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Package deal For NR442 / NR 442 Community Health Nursing Exam 1 & 2 Complete solutions for every chapter_Spring 2022
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COMMUNITY HEALTH NR442 EXAM 1
Which of the following statements best describes the relationship between the environment and health? a. Because of the large number of variables involved... [Show More] , the relationship between environment and health cannot be researched. b. Because the environment has such long-term effects on health, research findings are not yet available. c. Research shows that a healthy environment has limited impact on one's health. d. Research shows that a healthy environment increases quality of life and years of healthy living. - correct answer ANS: D A healthy environment increases quality of life and years of healthy living. Accumulated evidence shows that the environmental changes of the past few decades have profoundly influenced the status of public health. Globally, environmental factors contribute to nearly 25% of all deaths and increase disease burden (World Health Organization, 2006). The safety, beauty, and life-sustaining capacity of the physical environment are unquestionably of global consequence. DIF: Cognitive Level: Understand (Comprehension) REF: p. 250 When using an environmental perspective, which of the following would be the most important question for a nurse to ask when assessing potential health problems? a. "Can you tell me how you have been feeling?" b. "Can you tell me what you do at work?" c. "What brings you here today?" d. "What problems have you been having?" - correct answer ANS: B Because 25% of worldwide preventable illnesses are caused by poor environmental quality, nurses need to ask critical questions about their clients' work and home environments to help discern the contributions of specific hazards to their health. This can be accomplished by an environmental health history. The other responses do not address a question that would be addressed during an environmental health history. DIF: Cognitive Level: Understand (Comprehension) REF: p. 250 How does critical theory differ from other nursing theories such as the health belief model or Orem's self-care deficit theory? a. Critical theory can be used by professionals other than nurses. b. Critical theory focuses on oppression and facilitates group action. c. Critical theory is not directly related to health promotion. d. Critical theory confronts changing an individual's beliefs. - correct answer ANS: B Critical theory is an approach that raises questions about oppressive situations, involves community members in the definition and solution of problems, and facilitates group interventions. The other two theories focus more on individual beliefs and choice of action. DIF: Cognitive Level: Understand (Comprehension) REF: p. 250 Which of the following statements best describe why environmental health is more challenging than other variables related to an individual's health? a. Environmental health affects susceptible individuals more than groups. b. Environmental health demands that individuals be willing to change their beliefs. c. Environmental health is dependent on social neighborhoods, as well as geography. d. Environmental health requires social, economic, and political changes to improve. - correct answer ANS: D Intervening to improve environmental conditions requires basic social, economic, and political changes. Aggregates must work together to create such change. The other responses do not address the multiple dimensions that must be impacted in order to impact change within environmental health. DIF: Cognitive Level: Understand (Comprehension) REF: p. 250 Which of the following nursing actions would be the most helpful to the community's long-term health? a. Careful assessment, diagnosis, planning, and giving care to individual patients and their families b. Dialogue with community members concerning what health issues are of importance in that community c. Focusing on family health through school-based neighborhood clinics d. Helping the community create political change through organization, use of media, legislative lobbying, and mass demonstrations - correct answer ANS: D The ultimate goal is liberating people from health-damaging environmental conditions by using collective actions. Mechanisms have included strategic organization, litigation, public hearing testimony, letter-writing campaigns, legislative lobbying, and mass demonstrations. Helping the community create political change through organization, use of media, legislative lobbying, and mass demonstrations shows how collective action can be applied. The other interventions do not demonstrate the use of collective action. DIF: Cognitive Level: Understand (Comprehension) REF: p. 251 Which of the following best explains why it is difficult to get others interested in environmental health? a. Environmental problems just are not interesting or dramatic. b. It's difficult to get media interested. c. People respond more to an acute crisis than chronic environmental problems. d. People respond more to an individual asking for help than a community asking for help. - correct answer ANS: C People respond to acute crises with dramatic media coverage (such as hurricanes or earthquakes), but ongoing consistent pressure is needed to ensure day-to-day environmental integrity. Chronic environmental problems are rarely addressed effectively. DIF: Cognitive Level: Understand (Comprehension) REF: pp. 251-252 What would be an appropriate term for intoxicated drivers, secondhand smoke, urban crowding, noise, and mechanization? a. Risks of living style b. Risks in the built environment c. Personal health risks d. Modern day health risks - correct answer ANS: B The built environment is the connection between people, communities, and their surrounding environments that affect health habits and behaviors, interpersonal relationships, cultural values, and customs. Most people live within areas that require almost daily contact with potential health risks and threats, such as intoxicated or impaired drivers, secondhand smoke, urban crowding, noise exposure, unabated traffic, and the stress of increased mechanization. DIF: Cognitive Level: Understand (Comprehension) REF: p. 253 What is meant by discriminatory land use? a. Backlash against companies that do not protect the environment b. Daily insults to people who live in a particular community c. Locating industrial hazards in low-income communities d. Political recognition that companies support a safe environment - correct answer ANS: C Discriminatory land use ensures that many impoverished and marginalized groups, especially people of color, live in close proximity to industrial contamination. Members of these communities are at risk for illness and injury. The other responses do not correctly define discriminatory land use. DIF: Cognitive Level: Understand (Comprehension) REF: p. 253 It has been learned that a particular industry has vastly polluted the surrounding neighborhood. Which of the following actions would most likely be taken by those living in the neighborhood? a. Band together to shut the industry down b. Nothing, because of family ties and cost of relocation c. Immediately move to a different neighborhood d. Seek legal reimbursement for the hazard exposure - correct answer ANS: B Residents may be unwilling to disrupt family ties and cultural roots to start over elsewhere, or they may be unable to afford to move. Residents are revictimized by the difficulty in obtaining compensation. Attempting to shut the industry down, seeking reimbursement for the hazard exposure, and immediately moving to a different neighborhood are all costly interventions and in most cases cannot be easily accomplished by most residents. DIF: Cognitive Level: Apply (Application) REF: p. 254 Which of the following statements supports why it is believed that the risks of various employment positions are inaccurate? a. Companies refuse to share employee injury information. b. Because factories reimburse employees directly, the injury is not reported. c. Individuals assume it is a personal problem, not an employment issue. d. Most employment positions do not have known risks. - correct answer ANS: C Statistics do not reflect unreported health problems. Collective problems related to employment or occupation are often perceived as individualized injuries, and no one "connects the dots." Companies are willing to share employee injury information and recognize the risks of employment, but the information may be inaccurate because of the perception of individualized injuries. DIF: Cognitive Level: Understand (Comprehension) REF: p. 254 | p. 256 Why are health care providers concerned over such social issues as mass transit, clean power, and the farming industry? a. Because air pollutants are contributors to asthma and other health problems. b. Clean power would reduce the pollution that results from burning of high-sulfur coal. c. Manure runoff from industrial farming is polluting water and killing fish throughout the United States. d. Mass transit would remove the problem of so many Americans being killed or injured by drunken or impaired drivers. - correct answer ANS: A All three (mass transit, clean power, and industry) emit air pollutants, which result in smog, the most common outdoor air pollutant in the United States. Atmospheric pollutants cause or contribute to asthma, allergic reactions, bronchitis, lung cancer, chronic respiratory disease, and death. They also harm animals and plants. The most inclusive answer refers to air pollutants, although certainly, the others are true in society today. DIF: Cognitive Level: Understand (Comprehension) REF: pp. 256-257 Which of the following statements best describes what has happened to air quality since the United States outlawed the use of chlorofluorocarbons, halons, and carbon tetrachloride? a. Air quality immediately improved. b. Air quality is slowly improving. c. Little change occurred because these chemicals remain in the atmosphere. d. Nothing has happened because other countries worldwide continue to extensively use these products. - correct answer ANS: C These chemicals, which were in widespread use, remain in the atmosphere. Thus, air quality has not improved. This is a global concern and is being addressed worldwide by the World Health Organization. DIF: Cognitive Level: Understand (Comprehension) REF: p. 257 Which of the following is the leading cause of lung cancer among nonsmokers? a. Secondhand smoke b. Living near a nuclear power plant c. Exposure to pesticides d. Radon gas - correct answer ANS: D Radon exposure is the leading cause of lung cancer among nonsmokers in the United States. It is estimated that radon causes an estimated 21,000 lung cancer deaths every year. DIF: Cognitive Level: Understand (Comprehension) REF: p. 258 Which of the following best describes a food desert? a. The inability to store foods at an acceptable temperature b. The inability to have healthy foods at home c. A neighborhood with little to no access to healthy foods d. A neighborhood that has experienced a recent food-borne illness - correct answer ANS: C A food desert is a neighborhood with little or no access to healthy foods. There are significant disparities in access to healthy and fresh food supplies, with poor minority families being more likely to live in a food desert. The other responses are not the correct definition of a food desert. DIF: Cognitive Level: Understand (Comprehension) REF: p. 259 Which of the following is a direct result of global warming? a. Decreased prevalence of infectious diseases b. Increased water pollution from soil erosion c. Decreased protection from the ozone layer d. Increased number of parasites and insects - correct answer ANS: D Global warming is the gradual increase in the average temperature of Earth's near-surface air and oceans since the mid-twentieth century and its projected continuation (Easterling, 2011). Rising global temperatures may enhance the quantity and distribution of parasites, insects, and other disease vectors, potentially increasing the prevalence of a variety of infectious diseases. DIF: Cognitive Level: Understand (Comprehension) REF: p. 262 Which of the following conclusions can be drawn concerning efforts to decrease environmental pollution? a. The Environmental Protection Agency (EPA) sets priorities for environmental problems and funds action. b. Federal policies have been weakened, and enforcement lacks funding. c. Federal recycling mandates have decreased waste products. d. Legislation is increasingly being passed to force companies to lower toxic waste emissions. - correct answer ANS: B Legislation in the 1970s was aimed toward a comprehensive national environmental policy. The momentum slowed in the 1980s, with policies being reversed and regulation losing its funding. This trend has continued. The EPA sets rules but lacks resources to accomplish the goals. There are no federal mandates for recycling, but local communities have made great strides in this area. DIF: Cognitive Level: Understand (Comprehension) REF: p. 262 In a community presentation about asthma, a nurse explained the causes of asthma in children, how to observe for "triggers" that lead to an attack, and how to use an inhaler. Which of the following statements best identifies what was omitted from this presentation? a. The nurse did not ask the attendees to disclose if any of them smoke around children. b. The nurse did not address actions that should be taken to improve air quality and only focused on the treatment of asthma. c. The nurse did not address the need to avoid exposure to others who may have a communicable disease. d. The nurse did not review the genetic components related to asthma in families. - correct answer ANS: B By placing responsibility for the cause and cure of health problems exclusively on the individuals, the belief is reinforced that all individuals are free to control their lives. Such a perspective absolves society, government, industry, and business from accountability. Research suggests that changing individual behaviors does not lead to significant reductions in overall morbidity and morality in the absence of basic social, economic, and political changes. Thus, the nurse must include information in the presentation that addresses the need to improve air quality. DIF: Cognitive Level: Apply (Application) REF: pp. 263-264 The local stream was full of trash. The Boy Scouts had a cleanup day so they could again canoe on the stream. Which of the following actions should be taken by nurses in the local community? a. Hold a dialogue with community members about the problem and its effects b. Fight for stronger "do not trash" laws and harsher penalties c. Lecture community organizations about the value of safe water for recreation d. Put all personal trash in appropriate trash receptacles - correct answer ANS: A An important nursing goal is to help people learn from their own experiences and analyze the world with an intention to change it. It is essential that those affected participate in the process of identifying and working to solve environmental problems. The nurse's role is to ask critical questions and help groups reflect on the environmental realities of their lives. The only way for the nurse to promote this involvement is through a dialogue with the community members. DIF: Cognitive Level: Apply (Application) REF: p. 265 How does participatory action research differ from other research methods? a. Participatory action research does not use a control group. b. Participatory action research does not require randomization. c. Participatory action research is not based on a predetermined hypothesis. d. Participatory action research poses solutions to the problem. - correct answer ANS: D Participatory action research calls for nurses, community members, and other resource people to work together in identifying health problems, designing the studies, collecting and analyzing the data, disseminating the results, and posing solutions to the problems. The research process (use of control groups, randomization, and using a predetermined hypothesis) is part of participatory action research. DIF: Cognitive Level: Understand (Comprehension) REF: p. 266 Which of the following strategies should a nurse use to remember what should be included in a health history? a. Always use a preprinted form b. Depend on education to learn this c. Depend on experience to know what to ask d. Memorize the I PREPARE mnemonic e. Memorize the I HEALTH mnemonic - correct answer ANS: D The I PREPARE environmental exposure history mnemonic is a quick reference for primary care providers. I—Investigate Potential Exposures P—Present Work R—Residence E—Environmental Concerns P—Past Work A—Activities R—Referrals and Resources E—Educate This tool will help the nurse remember what to ask to determine environmental factors relevant to health. DIF: Cognitive Level: Understand (Comprehension) REF: p. 262 Which of the following describe a problem with the U.S. water quality today? (Select all that apply.) a. Companies demand high reimbursement when asked to stop dumping heavy metals into local water sources. b. Many aquifers are contaminated with pesticides and fertilizers. c. More than 45 million Americans drink untreated water. d. Sediment from construction, agriculture, and deforestation is often present. e. Underground water, if contaminated, cannot be cleansed. f. Water-related diseases (cholera, typhoid, dysentery) frequently occur. - correct answer ANS: B, C, D, E More than 45 million Americans obtain water from private wells, which have no treatment or monitoring guidelines. Water quality problems include dosing reservoirs with chemicals to reduce algae, contaminating aquifers with pesticides and fertilizers, and leaching lead from water pipes. Underground water cannot be cleansed. Companies demand high reimbursement when asked to stop dumping heavy metals into local water sources and the frequent occurrence of water-related diseases (cholera, typhoid, dysentery) are not current problems with the water quality in the United States. Which of the following have been identified as part of the core environmental health competencies? (Select all that apply.) a. Assurance b. Assessment c. Policy development d. Management e. Advocacy f. Communication - correct answer ANS: B, D, F The National Center for Environmental Health, the Centers for Disease Control and Prevention, and the American Public Health Association have established three core competencies for Environmental Health professionals: (1) assessment, (2) management, and (3) communication. Assurance, policy development, and advocacy are not part of the core environmental health competencies. DIF: Cognitive Level: Understand (Comprehension) REF: p. 264 | p. 265 Which of the following best describes the primary reason that Americans are concerned about health care? a. Politicians are discussing how to improve health care. b. The media has provided mixed messages about the health care system. c. Our national health care costs keep increasing. d. The new health care system offers free services to Americans. - correct answer ANS: C The primary reason for the focus on health care is the constantly increasing costs, which cannot be sustained. The costs of caring for the sick accounted for the majority of escalating health care dollars, which increased from 5.7% of the gross domestic product in 1965 to 17.6% in 2009. Politicians and the media both influence Americans' perceptions about health care; however, they are not the primary reason why Americans are concerned. The new health care system will change the health care access and availablity, but will not necessarily be offering any free services to Americans. DIF: Cognitive Level: Understand (Comprehension) REF: p. 2 A nurse has begun to lobby with politicians for changes to the health care system. Why is this involvement important? a. Nurses, as central characters in several popular TV series, are currently very visible in American media. b. Nurses are primarily responsible for managing the various units in our health care system. c. Nurses are the largest group of health care providers. d. Nurses are the only group that is employed both inside and outside of hospitals. - correct answer ANS: C As the largest group of health care providers, nurses are informed about the current health care system and all the problems that result from people not seeking care until they are desperately ill. Nurses, as the American Nurses Association (ANA) emphasize, usually believe that health care is a right, not a privilege. Therefore, nurses, whose work is central to our current health care delivery system, can also be instrumental in working politically to create a health care delivery system that will meet health needs. While nurses are in several current TV series and are employed both inside and outside of hospitals, physicians and other health care providers are as well. Nurses are often managers, but managers often have other backgrounds, such as business administration. DIF: Cognitive Level: Understand (Comprehension) REF: p. 2 What conclusion can be drawn from examining where nurses are employed? a. There is a trend toward consolidation of health care into large central medical centers. b. There is an increased emphasis on community-based health care. c. There is an obvious need to decrease health care costs by cutting positions. d. Managed care organizations (MCOs) are employing nurses to improve customer relations. - correct answer ANS: B MCOs are employing nurses in many capacities. Although hospitals are closing and acute care is increasingly found in central medical centers, the same trend may be seen in an increase in neighborhood-based practice centers. While positions are cut in most industries, health care is recognized as an area where growth in employment is expected. However, nurses are increasingly employed in community settings as opposed to hospitals. This change reflects the move toward community-based care rather than hospital-based tertiary care. To help decrease the continued rise in health care costs, the increased emphasis is on disease prevention rather than high-cost treatment. DIF: Cognitive Level: Understand (Comprehension) REF: p. 2 Which ethical belief would be most helpful in the current health care crisis? a. Emphasis should be on individual and corporation freedom in the marketplace. b. Emphasis should be on individual autonomy and freedom of choice. c. Emphasis should be on social justice and collective responsibility. d. Emphasis should be on the effectiveness of technology in resolving problems. - correct answer c What is the primary problem seen in Healthy People 2020's emphasis on choosing healthy lifestyle behaviors, such as daily exercise or healthy food choices? a. Emphasis on other lifestyle choices, such as not smoking and minimal use of alcohol or drugs, is also needed. b. All of us must work together to make unhealthy behaviors socially unacceptable. c. It costs more to make healthy choices, such as buying and eating fresh fruits and vegetables as opposed to quick and cheap fast-food choices. d. Public policy emphasizes personal responsibility but ignores social and environmental changes needed for well-being. - correct answer d What responsibility does the American Nurses Association (ANA) Code of Ethics require of the nurse beyond giving excellent care to patients? a. Accept longer work schedules to ensure that professional care is always available to clients b. Recognize the need for experienced nurses to mentor new graduates to help increase and expand the number of professionals available c. Support health legislation to improve accessibility and cost of health care d. Volunteer to work overtime as needed to ensure maximum quality of care - correct answer c What is the community health nursing definition of health? a. Health is a person's goal-directed purposeful process toward well-being or wholeness. b. Health is an individual's physical, mental, and social well-being, not merely the absence of disease or infirmity. c. Health is the mutual adaptation between a person and his or her environment in meeting daily existence. d. Health is families and aggregates choosing actions to ensure safety and well-being. - correct answer d How does community health nursing define community? a. A group of persons living within specific geographic boundaries b. A group of persons who share a common identity and environment c. A group of persons who work together to meet common goals d. Persons who form a group to resolve a common concern - correct answer b Which variable has a major influence on a community's health? a. Behavior choices made by persons in the community b. Number of health care providers and hospitals in the community c. Quality of the public safety officers (police officers, firefighters, etc.) d. The number and credentials of public health officials in the community - correct answer a What change could most effectively lead to a longer life span in Americans? a. Parenting and sexual behavior classes in all public school systems b. Legislation restricting alcohol and drug use c. Notably reducing speed limits on all state and federal highways, and changing the age limit for driving to 21 years of age d. The belief that smoking is shameful and disgusting, as well as expensive, becoming the social norm - correct answer d What is the health issue causing the most concern in the United States today? a. Diabetes epidemic b. Increase in cardiac disease c. Increase in obesity d. Rise in cancer rates - correct answer c What factors are most responsible for the increasing length of life of Americans over the past 100 years? a. Better nutrition and family planning options b. Education concerning the need to reduce salt and fat in the diet c. Improved medical care, including exciting new technologies d. More efficient cancer screenings and early intervention - correct answer a Why would a public health nurse want to know about morbidity and mortality statistics on the local, state, and national level? a. To be able to share current trends in health problems with the community b. To be able to observe the community's statistics over time and compare the community with other communities c. To justify local budgets and the need for increased income from citizens d. To publicize current health issues and suggest appropriate actions to citizens - correct answer b How do public health efforts differ from medical efforts in improving the health of our citizens? a. Medical care providers autonomously choose appropriate interventions, whereas public health care providers must engage in whatever actions legislation requires. b. Medical care providers are self-employed or agency employed, whereas public health care providers are employed by and paid through the government. c. Medical care providers focus only on individuals, whereas public health care providers focus only on aggregates. d. Medical care providers focus on disease diagnosis and management, whereas public health care providers focus on health promotion and disease prevention. - correct answer d Which primary prevention would the school nurse choose to address the school's number of unwed pregnancies? a. Create a class on parenting for both the moms-to-be and the dads-to-be b. Convince the school board to allow sex education classes to include birth control measures c. Employ the moms-to-be as 1-hour-a-day employees in the school day care center for children born to school students d. Establish a class where all the unwed moms-to-be can learn infant care - correct answer b What would be the proper term for the action of the school health nurse arranging for all the students in the elementary school to receive H1N1 immunizations? a. Health education b. Secondary prevention c. Specific protection d. Tertiary prevention - correct answer c Which action would probably result in the largest change in health care outcomes for Americans? a. Establish large numbers of scholarships for education of nurses, physicians, and other health care providers b. Fund a one-time extremely large stimulus to allow all health care providers and agencies to create and integrate computer network systems for client health care records c. Increase funding for hospitals and medical centers to expand their neighborhood clinics d. Redirect a large portion of federal funding from acute care to health promotion activities - correct answer d Which task will be most helpful in meeting the public health agency's goals? a. Complete staff evaluations in preparation for individual meetings to plan their agency and individual goals for the next year b. Actively participate in community agencies' collaborative action plan to meet the community's health goals for the year c. Meet with the college of nursing faculty to finalize student objectives and schedules for the next semester d. Teach a free course in healthful living for community residents - correct answer b A community health nurse is overwhelmed with all that needs to be done in one day. Which task could most easily be postponed? a. Reviewing the most recent hospital patient data collected by the local college of nursing b. Deciding which of several possible new clinic options would be most effective in better meeting the needs of the local community c. Evaluating the results of the most recent community-wide screening program before planning for the next community health program d. Giving testimony to the state legislature on a new health and safety bill - correct answer a A nurse who works on the surgical unit at the local hospital was asked by the home health unit to make a home visit to a patient who had been discharged the previous day and to give follow-up care (for overload pay). What kind of nursing would this nurse be doing? a. Acute care hospital nursing b. Community-based nursing c. Community health nursing d. Public health nursing - correct answer b Which task is most crucial for the community health nurse to do well? a. Review the most recent morbidity and mortality data b. Create a new clinic to better meet local health needs c. Evaluate the results of the recent screening program d. Give testimony regarding proposed state health legislation - correct answer d A new public health nurse carefully assessed all the local mortality and morbidity data in preparation for making appropriate planning suggestions at a meeting next week. What other action is crucial before the nurse can feel prepared? a. Ask other nursing staff their perceptions of the community's needs b. Assess the nurse's own assets, strengths, and ability to contribute c. Meet members of the community to determine their culture and values d. Review discussions and decisions from previous meetings - correct answer c A nurse works hard to develop alliances among various community organizations toward improving health in the community. What are actions such as this called? a. Building coalitions b. Collaboration c. Communication d. Community cooperation - correct answer a After completing a master's degree, a nurse took a course in marketing. Should the agency reimburse the nurse's tuition costs? a. No, courses taken for personal enjoyment are not eligible. b. No, courses taken outside the professional's responsibilities are not eligible. c. Yes, the nurse is demonstrating professional commitment by continuing education. d. Yes, the nurse could use such information in social marketing for the agency. - correct answer d 26. Which factor is most responsible for differences in an individual's health? a. Culture of the majority of the community's citizens b. Individual's education and income c. Number of physicians and other health care providers in the community d. Quality of the community health agency and hospital in the community - correct answer b What are the leading health indicators found in Healthy People 2020? (Select all that apply.) a. Financial issues b. Health system issues c. Individual behaviors d. Issues related to legal and illegal immigration e. Legislative issues f. Physical and social environmental factors - correct answer b,c,f What historically have been public health nurses' two most important priorities? (Select all that apply.) a. Establishing school nursing to improve care of children b. Engaging in political activity to improve living conditions c. Giving superb clinical bedside care in the home d. Increasing funding to public health efforts e. Teaching family members how to care for their family f. Working with the community to confront health issues and poverty - correct answer b,f As in Healthy People 2010, what are the two primary goals of Healthy People 2020? (Select all that apply.) a. Eliminate health disparities b. Expand health promotion activities in every community c. Improve funding, including diverting funds from other priorities to health care d. Improve health outcomes measures to be more consistent with other developed nations' outcomes e. Increase quality and years of healthy life f. Reduce mortality and morbidity figures nationwide - correct answer a,e Which of the following best describes the first measures used by large communities to ensure community health? a. Building safe sewage disposal systems b. Healthy food choices and exercise c. Praying to the gods for preservation d. Use of medicine and other herbal remedies - correct answer a A nurse has determined that there is always a consistent level of people in the population who experience pneumonia. Which of the following best describes the prevalence of this disease? a. Prevalent b. Endemic c. Epidemic d. Pandemic - correct answer b Which of the following best describes a modern public health practice that was originally developed as a means of self-protection from the Black Death (bubonic plague)? a. Care in a hospital b. Chemical intervention c. Isolation and quarantine d. Herbal remedies - correct answer c A scholar during the Sanitary Revolution created medical topographies. What was the advantage of these surveys? a. Citizens knew which wells were safe to use for drinking water. b. People knew what housing areas to avoid. c. Results demonstrated environmental factors related to regional disease. d. The king could isolate areas of disease from safe areas. - correct answer c How did Edwin Chadwick's ideas help decrease disease in the nineteenth century? a. The minimum wage was increased leading to improved quality of life. b. Parish workhouses where poverty-level children labored for their room and board were closed. c. Social reform legislation resulted in changes such as sidewalks. d. The new emphasis on individual responsibility encouraged people to act to protect their own health. - correct answer c Which of the following best describes how John Snow was able to decrease deaths from cholera? a. Removed a source of contaminated water b. Created the world's first antibiotic c. Encouraged the new process of vaccination d. Helped pass laws that required home quarantine - correct answer a Which of the following nursing interventions would have most likely been used by Florence Nightingale when treating wounded soldiers? a. Establishing private visits with spouses b. Improving food, clothing, and cleanliness c. Administering intravenous medications d. Completing a community assessment of the army hospital - correct answer b Which of the following best describes how Nightingale responded to challenges about her suggestions for reform of health care? a. She influenced male friends as political leaders to publicize her ideas. b. She conveyed her statistical data in more detail and depth, and shared it with political leaders. c. She encouraged those who challenged her to come up with more acceptable approaches to lowering the death rate. d. She understood their concerns and tried to word her suggestions in a more politically acceptable way. - correct answer b Which of the following groups was primarily responsible for the establishment of the first school of public health? a. The American Medical Association b. The Association of State Departments of Public Health c. The federal government d. The Rockefeller Foundation - correct answer d Which of the following best describes the district nursing service created in the United States by Lillian Wald and Mary Brewster? a. House on Henry Street b. Visiting Nurses Association c. New York City District Nursing Service d. Wald and Brewster Nursing Service - correct answer a [Show Less]
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NR442 EXAM 2
A nurse is collecting data for a community assessment, which of the following methods should the nurse use when having direct conversations with individual... [Show More] community members? - correct answer key informant interviews Why are key informant interviews important? - correct answer It is used for direct conversations with individual community members for the purpose of obtaining ideas and opinions Social Determinants of health in a community, includes factors affecting individual health: - correct answer o Neighborhood and built environment o Social and community context o Economic stability and education o Healthcare and Education Which of the following actions should the nurse include when planning a community health program as a part of the evaluation plan? - correct answer Compare program impact to similar program What should a public health nurse be concerned with regarding an elderly patient's safety and security needs when completing the plan of care - correct answer Falls, elder abuse, driver safety, etc. The purpose of environmental health is to ensure the conditions of human health and providing a healthy environment for people to live, to work in and play. Which statement best describes how this purpose is accomplished? - correct answer Risk assessment, prevention, and intervention Which statement best describes why environmental health is more of a challenge than other variables related to an individual's health? - correct answer Environment health requires social, economic, and political changes to improve what group is the fastest growing homeless population? - correct answer families w children Which statement best describes the relationship between health and the environment? - correct answer A healthy environment increases years of healthy living and quality of living according to research The girl scouts had a clean-up day so they could canoe a stream that was full of trash. Which action should be taken by the nurses in the local community? - correct answer Discuss with community members about the problem and its effect on the environment Which of the following statement describes a food desert? - correct answer A geographical area or neighborhood with little or no access to healthy food. A community health nurse is attempting to gain funds for a new youth program for violence prevention. Which of the following best describes why the community should care about young people joining gangs? - correct answer Gangs can permit as much as 90% of the crime in the area Which activity will the community health nurse include when planning secondary prevention activities for a community? - correct answer Arrange a health fair when blood pressure, hearing and cholesterol screenings are carried out A nurse is working for a home health care agency and is assessing an older male client. Which of the following is the priority for the nurse to address? - correct answer Dysphagia When a community health nurse engages in the referral process for a client or community upon discharge, the priority is: - correct answer Identify referrals that the client needs . A community health nurse is implementing health programs with several populations in the local area. In which of the following situations is the nurse using primary prevention? - correct answer Providing influenza immunizations at a local preschool Which of the following acts as an example of a nurse functioning as a consultant to influence health policy? - correct answer Updating state officials about health needs of the local community A nurse knows that factors influencing community help include understanding of culturally competent care. Acceleration includes which of the following? - correct answer Process of merging with or adapting the traits of a different culture Migrant workers make a temporary home during employment at a specific location. In order to use culturally competent care, the nurse understands the health problems of migrant workers can include - correct answer chronic conditions, dental disease, higher infant mortality rates, iron deficiency anemia, etc. a nurse is caring for a client who is from a different culture, other than their own. When beginning the cultural assessment, which of the following actions should the nurse take? - correct answer Gather data about the clients' cultural beliefs A nurse is developing a community health program and needs to determine barriers to a community resourced referral. Which of the following factors are examples of this resource barrier? - correct answer Service costs associated with the resource Which statement is true concerning tobacco and health risk? - correct answer Most common in less educated populations and those living below the poverty line. a nurse was becoming frustrated. It had been about 2 weeks since the client verbalized the best time of day to take a 15-minute walk was early in the morning. The client has not begun to exercise. The community health nurse understands the principles of the TTM model includes - correct answer A decision to act always occurs before action begins and behavior change is difficult and takes time The community nurse knows healthcare funding is very important. Which of the following statements best describe why health care is beneficial? - correct answer to better serve as patient advocates in policy making for funding that provides appropriate care for the greater good . A nurse wants to be more involved in our states politics but is unable to be actively involved in attending meetings are the state level. Which of the following actions would be most useful for the nurse? - correct answer Communicating rationales to stand on proposed legislation to legislators via email, telephone, or postal mail A nurse is caring for a client who is from a different culture than himself. Which action should be taken first? - correct answer Gather information about the clients' cultural beliefs . A nurse as a community clinic is conducting a well child visit with a preschool aged child. The nurse should identify which of the following manifestations as a possible indication of child neglect? - correct answer Poor hygiene, Underweight community health nurse develops an educational program and substance abuse order for adolescence. Which of the following information should the nurse include discussing nicotine and smoking? - correct answer Tolerance to nicotine develops quickly Which of the following best explains why a nurse should reviews medications taken by elderly clients in a clinic visit. - correct answer Age-related changes and polypharmacy make elderly clients vulnerable to drug interactions and dangerous adverse reactions, so it is important for A patient's adult daughter is talking to the nurse about how her father had no interest in life and told her that he was considering suicide since his wife died. What would be the most appropriate response by the nurse? - correct answer Suicide is a serious concern. Let's talk to his doctor about what you have noticed A nurse is planning to teach a class on health promotion and disease prevention. Which of the following is a method of secondary prevention for middle aged women? - correct answer yearly mammogram Health protection is used to detect disease in its early state or maximize health within the constraints of disease. Unfortunately, screening will not prevent disease. - correct answer Example: FIRST MAMMOGRAM Which of the following strategies would the community health nurse recommend as a home safety measure for an elderly client? - correct answer o Installing smoke detectors in the home o Carbon monoxide detectors o Fall precautions o Handrails o Slip proof rugs In which of the following clinical areas are the nurses most at risk for workplace violence? - correct answer Emergency departments, geriatric units, and psych units (acute care yes but not acute/ ICU) Double suicide's in the elderly is significant, and families worry so communication is key, how do families communicate elderly suicide concerns with the health care personnel? - correct answer Families can discuss this with their primary care providers, nurses about their concerns, and what they have noticed Most common mental health issue in the US? - correct answer depression Major problem in US? - correct answer Large number of underinsured and uninsured citizens a nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension, and has a BMI of 26. Which of the following goals should the nurse include? - correct answer The client will walk for 30 minutes 5 days a week. . community health nurse is reviewing the levels of disease prevention. Which of the following activities are an example of tertiary prevention? - correct answer Providing treatment for clients who have COPD A nurse is discussing culturally competent care at a nursing staff in-service. Which of the following information should the nurse include when discussing client's culture? - correct answer Nurses should focus on clients' cultures rather than ethnicity when providing care Which of the following risk factors are least subject to be modified by the individual? - correct answer Environment exposure How does traditional health care differ from complementary and alternative therapies? - correct answer Provides variety in training and licensure and reimbursement is often unavailable Which of the following have been effective in reducing problems related to alcohol use? - correct answer Enforcement of ban of sales to alcohol to minors A community health nurse is working to develop programs to include goals of healthy people 2020 cultural perspective. He knows the reason this initiative was started was to: - correct answer o Develop a set of national health targets, eliminating racial and ethnic disparities o Focus on disparities among racial and ethnic minorities, women, youth, older adults, people of low income and education and people with disabilities Which best defines the judgement of another culture solely by the values and standards of ones own culture? - correct answer Ethnocentrism What is the best way for the nurse to advocate for a client that is form a different culture? - correct answer Ask the client about their belief practices and cultural norms A nurse planning to discharge a patient who has quadriplegia to his home. The nurse suggest that the family might need respite care services. When a family member asks how respite care can help, which of the following responses should the nurse provide? - correct answer respite care allows the primary caregiver time away from day-to-day care responsibilities Risk reduction is of high importance in the US today. Which of the following statements best describes the importance? - correct answer The leading causes of deaths are all related to lifestyle choices A nurse is working with a client to exercise on a regular basis. Which of the following would be the easiest way for the nurse to determine if the client will engage in the activity according to the Theory of Recent Activity? - correct answer The client's intention to exercise regularly Which of the following statements best describe the rationale behind a community public health nurse asking a client how long she has been sleeping? - correct answer Many adults report sleep problems or occasional lack of sleep A nurse is reviewing information before a meeting with the residents of a community who are going to attend a program on healthful living. Which of the following best describes the action by the nurse? - correct answer Health promotion Which form of government primarily establishes regulation and provides funding for healthcare? - correct answer o Federal government o Medicare o Medicaid dollars Which activity would be a responsibility of a local health department? - correct answer o Providing free health screenings o Decrease cost of immunizations What has led to the more recent collaboration and focus between the federal and the state level in relation to public health? - correct answer Bioterrorism Threat Which of the following questions would be the most important for the nurse to ask when assessing potential health problems using an environmental perspective? - correct answer Can you tell me what you do at work? [Show Less]
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CHAMBERLAIN COMMUNITY NURSING NR 442 EXAM 2 IN CLASS REVIEW
Two resources a nurse to look for information on their scope of practice - correct answer Nurse Practice Act Hospital Policies and Procedures Most of... [Show More] Health Related activities at the Federal Level are administered by this agency. - correct answer Department of Health and Human Services Type of Managed Care plan in the private sector that has a preselected list of providers who have agreed to provide health services for those in the plan - correct answer Health Maintenance Organizations A state-administered health plan, providing a source for financial health care for the poor and disabled - correct answer Medicaid Helped the Federal Government form the Children's Bureau of 1912 - correct answer Lillian Wald Federal law that requires all hospitals with emergency services that participate in Medicare to treat any client in their emergency services whether they are covered or not or they have the ability to pay - correct answer Consolidated Omnibus Budget Reconciliation Act Essential health insurance program available to certain low income individuals and families who have recognized eligibility by federal and state law - correct answer Medicaid Transformed Military Health and was the first nurse to exert political pressure on a government. She advocated for more sanitary conditions for military patients - correct answer Florence Nightingale Placed restrictions on eligibility for Medicaid and other federally funded welfare programs - correct answer Welfare Reform Act What is the most important aspect of the Health Belief Model - correct answer Perceived Benefit Authorized federal assistance in the construction of hospitals and health centers with stipulations about services for the uninsured - correct answer Hill Burton Act of 1946 Federal entitlement program that is funded by the government to help cover the cost of health care for those over 65 and who are disable or have end-stage renal disease - correct answer Medicare Stages in the Transtheoretical Model of Change - correct answer Precomtemplation Comptemplation Preparation Action Maintenance Relapse Offers protection for patient privacy and that insurers cannot set limits on coverage for preexisting conditions longer than 12 months - correct answer HIPPA Health Insurance Portability and Accountability Act [Show Less]
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442 EXAM 2 PRACTICE QUESTIONS
A nurse is preparing to conduct a windshield survey. Which of the following data should the nurse collect as a component of this assessment? Select all tha... [Show More] t apply. A. Ethnicity of community members B. Individuals who hold power w/in community C. Natural community boundaries D. Prevalence of disease E. Presence of public protection - correct answerA, B, C, E A nurse is completing a needs assessment and beginning analysis of data. Which of the following actions should the nurse take first? A. Determine health patterns w/in collected data B. Compile collected data into a database C. Ensure data collection is complete D. Identify health needs of local community - correct answerB. Compile collected data into a database A nurse is planning a community health program. Which of the following actions should the nurse include as part of the evaluation plan? A. Determine availability of resources to initiate plan B. Gain approval for program from local leaders C. Establish timeline for implementation of interventions D. Compare program impact to similar programs - correct answerD. Compare program impact to similar programs A nurse is conducting a community assessment. Which of. the following data collection methods is the nurse using when having direct conversations with individual members of the community? A. Key informant interviews B. Participant occupations C. Focus groups D. Health surveys - correct answerA. Key informant interviews A nurse is collecting data to identify health needs in the local community. Which of the following examples should the nurse identify as secondary data? (Select all that apply). A. Birth statistics B. Previous health survey results C. Windshield Survey D. Community Forum E. Health Records - correct answerA, B, E A nurse is developing a community health education program for a group of clients who have a new diagnosis of diabetes mellitus. Which of the following learning strategies should the nurse include for clients who are auditory learning? A. Showing photographs of sites for injection B. Providing equipment to practice hands-on skills C. Supplying outlines for note-taking D. Facilitating small group discussions - correct answerD. Facilitating small group discussions A nurse is talking to a client who asks for additional info about hospice. Which of the following statements should the nurse make? A. "Clients who require skilled nursing care at home qualify for hospice care." B. "One function of hospice is to provide teaching to clients about life-sustaining measures." C. Hospice assists clients to develop the skills needed to care for themselves independently." D. A component of hospice care it to control client's manifestations." - correct answerD. Controlling the clients manifestations of medical problems or the dying process and improving quality of life are components of hospice care. A school nurse is scheduling visits w/a physical therapist for a child who has cerebral palsy. In which of the following roles is the nurse functioning? A. Direct caregiver B. Consultant C. Case manager D. Counselor - correct answerC. In the role of case manager, a school coordinates comprehensive services for students who have complex health needs. An occupational health nurse is consulting with senior management of a local industrial facility. When discussing work-related illness and injury, the nurse should include which of the following factors as physical agents? Select all that apply. A. Noise B. Age C. Lighting D. Viruses E. Stress - correct answerA, C A newly hired occupational health nurse at an industrial facility is performing an initial workplace assessment. Which of the following info should the nurse determining when conducting a work site survey? A. Work practices of employees B. Past exposure to specific agents C. Past jobs of individual employees D. Length of time working in current role - correct answerA. Work practices of employees A school nurse is planning health promo and disease prevention activities for the upcoming school year. In which of the following situations is the nurse planning a secondary prevention strategy? A. Placing posters w/images of appropriate hand hygiene near restrooms. B. Routinely checking students for pediculosis throughout the school year. C. Implementing age-appropriate injury prevention programs for each grade level. D. Working w/a dietitian to determine carb counts for students who have diabetes - correct answerB. Routinely checking students for pediculosis throughout the school year. A nurse is completing an ecomap as part of a family assessment. Which the following questions should the nurse plan to ask to gather appropriate data? A. "Do you have a family history of heart disease?" B. "What kinds of foods does your family eat?" C. "Is your family involved in community orgs?" D. "How does your family cultural beliefs influence your health values?" - correct answerC. An ecomap studies the family's relationships w/groups and organizations A home health nurse is planning care for a client following a stroke. The nurse plans to interview each member of the family to see how they might help the client progress towards recovery. The nurse is using which of the following approaches to family health? A. Family as component of society B. Family as a system C. Family as a client D. Family as context - correct answerD. Context promotes individual recovery following a disease or event. The client is the focus and members are viewed as a source of support A public health nurse is planning interventions for children in the community. Which of the following topics should the nurse choose to target a major concern for school-aged children? A. Skin cancer detection B. Access to health care C. STI prevention D. Cholesterol Screening - correct answerB. Caregiver income affects child health A public health nurse is planning an inter-service on older adult health. Which of the following information should the nurse include? A. The percentage of older adults in the population is decreasing. B. Proportion of older adults who live alone is increasing. C. Older adults take one-half of all prescriptions meds D. Older adults have decreased recovery time following injury - correct answerB. Proportion of older adults who live alone is increasing. A nurse is preparing a list of important topics to discuss w/young adults who are seen at the clinic. Which of the following topics should the nurse plan to address w/this aggregate? A. Preconception counseling B. Managing the common cold C. Detecting congenital abnormalities D. Accessing Medicare benefits - correct answerA. Plan to ask clients if they want to discuss childbearing, and answer any questions. What are Informant Interviews? - correct answerA DIRECT formal and/or informal discussion with purpose of gaining ideas or opinions from key informants What are Windshield surveys? - correct answerdescriptive approach tat assesses several community components by driving through community Components of a windshield survey - correct answerPeople Place Natural Environment Man-made Environment Housing Societal Systems An ecological model can be used as a guide to examine . . . - correct answerDeterminants of health for a population, and for targeting interventions to multiple factors that affect health Community Assessment Steps - correct answer1. Define the community 2. Collect data 3. Analyze data (organize, review, prioritize) 4. Establish community diagnoses 5. Plan programs 6. Implement program 7. Evaluate program Writing a community health diagnoses includes . . . - correct answerRisk of specific problem Among specific population affected Related to (weakness that influences problem) Examples of social systems - correct answerHealth systems/resources Welfare Systems Legal Systems Recreation Systems Transportation Systems Communication Systems Religious Systems Political Systems When determining the health of a community, consider . . . - correct answerStatus Structure Process Effective community health education requires . . . - correct answerPlanning What does a community assessment begin with? - correct answerDefining the community to be studied What are the 3 types of communities? - correct answer1. Geographic community (shared place) 2. Demographic group (Shared characteristics) 3. Functional community (common interests) What is the ecological model used for? - correct answeras a guide to examine the determinants of health for a population and for targeting interventions to multiple factors that affect health When collecting data, it is best to... - correct answercombine several methods of collection Components of ecological model - correct answer-Individual traits (age, gender biological, mental, behavioral factors) -Social, family, community relationships -Occupational and home environments -Overall conditions created by local, state, national, and worldwide forces and trends Factors to consider when determining the health of a community - correct answer1. status: epidemiological data (incidence/prevalence rates), client satisfaction, mental health, crime rates 2. structure: presence of health care facilities, service types and patterns of use, demographic data 3. process: relationships, communication, commitment to and participation in health Community assessment components for people - correct answerDemographic, biological, social factors, cultural factors Community assessment components for place/environment - correct answerphysical factors & environmental factors Factors when Determining Health of a Community: status examples - correct answerEpidemiological data (incidence/prevalence rates), Client satisfaction Mental health Crime rates Factors when Determining Health of a Community: Structure examples - correct answerPresence of health care facilities Service types and patterns of use Demographic data Factors when Determining Health of a Community: Process examples - correct answerRelationships Communication Commitment to and participation in health What is the first step when developing a needs assessment? - correct answerCompile data in database The CIRCLE Model of Care means . . . - correct answerC: Caring I: Intuition R: Respect C: Caution L: Listening E: Emotional Support Informant interview limitations - correct answerMeeting time and place Built-in bias Community forum limitations - correct answerDifficulty finding meeting time and place Challenging to get adequate participation Where do home health nurses provide care? - correct answerTraditional Homes Assisted Living Nursing Homes Skilled Services include: - correct answerSkilled assessment Wound care Lab draws Med edu and admin parenteral nutrition IV fluids and medication Central line care urinary catheter insertion/maintenance Coordination, delegation, supervision Informant interview strengths - correct answerMINIMAL COST Participants serving as future supporters Offers insight into beliefs and attitudes of community members Reading/writing of participants not required Can elicit more detailed responses Community forum strengths - correct answerMINIMAL COST Opportunity for community input Secondary data strengths - correct answerDatabase of prior concerns/needs of population Ability to trend health issues over time Secondary data limitations - correct answerPossibility that data may not represent current situation Can be time-consuming Participant observation strengths - correct answerIndication of community priorities, environmental profile, and identification of power structures Participant observation limitations - correct answerBias Time consuming Inability to ask participants questions Focus groups strengths - correct answerPossibility of participants being potential supporters Provides insight into community support Reading/writing of participants not required Focus group limitations - correct answerPossible discussion of irrelevant issues Challenging to get participants Requires strong facilitator Difficult to say that sample is representative of entire community TIME-CONSUMING Surveys strengths - correct answerData collected on population and problems random sampling written or online format contact with participants not required Surveys limitations - correct answerLow response rate EXPENSIVE TIME CONSUMING collection of superficial data requires participants to be literate Windshield survey strengths - correct answerprovides a descriptive overview of a community Windshield survey limitations - correct answerNeed for driver Can be TIME CONSUMING Results based solely on visualization Examples of formal leaders - correct answerelected leaders; government officials, representatives PEOPLE WHO ARE A BIG DEAL Examples of informal leaders - correct answerpastors, tribal leader, grassroots leaders Barriers to education - correct answerAge, cultural barriers, poor reading and comprehension skills, language barriers, barriers to access, and lack of motivation Describe behavioral theory - correct answerUse of reinforcement methods to change learners' behaviors Describe cognitive theory - correct answerUse of sensory input and repetition to change learners' patterns of thought, thereby changing behaviors Describe critical theory - correct answerUse of ongoing discussion and inquiry to increase learners' depth of knowledge, thereby changing thinking and behaviors Describe developmental theory - correct answerUse of techniques specific to learners' developmental stages to determine readiness to learn and impart knowledge Describe humanistic theory - correct answerAssists learners to grow by emphasizing emotions and relationships and believing that free choice will prompt actions that are in their own best interest Describe social learning theory - correct answerLinks information to beliefs and values to change or shift learners' expectations Someone who "thinks in pictures" and learns through seeing and uses methods such as note-taking, video-viewing, and presentations is a _________ learner - correct answerVisual Someone who learns through listening and methods such as verbal lectures, discussion, and reading aloud is a _________ learner - correct answerAuditory Someone who learns through doing and methods such as trial and error, hands-on approaches, and return demonstration is a _______ learner - correct answerTactile-kinesthetic When developing interventions, it's important for the nurse to consider the patient's... - correct answerhealth literacy What is the first step to developing a community health education plan? - correct answerIdentifying population-specific learning needs What occurs during the preplanning step of community assessment? - correct answerBrainstorm ideas -Gain entry into community and establish trust -Obtain community awareness, support, and involvement -Coordinate collaborations that have similar interests in addressing identified problems What are ecomaps? - correct answerEco-maps are a visual map of a family's connections to the external world. They provide a useful tool for assessment of family, social and community relationships and highlight the quality of these connections. What are genomaps? - correct answer What occurs during the assessment part of community assessment? - correct answerCollect data about community and its members -Complete needs assessment and identify community strengths and weaknesses -Assess availability of community resources -List potential sources for program funding -Evaluate secondary health data What occurs during the diagnosis part of community assessment? - correct answerIdentify and prioritize health needs of the community. -Analyze data to determine health needs -Work with community members, local health professionals, and administrators to develop priorities and establish outcomes What occurs during the planning part of a community assessment? - correct answerDevelop interventions to meet identified outcomes. -Determine possible solutions to meet the health need -Compare resources and interventions required for each solution and select best option -Establish goals and objectives -Select strategies/interventions -Determine available and needed resources -Assess personnel needed and special training required -Determine funding opportunities -Plan for program evaluation What occurs during the implementation part of the community assessment? - correct answerCarry out the plan -Initiate interventions -Monitor intervention process and community response What occurs during the evaluation part of the community assessment? - correct answerExamine the success of the interventions. 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NR442-COMMUNITY HEALTH (WEEKS ONE, TWO, & THREE) FIRST TEST
What influenced the Patient Protection and Affordable Care Act? - correct answer Strongly influenced by the rising numbers of uninsured & underinsured W... [Show More] hat is the goal of Community and Public Health Nursing? - correct answer To preserve the health of the community and surrounding population including healing maintenance of individuals, families, and groups within the community. What is Public Health? - correct answer A long term commitment to the community to focus on health promotion and prevention. *Population based *Grounded in social justice *Relies on science of epidemiology Describe Nursing - correct answer Relationship based care in an independent practice that is: *Grounded in an ethic of caring *Holistic *Sensitivity to diversity What are the goal of Public Health? - correct answer *Preventing Disease *Prolonging life *Promoting Individual and Community Health Describe Community-based nursing - correct answer All nursing care provided outside of an acute care into the community. - Provision of personal care to individuals and families in the community. What are the roles of a Community Nurse? - correct answer -Immunizations -Communicable disease surveillance & control -Teach & monitor blood borne pathogen control -Advise on prevention of vector borne diseases -Teach methods for responsible sexual behavior & screen for STDs -Screen for TB, identify TB contacts, & deliver directly observed TB treatment. What is Community-oriented nursing? - correct answer All nursing care that is provided within in the overall focus of the well beings of the community. Describe a community - correct answer People, place, social interactions/common characteristics *Two types -Geopolitical -Phenomenological Describe geopolitical - correct answer A spatial designation; a geographic or geopolitical area or place. Describe phenomenological - correct answer Relationally-bound by similar characteristics, goals, and/or interests but do not live in the same area (Military) What are social determinants of health? - correct answer The conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels -Childhood experiences -Housing -Education -Social Support -Family income -Employment -Communities -Health Service access Name some Health Disparities - correct answer *Culture *Literacy *Language *Geography *Socio-economic *Access *Gender *Religion What are the two major causes of death amoungst all ethics? - correct answer *Heart diseases and Cancer What are some benefits of public health practices? - correct answer *Improved life expectancy *Population-based prevention programs *Potential issues identified *Fundings What is the vision of public health in America? - correct answer Healthy people in healthy communities What is the mission of public health in America? - correct answer To promote physical and mental health and prevent diseases, injuries, and disabilities. What are the essentials of public health service? - correct answer *Assessments, Policy developments, and assurance What are some major public health issues? - correct answer *Alcohol, Tobacco, and Substance abuse *Child and Adolescent growth & developmetal issues *Chronic and noninfectious diseases *Disabilities and decreased independence *Environmental conditions *Infectious diseases *Mental Health issues *Pregnancy & Birth defects *Service delivery systems *Unintended pregnancies What are some public health interventions? - correct answer *Surveillance *Coalition buildings *Disease & Health investigations *Outreach programs *Screenings *Referrals & Follow-ups *Case Management *Delegated functions *Consultations *Collaborations *Community organization *Advocacy *Social Marketing *Policy Development & Enforcement *Health Disparities evaluated *Counsiling What are the core functions of Public Health? - correct answer 1. Assessment -Monitor health, diagnosis, & investigate 2. Policy Development -Informed, educate, empower -Mobilize community partnership -Develop policies 3. Assurance -Enforce laws -Link to/provide care -Assure competent workforce -Evaluate Describe the Stages of disease history - correct answer *Hunting & Gathering - prior to 10,000 BCE *Settled Villages - 10,000-6000 BCE *Prindustrial Cities - 6000-18,000 CE *Industrial Cities - 17,000-18,000 CE *Present Period - 19,000-20,000 CE What are some Aggregate Impacts? - correct answer *Growing population *Overpopulated *Imbalanced Human Ecology (Changes in cultural adaption) Who is William Rathborne? - correct answer The one who Founded the first district nursing association in Liverpool, England and helped establish district nursing throughout England with Nightingale. Who is Lillian Wald? - correct answer She was a Founder of Henry Street Settlement House in NY and Founder of Public Health Nursing, who recognized connections between health and social conditions. She advocated for the development of national and international policies. What is NOPHN? - correct answer The National organization of Public Health It improves educational & service standards of public health nursing & promotes public understanding of and respecting of workers. What are some ways to decrease community acquired illnesses? - correct answer *Immunizations *Nutrition Improvements *Hygiene & sanitation education and improvements *Improved medications *Better Housing *Innovative emergencies & Critical care services What is the Nursing process amongst communities? - correct answer 1. Assessment & Analysis -Include community members 2. Diagnosis -ID health issues and problems 3. Planning -Include community leaders 4. Implementations -Include community 5. Evaluation -Includes process & outcomes -Community members must contribute What are the benefits of Community assessment? - correct answer Identifies community needs, problems, strengths, and resources. What is involved in Community assessment? - correct answer *Defining the community *Gathering relevant existing data and generating missing data *Developing databases *Interpreting data to identify problems & strengths *Analyzing problems & developing a diagnosis Describe the Community nursing process - correct answer 1. Establish partnership 2. Assessment & Analysis 3. Nursing diagnosis 4. Planning 5. Implementation 6. Evaluation May need to be renegotiated throughout the process What is considered personal observations? - correct answer *Senses: sight, smell, hearing, taste, touch, & body *Observe community members, read and collect literature on community (newspapers, TV, Publications) What are existing data sources? - correct answer *Secondary analysis: - vital stats - census data - CDC *National sources: - special interest groups - longitudinal research - state & local, Internet What are Assessment Parameters? - correct answer - Physical environment - Education level - Safety and transportation - Politics and government - Health & Social Services - Communication - Economics - Recreation What questions are asked during Intervention work-planning? - correct answer *What is to be done? *How will it happen? *What resources are needed? *Who is responsible for the interventions? *When & Where will each action occur? *How much time will be required? *How much will it cost? *Who will fund it? What is included in the MAPP model? - correct answer *Community Themes & Strengths assessment *Forces of change assessment *Community health status assessment *Local public health systems assessment -Organize for success -Partnership development -Visioning -4 MAPP assessment -ID strategic issues -Formulate goals & strategies -Eval > Plan > Implement What is invovled in the Evaluation process - correct answer *Formative vs Summative evaluation *Questions answered by evaluation *Ensure program met goals *Documenting accountability by program managers to patients and the funding sources *Shows whether the program fulfills purpose *Used to make judgement about a program *May be used to justify sustaining the program, making any adjustments, expanding/reducing program, or even discontinuing. What is formative evaluation? - correct answer An evaluation throughout the nursing process that does a prior eval of outcome of care. During which the formation of nursing care is delivered., this care is modified throughout. What is summative evaluation? - correct answer An evaluation done at the end, after the interventions, to measure outcomes and goal attainment. * "The Sum" * "The bottom line" What is System Thinking Theory? - correct answer The study of how persons/units interact with other organizations/systems What is Upstream Thinking Theory? - correct answer The focus on interventions that promote health and prevent illness What is the Epidemiology Model? - correct answer The study of ways in which determinants of health and disease distributed in population (those who are/are not affected) What is epidemiology? - correct answer The investigation of distribution or patterns of health events and what influences the patterns -Studies the effect of disease state in population over time -Predicts future health of community -Evaluates health services -Estimates individual risks from group experiences -Identifies syndromes -Informs prevention measures before disease becomes irreversible. -Searches for cause What is included in the Epidemiological Triangle? - correct answer 1. Social: - Nutritive, Chemical, Physical, Infectious, Agents 2. Biological: - Genetics, Age, Sex, Ethics, Physiological, Immunological, Intercurrents, pre-existing diseases, behavior 3. Environmental: - Influence existence of the agent, exposure, suscept. (Physical, biological, social environments) What is Descriptive epidemiology? - correct answer It Describes who, why, and when affected -Localized/Pandemic -Distribution, deaths, and outcomes -Person, place, and time model What are Characteristics of Epidemiology? - correct answer -Race -Ethics -Age -Education -Income -Marital Status -Sex -Occupation -Geographics What are some questions for "Time"? - correct answer -Is there an increase or decrease in frequency? -Are there other temporal patterns? *Secular trends (long term patterns of morbidity/mortality) *Point epidemics *Cyclical (Disease patterns) *Patterns *Events related to clusters What is analytic epidemiology? - correct answer The factors determined health event -Exposure, Factors, Behaviors -Determinants of patterns (how & Why) What is Ecological Fallacies? - correct answer Associations observed at group levels that may not hold true for individuals who make up groups or associations that actually exist, may be masked in group data. What are Problems and Events Investigated? - correct answer -Environmental Exposures: * lead/heavy metals, Air pollutants, Asthma triggers. -Infectious Disease: * Food borne, airborne, contact. -Injuries: * Increased homicides/domestic violence -Non-Infectious Disease: * Localized/Widespread, rise in cancer, Increase in birth defects -Natural Disasters: * Hurricanes, earthquakes -Terrorism: * Trade Center, Anthrax What is a rate in Epidemiology? - correct answer A statistic used for describing an event, characteristics, or happenings -Time is important/proportion -Makes comparisons among populations Whar is Crude Rate? - correct answer Total Population What is Specific Rate? - correct answer Subgroup of a population What is Attack Rate? - correct answer New cases in those exposed Whar are Routinely Collected Data? - correct answer -Census -Vital Records -Surveillance (CDC) -Medical -Health Department -Insurance What is Rate formula? - correct answer (Number of events/population at risk) X 100,000 What Morbidity? - correct answer The event that illness or disease symptoms are present and affecting a population What is Mortality? - correct answer The number of deaths as a result of a disease or health event What is incidence? - correct answer New cases of disease or illness What is incidence rate? - correct answer (Number of new cases/population at risk) x 100,000 What is prevalence? - correct answer Number of all cases of disease or illness What is Prevalence Rate? - correct answer (All Cases/population at risk) x 100,000 What are vital statistics? - correct answer -Death/Birth/Marriage/Divorce Certificate -Crude birth rates -Crude death rates -Infant Mortality (Increase in African American) -Mortality death rates What is included in Demographic Data? - correct answer -Age -Sex -Race -Ethics -Social Class -Occupation -Marital/Health Status -Health related behavior -Use of Health Care What is endemic? - correct answer Disease that occurs at a constant expected level in an area What is Epidemic? - correct answer An unexpected increase of an infectious disease in an area over an extended period of time What is a pandemic? - correct answer Steady occurrence of a disease over a large area/world-wide What is the Nursing role of epidemiology surveillance? - correct answer -Case finding: * Identifies who may be infected from exposure, identifying risk factors, and high risk behavior locations -Reporting: * Mandatory to CDC, 74 diseases -Surveillance: * Use of statistic measurements to look for trends, cycles, and monitoring (Who, What, When, Where, and Why) -Follow-Up Evaluation: * Is problem controlled?, Measures for preventions What is the Triangle of Epidemiology? - correct answer host, agent, environment What is a Vector? - correct answer Mechanical or Biological role in transmission of disease from source to host (insect). What is an Agent? - correct answer Infectious, chemical, physical -Microbes -Bacterial -Fungus -Virus -Parasites What are Factors of agents? - correct answer -Virulence: the ability to produce severe disease *Higher virulent organisms cause greater morbidity/mortality -Pathogenicity: Seriousness -Invasiveness: Spread throughout the rest of the body -Infective dose: amount of microbes needed to produce a response. *Highly infectious- Small amount of microbe needed to cause illness -Resistance What is a host? - correct answer Genetic susceptibility, acquired immutable characters, characteristics, life styles What are environmental factors? - correct answer -Climate -Plant/Animal -Human Population Distribution -Socioeconomic factors -Working conditions What is a Wheel Model? - correct answer Shows multiplicity of host and environmental factors -Agent, Host, Environment What is The Web of Causality? - correct answer Multiple population and environmental factors causing illness or disease -Illustrates the complexity of relationships among casual variables for diesase Ecological Model - correct answer Studies upward/broader context and downward to genetic and molecular etiology -Encompasses determinate at many levels (biological, mental, behavioral, social, & environmental) -Includes policy, culture, and economic environment. Ecosocial Approach - correct answer Emphasizes role of evolving macro level factors and microbiological process in understanding health and illness. -Challenges individual focused risk factors approach to understand disease. Levels of Prevention - correct answer -Primary: Reduction of risk factors before occurrence of disease, condition, or injury -Secondary: Early detection of potential development of disease, condition, injury -Tertiary: Treatment of an existing symptomatic disease to delay/prevent progress Primary prevention - correct answer Health promotion: -Education -Good Nutrition -Personality development -Adequate housing, recreation, & agreeable working conditions -Marriage Counseling -Sex education -Genetics -Periodic selective exams Specific Protection: -Immunizations -Hygiene -Environmental sanitations -Protection against occupational hazards -Use of specific nutrients -Prevent/protect against accidents -Protection from carcinogens -Avoidance of allergies Secondary prevention - correct answer Early diagnosis & Prompt treatment: -Case finding measures, individual & mass -Screening Surveys -Selective exams (Objective) -Cure & prevent disease process -Prevent spread of communicable disease -Prevent complications & sequelae -Shorten periods of disability Disability Limitation: -Adequate treatment -Provision of facilities Tertiary prevention - correct answer Rehabilitation: -Provisions of hospitals/facillities *Retraining *Education [Show Less]
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