Details of TEST BANK FOR Public Health Nursing PopulationCentered Health Care in the Community 9e StanhopeChapter 01: Community and Prevention-Oriented,
... [Show More] Population-Focused Practice: The Foundation of Specialization in Public Health Nursing
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 Planning MSC: NCLEX: Health Promotion and Maintenance
TOP: Nursing process:
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 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
1 | P a g e TOP: Nursing process:directly cause Americans to pay closer attention to their health status or decrease the
prevalence of obesity.
DIF: Cognitive level: Remembering
TOP: Nursing process: Assessment
REF: p. 5
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
TOP: Nursing process: Assessment
REF: p. 6
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
2 | P a g ed. 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
TOP: Nursing process: Assessment
REF: p. 14
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
3 | P a g efollowing 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
TOP: Nursing process: Assessment
REF: p. 6
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
TOP: Nursing process: Assessment
REF: p. 6
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
TOP: Nursing process: Assessment
REF: p. 6
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
4 | P a g ec. 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
TOP: Nursing process: Assessment
REF: p. 6
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
TOP: Nursing process: Assessment
REF: p. 6
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
5 | P a g ed. 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
TOP: Nursing process: Assessment
REF: p. 9 (Box 1-1)
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
TOP: Nursing process: Assessment
REF: p. 9 (Box 1-1)
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
6 | P a g e18. 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
7 | P a g eb. 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
TOP: Nursing process: Assessment
REF: p. 10
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
8 | P a g eb. 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
TOP: Nursing process: Assessment
REF: p. 11
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.
DIF: Cognitive level: Remembering
TOP: Nursing process: Assessment
REF: p. 11
MSC: NCLEX: Health Promotion and Maintenance
26. Population-focused practice focuses on defining the problems or needs of and
implementing solutions for:
a. individuals.
b. aggregates.
c. communities.
d. geographical regions.
ANS: B
Aggregates are a defined population made up of individuals in communities of a specific
geographical region. Population-focused practice is implemented with defined
populations or subpopulations. This is larger than the scope of individual care, but may
not address the larger needs of the entire community or geographical region.
DIF: Cognitive level: Understanding REF: p. 11
TOP: Nursing process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
27. A nurse is using a population focus when providing public health nursing care. Which
of the following statements best describes the care that is being provided?
a. Priority is given to the highest risk population.
9 | P a g eb. Direct caregiving is limited to preventive measures, such as
administration of immunizations.
c. Attention is given to the population or community as a whole,
regardless of whether they do or do not access the health care
system.
d. Only populations outside institutional settings are considered.
ANS: C
PHNs are concerned with the health of the entire population. Priority is given to the
entire population, not just the group at highest risk or those outside of institutional
settings. Direct caregiving is not the focus of public health nursing care.
DIF: Cognitive level: Analyzing
TOP: Nursing process: Assessment
REF: pp. 12-13
MSC: NCLEX: Health Promotion and Maintenance
28. A nurse is working in a community health nursing practice setting. Which of the
following is the nurse most likely to implement?
a. Administrating a flu shot to a client in a physician’s office
b. Conducting a flu shot clinic at a community center
c. Performing a client assessment in a hospital
d. Providing supervision of staff in a rehabilitation center
ANS: A
Community health nursing practice focuses on the health of individuals, families, and
groups and the effect of their health status on the health of the community as a whole.
Administrating a flu shot to an individual is the only example that meets this criterion.
Performing a client assessment focuses only on individual care and not the
community. Providing supervision of staff does not focus on the community.
Conducting a flu shot clinic at a community center focuses on protecting the
community as a whole and would be considered public health nursing practice.
DIF: Cognitive level: Applying
REF: p. 16 (Box 1-5)
TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
29. Which statement about community health nursing practice is correct?
a. It focuses on the delivery of personal health services to individuals and families.
b. It provides care to protect the health of the community as a whole.
c. It emphasizes the setting where care is provided for clients and families.
d. It requires a baccalaureate preparation for practice.
ANS: A
By definition, the first option is correct. Public health nursing provides care to protect
the health of the community as a whole. Community-based nursing practice
emphasizes the setting where care is provided for clients and families. It is generally
assumed that a graduate of any baccalaureate program has the necessary basic
preparation to function as a beginning staff PHN; however, this is not a requirement
for public health nursing or community health nursing practices.
DIF: Cognitive level: Understanding REF: p. 16 (Box 1-5)
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
10 | P a g e30. A nurse is implementing community-based nursing care. Which of the following
nursing interventions is the nurse most likely to complete?
a. Assessing the health needs of a defined community
b. Providing care to families in a community
c. Promoting the health of an entire community
d. Investigating environmental health problems in a community
ANS: B
Community-based nursing practice is a setting-specific practice whereby care is
provided for families where they live, work, and attend school. The focus is on acute
and chronic care and the provision of services. Providing care to families is the only
intervention that accurately describes this definition. Assessing the health needs of a
community, promoting the health needs of an entire community, and investigating
environmental health problems in a community would be considered public health
nursing practice.
DIF: Cognitive level: Applying
REF: p. 16 (Box 1-5)
TOP: Nursing process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
31. A nurse is conducting vision screenings on children in the school setting. Which
type of nursing practice is the nurse performing?
a. Community-oriented
b. Public health
c. Community health
d. Community-based
ANS: D
Community-based nursing practice is a setting-specific practice whereby care is
provided for clients and families where they live, work, and attend school. Community-
oriented nursing emphasizes the prevention of disease and disability. Public health
nursing focuses on the care within the community as a whole. Community health nursing
focuses on the health status of individuals and the effect of their health status on the
community as a whole.
DIF: Cognitive level: Applying
REF: p. 16 (Box 1-5)
TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
32. The nurse is investigating environmental health problems caused by contaminated
ground water. Which of the following types of nursing practice is being used?
a. Community-oriented
b. Community-based
c. Policy development
d. Tertiary care
ANS: A
Community-oriented nursing emphasizes the prevention of disease and disability.
Community-based nursing practice is a setting-specific practice whereby care is
provided for clients and families where they live, work, and attend school. Policy
development seeks to build constituencies that can help bring about change in public
policy. Tertiary care focuses on highly specialized medical care.
11 | P a g eDIF: Cognitive level: Analyzing
REF: p. 16 (Box 1-5)
TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
33. A public health staff nurse has a clear understanding of population-focused practice.
Which of the following characteristics would the nurse most likely display?
a. Volunteering for a local community action coalition
b. Able to perform interventions with individuals in the community
c. Able to improve the effectiveness of care provided
d. Considered a PHN specialist
ANS: C
Public health staff nurses who have a clear understanding of population-focused care
improve their effectiveness and efficiency of practice; have professional satisfaction by
seeing how individual care contributes to health at the population level; and
appreciate the practice of others who are population-focused specialists. PHN
specialists are prepared at the master’s level and function in an administrative role.
DIF: Cognitive level: Analyzing
TOP: Nursing process: Assessment
REF: p. 17
MSC: NCLEX: Health Promotion and Maintenance
34. PHNs are looking to improve population-focused care in the community. Which
of the following best describes a key opportunity for the nurses to accomplish
this goal?
a. Assuming traditional nursing roles
b. Influencing public health policy
c. Conducting community assessments
d. Specializing in community-based nursing practice
ANS: B
PHNs must move into positions in which they can influence policy formation. They
must assume positions that are not traditionally considered nursing. Conducting
community assessments is part of public health nursing practice, not necessarily a
key opportunity to improve practice. Specializing in community-based nursing
practice is setting-specific and does not relate to a key opportunity to improve
population-focused care.
DIF: Cognitive level: Analyzing
REF: p. 17
TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance
35. A local senator has proposed changes to the health care delivery system in the United
States. Based on current trends, which of the following is most likely to occur?
a. There will be new opportunities provided for public health specialists.
b. It will result in isolated care being provided to individuals.
c. There will be an increased emphasis in specialty care.
d. It will increase the utilization of acute care services.
ANS: A
Proposed changes in the health care delivery system will provide new opportunities
for public health specialists and result in the creation of new roles within the system.
The proposed changes will build an integrated system (not isolated), decrease
emphasis on acute care services, and focus on health promotion and disease
prevention.
12 | P a g eDIF: Cognitive level: Analyzing
REF: p. 18
TOP: Nursing process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
MULTIPLE RESPONSE
1. Which of the following are considered barriers to public health nursing? (Select
all that apply.)
a. The mindset that the only role for the nurse is at the bedside
b. The structures within which nurses work and the process of role
socialization within those structures
c. Few nurses receive graduate-level preparation in the concepts and
strategies of the disciplines basic to public health
d. The steady decline in the number of job opportunities in the area
e. The inability to equally distribute the increasing funds
ANS: A, B, C
Barriers exist in thinking that nurses only work in a hospital at the bedside, the
process of role socialization in public health which can be a very autonomous
profession, and that few nurses have had advanced education in public health. The
number of job opportunities continues to increase, but the amount of funding allotted
to public health continues to decline.
DIF: Cognitive level: Understanding REF: pp. 17-18
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
Chapter 02: History of Public Health and Public and Community Health Nursing
MULTIPLE CHOICE
1. In the past, population-centered nurses have been called:
a. district nurses.
b. almshouse nurses.
c. soldier nurses.
d. sisters.
ANS: A
In the past, population-centered nurses have been called public health nurses
(PHNs), district nurses, visiting nurses, school nurses, occupational health nurses,
and home health nurses. Many women who performed nursing functions in
almshouses and early hospitals in Great Britain were poorly educated, untrained, and
often undependable. The original soldier nurses worked with Florence Nightingale at
Scutari. Various groups of “sisters” have been used throughout history to care for
the poor.
DIF: Cognitive level: Remembering
23 TOP:
REF: p.
Nursing
process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
13 | P a g e2. A nurse is working in a public health nursing setting. Which of the following best
describes why this specialty is appealing to nurses?
a. Interactions with wealthy contributors to secure funding
b. Autonomy and independence of practice
c. Ability to locate the source of diseases and cure patients
d. Opportunities to meet a variety of people
ANS: B
Community health nurses have a long history of autonomous practice, problem solving,
and decision making. Community health care nurses engage in the other activities as
well, but overall, they have been best known for autonomy of practice.
DIF: Cognitive level: Applying
23 TOP:
REF: p.
Nursing
process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
3. Current threats to health in the United States that community health nurses
are faced include:
a. diphtheria, cholera, and hepatitis.
b. HIV, H1N1 influenza, and bioterrorism.
c. avian flu, tuberculosis (TB), and radiation.
d. polluted water and
air. ANS: B
The newest threats to health that PHNs are involved in are HIV, H1N1 influenza, and
bioterrorism. Hepatitis is also a current threat, but diphtheria and cholera are not
concerns in the United States. Avian flu may be a threat, but radiation and TB are
ongoing.
Environmental pollution has been reduced; however, there are pollution issues that do
raise concerns.
DIF: Cognitive level: Understanding REF: p.
23 TOP:
Nursing
process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
4. A nurse is working to reform a program that was based on the Elizabethan Poor
Law of 1601. Which of the following programs is the nurse most likely working
on?
a. Welfare
b. Food Stamps
c. Medicaid
d. Medicare
ANS: C
The Poor Law guaranteed medical care for poor, blind, and “lame” individuals,
making it most similar to Medicaid since this program provides medical insurance
to these types of individuals. Welfare provides more than health care. Food stamps
do not provide medical care. The Medicare program provides medical care to the
14 | P a g eelderly population.
DIF: Cognitive level: Analyzing
24 TOP:
REF: p.
Nursing
process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. In early colonial North America, a colonist worked in the public health sector. Which
of the following would have most likely been the focus?
a. Establishing schools of nursing
b. Developing vaccines to administer to large numbers of people
c. Collecting vital statistics and improving sanitation
d. Developing public housing and almshouses
ANS: C
The early colonial public health efforts included the collection of vital statistics,
improvements to sanitation systems, and control of communicable disease
introduced through seaports. Establishing schools of nursing, developing vaccines,
and developing public housing are all events that happened after the colonial
period.
DIF: Cognitive level: Applying
24 TOP:
REF: p.
Nursing
process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
6. A nurse was employed by the Marine Hospital Service. Which of the following tasks
would have most likely been the responsibility of the nurse?
a. Setting policy on quarantine legislation for immigrants
b. Establishing hospital-based programs to care for the sick at home
c. Identifying and improving environmental conditions
d. Providing health care for merchant seamen
ANS: D
Providing health care to seamen was an early effort by the federal government to
improve public health. The purpose of the Marine Hospital Service was to secure its
maritime trade and seacoast cities. Marine Hospital Service nurses did not establish
policies or hospital programs. They also did not identify and improve
environmental conditions as Florence Nightingale did. Their sole purpose was to
provide care for this population.
DIF: Cognitive level: Analyzing
26 TOP:
REF: p.
Nursing
process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
7. Florence Nightingale’s contributions to public health included:
a. caring for the sick, poor, and neglected in institutions and at home.
b. using a population-based approach that led to improved environmental conditions.
c. writing the Elizabethan Poor Law to guarantee medical care for all.
d. founding of the district nursing association to provide health care to needy people.
15 | P a g eANS: B
During the Crimean War, Nightingale progressively improved the soldiers’ health
by adopting a population-based approach that used simple epidemiological
measures and greatly decreased mortality. The focus of her care was on wounded
soldiers, not those who were sick, poor, and neglected at homes and institutions. She
did not write the Elizabethan Poor Law. William Rathbone founded the district
nursing association.
DIF: Cognitive level: Remembering
27 TOP:
REF: p.
Nursing
process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
8. Lillian Wald’s major contribution to public health nursing was:
a. founding the American Nurses Association.
b. developing the New York Training Hospital for Nurses.
c. creating the Public Health Service.
d. establishing the Henry Street Settlement.
ANS: D
Lillian Wald established the Henry Street Settlement. Isabel Hampton Robb founded
the American Nurses Association. Lillian Wald was a graduate of the New York
Training Hospital for Nurses. The Public Health Service was established by the
federal government.
DIF: Cognitive level: Remembering
28 TOP:
REF: p.
Nursing
process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
9. A nurse is providing public health education based on the teachings of Lillian Wald.
Which of the following topics will the nurse most likely discuss?
a. Taking and recording blood pressures accurately
b. Safe and sanitary baby and child care
c. Environmental pollutants and their effects on lung disease
d. Time management: balancing factory work and the home
ANS: B
Lillian Wald provided health care that included educating the community on health
care matters. The focus of the majority of her work was on health services and
health promotion for families and children. Because of her focus on health
promotion for families and children, her primary role would not have been taking
and recording blood pressures, discussing environmental pollutants (as her focus
was not occupational health), or time management (as at this point in time very few
women were working outside of the home).
DIF: Cognitive level: Applying
29 TOP:
REF: pp. 28-
Nursing
process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
16 | P a g e10. Nurses who provided care to people in their homes and provided that care to
several people at a time were called
nurses.
a. private duty
b. visiting
c. public health
d. community health
ANS: B
The visiting nurse cared for several families in a day and helped make care of the
sick poor at home economical, whereas a private duty nurse may live with a family
of clients receiving care and was to be available 24 hours a day. PHNs focused on
care of populations. Community health nurses would be considered to be anyone who
worked outside of a hospital setting.
DIF: Cognitive level: Remembering
28 TOP:
REF: p.
Nursing
process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
11. Neighborhood centers that provided health care, education, and social welfare
programs were called:
a. settlement houses.
b. nursing care centers.
c. nurse-managed clinics.
d. public health services (PHSs).
ANS: A
Settlement houses were neighborhood centers that provided health care, education,
and social welfare programs. Nursing centers, nurse-managed clinics, and PHSs are
not necessarily in neighborhoods.
DIF: Cognitive level: Remembering
28 TOP:
REF: p.
Nursing
process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
12. A nurse worked in a school setting during the early twentieth century.
Which of the following would have been the focus of this nurse’s practice?
a. Investigating causes of absenteeism
b. Teaching school as well as being a nurse
c. Promoting nursing as an autonomous practice
d. Providing medical treatment to enable children to return to school
ANS: A
Early school nursing focused on investigating causes of absenteeism, not providing
medical treatment. That was the responsibility of physicians. Early school nurses did
not teach in the schools. Early school nurses did not promote nursing as an
autonomous practice.
DIF: Cognitive level: Applying
30 TOP:
17 | P a g e
REF: p.
Nursingprocess: Implementation
MSC: NCLEX: Health Promotion and Maintenance
13. A nurse is comparing the historical practices of industrial and occupational health
nurses. Which of the following would the nurse most likely note when comparing
these two occupations?
a. Industrial nurses invented new machines to streamline production of
medical goods, whereas occupational health nurses provide care to
employees.
b. Industrial nurses investigated industrial injuries to improve work
conditions, whereas occupational health nurses demonstrated proper
body mechanics.
c. Industrial nurses treated work related-injuries, whereas occupational
health nurses care for families in their homes.
d. Industrial nurses provided care for workers in their homes, whereas
occupational health nurses care for work-related injuries.
ANS: D
Early occupational health nursing did not provide care for work-related injuries, but
instead focused on the care of employees and their families in the home.
Contemporary occupational health nurses provide care for work-related injuries. The
focus of both of these professions has been on employee care and the work
environment.
DIF: Cognitive level: Analyzing
29 TOP:
REF: p.
Nursing
process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
14. The document Visiting Nursing in the United States highlighted the fact that:
a. nurses were trained by Boards of Education.
b. trained nurses adequately covered less-densely populated areas.
c. visiting nurse services were concentrated in the northeastern United States.
d. nurses were curing diseases such as TB and typhoid fever.
ANS: C
This report emphasized the fact that visiting nurse services were concentrated in
the northeast, which underscored the need for rural health. The document did not
address how the nurses were educated or the diseases that nurses were curing.
This report showed that there was not adequate coverage for nurses in less
populated areas.
DIF: Cognitive level: Remembering
29 TOP:
REF: p.
Nursing
process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
15. During the time when the Rural Nursing Service was operating through the
American Red Cross, a nurse needed to demonstrate resourcefulness. Which of the
following tasks would the nurse most likely have done?
a. Using hot bricks, salt, or sandbags to substitute for hot water bottles
18 | P a g eb. Testing well water for pollutants
c. Teaching school and developing curricula for rural nursing programs
d. Providing post-surgical care
ANS: A
In providing medical care, rural nurses were resourceful in finding alternatives
when they did not have medical products that were available in urban areas. They
were not involved in testing well water, providing post-surgical care, or teaching in
rural nursing programs.
DIF: Cognitive level: Applying
29 TOP:
REF: p.
Nursing
process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
16. Local health departments were formed in urban areas in the late 1800s to:
a. target environmental hazards associated with crowded living conditions.
b. facilitate interdisciplinary efforts and promote “practical nursing.”
c. provide immunizations and health care services to all citizens.
d. offer public health education to nurses who had finished basic training.
ANS: A
Local health departments were formed to handle environmental issues in cities,
including problems associated with crowded living conditions and dirty streets, and to
regulate public baths, slaughterhouses, and pigsties. Because sanitation was such an
issue, there was not a focus on interdisciplinary care, provision of immunizations, or
public health education for nurses.
DIF: Cognitive level: Understanding REF: p.
23 TOP:
Nursing
process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
17. A nurse was involved in the original work of the National Organization for Public
Health Nursing. Which of the following best describes the influence this has had
on nursing practice today?
a. Requiring that PHNs have a baccalaureate degree in nursing
b. Standardizing public health nursing education
c. Developing nursing cooperatives
d. Opening the Henry Street Settlement
ANS: B
The National Organization for Public Health Nursing sought to standardize public
health nursing. The Henry Street Settlement was already in existence. The
baccalaureate degree in nursing was not developed yet. Cooperative agreements were
made between life insurance companies and visiting nurses associations that
expanded availability of public health nursing services.
DIF: Cognitive level: Applying
REF: p. 30
TOP: Nursing process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
19 | P a g e18. A nurse is considering joining the American Public Health Association (APHA).
Which of the following information about this organization should be considered
when making this decision?
a. APHA focuses on the public health concerns of the medical profession.
b. APHA represents concerns of nursing specialty practices.
c. APHA provides a forum for nurses to discuss their public health concerns.
d. APHA focuses on providing health promotion education to the public.
ANS: C
APHA was formed to facilitate interprofessional efforts and promote the “practical
application of public hygiene.” The Public Health Section within APHA provides
nurses with a forum to discuss their concerns and strategies. It also serves as a focus
of leadership and policy development for community/public health nursing.
DIF: Cognitive level: Applying
30 TOP:
REF: p.
Nursing
process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
19. Which statement is true about African American nurses in public health?
a. Certificate and graduate education were more difficult to obtain.
b. Cities were the major areas where they practiced.
c. They often belonged to the Frontier Nursing Service (FNS).
d. They were recruited heavily as military nurses.
ANS: A
Due to segregation, certification and graduate education were more difficult to obtain.
They were faced with many challenges because of discrimination and had a limited
presence in public health nursing practice. They were not part of the FNS or recruited
as military nurses.
DIF: Cognitive level: Understanding REF: p.
31 TOP:
Nursing
process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
20. A nurse had the opportunity to work with Mary Breckinridge. Which of the following
would the nurse most likely have assisted with?
a. Establishing the Henry Street Settlement
b. Developing health programs geared toward improving the health care of
the rural populations
c. Blazing a nursing trail through the Rockies, providing nursing care to
miners and their families
d. Teaching birth control measures to large numbers of women in the South
ANS: B
Mary Breckinridge developed health programs geared toward improving the health
care of the rural and often inaccessible populations in the Appalachian regions of
southern Kentucky. Lillian Wald established the Henry Street Settlement.
DIF: Cognitive level: Applying
REF: p.
20 | P a g e31 TOP: Nursing
process: Implementation MSC: NCLEX: Health Promotion [Show Less]