Chapter 01: Community and Prevention-Oriented, Population-Focused Practice: The Foundation of Specialization in Public Health Nursing
Stanhope: Public
... [Show More] Health Nursing: Population-Centered Health Care in the Community, 9th Edition MULTIPLE CHOICE
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.
ANS: A
There are new concerns, and of the most serious are bioterrorism and globally induced infections, such as the avian flu. These threats will divert health care funds and resources from other health care programs to be spent for public safety. The others are not related to public health or are concerns that have been present for many years.
DIF: Cognitive level: Understanding REF: p. 5 TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance
2. A community is concerned about the threat of bioterrorism. Which of the following best describes the basis for this concern?
a. Bioterrorism has the potential to dissolve community-based programs.
b. This threat could cause the health care system to collapse.
c. The threat of bioterrorism may divert funds from other public safety health care programs.
d. Fear of bioterrorism will increase the need for shelters.
ANS: C
Bioterrorism may have an impact on the availability of resources for public safety health care programs. Because funds are diverted it is possible that community-based programs would be eliminated, the health care system could experience changes, and that there would be an increase in the need for shelter.
However, all of these things would happen because of the diversion of funds.
DIF: Cognitive level: Analyzing REF: p. 5 TOP: Nursing process: Diagnosis MSC: NCLEX: Psychosocial Integrity
3. Which of the following describes the consequence of the successful implementation of the Affordable Care Act?
a. Americans will pay closer attention to their health status.
b. The majority of the population will be covered by insurance.
c. Public health departments will need to increase the number of nursing positions.
d. The prevalence of obesity will decrease.
ANS: B
One consequence of successful implementation of the Affordable Care Act might actually be that the majority of the population would be covered by insurance and public health agencies will not need to provide direct clinical services in order to assure that those who need them can receive them. The Affordable Care Act will not directly cause Americans to pay closer attention to their health status or decrease the prevalence of obesity.
DIF: Cognitive level: Remembering REF: p. 5
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
4. The public health nurse (PHN) must participate in the essential services of public health. Which of the following most accurately describes one of the essential services of public health?
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
ANS: C
The PHN monitors health status in several ways, completing a community assessment is only one way that health status is monitored. The PHN would not diagnose or solve “world” problems, or work in law enforcement. Rather, the PHN would participate with local regulators to protect communities and empower people to address health issues.
DIF: Cognitive level: Understanding REF: p. 8 (How to Box)
TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
5. A public health department is using the mission of public health as described by the Institute of Medicine when planning its health programming. Which of the following activities will most likely be implemented?
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
ANS: A
The Institute of Medicine’s stated mission on public health is “to generate organized community and technical knowledge to prevent disease and promote health.” Tracking avian flu outbreaks and doing surveillance applies this concept at a population level. Providing a flu shot for an elderly person only addresses individual care. Keeping track of the use of alternative therapies does nothing to prevent disease or promote health of the population. Keeping snake antivenom is aimed at disease care for an individual, not health promotion or disease prevention.
DIF: Cognitive level: Analyzing REF: p. 6
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
6. A public health department makes sure that the essential community-oriented health services are available in the community. Which of the following core public health functions is being implemented?
a. Policy development
b. Assessment
c. Assurance
d. Scientific knowledge-based care
ANS: C
Assurance focuses on the responsibility of public health agencies to ensure certain activities have been appropriately carried out to meet public health goals and plans. Policy development seeks to build constituencies that can help bring about change in public policy. Assessment includes activities that involve collecting, analyzing, and disseminating information on both the health status and the health- related aspects of a community or a specific population. Public health is based on scientific knowledge, but is not a core function.
DIF: Cognitive level: Applying REF: p. 14
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
7. 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.
ANS: A
As defined by the Institute of Medicine in its 1988 report The Future of Public Health, assessment, policy development, and assurance are core functions at all levels of government for the purpose of clarifying the government’s role.
DIF: Cognitive level: Understanding REF: p. 6
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
8. 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.
ANS: C
Fielding and Tilson have asserted that most of the increase in life span has been made through improvements in sanitation, clean water supplies, making workplaces safer, improving food and drug safety, immunizing children, and improving nutrition, hygiene, and housing. Medical treatment has not made as significant of an impact on the life span as public health measures. Funding for public health in recent years has been on a gradual decline. Although reform of the medical insurance system may help improve the health of Americans, there are many other factors that will need to be addressed.
DIF: Cognitive level: Understanding REF: p. 5 TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
9. A PHN collects data and monitors the health status of the population. Which of the following core public health functions is being implemented?
a. Assessment
b. Prevention
c. Assurance
d. Policy development
ANS: A
Assessment consists of systematic data collection and monitoring health status.
Prevention is not a core function, assurance is making sure essential services are available, and policy development is needed to provide leadership in developing policies.
DIF: Cognitive level: Applying REF: p. 6
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
10. The PHN compares the rate of teenage pregnancy in various areas of the city. Which of the core functions of public health is being implemented?
a. Assurance
b. Assessment
c. Prevention
d. Policy development
ANS: B
Assessment refers to systematic data collection, which this nurse is doing for teenage pregnancy. Prevention is not a core function, assurance is making sure essential services are available, and policy development is needed to provide leadership in developing policies.
DIF: Cognitive level: Applying REF: p. 6
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
11. A PHN develops and implements local public health policies through partnerships with agencies, organizations, and consumers within the community. Which of the following core public health functions is being used?
a. Assessment
b. Prevention
c. Assurance
d. Policy development
ANS: D
Policy development deals with developing and implementing health policies. Prevention is not a core function, assurance is making sure essential services are available, and assessment refers to systematic data collection.
DIF: Cognitive level: Applying REF: p. 6
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
12. A nurse provides for the availability of essential personal health services for people who would otherwise not receive health care. Which of the public health core functions is being used?
a. Assessment
b. Prevention
c. Assurance
d. Policy development
ANS: C
Assurance deals with the availability of health services. Prevention is not a core function, assessment refers to systematic data collection, and policy development refers to the need to provide leadership in developing health policies.
DIF: Cognitive level: Applying REF: p. 6
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
13. The nurse manager makes sure that the staff members who work in a local clinic are competent in their job responsibilities. Which of the public health core functions is being demonstrated?
a. Assurance
b. Assessment
c. Prevention
d. Policy development
ANS: A
Assurance refers to making sure a competent health care workforce is available. Prevention is not a core function, assessment refers to systematic data collection, and policy development refers to the need to provide leadership in developing health policies.
DIF: Cognitive level: Applying REF: p. 6
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
14. A nurse performs activities to meet the primary goals of public health. Which of the following is the nurse most likely to complete?
a. Ensuring that a newly diagnosed 40-year-old hypertensive man takes his medication
b. Finding home care for a 70-year-old client recuperating from a hip replacement
c. Conducting an infant car seat safety check
d. Contacting a local hospice to admit a terminally ill 60-year-old woman
ANS: C
The correct answer is concerned with the health of many people, while the other answers address individual interventions. According to the Core Functions Project, all levels of health care, including population-based public health care, must be funded or the goal of health of populations may never be reached.
DIF: Cognitive level: Analyzing REF: p. 6
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
15. A community health nurse collects data about the number and proportion of persons aged 25 or older with less than a high school education. Which of the following best describes this data?
a. Sociodemographic characteristics
b. Health status data
c. Health risk factors
d. Health care resource consumption information
ANS: A
The number and proportion of people is a sociodemographic characteristic. Health status includes birth and death rates. Health risk factors discuss proportions of populations who have particular health conditions or health risks. Health care resource consumption refers to spending on health care per capita.
DIF: Cognitive level: Applying REF: p. 9 (Box 1-1)
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
16. The PHN analyzes data related to the number and type of United States Environmental Protection Agency air quality standards that a community failed to meet. This data is an example of using which community health profile indicator?
a. Sociodemographic characteristics
b. Health status
c. Health risk factor
d. Functional status
ANS: C
Health risk factors discuss proportions of populations who have particular health conditions or health risks; breathing air of poor quality is a risk to health. The number and proportion of people is a sociodemographic characteristic. Health status includes birth and death rates. Functional status refers to reports of good health status by members of the population.
DIF: Cognitive level: Applying REF: p. 9 (Box 1-1)
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
17. A nurse is implementing quality performance standards in a public health department. Which of the following best describes the importance of this action?
a. Quality performance standards are used to
guide improvement in the public health system.
b. Quality performance standards rigidly control public health.
c. Quality performance standards guide
administrators to monitor public health at the national level.
d. Quality performance standards can be used as hiring guidelines for nurses.
ANS: A
These standards were developed by the Centers for Disease Control and Prevention in 1998. They set the bar for the level of performance that is necessary to deliver essential public health services (PHSs). These standards were developed around the 10 essential PHSs. They focus on the overall public health system rather than on single organizations and describe an optimal level of performance. They are intended to support a process of quality improvement. State and local communities can assess their performance using certain available tools. They are not meant to control public health or be used for hiring guidelines.
DIF: Cognitive level: Applying REF: p. 10 TOP: Nursing process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
18. To better address emerging public health issues, a PHN plans to complete continuing education in this area. Which of the following content areas should be included in the course that is chosen?
a. Leadership
b. Ethics
c. Communication
d. Finance
ANS: B
Public health workers should be educated in eight content areas to be able to address emerging public health issues and advances in science and policy: (1) informatics, (2) genomics, (3) cultural competence,
(4) community-based participatory research, (5) policy, (6) law, (7) global health, and (8) ethics.
DIF: Cognitive level: Analyzing REF: p. 10 TOP: Nursing process: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care
19. The public health workforce should demonstrate competency in which of the following competency categories?
a. Financial planning and management
b. Workforce needs assessment
c. Acute care services
d. Curriculum development
ANS: A
Workforce needs assessment, acute care services, and curriculum developments are not considered categories of core competencies of public health. Rather there are eight categories of competency, which include: (1) analytic/assessment, (2) policy development/program planning, (3) communication, (4)
cultural competence, (5) community dimensions of practice, (6) basic public health sciences, (7) financial planning and management, and (8) leadership and systems thinking.
DIF: Cognitive level: Understanding REF: p. 9 (Box 1-2)
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
20. Public health nursing is a specialty because:
a. it has a distinct focus and scope of practice.
b. it must be done by a registered nurse with a master’s degree.
c. it is focused on disadvantaged citizens.
d. it performs interventions at the acute care level.
ANS: A
Public health nursing has a distinct focus and requires a special knowledge base. The other answers are not characteristics of a specialty.
DIF: Cognitive level: Understanding REF: p. 10 TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
21. The necessary basic preparation for public health nursing is a(n) in nursing.
a. associate’s degree
b. baccalaureate degree
c. master’s degree
d. Doctor of Nursing Practice degree
ANS: B
A bachelor of science in nursing (BSN) is the necessary basic preparation to function as a beginning staff PHN. An associate’s degree is not enough for basic preparation. A master’s degree or Doctor of Nursing Practice degree would be part of preparation for advanced practice.
DIF: Cognitive level: Remembering REF: p. 10
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
22. A PHN has been prepared at the graduate level. Which of the following activities should the practitioner be able to complete?
a. Teach public and community health nursing
b. Assess and intervene successfully at the aggregate level
c. Diagnose and treat disease and have prescriptive authority
d. Run for political office as experts in public health policy
ANS: B
According to the Consensus Conference, specialists should have assessment skills that allow them to intervene at the aggregate level. Public health practitioners have a broad range of practice areas within public health and are not limited to only nursing and medicine.
DIF: Cognitive level: Applying REF: p. 11 TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
23. A PHN provides a clinic for HIV-positive citizens in the community. Which of the following best describe this activity?
a. Primary prevention
b. Health education
c. Tertiary prevention
d. Policy making
ANS: C
This clinic is for clients who already have a disease process; therefore, it is tertiary prevention (preventing deterioration in a patient, a relapse, or disability and dependency by anticipatory nursing and medical care). Primary prevention is using general and specific measures in a population to promote health and prevent the development of disease (incidence) and using specific measures to prevent disease in those who are predisposed to developing a particular condition. Health education would involve providing specific education to this population. Policy making is formulating plans by an organization in order to make decisions.
DIF: Cognitive level: Applying REF: p. 12 (Levels of Prevention box)
TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
24. A nurse is working in the community with an aggregate/population. Who is the nurse most likely to interact with?
a. Students in a county school system
b. Christians around the world
c. A patient in the intensive care unit at the local hospital
d. People who drink coffee
ANS: A
A population or aggregate is a collection of individuals who have one or more personal or environmental characteristics in common. Members of a community who can be defined in terms of geography or a special interest can be seen as constituting a population. The clients in the first option share a
geographical and special circumstance (school) characteristic. Christians around the world are too large of a geographical space. A patient cannot be an aggregate/population as there is no one to interact with.
People who drink coffee share a common interest, but may not share a common geographical location to interact.
DIF: Cognitive level: Applying REF: p. 11
TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance
25. A population is best defined as a:
a. high-risk group.
b. those interacting within a school or institutional setting.
c. collection of individuals who share at least one common characteristic.
d. geographical location within a community.
ANS: C
A population or aggregate is a collection of individuals who have one or more personal or environmental characteristics in common. High risk groups, school or institutional setting, and geographical location within the community all describe types of populations, not the definition of population. [Show Less]