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FULL TEST BANK
Test bank For Community/Public Health Nursing:
Promoting the Health of Populations 8th Edition by
by Mary A. Nies ,Melanie McEwen
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Table of Contents
Chapter 01 Health-A Community View 1
Chapter 02 Historical Factors-Community Health Nursing in Context 12
Chapter 03 Thinking Upstream-Nursing Theories and Population-Focused Nursing Practice 23
Chapter 04 Health Promotion and Risk Reduction 31
Chapter 05 Epidemiology 40
Chapter 06 Community Assessment 52
Chapter 07 Community Health Planning, Implementation, and Evaluation 60
Chapter 08 Community Health Education 71
Chapter 09 Case Management 81
Chapter 10 Policy, Politics, Legislation, and Community Health Nursing 88
Chapter 11 The Health Care System 101
Chapter 12 Economics of Health Care 110
Chapter 13 Cultural Diversity and Community Health Nursing 122
Chapter 14 Environmental Health 133
Chapter 15 Health in the Global Community 141
Chapter 16 Child and Adolescent Health 149
Chapter 17 Women’s Health 162
Chapter 18 Men’s Health 175
Chapter 19 Senior Health 181
Chapter 20 Family Health 193
Chapter 21 Populations Affected by Disabilities 204
Chapter 22 Veterans Health 213
Chapter 23 Homeless Populations 223
Chapter 24 Rural and Migrant Health 233
Chapter 25 Populations Affected by Mental Illness 246
Chapter 26 Communicable Disease 255
Chapter 27 Substance Abuse 265
Chapter 28 Violence 278
Chapter 29 Natural and Man-Made Disasters 287
Chapter 30 School Health 297
Chapter 31 Occupational Health 309
Chapter 32 Forensic and Correctional Nursing 320
Chapter 33 Faith Community Nursing 328
Chapter 34 Home Health and Hospice 335Stuvia.com - The Marketplace to Buy and Sell your Study Material
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Chapter 01: Health: A Community View Nies: Community/Public Health Nursing, 8th Edition MULTIPLE CHOICE 1. Which statement best describes the primary reason tha t Americans are concerned about health care? a. Politicians are discussing how to improve health ca re. b. The media has provided mixed messages about the heal th 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 t he constantly increasing costs, which cannot be sustained. The costs of caring for the sic k accounted for the majority of escalating health care dollars, which increased from 5.7% of t he gross domestic product in 1965 to 18% in 2018. Politicians and the media both influence Am ericans’ perceptions about health care; however, they are not the primary reason why America ns are concerned. The new health care system will change the health care access and avail ability 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 politic ians 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 va rious units in our health care system. c. Nurses are the largest segment of health care provi ders. d. Nurses are the only group that is employed both insi de and outside of hospitals. ANS: C 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, nur ses are informed about the current health care system and all the problems that result from peo ple not seeking care until they are desperately ill. Nurses, as the American Nurses Asso ciation (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 o utside of hospitals, physicians and other health care providers are as well. Nurses are often m anagers, but managers often have other backgrounds, such as business administration. DIF: Cognitive Level: Understand (Comprehension) 3. What conclusion can be drawn from examining where nu rses are currently being employed? a. There is a trend toward consolidation of health car e into large central medical centers. ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Community/Public Health Nursing, 8th Edition (Nies, 2024)
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b. There is an increased emphasis on health promotion a nd preventive care. c. There is an obvious need to decrease health care co sts by cutting positions. d. Managed care organizations (MCOs) are employing nur ses 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 sh ift in focus from illness and institution- based care to health promotion and preventive care. T his shift will likely continue into the future as alternative delivery systems, such as amb ulatory, home care, and hospice employ more nurses. MCOs are employing nurses in many capa cities. Although hospitals are closing and acute care is increasingly found in central med ical 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 i n employment is expected. However, nurses are increasingly employed in community setti ngs as opposed to hospitals. This change reflects the move toward community-based care rathe r than hospital-based tertiary care. To help decrease the continued rise in health care cos ts, 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 nur sing? a. Emphasis should be on individual and corporation fre edom in the marketplace. b. Emphasis should be on individual autonomy and freedo m of choice. c. Emphasis should be on social justice and collective r esponsibility. d. Emphasis should be on the effectiv eness 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 ac cepts collective burdens to make it possible. An overinvestment in technology and seeki ng 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 freedo m of choice are important, so is the recognition of collective responsibility in ensurin g social justice, which entitles all people to basic necessities. 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 healt hy food choices? a. Emphasis on other lifestyle choices, such as not sm oking and minimal use of alcohol or drugs, is also needed. b. All of us must work together to make unhealthy behav iors socially unacceptable. c. It costs more to make healthy choices, such as buyin g and eating fresh fruits and vegetables as opposed to quick and cheap fast -food choices. d. Public policy emphasizes personal responsibility but i gnores social and environmental changes needed for well -being. ANS: D ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Community/Public Health Nursing, 8th Edition (Nies, 2024)
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Although all responses are accurate, the primary prob lem 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 Associ ation (ANA) Code of Ethics require of the nurse beyond giving excellent care to patients? a. Accept longer work schedules to ensure that professi onal 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 avai lable. c. Support health legislation to improve accessibility and cost of health care. d. Volunteer to work overtime as needed to ensure maxi mum quality of care. ANS: C The ANA Code of Ethics promotes social reform by foc using on health policy and legislation to positively affect accessibility, quality, and cos t 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 soci al 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 e nsure 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 commu nities that lead to better health. DIF: Cognitive Level: Understand (Comprehension) 8. 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 e nvironment c. A group of persons who work together to meet common goals d. A group of persons who resolve a community concern ANS: B ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Community/Public Health Nursing, 8th Edition (Nies, 2024)
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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 gro up may or may not have been a planned group—that is, a group that came together to resolv e 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 definitio n. 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 hea lth care providers and hospitals in the community c. Quality of the public safety officers (police office rs, firefighters, etc.) d. The number and credentials of public health official s in the community ANS: A Individual behavior choices are responsible for abou t 50% of health outcomes responsible for premature deaths. Individual choices are affected t hrough interaction with other individuals, and their mutual social and physical environments. T he number of health care providers has not played a major role in the health outcomes in th e community in comparison to individual health behaviors. The quality of public safety office rs and number of public health officials have not been identified as major contributors to th e 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 fede ral 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 b y social norms. Parenting and sexual behavior classes and legislative changes may influe nce health but may not necessarily lead to a longer lifespan. Community health nurses should r ecognize that health is influenced by a web of factors, some that can be changed and some th at 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 ce nter of concern in the United States today? a. Diabetes epidemic b. Increase in cardiac disease c. Increase in obesity d. Rise in cancer rates ANS: C ______________________________________________________________________________________________
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The widespread increase in incidence of overweight and obesity has led to calls for population-based measures to address this issue. Th e overarching problem of obesity has led to an increase in diabetes as well as cardiac disea se. If this health issue was controlled, there should be in a decrease in the other health issues. DIF: Cognitive Level: Understand (Comprehension) 12. What factors are most responsible for the increasin g 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 fa t in the diet c. Improved medical care, includ ing exciting new technologies d. More efficient cancer screenings and early interven tion ANS: A Average increased life span over the past 100 years can be largely attributed to higher standards of living, better nutrition, a healthier e nvironment, and having fewer children. Public health efforts such as immunization and medi cal care have also contributed. DIF: Cognitive Level: Understand (Comprehension) 13. Why would a public health nurse want to know about m orbidity 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 ove r time and compare the community with other communities c. To justify local budgets and the need for increased i ncome from citizens d. To publicize current health issues and suggest appro priate actions to citizens ANS: B Although being informed and being able to educate the public is always preferred and nurses often do have to justify budgets, data are needed to compare the local community with itself over time and with other communities so that problem s may be recognized and action taken to confront health issues. The first step is always to recognize problems as they develop. DIF: Cognitive Level: Apply (Application) 14. How do public health efforts differ from medical eff orts in improving the health of our citizens? a. Medical care providers autonomously choose appropria te interventions, whereas public health care providers must engage in whatever actions legislation requires. b. Medical care providers are self-employed or agency e mployed, whereas public health care pro viders are employed by and paid through the governmen t. c. Medical care providers focus only on individuals, wh ereas public health care providers focus only on aggregates. d. Medical care providers focus on disease management a nd cure, whereas public health care providers focus on health promotion and dise ase prevention. ANS: D ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Community/Public Health Nursing, 8th Edition (Nies, 2024)
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Contrasting with “medical care,” which focuses on d isease management and “cure,” public health efforts focus on health promotion and disease prevention. Medical care providers are restricted by insurance and government regulations. Providers may also be employed in government facilities, such as Veterans Administrat ion facilities. Although medical care providers primarily focus on individuals and public h ealth care providers primarily focus on aggregates, their practice is not limited to only in dividuals or only aggregates. DIF: Cognitive Level: Understand (Comprehension) 15. Which primary prevention would the school nurse choos e 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 cla sses to include birth control measures. c. Employ the moms-to-be as 1-hour-a-day employees in the school daycare center for children born to school students. d. Establish a class where all the unwed moms -to-be can learn infant care. ANS: B Primary prevention relates to activities directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for su sceptible individuals. Primary prevention consists of two elements: general health promotion a nd specific protection. Health promotion efforts enhance resiliency and protective factors an d target essentially well populations. Specific protection efforts reduce or eliminate risk factors. Although all choices would be appropriate actions in a school, only education reg arding sexuality and birth control would help prevent future pregnancies. DIF: Cognitive Level: Apply (Application) 16. What would be the proper term for the action of the s chool health nurse arranging for all the students in the elementary school to receive H1N1 i mmunizations? a. Health education b. Secondary prevention c. Specific protection d. Tertiary prevention ANS: C Immunizations are a specific protection effort as par t of primary prevention. Primary prevention relates to activities directed at prevent ing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals. Primary prevention consists of two elements: general health promotion and specific p rotection. Health promotion efforts enhance resiliency and protective factors and target essentially well populations. Specific protection efforts reduce or eliminate risk factors . Secondary prevention refers to early detection and prompt intervention during the period o f early disease pathogenesis. Tertiary prevention targets populations that have experienced disease or injury and focuses on limitation of disability and rehabilitation. Health education would relate to educating the students about the immunization not making the arra ngements for the immunization to be given. DIF: Cognitive Level: Understand (Comprehension) ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Community/Public Health Nursing, 8th Edition (Nies, 2024)
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Distribution of this document is illegalWant to earn $1.236 extra per year? Stuvia.com - The Marketplace to Buy and Sell your Study Material 17. Which action would probably result in the largest ch ange in health care outcomes for Americans? a. Establish large numbers of scholarships for educati on of nurses, physicians, and other health care providers. b. Fund a one-time extremely large stimulus to allow a ll health care providers and agencies to create and integrate computer network s ystems 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 acu te care to health promotion activities. ANS: D Of the choices given, health promotion activities wo uld make the largest difference. Increased expenditures on acute care will not notably change the health of the population, whereas funding that addresses health promotion such as educ ation and safe environments would improve the health of the aggregate. DIF: Cognitive Level: Understand (Comprehension) 18. Which task will be most helpful in meeting the public health agency’s goals? a. Complete staff evaluations in preparation for indivi dual meetings to plan their agency and individual goals for the next year. b. Actively participate in community agencies’ collabor ative action plan to meet the community’s health goals for the year. c. Meet with the college of nursing faculty to finaliz e student objectives and schedules for the next semester. d. Teach a free course in healthful living for communi ty residents . ANS: B Although all tasks may be necessary and important, i ntra-agency cooperation to meet the health goals of the community as a whole is more ce ntral to the agency’s mission than other choices that meet the needs of individuals or group s rather than the community as a whole. DIF: Cognitive Level: Analyze (Analysis) 19. A community health nurse is overwhelmed with all th at needs to be done in one day. Which task could most easily be postponed without directly affecting health promotion and disease prevention outcomes? a. Reviewing the most recent hospital patient data coll ected by the local college of nursing b. Deciding which of several possible new clinic option s 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 ANS: A ______________________________________________________________________________________________
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All of the tasks are related to assessing needs, im plementing new care options, or evaluating health outcomes measures in the community except re viewing hospital patient data. Hospital patient data may be helpful but not directly related to the agency’s ability to promote primary health and prevent disease. DIF: Cognitive Level: Analyze (Analysis) 20. 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 discha rged the previous day and to give follow-up care (for overload pay). What kind of nurs ing would this nurse be doing? a. Acute care hospital nursing b. Community -based nursing c. Community health nursing d. Public health nursing ANS: B The nurse is caring for a patient in the home. Comm unity-based nursing is nursing somewhere in the community. Community-based nursing practice r efers to “application of the nursing process in caring for individuals, families and gro ups where they live, work or go to school or as they move through the health care system” (McEwe n and Pullis, 2009, p. 6). Community-based nursing is setting specific, and th e emphasis is on acute and chronic care and includes such practice areas as home health nurs ing and nursing in outpatient or ambulatory settings. As the nurse is not focusing o n the health of the community but on an individual, it is not community or public health nur sing. It is not acute care hospital nursing because the nurse is seeing the patient in his or he r home. DIF: Cognitive Level: Understand (Comprehension) 21. Which task is most crucial for the community health nurse to do effectively? a. Review the most recent morbidity and mortality data . b. Create a new clinic to better meet local health need s. c. Evaluate the results of the recent screening program . d. Give testimony regarding proposed state health legis lation. ANS: D Public health’s core functions are assurance, asses sment, and policy development. Giving testimony regarding legislation directly reflects po licy development, which would have a wider impact than the other options, which are more local and narrower in focus. DIF: Cognitive Level: Analyze (Analysis) 22. A novice public health nurse carefully assessed all the local mortality and morbidity data in preparation for making appropriate planning suggesti ons 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 com munity’s needs. b. Assess the nurse’s own assets, strengths, and ability to contribute. c. Meet members of the community to determine their cu lture and values. d. Review discussions and decisions from previous meeti ngs. ANS: C ______________________________________________________________________________________________
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