Exam 1 Public Health Nursing exam with
complete solutions
1. In 1988, the Institute of Medicine (IOM) published a report on the future of public
health and its mission that defined public health as:
a. what public-private partnerships do to treat vulnerable populations.
b. what the government does to ensure that vital programs are in place.
c. what the U.S. Public Health Service does to prevent disease, promote health, and
deliver services.
d. what society does collectively to ensure the conditions in which people can be
healthy. - ANSWER-ANS: D
In 1988, the IOM's report stated that public health is "what we, as a society, do
collectively to assure the conditions in which people can be healthy." Consequently, the
mission of public health is "to generate organized community effort to address the
public's interest in health by applying scientific and technical knowledge to prevent
disease and promote health." This clearly places the emphasis on the desire of the
population and community to ensure access to services that foster the health status of
the overall community through the equitable distribution of resources addressed to
community problems that affect health.
2. A registered nurse is seeking a position as a public health nurse. In reviewing the job
description, the nurse would expect to find a description of a position that focused on
functions such as:
a. monitoring pregnant teenagers for symptoms of complications of pregnancy.
b. offering free hypertension screening and treatment referral at local health fairs to low-
income, uninsured, community members.
c. partnering with local seasonal farmworkers to design a program aimed at preventing
illness and injury, and advocating for this population with local political and community
leaders.
d. preventing injury among a population of elderly residents in an assisted living facility
and treating residents' chronic illnesses. - ANSWER-ANS: C
,The scope of practice of public health nurses is population focused and community
oriented, with a primary emphasis on population-level interventions that target strategies
for health promotion and disease prevention. In addition, public health nursing is
concerned with the health of all members of a population or community, particularly
vulnerable populations, and uses political processes as a major intervention strategy.
3. A public health nurse leader is encountering barriers when trying to shift the public
health agency's efforts to a population-focused practice. The reasons peers are not
supportive of the proposed shift to a population focus are most likely related to:
a. agency colleagues' push for nurses to focus on population initiatives.
b. costs associated with staff training and revision of documents.
c. lack of support from the agency's funding sources.
d. opinions that nursing should focus on the provision of direct client care and services.
- ANSWER-ANS: D
Barriers to implementing population-focused care include lack of understanding of the
public health nurse role and its relationship to other roles in nursing, such as direct care
and services; workplace role socialization that determines what roles are appropriate
and inappropriate or accessible and inaccessible for nurses; and lack of comprehensive
training at the graduate level in the disciplines basic to public health such as
epidemiology, biostatistics, community development, service administration, and policy
formation.
4. The role and goals of the community health nursing practice can best be described
as:
a. community-based interventions aimed at promoting, preserving, and maintaining the
health of populations residing in institutional facilities such as nursing homes.
b. education of nurses and other staff working in community-based and community-
oriented settings to improve the overall effectiveness of their programs to meet client
needs.
c. population-level strategies aimed at promoting, preserving, and maintaining the
health of populations through the delivery of personal health care services to
individuals, families, and groups in an effort to improve the health of the community as a
whole.
d. activities targeted at improving the health status of clients served by community-
based health service agencies such as hospice and home health agencies. - ANSWER-
ANS: C
Community health nursing practice is the synthesis of nursing theory and public health
theory applied to promoting, preserving, and maintaining the health of populations
,through the delivery of personal health care services to individuals, families, and
groups. The focus of community health nursing practice is the health of individuals,
families, and groups and the effect of their health status on the health of the community
as a whole (individual to families to groups to community flow). This is different from
public health nursing, which is the synthesis of nursing theory and public health theory
applied to promoting and preserving the health of populations. The focus of public
health nursing practice is the community as a whole and the effect that the community's
health status, including health care resources, has on the health of individuals, families,
and groups (community to groups to families to individual flow). Both community health
and public health nursing are considered to be community-oriented practices involving
free-living (noninstitutionalized) clients. Community-based nursing practice is setting
specific, and care is provided to clients where they live (home health or hospice nursing,
community-based clinic), work (occupational health nursing), and/or attend school
(school nursing). The emphasis of community-based nursing practice is acute and
chronic care (illness care) and the provision of comprehensive, coordinated, and
continuous services, usually within a specialty area.
5. A community-oriented nurse has identified obesity as a problem in the middle school.
The next step in a population-focused practice is to make information available about
the health of the middle school students. This describes the core public health function
of:
a. assessment.
b. assurance.
c. policy development.
d. research. - ANSWER-ANS: A
Assessment is a core function of public health and refers to systematically collecting
data concerning the population, monitoring the population's health status, and making
information available on the health of the community. In a community-oriented
approach, a nurse would apply both nursing and public health theory. In this case,
assessment would be the first step from the perspective of both theories. Because the
practice is population focused and community oriented, it would involve the assessment
of the community subpopulation of middle school children and the impact of obesity on
their overall health status.
6. The state public health agency has received multiple complaints regarding the
availability of elder transportation services to a specific county senior center. The state
agency assigns a public health nurse to work with the community to evaluate its
program for elder transportation services to publicly sponsored eldercare programs. The
public health core function applied is:
a. assurance.
, b. policy development.
c. primary prevention.
d. public transportation. - ANSWER-ANS: A
The public health core function of assurance focuses on the responsibility of public
health agencies to be sure that activities are appropriately carried out to meet public
health goals and plans. This involves making sure that essential community-oriented
health services are available and accessible, especially to vulnerable populations who
would otherwise not receive necessary services. Assurance also includes assisting
communities to implement and evaluate plans and practices.
7. A nurse planning a smoking cessation clinic for adolescents in the local middle
schools and high schools is providing:
a. community-oriented care.
b. community-based care.
c. secondary care.
d. tertiary care. - ANSWER-ANS: A
Community-oriented nurses emphasize health promotion, health maintenance, and
disease prevention, as well as self-reliance on the part of clients. Regardless of whether
the client is a person, family, or group, the goal is to promote health through education
about prevailing health problems, proper nutrition, beneficial forms of exercise, and
environmental factors such as the safety of food, water, air, and buildings.
8. A community-oriented nurse conducts home visits to new parents to assess the
health status of the infant, the parent-child relationship, the parents' knowledge
regarding the care of the infant, and the need for health department and social services
referrals to support the needs of the new parents and the infant. This can best be
described as an example of:
a. clinical community health practice.
b. community-based practice.
c. population-focused practice.
d. public health nursing. - ANSWER-ANS: A
Community-oriented nurses who provide direct care services to individuals, families, or
groups are engaging in a clinically oriented practice even when they apply concepts of
population-focused, community-oriented strategies along with their direct care clinical
strategies.
