Community/Public Health Nursing: Promoting the Health of Populations 8th Edition Test Bank
Chapter 01: Health: A Community View
Nies: Community/Public Health Nursing, 8th Edition
MULTIPLE CHOICE
1. Which statement 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.
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 18%
in 2018. 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 availability but will not necessarily be offering
any free services to Americans.
DIF: Cognitive Level: Understand (Comprehension)
2. Why is it important for nurses to lobby with politicians for changes to the health care system?
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 segment of health care providers.
d. Nurses are the only group that is employed both inside and outside of hospitals.
ANS: C
, Community/Public Health Nursing: Promoting the Health of Populations 8th Edition Test Bank
Nurses constitute the largest segment of healthcare workers; therefore, they are instrumental
in creating a healthcare delivery system that will meet the health-oriented needs of the people.
As the largest segment 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)
3. What conclusion can be drawn from examining where nurses are currently being employed?
a. There is a trend toward consolidation of health care into large central medical
centers.
b. There is an increased emphasis on health promotion and preventive 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.
ANS: B
The decline in the percentage of nurses employed in hospitals and the subsequent increase in
nurses employed in community settings suggests a shift in focus from illness and institution-
based care to health promotion and preventive care. This shift will likely continue into the
future as alternative delivery systems, such as ambulatory, home care, and hospice employ
more nurses. 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)
4. Which ethical belief is the basis of public health nursing?
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.
ANS: C
The mission of public health is social justice, which entitles all people to basic necessities
such as adequate income and health protection and accepts collective burdens to make it
possible. An overinvestment in technology and seeking of cures within the market justice
system has stifled the evolution of a health system to protect and preserve the health of the
population. Although individual autonomy and freedom of choice are important, so is the
recognition of collective responsibility in ensuring social justice, which entitles all people to
basic necessities.
, Community/Public Health Nursing: Promoting the Health of Populations 8th Edition Test Bank
DIF: Cognitive Level: Understand (Comprehension)
5. 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.
ANS: D
Although all responses are accurate, the primary problem is the emphasis on personal choices
in the Healthy People 2020 objectives. Emphasis on personal choices ignores the need for
community responsibility and action that addresses environmental or cultural restraints to
health.
DIF: Cognitive Level: Understand (Comprehension)
6. 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.
ANS: C
The ANA Code of Ethics promotes social reform by focusing on health policy and legislation
to positively affect accessibility, quality, and cost of health care. The code does not directly
address workplace issues, such as work schedules or need for overtime.
DIF: Cognitive Level: Understand (Comprehension)
7. 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 groups choosing actions to ensure safety and well-being.
ANS: D
The text stresses that health is not just the result of an individual’s choices, but choices and
actions of individuals, families, groups, and communities that lead to better health.
DIF: Cognitive Level: Understand (Comprehension)
8. How does community health nursing define community?
, Community/Public Health Nursing: Promoting the Health of Populations 8th Edition Test Bank
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. A group of persons who resolve a community concern
ANS: B
Community health nurses work with both geopolitical groups (within specific geographic
boundaries) and phenomenological groups (who have a common identity based on culture,
history, or goals). A particular phenomenological group may or may not have been a planned
group—that is, a group that came together to resolve a recognized common problem or to
meet a common goal. However, of all the choices, a group of persons who share a common
identity (phenomenological group) and environment (which implies a specific geographic
setting) is the broadest and most complete definition.
DIF: Cognitive Level: Understand (Comprehension)
9. 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
ANS: A
Individual behavior choices are responsible for about 50% of health outcomes responsible for
premature deaths. Individual choices are affected through interaction with other individuals,
and their mutual social and physical environments. The number of health care providers has
not played a major role in the health outcomes in the community in comparison to individual
health behaviors. The quality of public safety officers and number of public health officials
have not been identified as major contributors to the determinants of health.
DIF: Cognitive Level: Understand (Comprehension)
10. 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
ANS: D
Smoking is responsible for almost 20% of all deaths in the United States. Although smoking
is an individual’s choice, all people are affected by social norms. Parenting and sexual
behavior classes and legislative changes may influence health but may not necessarily lead to
a longer lifespan. Community health nurses should recognize that health is influenced by a
web of factors, some that can be changed and some that cannot. Influencing social norms may
better promote change among Americans.
DIF: Cognitive Level: Apply (Application)
11. What of the following is the health issue at the center of concern in the United States today?
a. Diabetes epidemic
