healthy community?
a. Excellent private schools and superb fire and police systems
b. A United Way that receives large donations each year
c. An extensive array of services offered by private physicians
d. Clean air and water and a sense of community cohesion
3. A nurse was assessing the neighborhood near the health agency. The nurse drove around observing the condition of the buildings, sidewalks, and the people in the community. Which of the following best describes the actions of the nurse?
a. A drive-through
b. A neighborhood observation
c. A quick overview
d. A windshield survey
4. Which of the following would be the best definition of a community?
a. People with open boundaries living in a particular area
b. People gathered together to solve a particular problem
c. People with a sense of belonging or common identity
d. People with at least one common demographic characteristic
5. Which of the following is an essential characteristic of a community?
a. A geographic area with defined boundaries
b. A particular place over time for common purposes
c. A place and beliefs or value systems
d. A place or common demographic characteristics
6. Which of the following is an example of a phenomenologic community?
a. The employees of Delco Manufacturing
b. The Miami Valley region
c. The village of Yellow Springs
d. The United States Census Bureau census tract #1017
7. Which of the following best describes a group?
a. Those who are all living in the same geopolitical area
b. Those who are all members of the same phenomenologic community
c. Those who engage in repeated face-to-face communication
d. Those who respect each other’s perspective
8. When community/public health personnel speak of a community of solution, to what are they referring?
a. A community that has resolved its major problems at least temporarily
b. The area in which some problems are approached on a wider regional basis
c. The fact that communities have to solve their own problems
d. The reality that some problems have to be approached on a federal basis
9. When a community is assessed from a developmental framework, which data must be determined?
a. The demographics (such as age) of the persons living in the community
b. The emotional maturity of the community’s residents
c. The history of the community
d. The number and quality of daycare centers and schools
10. Which of the following would be the focus of a nurse who is using an epidemiologic framework to assess a community?
a. Interviewing health care professionals concerning the community
b. Researching findings from epidemiologic studies
c. Learning about the health of the community’s population
d. Discovering groups among the community residents who are most at risk
Chapter 16: Community Diagnosis, Planning, and Intervention
1. A community/public health nurse employed by the local health department is told by the director to engage in health planning. Which of the following actions will the nurse perform?
a. Collecting and analyzing data
b. Serving vulnerable populations
c. Planning for health care needs of individuals
d. Applying the nursing process to community-based care
2. The director of a public health agency suggested that the community/public health nurse select the target population for a new program. Of the following populations, which would be considered the target population?
a. Persons for whom the nurse is most comfortable caring
b. Persons for whom some change in health or lifestyle behaviors is desired
c. Persons eligible for care according to federal guidelines
d. Persons that can afford to pay for their care
3. What was the significance of the National Health Planning and Resources Development Act of 1974?
a. It created the program that yielded the first evidence that managed care reduced costs.
b. It funded nationwide health planning to improve health care and reduce costs.
c. It provided additional federal money to the states to spend on health care.
d. It allowed states to take responsibility for planning health care services.
4. What was the result of the prospective payment system legislation?
a. Hospital stays were shortened, which placed a greater responsibility on family care.
b. Payments to the hospitals and physicians that fulfilled the new rules were higher.
c. Nursing staffing was increased to meet the needs of more acutely ill patients.
d. Diagnoses were more accurate and complete before clients were admitted to acute care.
5. According to the American Nurses Association (ANA) and the American Public Health Association (APHA), the community/public health nurse is responsible primarily for whom?
a. The community as a whole
b. The employer who is paying the nurse’s salary
c. The individual for whom the nurse is caring
d. The governmental unit that is responsible for its citizens
6. Whether a nurse’s plan of care for a community is acceptable is probably determined by which aspect of the plan?
a. It was created in coordination with community members.
b. It was financially feasible.
c. It was politically correct and feasible.
d. It was something in which the nurse really believes.
7. Which of the following actions is a nurse most likely to perform in an approach to community health planning with the community empowerment model?
a. Motivating bankers and financial advisers to help the community in its development
b. Obtaining the best experts available to help the community develop
c. Using a grassroots approach and democratic decision making
d. Writing grants to obtain money for the community and health care programs
8. Which of the following facts is a drawback of the community empowerment model?
a. Bankers and other money people are very busy and often uninterested.
b. Grants, although beautifully written, may not get funded.
c. It is hard to persuade experts to volunteer their time.
d. It is the slowest approach and takes the longest to obtain results.
9. How might the social planning model best be defined?
a. A process of experts engaging in rational, deliberate problem solving
b. A process of group meetings that take place until everyone reaches consensus
c. A process of collaboration to write grants to fund health care programs
d. A process of using democratic decision making through a grassroots approach
10. How might the social action approach be summarized?
a. A process of experts engaging in rational, deliberate problem solving
b. A process of group meetings that take place until everyone reaches consensus
c. A process in which groups seek redistribution of power or basic change in organizational policies
d. A process in which groups work together to write several grants to get money for health care programs
Chapter 17: Evaluation of Nursing Care with Communities
1. A community/public health nurse is planning the evaluation of a community education program about smoking cessation. Why is it important to complete this evaluation?
a. It facilitates additional decision making.
b. It clarifies the actual care involved in the service.
c. It is required by accrediting agencies.
d. It demonstrates that outcomes of the program were met.
2. Which of the following is a necessary assumption for evaluation to occur?
a. Accrediting agencies focus on careful documentation.
b. Actions have both intended and unintended results.
c. Nursing care is dependent on the reimbursement available.
d. People expect professionals to document their care.
3. What is the purpose of outcome attainment?
a. Answering the question “Were goals achieved?”
b. Clarifying whether agency funds were appropriately expended
c. Determining quantity of care given
d. Measurement of community living outcomes
4. A nurse is determining the quality of care that is provided. Which of the following factors would the nurse examine?
a. Adequacy and appropriateness
b. Agency mission statements
c. Cost–benefit ratios
d. Personal feelings about the care
5. How does summative evaluation help the community/public health nurse?
a. Analyzing the data and recognizing gaps
b. Determining long-term effect on health
c. Improving care as it is being delivered
d. Enhancing future offerings of the program
6. How does formative evaluation help the community/public health nurse?
a. Analyzing the data and recognizing gaps
b. Determining what to do differently next time
c. Improving care as it is being delivered
d. Enhancing future offerings of the program
7. A nurse is planning to involve the community in the evaluation process. Why is this a critical part of evaluation?
a. The nurse has completed her ethical, legal, and political responsibilities.
b. The agency retains state approval and national accreditation.
c. The community does not feel ignored by the agency.
d. The interventions helped community members make appropriate lifestyle changes.
8. Stakeholders are defined as persons who
a. Have expectations about care to be delivered.
b. Have loaned money to the agency.
c. Helped write the legislation for health care agency funding.
d. Own stock in the agency.
9. Which of the following groups created the standards for evaluating effective nursing care with communities?
a. The American Association of Colleges of Nursing
b. The American Public Health Association
c. The Quad Council of Public Health Nursing Organizations
d. The National Council of State Boards of Nursing
10. A nurse is planning to examine program outcomes. Which of the following would be the most important question to ask?
a. Was the agency adequately funded?
b. What organizational process was used?
c. What techniques were used?
d. What were the end effects on clients?
Chapter 18: Health Promotion and Risk Reduction in the Community
1. Which of the following is one of the goals of Healthy People 2020?
a. Decreasing institutionalization and increasing community-based care services
b. Achieving health equity, eliminating disparities, and improving the health of all groups
c. Creating environments to improve the eating and exercise habits of all people
d. Expanding the technology, resources, and medications used to treat chronic illness
2. Because, in relation to physical activity, none of the Healthy People 2010 objectives was met, what does the United States need to do?
a. Ensure more tax funding for education of physical education teachers.
b. Encourage funding for an increased number of exercise centers.
c. Increase programs for teaching and encouraging health-promoting lifestyle choices.
d. Require health care providers to serve as role models of appropriate physical activity choices.
3. Which of the following would be the most effective mechanism to use when collaborating with others to have an extensive and lasting impact on health outcomes?
a. Broadly disseminating health-related information to inform citizens
b. Encouraging the creation of more health programs on client lifestyle modification
c. Increasing funding to health agencies for more health education programs
d. Influencing improved health policies and legislation for healthier communities
4. How was the concept of health defined originally?
a. Balance and harmony
b. Maximum self-actualization
c. Absence of disease
d. Total well-being
5. Which of the following definitions of health is most typically used in nursing today?
a. Ability to interact and adapt to the environment
b. Ability to perform required social roles
c. Ability to stay free from disease
d. Ability to maximize human potential
6. What is the primary goal of health promotion?
a. Discovering people who are at risk and helping them obtain appropriate health care
b. Enabling people to exercise control over their own well-being
c. Preventing further physiologic damage by early intervention and education
d. Reducing specific risks by early diagnosis and treatment
7. A public health agency had enough funds to provide one more health-promotion program during the calendar year. In relation to nutrition and exercise, which of the following would be the best choice?
a. Elementary school program for children to which parents are invited
b. High school program for those who are involved in athletics
c. Young adult programs provided at the YMCA
d. Senior citizen programs offered during a free meal
8. Which of the following is the most crucial environmental influence on health?
a. Government in the local community
b. Health care system in the local community
c. Food, water, and exposure to toxic substances
d. Religious and cultural beliefs and values
9. In the United States, which of the following is the most crucial influence in the sociocultural environment?
a. The community in which a person grows and develops
b. Family’s values and beliefs
c. Health care provider from whom care is sought as needed
d. Socioeconomic class, education, and occupation
10. Which of the following services implemented by nurses would represent primary prevention?
a. A nurse-managed hospital respiratory unit for patients with chronic obstructive pulmonary disease (COPD) and emphysema
b. A quit-smoking-now clinic for adults who want to give up the habit
c. A “don’t smoke” campaign for elementary school students
d. A “stay beautiful” campaign for high school female smokers that stresses that smokers have wrinkles about a decade earlier than their chronologic peers
Chapter 19: Screening and Referral
1. Why is health screening considered a secondary level of prevention?
a. It distinguishes between populations at high risk for disease from those at low risk for disease.
b. It identifies patients who may need intervention.
c. It diagnoses many easily treated diseases.
d. It promotes health and well-being.
2. Why are results of screening tests referred to as presumptive?
a. If the test result is positive, it may be assumed that the disease is present.
b. The test results lead to recognition of symptoms.
c. The tests detect previously unrecognized signs and symptoms.
d. Because screening test results have less than 100% accuracy, referral for further tests is necessary.
3. Any screening test must absolutely be
a. Accurate in its conclusion.
b. Capable of being administered in a quiet area.
c. Equally effective with both children and adults.
d. Inexpensive and easy to perform.
4. A community/public health nurse was planning a prostate cancer screening in cooperation with the local community hospital. Whom should the nurse be sure to invite?
a. Men older than 50 years in the community
b. Anyone who had ever been involved with the local community hospital
c. Anyone who has a family history of cancer
d. Community members from infants to senior citizens
5. A community/public health nurse had a referral to visit a grandmother in her apartment to follow up on blood pressure readings because she was on a new medication. While in the apartment, the nurse took the blood pressure readings of all the adults and children there. What is the nurse attempting to do?
a. Perform a case finding.
b. Follow the American Heart Association guidelines.
c. Give care to all members of the family, regardless of reimbursement.
d. Involve the family in the care.
6. A community/public health nurse was responsible for setting up a health fair in a very heavily attended inner-city church, with several screenings being given simultaneously. Within the public health agency, what would the nurse call the health fair?
a. Case finding
b. Community service
c. Multiphasic screening
d. Unreimbursed care
7. A local community hospital offers weekly hypertension screenings at the community center. A community/public health nurse was asked by a community member about when the health department would be offering a hypertension screening at the center. Which of the following would be the best response from the community/public health nurse?
a. “When the public health department receives additional grant funding.”
b. “When the residents of the neighborhood request free screenings.”
c. “When the community/public health nurse has extra time.”
d. “When the community hospital stops offering screenings.”
8. As nursing students were setting up a health screening at a local community center, they reviewed the need to screen for heart disease and cancer. One student asked, “But colon cancer is prevalent; why aren’t we setting up for sigmoidoscopy?” How would the instructor reply?
a. “A sigmoidoscopy is expensive to perform and invasive.”
b. “Can you find adequate privacy for a sigmoidoscopy?”
c. “What a great idea. Would you like to help arrange it?”
d. “Would you like to administer that test for the screening?”
9. The ability of a screening test to distinguish correctly between persons with and without a disease is known as
10. Sensitivity is the ability of a screening test to accurately identify what aspect of the screening?
a. Persons who do not have the disease
b. Persons who have the disease
c. Persons with symptoms of the disease
d. Persons who now have a diagnosis of the disease
Chapter 20: Health Teaching
1. For whom are patient education programs very helpful?
a. Adults and families who can learn to avoid health problems
b. Adults and families, who will all be clients in the future
c. People who wish to learn how best to use the health care system
d. People with an identified health problem
2. Toward which individuals and their families are health education programs primarily aimed?
a. Those who are acutely ill and need information to help them recover and avoid further problems
b. Those who are healthy and can support each other in maintaining healthy lifestyles
c. Those who must cope with an ongoing chronic disease
d. Those who have defined health problems and who can support each other in maintaining healthy lifestyles
3. Which of the following criteria must be met in order for an educational program to receive third-party reimbursement?
a. It must be provided to a geriatric population.
b. It must be given by an advanced nurse practitioner.
c. It must occur in a rural, underserved area.
d. It must be prescribed by a physician for an ill client.
4. How can nurses best help expand availability of health education programs?
a. Being entrepreneurs and asking patients to pay what they think the educational program was worth
b. Suggesting to their friends and neighbors that they lobby local health organizations to provide such health education programs
c. Teaching health education programs as unpaid volunteers in the community
d. Working politically to influence public policy regarding funding health education programs
5. What strategies will a nurse include when planning an educational program for adults that ensures student learning?
a. Individual one-on-one tutorials to ensure maximum understanding
b. Large group lectures with handouts of main points along with culturally appropriate pictures
c. Small peer group discussions on how to apply the new knowledge with prompt feedback
d. Use of multimedia technologies such as videotapes and PowerPoint presentations
6. In what way is the Predisposing, Reinforcing, Enabling, Causes in Educational Diagnosis, and Evaluation (PRECEDE) model helpful when health education programs are implemented?
a. It addresses the learning needs of ill individuals.
b. It begins with examining an aggregate’s general concerns and quality of life.
c. It emphasizes the learning needs of families who have an ill member.
d. It focuses primarily on environmental resources.
7. Which of the following factors most influences a client’s ability to learn from a health education program?
a. Client’s belief that the information will be useful or enjoyable
b. Handouts given to the client
c. Nurse’s ability to teach
d. Setting in which the educational program is given
8. A nurse is teaching a client how to perform her own insulin injections. Which of the following should the nurse assess first to determine the client’s experiential readiness to learn?
a. Culture and ethnic background
b. Educational ability
c. Family structure
d. Home environment
9. Behavioral objectives should be
a. Comprehensive and complete.
b. Observable, measurable, and clearly communicated.
c. Specific and detailed.
d. Written on the teaching plan.
10. The nurse distributed written materials with culturally appropriate pictures to the small groups in the audience and began to lecture on the important content before the planned discussion period. However, no one was listening. What should the nurse have done differently?
a. Created a more interesting and entertaining lecture
b. Withheld the written materials until after the lecture
c. Let the audience discuss the material as a whole, not in small groups
d. Skipped the lecture and went directly to the discussion period
AND MUCH MORE