Test Bank Public Health Nursing 8th Marcia
Chapter 01: Population-Focused Practice: The Foundation of Specialization in Public Health Nursing
1. One of the primary focuses of improving the health of the American people in the twenty-first century is to address:
a. Bioterrorism and global health threats
b. Delivery of individual care and hygiene
c. The need for increased hospital and acute care
d. Chronic disease and disability management
2. The threat of bioterrorism has the potential to:
a. Dissolve community-based programs.
b. Cause the health care system to collapse.
c. Divert funds from other public safety health care programs.
d. Increase the need for shelters.
3. Population-based preventive programs launched in the 1970s are responsible for increased:
a. Use of tobacco
b. Use of automobile safety restraints
c. Incidence of hypertension
d. Incidence of obesity
4. The public health nurse must participate in the essential services of public health. These include:
a. Monitoring health status by completing a community assessment
b. Diagnosing and investigating health problems in the world
c. Informing, educating, and empowering people about health issues
d. Working in law enforcement to regulate health and ensure safety
5. Which of the following is an example of the mission of public health according to the Institute of Medicine?
a. Tracking avian flu outbreaks and doing surveillance in the United States
b. Providing a flu shot for an elderly person at the health department
c. Keeping track of alternative therapies in use in the United States
d. Keeping snake antivenom at the Centers for Disease Control and Prevention in Atlanta
6. Making sure that essential community-oriented health services are available defines which of the core public health functions?
a. Policy development
d. Scientific knowledge-based care
7. The number and proportion of persons aged 25 or older with less than a high school education is an example of:
a. Sociodemographic characteristics
b. Health status
c. Health risk factors
d. Health care resource consumption
8. The purpose of public health core functions is to:
a. Clarify the role of the government in fulfilling the mission of public health.
b. Ensure the safety of populations in receiving quality health care.
c. Provide community-based individualized care to every person in the United States.
d. Unite public and private providers of care in a comprehensive approach to providing health care.
9. Which of the following statements about public health is accurate?
a. Prevention of early deaths can be more effectively accomplished by medical treatment than by public health approaches.
b. Expenditures and resources for public health have increased in recent years.
c. Historically, gains in the health of populations have been related largely to changes in safety, sanitation, and personal behavior.
d. Reform of the medical insurance system is the single change needed to improve the health of Americans.
10. Collecting data and monitoring the health status of the population defines which of the core public health functions?
d. Policy development
Chapter 02: History of Public Health and Public and Community Health Nursing
1. In the past, population-centered nurses have been called:
a. District nurses
b. Almshouse nurses
c. Soldier nurses
2. Public health practice is an appealing specialty to nurses because of its:
a. Interactions with wealthy contributors to secure funding
b. Autonomy and independence of practice
c. Ability to locate the source of diseases and cure patients
d. Opportunities to meet a variety of people
3. The Elizabethan Poor Law of 1601 is similar to which current law?
b. Food Stamps
4. Current threats to health in the United States that community health nurses are faced with include:
a. Diphtheria, cholera, and hepatitis
b. HIV, H1N1 influenza, and bioterrorism
c. Avian flu, tuberculosis, and radiation
d. Polluted water and air
5. A colonist working in the public health sector in early colonial North America would likely have focused on:
a. Establishing schools of nursing
b. Developing vaccines to administer to large numbers of people
c. Collecting vital statistics and improving sanitation
d. Developing public housing and almshouses
6. The original work of the National Organization for Public Health Nursing has influenced nursing practice today by:
a. Requiring that public health nurses have a baccalaureate degree in nursing
b. Standardizing public health nursing education
c. Developing nursing cooperatives
d. Opening the Henry Street Settlement
7. A public health nurse is compiling information about how to promote early detection of breast cancer in women. Which document would most likely provide useful information about this topic?
a. The Future of Public Health
b. Healthy People 2020
c. Patient Protection and Affordable Care Act
d. Scope and Standards of Public Health Nursing Practice
8. A major provision of the Social Security Act of 1935 was the establishment of:
a. The Frontier Nursing Service to provide nursing service to rural communities
b. State and local community health services and training of personnel
c. District nursing to provide home health care to sick people
d. Community-based settlement houses
9. Public health nurses are involved in health care reform because reform should:
a. Promote the nursing profession.
b. Increase funding for public health nursing.
c. Address the concerns of nurses.
d. Improve health care access and reduce health care costs.
10. A neighborhood health center is researching its origins. Which of the legislative acts most likely provided funds for its development?
a. Emergency Maternity and Infant Care Act of 1943
b. Medicaid legislation
c. Social Security Act of 1935
d. Economic Opportunity Act
Chapter 03: Public Health and Primary Health Care Systems and Health Care Transformation
1. According to the 1999 Institute of Medicine report, as many as 98,000 deaths each year are caused by:
a. Cardiovascular disease
c. Medical error
d. Drug overdose
2. In the United States, the majority of health care dollars are spent on:
a. Prescription drugs
b. Hospital care
c. Physician services
d. Public health services
3. The number of uninsured Americans has dramatically increased because:
a. Medicare took over payment of health care costs.
b. With a declining population, the costs for health care rose.
c. Nursing salaries greatly increased, causing health care costs to rise.
d. Health insurance coverage was dropped from employment-based health plans.
4. The primary purpose of the World Health Organization is to:
a. Coordinate surveillance at the global level.
b. Prevent outbreaks of disease.
c. Prevent the transmittal of communicable disease among nations of the world.
d. Provide humanitarian support in times of disaster.
5. One of the benefits that a public health agency will experience by choosing to implement the electronic health record is:
a. Facilitation of interprofessional care
b. Improved client compliance with medical regimens
c. Cost-savings to the agency
d. Compliance with JACHO standards
6. African American females have a higher mortality rate from breast cancer than Caucasian females. This is an example of:
d. A sentinel event
7. A nursing program has initiated a recruitment campaign focusing on increasing the minority students in its program. The rationale for this campaign is that:
a. The number of minority versus non-minority nurses should be equal.
b. Minority health care professionals who share the same culture with the clients may provide more effective care.
c. The profession should be more diverse.
d. Minority nurses can mentor other nurses when providing care for diverse populations.
8. A community health nurse utilizes telehealth because it:
a. Enables clients to get nursing care in their homes
b. Substitutes for health department delivered care
c. Improves access to care in rural areas
d. Replaces face-to-face care for those who cannot afford it
9. An 80-year-old woman comes to the community health center with a large bag of medications. She tells the nurse she can no longer afford these medications because her only income is Social Security. Which statement is the best response by the nurse?
a. “Let’s go through these medications and see which ones we can delete.”
b. “You can get these medicines at this clinic for free.”
c. “Let’s see if we can get some help from Medicare to pay for these medications. I will refer you to our social worker.”
d. “These medications are important. Do your best to pay for them.”
10. Residents of rural communities report that they must travel for long distances to obtain health care services. As a result, they seek health care only for emergencies and severe illnesses. Which aspect of the health care system in the United States is illustrated in this situation?
a. Access to care
d. Advances in technology
Chapter 04: Perspectives in Global Health Care
1. The key to achieving the goals of Health for All in the 21st Century (HEALTH21) is the worldwide:
a. Cure of communicable disease
b. Technological development of all nations
c. Availability of health care insurance
d. Implementation of primary health care
2. Which health problem is in need of control in developed countries?
3. Which is a disease that was once isolated and rare but is now widespread throughout the world?
a. Acquired immunodeficiency syndrome (AIDS)
4. The health priorities in HEALTH21 are based on the concept of:
a. Eradication of communicable disease worldwide
b. Equality and solidarity with an emphasis on the responsibility for health
c. World trade and knowledge sharing about health concerns
d. Provisions for the creation of UNICEF
5. Which is referred to as a lesser-developed country?
6. Population health is an approach and perspective that focuses on:
a. Control of the spread of the HIV virus worldwide
b. The broad range of factors and conditions that influence health
c. Community-based care for all citizens
d. Prevention and diagnosis of disease worldwide
7. Income level and social networks are examples of:
8. Worldwide, the most frequent cause of death from a single agent is:
9. An example of a successful campaign against which of the following communicable diseases was carried out during the 1960s and 1970s?
10. Which statement about tuberculosis (TB) is true?
a. Meningitis is the leading cause of death from tuberculosis.
b. Chemotherapy, if made widely available, could eradicate the disease.
c. Many TB cases are associated with HIV.
d. The TB bacillus is difficult to isolate.
Chapter 05: Economics of Health Care Delivery
1. The allocation of scarce resources within the health care sector and the focus on resource allocation issues related to producing and distributing health care is called:
b. Health economics
c. Economic evaluation of health care
d. Microeconomic theory
2. Public health economics focuses on the:
a. Use of resources
b. Availability and usage of goods and services related to public health
c. Scarcity of resources in the health care industry
d. Management and use of monies to improve the health of populations
3. Which statement regarding poverty and health insurance is true?
a. Millions of people in the United States are without health insurance.
b. The poor in the United States are as healthy as persons with higher incomes.
c. Persons with money or health insurance are less likely to seek health care.
d. The poor are more likely to receive health care through private agencies.
4. Implementation of a teen pregnancy prevention program in a high school is shown to decrease the rate of teen pregnancy. This is an example of:
5. Which is an example of a service offered at the federal government level?
a. Family planning
c. Policy making
d. Prevention of communicable diseases
6. Conducting a class at a public health clinic on breast self-examination to a group of 50 women is an example of:
a. Supply and demand
7. Nurses can promote efficiency by:
a. Evaluating how well a program of service achieves what was intended
b. Trying new products provided by sales representatives
c. Using time wisely by delegating non-nursing tasks to unlicensed care providers
d. Setting up a clinic to look aesthetically pleasing to clients
8. When a business offers wellness incentives to its employees and then notices a decrease in the frequency of physician visits among employees, this is an example of:
a. Macroeconomic theory
c. Supply and demand
d. Microeconomic theory
9. Nurses should be cognizant of microeconomics because:
a. Nurses are often the ones to allocate resources to solve a problem.
b. Nurses are often involved in federal policy making.
c. Nurses should know about microeconomics in order to deliver quality patient care.
d. Health care supplies can be very costly and nurses must use them wisely.
10. Evaluating a smoking cessation program, the gained or increased financial income, the improvements in the community attributable to the program, or costs that would result if the program was not given are examples of:
a. Cost-effectiveness analysis
b. Cost-benefit analysis
c. Supply and demand
d. Microeconomic theory
Chapter 06: Application of Ethics in the Community
1. Which statement about Florence Nightingale’s ideas about ethics is correct?
a. Nursing is a call to service, and the moral character of persons entering nursing is important.
b. Ethical principles are based on the values of the individual nurse.
c. Society will dictate the ethical principles to which nurses must adhere.
d. Ethics are very important in times of war, such as in the Crimean War, when she set up public health centers.
2. When nurses apply the knowledge and processes of ethics to the examination of ethical problems in health care, they are using:
3. A nurse in the 1960s would have referred to which code of ethics to guide ethical decision making?
a. Nightingale Pledge
b. Code for Professional Nurses
c. Code of Ethics for Nurses with Interpretive Statements
d. International Council of Nurses (ICN) Code of Ethics for Nurses
4. An orderly process that considers ethical principles, client values, and professional obligations is:
b. Ethical decision making
c. Moral principles
d. Code for Nursing Practice
5. The growing multiculturalism of American society can contribute to ethnicity conflicts when:
a. Cultural standards are congruent with professional standards.
b. Cultural traditions within an ethnic group align with those of the community.
c. Ethnic groups overburden the health care system.
d. The greater community’s values are jeopardized by specific ethnic values.
6. There are two medically indigent clients in the clinic who have come to get their monthly supply of free insulin. There is only enough for one client. Which action does the nurse take first?
a. Identify all options.
b. Make a decision.
c. Gather additional information.
d. Act and assess decisions made.
7. An example of an ethical dilemma is:
a. Whether or not to set up a community health center in a rural area
b. Allocating resources in a natural disaster
c. Deciding to withdraw care on a hospice patient
d. Applying the principles of Florence Nightingale in Bangladesh
8. The steps of the ethical decision making process are similar to the steps of:
a. Healthy People 2010
c. The nursing process
9. Which ethical principle requires “doing no harm”?
a. Respect for autonomy
d. Distributive justice
10. Which statement fits the Liberal Democratic Theory of John Rawls?
a. Rejection of any idea that societies, states, or collectives of any form can be the bearers of rights or can owe duties.
b. Inequalities result from birth, natural endowment, and historic circumstances.
c. Everyone has a right to private property.
d. Government should be limited.
Chapter 07: Cultural Diversity in the Community
1. Which statement about the nursing workforce is true?
a. The nursing workforce is overwhelmingly Caucasian.
b. The number of minority nurses meets the needs of the country’s demographics.
c. The nursing workforce has many unauthorized immigrants.
d. Refugees make up a large part of the nursing workforce in some areas.
2. The 1986 Immigration Reform and Control Act had what effect on illegal aliens living in the United States?
a. Discriminated against individuals from Southern and Eastern Europe
b. Allowed illegal aliens already living in the United States to apply for legal status
c. Permitted foreign-born populations to set up communities in or around major metropolitan areas
d. Allowed illegal aliens access to “green cards” that would allow them to work in the United States
3. A large portion of foreign-born residents of the United States:
a. Work in service-producing and blue-collar sectors
b. Reside in rural areas
c. Have language barriers
d. Are refugees and non-immigrants
4. Which statement about race is true?
a. In the United States, children of biracial parents are usually assigned the race of the father.
b. Ethnicity and race are synonymous terms.
c. Individuals may be of the same race but of different cultures.
d. No social significance is usually placed on race.
5. A person’s skin color is an example of:
6. An example of an explicit cultural behavior is:
a. Verbal communication
b. Body language
c. Use of titles
d. Perception of health and illness
7. A 35-year-old man from Russia comes to the United States seeking asylum because of religious persecution in his native country. This type of immigrant is known as a(n):
a. Legal immigrant
b. Lawful permanent resident
d. Unauthorized immigrant
8. A visitor from Japan comes to the United States for a two-week vacation. This person is known as a:
c. Legal immigrant
d. Lawful permanent resident
9. An example of a behavior that may be defined by culture is:
a. Speaking a dialect of a language in a local region
b. Standing when an older adult gets on the bus to give him a seat
c. Immigrating to the United States seeking work
d. An organizational structure of a cultural group
10. Nurses who strive to be culturally competent should:
a. Respect individuals from different cultures and value diversity.
b. Immerse themselves in different cultures.
c. Design care for special ethnic groups.
d. Give explicit instructions to avoid client decision making.
Chapter 08: Public Health Policy
1. The first major federal government action relating to health was the:
a. Passage of the Social Security Act
b. Creation of the National Institutes of Health (NIH)
c. Creation of the Public Health Service (PHS)
d. Creation of Medicare and Medicaid
2. One of the main purposes of the Patient Protection and Affordable Care Act was to:
a. Create a government-funded insurance program for all Americans.
b. Make health insurance affordable for the middle class and small businesses.
c. Decrease the rates of chronic disease in the United States.
d. Increase the funding for public health agencies.
3. One effect of the use of block grants was a:
a. Reduction of federal expenditures
b. Decreased ability of states to spend money on programming
c. Guaranteed continuation of programs with demonstrated effectiveness
d. Shift from hospital-based to community-based nursing care
4. It is important that nurses are involved in health policy because:
a. Government and policy have a large impact on nursing and health.
b. Policy affects nursing values as set forth by Florence Nightingale.
c. Political science is a course of study that parallels nursing.
d. Nurses must interpret laws to fit their practice.
5. The United States Department of Health and Human Services (DHHS) is part of which branch of the government?
6. Which branch of the government interprets the states’ rights to grant abortions?
a. Executive branch
b. Legislative branch
c. Judicial branch
d. Federal branch
7. Action taken to protect the health, safety, and welfare of citizens, such as requiring immunizations of children before admission to school, is called what kind of power?
8. When a local health department provides a hypertension screening to all individuals, which general category of health care functions is being used?
a. Direct services
d. Policy setting
9. The federal government provides for the protection of the public’s health by:
a. Interpreting decisions related to women’s right to privacy
b. Setting up immunization clinics for smallpox vaccine
c. Regulating nursing at the state level
d. Monitoring the influx of disease at the borders
10. A goal of the Division of Nursing is to:
a. Enhance nursing’s competence in providing high-tech skills
b. Apply disease prevention, environmental health, and health promotion concepts
c. Provide scholarships for advanced nursing education
d. Enhance racial and ethnic diversity in the nursing workforce
Chapter 09: Population-Based Public Health Nursing Practice: The Intervention Wheel
1. Which statement about the Intervention Wheel is true?
a. It provides a graphic illustration of population-based public health practice.
b. It describes in detail the components of public health nursing.
c. It demonstrates the practice of community health nurses for policy and lawmakers.
d. It is a framework used by all health departments in the United States.
2. Since the Intervention Wheel was first published in 1998, it has:
a. Guided national policy
b. Been used as a tool in deciding licensure issues for State Boards of Nursing
c. Been incorporated into the public health curricula of many nursing programs
d. Gained wide acceptance internationally
3. Public health interventions are implemented with:
a. Legislators, policy makers, and community leaders
b. Individuals and families, communities, and systems
c. Children, adolescents, and adults
d. Health departments, public health agencies, and visiting nurses associations
4. Which statement is true about the origins of the Intervention Wheel?
a. A panel of nurses from Iowa, Minnesota, North Dakota, South Dakota, and Wisconsin developed and refined the Intervention Wheel.
b. It was conceived by a group of international nurses from Norway, Kazakhstan, and Japan.
c. It was a result of a qualitative analysis carried out by the State Boards of Nursing.
d. It resulted from a grounded theory process carried out by public health consultants at the Minnesota Department of Health.
5. When public health nurses conduct an assessment of a community’s health, they
a. Define one problem that will be the focus for a year.
b. Assess a social network of interacting individuals usually in a defined territory.
c. Minimize the effects of health risks and hazards.
d. Intervene at the population-level by changing laws and regulations.
6. A public health nurse utilizes the nursing process at all levels of practice by:
a. Including specific goals for community health nurses
b. Developing an accurate nursing diagnosis
c. Analyzing the needs of the community, system, and individuals and families
d. Utilizing primary, secondary, and tertiary prevention
7. Public health nurses use a common set of interventions to:
a. Describe the proper order of implementation.
b. Emphasize surveillance as the main focus of public health practice.
c. Guide practice and generate agency protocols.
d. Improve the health status of communities, systems, individuals, and families.
8. A public health nurse uses Assumption 2, “Public health nursing practice focuses on populations,” to guide practice. Which would be considered a population of interest?
a. Healthy school children
b. Homeless individuals
c. A person recently diagnosed with diabetes
d. Teenage parents
9. What is the purpose of the color-coded wedges on the Intervention Wheel?
a. The interventions are grouped together in related wedges.
b. The wedges consist of referral information for each wedge.
c. The element of health teaching is the predominant feature of each wedge.
d. Coalition building must be implemented with each wedge.
10. A nurse who is involved in identifying individuals with unrecognized health risk factors or asymptomatic disease is using which intervention?
b. Referral and follow-up
d. Health teaching
Chapter 10: Environmental Health
1. Why is it important for nurses to understand the premises of environmental health?
a. Nurses should be able to assess risks and advocate for policies that support healthy environments.
b. Toxicologists often consult nurses about environmental pollutants.
c. Pollutant exposures such as lead are reported by nurses to the Environmental Protection Agency.
d. Many Americans live in areas that do not meet current national air quality standards.
2. Environmental health is important to nurses because chemical, biological, and radiological materials are:
a. A major cause of global warming
b. Often found in the air, water, and products we use
c. Frequently linked to the development of chronic illnesses
d. Products that nurses work with on a daily basis
3. How have nurses historically learned to identify a possible relationship between environmental chemical exposures and their potential harm?
a. Extrapolation by toxicologists
c. Completing chemistry courses
d. Observing signs and symptoms in clients
4. The basic science applied to understanding the health effects associated with chemical exposures is:
d. Environmental epidemiology
a. Is a science that studies the poisonous effects of chemicals
b. Explains the association between learning disabilities and exposure to lead-based paint at the cellular level
c. Helps nurses understand the strength of the association between exposure and health effects
d. Is a method for tracking the prevalence of a disease
6. A public health nurse is working with a migrant farm worker who has experienced an exposure to a pesticide. When researching pesticides, the nurse looks at the “family” of the chemical. What similarities are found among chemicals that have been placed in the same family?
a. Route of entry into the body
b. Actions and associated risks
c. Effects that they have on the body
d. Potency and toxicity
7. A public health nurse is organizing a multidisciplinary team to address the issue of water pollution in the community. The most likely members that would be invited to address this issue would be:
a. Physicians, water sanitation workers, and occupational therapists
b. Pharmacologists, radiologists, and epidemiologists
c. Nurse practitioners, pharmacologists, and environmentalists
d. Geologists, meteorologists, and chemists
8. Which example contains the components necessary to form an epidemiologic triangle?
a. Pesticides, water, food
b. Lead, mercury, soil
c. Trichloroethylene, water, infants
d. Children under 12, elderly, temperature
9. An example of a point source of air pollution is:
a. A smoke stack
b. The number of cars and trucks
c. How much fossil fuel is consumed in a community
d. Ground ozone levels
10. Which is considered a non–point source of pollution?
a. Hazardous waste site
b. Animal waste from wildlife
c. Chlorine poured down a well
d. Stagnant water
Chapter 11: Genomics in Public Health Nursing
1. The blueprint or code that is used to construct other components of cells is called the:
2. Which statement regarding mutations is true?
a. Mutations in the DNA sequence occur on a regular basis.
b. Mutagens are a result of a mutation.
c. Environmental factors can be linked to many mutations.
d. Spontaneous mutations occur because of environmental exposure.
3. When a nurse learns more about the Human Genome Project to better counsel families about the process of genetic testing, the nurse is learning about:
d. Genetic susceptibility
4. An example of a multifactorial disorder is:
b. Hepatitis B
d. Type I diabetes
5. The increasing knowledge about genetics and genomics will influence nursing practice by changing how:
a. Nurses collect and use health histories
b. Nursing students complete clinical experiences
c. Referrals to other disciplines are made
d. Ethical dilemmas are solved
6. The father of genetics is:
a. Charles Darwin
b. Gregor Mendel
c. James Watson
d. Francis Galton
7. One of the main goals of the Human Genome Project was:
a. Providing physicians with a national database for information related to genetic disorders
b. Developing new medications that can be used in genetics research
c. Addressing ethical, legal, and social issues related to this research
d. Improving the ability to accurately test for genetic disorders
8. While collecting a medical history, a client reports having a family history positive for Huntington’s disease. However, the client states he does not want to have genetic testing performed. The nurse recognizes that one reason a client may refuse genetic testing is because of the:
a. Impact it may have on obtaining health insurance in the future
b. Legal consequences that may result
c. Inaccuracy of the results that are obtained
d. Decreased quality of life that may occur if the results are positive
9. A nurse working in the 1970s would have applied genetic concepts by:
a. Providing genetic counseling to those with genetic disorders
b. Educating clients about using genetic testing for risk identification
c. Explaining the purposes of the Human Genome Project to clients
d. Facilitating referrals for specialized genetic services for clients
10. Which question would be the most appropriate for the nurse to ask when eliciting information about a client’s genetic history?
a. “Have any of your family members ever completed genetic testing?”
b. “Do any of your family members have a genetic disorder?”
c. “What medical problems have your parents and grandparents experienced?”
d. “What environmental exposures have you had?”
Chapter 12: Epidemiology
1. The factors, exposures, characteristics, and behaviors that determine patterns of disease are described using:
a. Descriptive epidemiology
b. Analytic epidemiology
2. To understand the causes of health and disease, epidemiology studies:
3. When a nurse examines birth and death certificates during an epidemiologic investigation, what data category is being used?
a. Routinely collected data
b. Data collected for other purposes but useful for epidemiologic research
c. Original data collected for specific epidemiologic studies
d. Surveillance data
4. An epidemiologist wanting to know what caused severe diarrhea and vomiting in several people at a local banquet would be using:
a. Descriptive epidemiology
b. Analytic epidemiology
5. Which is an example of an epidemic?
a. “Bird” flu in China
b. Adult obesity in the United States
c. An isolated case of smallpox in Africa
d. The nursing shortage in the United States
6. John Snow is called the “father of epidemiology” because of his work with:
d. Germ theory
7. The interaction between an agent, a host, and the environment is called:
a. Natural history of disease
c. Web of causality
d. The epidemiologic triangle
8. Public health professionals refer to three levels of prevention as tied to specific stages in the:
a. Epidemiologic triangle
b. Web of causation
c. Natural history of disease
d. Surveillance process
9. Which is an example of an agent in the epidemiologic triangle?
a. Human population distribution
c. Genetic susceptibility
10. When studying chronic disease, the multifactorial etiology of illness is considered. What does this imply?
a. Genetics and molecular structure of disease is paramount.
b. Single organisms that cause a disease, such as cholera, must be studied in more detail.
c. Focus should be on the factors or combinations and levels of factors contributing to disease.
d. The recent rise in infectious disease is the main focus.
Chapter 13: Infectious Disease Prevention and Control
1. When caring for a client with methicillin-resistant S. aureus (MRSA), the community health nurse should know:
a. Persons with MRSA usually have a chronic illness.
b. MRSA is a hospital-acquired infection and not often seen in the community.
c. VRE (vancomycin-resistant Staphylococcus aureus) follows MRSA.
d. MRSA is becoming more common in the community.
2. The time interval between invasion by an infectious agent and the first appearance of signs and symptoms of the disease is called:
a. Communicable period
b. Incubation period
d. Pathologic reaction
3. The ability of an agent to produce a severe pathologic reaction is known as:
4. Immunity is a characteristic of the:
a. Agent factor
b. Host factor
c. Environmental factor
d. Epidemiologic triad
5. The nurse teaches food handlers to wash utensils after contact with raw meat. This prevention focuses on the:
d. Food handler
6. An example of an agent is:
a. Host resistance
d. Bug bite
7. An example of a vertical transmission of a disease is through:
a. Breast milk
b. Sexual transmission
d. Contaminated food
8. An example of a vector is:
a. Contaminated water
b. A tick
c. A dirty needle
d. An infected person
9. When one case of smallpox occurs in a population in which it was considered to be previously eliminated, it is called:
b. An epidemic
10. A nurse is providing education to a mother about the importance of having her infant immunized for measles, mumps, and rubella. This immunization will provide what type of immunity?
Chapter 14: Communicable and Infectious Disease Risks
1. Which part of the immunological system suffers the greatest damage as a result of HIV infection?
a. Dendrite cells
b. CD4+ T-lymphocytes
2. HIV transmission can occur through:
a. Exposure to blood
b. Insect bites
c. Sharing of school supplies
3. In comparison with HIV infection in adults, HIV infection in infants and children:
a. Has the same signs and symptoms
b. Has a shorter incubation period
c. Has a longer survival period
d. Is detected by using the same tests
4. The nurse counsels a client to have the enzyme-linked immunosorbent assay (EIA) test in order to:
a. Indicate the presence of the antibody to HIV.
b. Reveal whether or not the client has AIDS.
c. Isolate the HIV virus.
d. Confirm HIV after having a positive Western blot.
5. An example of HIV transmission is:
a. Having contact with a HIV-positive individual who is coughing
b. An infant receiving breast milk from a HIV-positive mother
c. Receiving a mosquito bite while in Africa
d. Being near a HIV-positive individual who is sneezing
6. A nurse examining a child in the early stages of HIV infection would expect to see:
a. Failure to thrive and developmental delays
b. Kaposi’s sarcoma and developmental delays
c. Toxoplasmosis and oral candidiasis
d. Fatigue and shortness of breath
7. When working with a client who is HIV positive, the nurse serves as an educator, teaching about the modes of transmission, and serves as a(n):
a. Advocate, lobbying for AIDS research
b. Counselor, discussing implications of future sexual activity
c. Role model, providing supportive care
d. Policy maker, addressing laws governing privacy rights of HIV-positive persons
8. A public health nurse is reviewing Healthy People 2020 to determine where to prioritize programming for the county health department. Based on Healthy People 2020, the nurse decides to implement programming to:
a. Reduce the rate of HIV transmission among adults and adolescents.
b. Eliminate STDs from developed countries.
c. Reduce deaths from gonorrhea.
d. Increase awareness about HIV in lesbian females.
9. The most common reportable infectious disease in the United States is:
10. Pelvic inflammatory disease (PID) is a common complication of:
Chapter 15: Evidence-Based Practice
1. Evidence-based public health is:
a. An integration of the best available nursing expertise
b. Derived from community principles to fit the area where it is practiced
c. A health endeavor that makes informed use of evidence
d. Comprised of only public health records
2. A nurse makes clinical judgments based upon trial and error and past clinical experiences. What problem can result from using these data sources in clinical decision making?
a. Not all sources of information are reliable.
b. Authority always leads to faulty decision making.
c. Ethical knowledge is not taken into account.
d. Trial and error has lead to poor outcomes.
3. A nurse uses clinical experience and client preference to guide clinical decision making when using:
a. Evidence-based practice
b. Internal evidence
c. Research utilization
d. External evidence
4. The term evidence-based was first used in:
b. Great Britain
c. The United States
5. A nurse providing care in the 1970s would have used which process as the guide for making clinical decisions?
a. Evidence-based nursing practice
b. The science of medicine
c. Evidenced-based medicine
d. Research utilization
6. A summary of the research evidence that relates to a specific question and to the effects of an intervention is:
a. Evidence-based practice
b. Action research
c. Systematic review
d. Best practices
7. Which type of research is defined as the gold standard of evidence in evidence-based practice?
a. Clinical expertise
b. Randomized controlled trials
c. Case studies
d. Systematic review
8. A nurse is grading the strength of evidence when critiquing a research study. Which domains will the nurse need to consider?
a. Randomness, sample size, and blinding
b. Selection, variables, and description
c. Nursing, medicine, and physiology
d. Quality, quantity, and consistency
9. It would be important for a nurse researcher to use blinding when:
a. The sample size is small
b. The outcomes must be accurately measured
c. Using a control group
d. Studying the attrition rate
10. What information will a nurse find when reading a systematic review?
a. Results of randomized controlled trials
b. A description of the methods used to search for evidence
c. Data compiled on a particular question
d. An in-depth review of the literature completed by one person
Chapter 16: Using Health Education and Groups to Promote Health
1. The cognitive domain includes:
a. Changes in attitudes and the development of values
b. The performance of skills
c. Memory, recognition, understanding, reasoning, and problem solving
d. Memorization of one set of skills before moving on to the next
2. What is the purpose of providing education across the three levels of prevention? Education:
a. Enables clients to attain optimal health
b. Identifies and treats health problems early to eliminate disability
c. Enables populations to break into individuals
d. Teaches people about Healthy People 2010
3. A nurse is teaching a client about how to complete a dressing change of a wound. The nurse knows that what conditions must be met before learning will occur?
a. Must be able to memorize the instructions, relay this information to a partner, and demonstrate the dressing change
b. Must master the dressing change at the time it is taught, repeat the demonstration for the nurse, and teach another person
c. Must be able to speak the language of the nurse, have time to practice the dressing change, and master the dressing change in a short time
d. Must have the necessary ability, a sensory image of how to carry out the dressing change, and an opportunity to practice the dressing change
4. A health educator trying to change a client’s attitudes about smoking would be using which of the following domains?
5. Which of the following domains would be used to teach a new diabetic how to give an insulin injection?
6. Which format would be most appropriate for teaching a group of nursing students who are learning to give injections?
b. Health fair
d. Non–native language session
7. Which statement about education is true?
a. It emphasizes the provider of knowledge and skills.
b. It emphasizes the recipient of knowledge and skills.
c. It is a process of gaining knowledge and expertise.
d. It results in behavioral change.
8. Which core competency of communication is used by nurses engaged in group work?
a. Soliciting input from individuals and organizations
b. Using simple language when presenting information
c. Asking the group to develop the program of interest
d. Presenting material to lay audiences only
9. When implementing a community health education program, which educational principle will the nurse use as a guide?
a. Refer to trustworthy sources
b. Use an active voice
c. Create the best learning environment
d. Accentuate the positive
10. Nurses who use Healthy People 2020 as a guide for education:
a. Focus on avoiding cigarette smoking and using alcohol in moderation
b. Educate clients using primary and secondary levels of prevention
c. Use Bloom’s taxonomy when planning educational objectives
d. Design health fairs aimed at individuals
Chapter 17: Promoting Healthy Communities Using Multilevel Participatory Strategies
1. The biomedical model defines health as the:
a. Avoidance of illness
b. Absence of disease
c. Promotion of healthy behaviors
d. Protection from illness and disease states
2. According to Leavell and Clark, primary prevention consists of:
a. Health promotion and rehabilitation
b. Health promotion and specific protection
c. Early diagnosis and prompt treatment
d. Health maintenance and early diagnosis
3. According to Laffrey, Loveland-Cherry, and Winkler, the health perspective views:
a. Health as the absence of disease
b. Human lifestyle based on one’s prescribed regime
c. Humans as complex and interconnected with the environment
d. Community education as the role of the registered nurse
4. Screening school-age children for hearing deficits is an example of:
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Health promotion
5. Examples of modifiable behaviors include:
a. Smoking, poor diet, and alcohol consumption
b. Cancer, emphysema, and cardiovascular disease
c. Walking, running, and aerobic exercise
d. Genetic abnormalities
6. A nurse utilizing a disease-oriented approach would:
a. Promote a greater level of positive health.
b. Teach about common disease processes.
c. Provide acute care management of chronic disease.
d. Direct care toward disease prevention.
7. A client eats a nutritious, balanced diet on a daily basis to keep the current state of health. This is described as _____ behavior.
a. Illness prevention
b. Health promotion
c. Health maintenance
d. Health protective
8. A 5-feet, 6-inch, 25-year-old female who weighs 120 pounds walks 5 miles a day because she has a long family history of early death from heart attacks and is refraining from a sedentary lifestyle. Which term best describes this example?
a. Health promotion
b. Illness prevention
c. Health maintenance
d. Health protection
9. A 5-feet, 6-inch, 25-year-old woman who weighs 120 pounds runs 5 miles a day because it improves her mood and energy level. Which term best describes this example?
a. Health promotion
b. Illness prevention
c. Health maintenance
d. Health protection
10. A woman has attended a weight reduction program for a year and lost 75 pounds. She now attends weekly meetings to keep the weight off. Which term best describes this example?
a. Health promotion
b. Illness prevention
c. Health maintenance
d. Health protection
Chapter 18: Community as Client: Assessment and Analysis
1. Change for the community as client must often occur at several levels because:
a. Health problems caused by lifestyle are multidimensional.
b. Most individuals can change their habits alone.
c. Aggregates are responsible for social change.
d. Geographic areas often have health risks that the nurse must identify.
2. A nurse cares for the community as the client when focusing on:
a. Providing care for aggregates living in the community
b. The collective good of the population
c. The provision of care for families in the home setting
d. Providing health education in the community
3. A collection of individuals who have in common one or more personal or environmental characteristics is the definition of a(n):
4. What are the critical attributes in the definition of community?
a. Families, groups, and health organizations
b. Health needs, geographical boundaries, and target population
c. People, place, and functions
d. Populations and health resources
5. A group of nursing students forms a student nursing association to provide support while they are enrolled in a nursing program. This is known as a community of:
b. Special interest
c. Problem ecology
6. A public health nurse is collecting data about the biological aspects of community health. What data will the nurse collect?
b. Traditional morbidity and mortality rates
c. Policy making and social change
d. Homicide rates
7. A community that has residents who are very involved in its activities and encourage activities that promote the health of the community displays which condition of community competence?
d. Effective communication
8. Which data source provides information about the function of the community?
b. Census data
c. State departments, business and labor, local library
d. Civic groups
9. Which characteristic is an indicator of community health process?
a. Participation and community action
b. Live birth rate
c. Racial distribution
d. Socioeconomic levels
10. A community that demonstrates commitment would most likely support the development of a:
a. Community club to facilitate community involvement
b. Children’s recreation program
c. Curb-side recycling program and community-based education about recycling
d. Cooperative agreement with a neighboring city to share needed services
Chapter 19: Population-Centered Nursing in Rural and Urban Environments
1. The percentage of United States residents living in rural settings is about:
2. Which group is over-represented in rural areas when compared with urban areas?
a. African Americans
b. Asian-Pacific Islanders
d. Native Americans
3. Rurality is a subjective concept because:
a. Everyone has an idea as to what constitutes a rural setting.
b. The differences between rural and urban areas are very distinct.
c. Rural health has not been very well researched.
d. The demographic and social characteristics of urban people are similar.
4. Which population is a nurse most likely to encounter in a rural area compared to an urban area?
a. Residents under age 18
b. Residents over age 50
c. Residents who are married
d. Residents who have more years of formal education
5. A nurse visits a client living on a farm residency. Which area did the nurse visit?
a. A region that has fewer than six persons per square mile
b. A home outside areas zoned as “city limits”
c. A county in a metro area with fewer than 1 million people
d. An area adjacent to a highly populated city
6. A nurse builds a vacation home in a remote area having fewer than six people per square mile so he can “get away from it all.” This area is classified as a:
a. Standard metropolitan statistical area
b. Metropolitan county
d. Rural area
7. Compared with urban Americans, rural residents:
a. Are more likely to engage in preventive health behavior
b. Are less likely to be exposed to occupational and environmental hazards
c. Have a higher rate of chronic illness
d. Rate their overall health status more favorably
8. In comparison with urban adults, rural adults:
a. Seek medical care more often
b. Have poorer overall health status
c. Are less likely to identify a usual source of medical care
d. Are usually seen by a specialist rather than a general practitioner
9. A nurse is providing care to a Native Alaskan client. The nurse recognizes the client may need specialized community nursing care related to:
a. Exposure to petroleum products
b. Farmer’s lung
c. Field sanitation
d. Black lung, chronic obstructive pulmonary disease
10. A nurse who provides care to rural adults recognizes that they are more _____ than urban adults.
a. Likely to have health insurance
b. Likely to have access to health care providers
c. Concerned about their health status
d. Likely to experience mobility limitations
Chapter 20: Promoting Health Through Healthy Communities and Cities
1. The goal of the Healthy Communities and Cities initiative is to:
a. Promote health through community participation.
b. Reorganize the current health care system.
c. Maximize the cost-benefit ratio of health care.
d. Improve the quality of care in communities.
2. The Healthy Communities and Cities initiative supports the idea that:
a. Healthy cities and communities must be both environmentally and socially sustainable.
b. Health public policy is the responsibility of elected officials.
c. Physical environments cannot be changed, thus strategies must be developed in order to cope with them.
d. The World Health Organization is the primary source of information for cities.
3. When the Healthy Communities and Cities concept was brought to the United States:
a. The cities chosen for the initial work were Los Angeles and New York City.
b. Canada adopted the program at the same time for continuity across borders.
c. The same strict guidelines that were implemented in Europe were used.
d. Smaller communities and localities were targeted instead of large cities.
4. When utilizing the Centers for Disease Control and Prevention’s Healthy Communities Program, a nurse recognizes that a factor that will influence the continuance of this program is:
b. Community participation
c. Federal involvement
5. Healthy Communities and Cities is based on which of the following premises?
a. When people have the opportunity to work out their own locally defined health problems, they will find sustainable solutions to those problems.
b. When the health of a community is improved, the focus will be on life expectancy rather than quality of life.
c. When health professionals assume a leadership role, the health of the community will improve.
d. When cities recruit enough health professionals to care for those needing medical care, the cities health will improve.
6. Which approach should a nurse take when implementing interventions to improve the health of a community?
a. A top-down approach with rational-empirical problem solving
b. A top-down approach with community practice planned by experts
c. A bottom-up approach with facilitation of communication
d. A bottom-up approach with multi-sectoral planning and action for health
7. A nurse is leading a team responsible for evaluating the health of a community using the Community Health Promotion Model. Based on this model, which step would you expect the nurse to complete?
a. Ensuring high technological access before the plan can be implemented
b. Soliciting the consent of every member of the community
c. Assessing the community
d. Restructuring the public health policy in the community
8. Why would a nurse perform a community assessment as part of the Community Health Promotion Model?
a. To become more acquainted with the multiple factors that influence health status
b. To survey the people in the community about their wants and needs
c. To allow special interest groups a say in health policy
d. To provide a narrow focus for the committee work
9. When implementing the Community Health Promotion Model, which underlying principle should the nurse use in order to facilitate active participation?
a. Individuals should work in groups to complete necessary tasks.
b. Individuals participating should represent all segments of the population.
c. People will work together if they like the leadership.
d. People will participate when they see the issues as worthy of their time.
10. The steps of the Community Health Promotion Model resemble the:
a. Collaboration process
b. WHO’s Ottawa Charter
c. Nursing process
d. CDC’s monitoring program
AND MUCH MORE