Community Health Nursing: Test Bank Exam Questions and Complete Solutions, Exams of Nursing

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Community Test 1 - Test Bank Exam Questions and Complete Solution [Document subtitle] Denning [Date] [Course title]

3. Which of the following is the primary focus of public health nursing? a. Families and groups b. Illness-oriented care c. Individuals within the family unit d. Promotion of quality of life - Correct Answer ANS Correct Ans: D The key difference between community-based and community-oriented nursing is that community- based nurses deal primarily with illness-oriented care, whereas community-oriented nursesor public health nursesprovide health care to promote quality of life.
4. Which of the following best describes community-based nursing? a. A philosophy that guides family-centered illness care b. Providing care with a focus on the groups needs c. Giving care with a focus on the aggregates needs d. A value system in which all clients receive optimal care - Correct Answer ANS Correct Ans: A By definition, community-based nursing is nursing that focuses on family-centered illness care to individuals and families in the community.
5. Which of the following best describes community-oriented nursing? a. Focusing on the provision of care to individuals and families

b. Promote healthy lifestyle behavior choices among the community members. c. Encourage employers to have wellness centers at each industrial site. d. Ensure timely and effective medical intervention and treatment for community members. - Correct Answer ANS Correct Ans: B Public health approaches could help prevent about 70% of early deaths by influencing the way people eat, drink, drive, engage in exercise, and treat the environment.

6. Which of the following is a basic assumption of public health efforts? a. Health disparities among any groups are morally and legally wrong. b. Health care is the most important priority in government planning and funding. c. The health of individuals cannot be separated from the health of the community. d. The government is responsible for lengthening the life span of Americans. - Correct Answer ANS Correct Ans: C Public health can be described as what society collectively does to ensure that conditions exist in which people can be healthy.
7. Which of the following actions would most likely be performed by a public health nurse? a. Asking community leaders what interventions should be chosen b. Assessing the community and deciding on appropriate interventions

c. Using data from the main health care institutions in the community to determine needed health services d. Working with community groups to create policies to improve the environment - Correct Answer ANS Correct Ans: D Although the public health nurse might engage in any of the tasks listed, he or she works primarily with members of the community to carry out core public health functions, including assessment of the population as a whole and engaging in promoting health and improving the environment.

8. Which of the following public health nurses most clearly fulfills the responsibilities of this role? a. The nurse who met with several groups to discuss community recreation issues b. The nurse who spent the day attending meetings of various health agencies c. The nurse who talked to several people about their particular health concerns d. The nurse who watched the city council meeting on local cable television - Correct Answer ANS Correct Ans: B Any of these descriptions might represent a nurse communicating, cooperating, or collaborating with community residents or groups about health concerns. However, the nurse who spent the day attending meetings of various health agencies is the most representative, because in public health, concerns are broader than recreation, individual concerns are not as important as aggregate priorities, and watching television (a one-way form of communication) is less effective than interacting with others.
9. Which of the following best defines aggregate? a. A large group of persons b. A collection of individuals and families

d. Scientific knowledge-based care - Correct Answer ANS Correct Ans: C Public health is based on scientific knowledge but is not a core function. The definition does not fit the terms assessment or policy development.

12. When talking to a womens group at the senior citizens center, the nurse reminded them that the only way the center would be able to afford to provide transportation services for them would be for them to continue to write letters to their local city council representatives requesting funding for such a service. What was the nurse trying to accomplish through this action? a. Ensure that the women did not expect the nurse to solve their problem b. Demonstrate that the nurse understood the womens concerns and needs c. Express empathy, support, and concern d. Help the women engage in political action - Correct Answer ANS Correct Ans: D Public health nurses engage themselves and others in policy development and encourage and assist persons to communicate their needs to those with the power to take action.
13. The public health nurse has a clear vision of what needs to be done and where to begin to improve the health of the community. Why would the nurse spend time meeting with community groups to discuss the most important task to be addressed first? a. To increase the groups self-esteem b. To maintain communication links with the groups c. To make the groups feel good about their contribution

d. To work with the groups, not for the groups - Correct Answer ANS Correct Ans: D Historically, health care providers have been accused of providing care for or to people without actually involving the recipients in the decisions. Public health nursing is a with the peoplenot a to the people or for the peopleapproach to planning.

14. The nurse often has to make resource allocation decisions. Which of the following best describes the criterion the nurse should use in such cases? a. The specific moral or ethical principle related to the situation b. The cheapest, most economical approach c. The most rational probable outcome d. The needs of the aggregate rather than a few individuals - Correct Answer ANS Correct Ans: D Although all of the choices represent components of a decision that the nurse might consider, the dominant needs of the population outweigh the expressed needs of one or a few people.
15. Which of the following actions best represents public health nursing? a. Assessing the effectiveness of the large high school health clinic b. Caring for clients in their home following their outpatient surgeries c. Providing care to children and their families at the school clinic

d. Threat of bioterrorism - Correct Answer ANS Correct Ans: B, C, D As overall health needs become the focus of care in the United States, a stronger commitment to population-focused services is emerging. Threats of bioterrorism, anthrax scares, and the emergence of modern-day epidemics have drawn attention to population-focused safety and services.

2. Which of the following actions demonstrate(s) effective public health nursing practice in the community? (Select all that apply.) a. Epidemiologic investigations examine the environment for health hazards. b. New services are organized where particular vulnerable populations live. c. Partnerships are established with community coalitions. d. Staff members at the public health agency continue to increase in number. - Correct Answer ANS Correct Ans: A, B, C Evidence that public health nurses are practicing effectively in the community would include these Correct Ans: organizing services where people live, work, play, and learn; working in partnerships and with coalitions; and participating in epidemiologic studies.
3. Why are nurses increasingly providing care in clients homes rather than in hospitals? (Select all that apply.) a. Home care is less expensive. b. It is much more efficient to give care in the home. c. Nurses prefer to give home care with individual attention.

d. People prefer to receive care in their homes rather than in hospitals. - Correct Answer ANS Correct Ans: A, D An increasing number of clients are receiving care in the home because it is less expensive and clients prefer to receive care in familiar and comfortable settings. It is not more efficient nor more convenient, since travel time has to be considered. Nurses differ as to their preferred employment setting.

1. A nurse is using analytic epidemiology when conducting a research project. Which of the following projects is the nurse most likely completing? a. Reviewing communicable disease statistics b. Determining factors contributing to childhood obesity c. Analyzing locations where family violence is increasing d. Documenting population characteristics for healthy older citizens - Correct Answer ANS Correct Ans: B Epidemiology refers not only to infectious epidemics but also to other health-related events. Analytic epidemiology looks at the etiology (origins or causes) of disease.
2. A nurse is employed as a nurse epidemiologist. Which of the following activities would most likely be completed by the nurse? a. Eliciting the health history of a client presenting with an illness b. Evaluating the number of clients presenting with similar diseases c. Performing a physical examination of an ill client

d. Specialization isnt possible in the community setting. - Correct Answer ANS Correct Ans: C In the community, nurses often use epidemiology, since the factors that affect the individual, family, and population group cannot be as easily controlled as in acute care settings. It is essentially impossible to control the environment in the community.

5. Several small communities have applied for grant funding from the state department of health to help decrease their teenage pregnancy rate. Which of the following communities should the nurse suggest receive funding first? a. Community Awith 23 single teenage pregnancies in a city of 500 b. Community Bwith 45 single teenage pregnancies in a city of 1000 c. Community Cwith 90 single teenage pregnancies in a city of 2000 d. Community Dwith 90 single teenage pregnancies in a city of 1500 - Correct Answer ANS Correct Ans: D Without doing any actual math, it should be fairly obvious that 23 Correct Ans:500, 45 Correct Ans:1000, and 90 Correct Ans:2000 are all about the same proportion but that 90 Correct Ans:1500 is a larger proportion. Doing the math, the pregnancy rates of A, B, and C are 45-46 Correct Ans:1000, whereas the rate in Community D is 60 Correct Ans:1000.
6. Between 2000 and 2005, 1000 of 10,000 young women ages 17 to 20 years at a university tested positive for a sexually transmitted infection (STI). Of the 1000 diagnosed STIs, 300 were gonorrhea and 500 were chlamydia. Which of the following statements best summarizes these findings? a. The proportion of cases of gonorrhea to all STIs was 300 Correct Ans:1300. b. The proportion of cases of gonorrhea to chlamydia was 300 Correct Ans:500. c. The proportion of cases of gonorrhea to all STIs was 50%.

d. The proportion of STIs to the total population was 100 Correct Ans:1000. - Correct Answer ANS Correct Ans: D A proportion is a ratio in which the denominator includes the numerator. If the proportion is small, we can express the number per 1000. The answer of 300 Correct Ans: 1300 adds the total of the numerator to the denominator, which is unnecessary because the gonorrhea cases were already included in the denominator. In the answer of 300 Correct Ans:500, the ratio comparing gonorrhea to chlamydia does not meet the epidemiological definition of proportion (i.e., the denominator must contain the numerator). Although proportions may be expressed as percentages, in the answer of 50% the percentage reflects the number of gonorrhea cases to all STIs, which doesnt summarize the total STI problem. The answer of 100 Correct Ans:1000 correctly summarizes that 1000 of 10,000 (or 100 Correct Ans:1000) young women had the problem.

7. The nursing staff has attempted to screen the entire African-American population in the community for diabetes. Which of the following would provide immediate verification of the success of the nursing staffs efforts? a. An epidemic of diabetes will be recognized. b. The incidence of diabetes will increase in the community. c. The prevalence of diabetes will decrease in the community. d. The risk for diabetes in the community will increase. - Correct Answer ANS Correct Ans: B If the screening has been successful, more diabetes will be diagnosed and, hopefully, treated. Thus, the incidence of new cases will increase. Overall, prevalence will also increase, but that is not one of the answer options.
8. In a particular community, several high school students were diagnosed with diabetes mellitus Type 2 during the annual high school health fair. Over the next few years, the nursing staff developed and implemented educational programs about the risk factors for diabetes mellitus Type 2 and proper

are new cases (incidence), but the results do represent all cases (prevalence). Risk is the probability of developing an STI, but no risk factors are discussed.

10. A nursing staff has successfully screened for diabetes in the community. Which of the following might best persuade the health board to increase funding for diabetic clinics in this community? a. An epidemic of diabetes is now recognized and must be addressed. b. The incidence of diabetes is now higher than previously recognized in the community. c. The prevalence of diabetes is now higher than previously recognized in the community. d. The risk for diabetes in the community could decrease if funding is received. - Correct Answer ANS Correct Ans: C If more people are now being diagnosed with diabetes and need support, more ongoing services will be needed for this population. Incidence may go up and down, but prevalence is a fairly stable number.
11. A public health nurse found that out of the 70 people who ate the potato salad at a school picnic, 63 developed symptoms of food poisoning. Which of the following best describes the attack rate? a. 63% b. 70% c. 90% d. 100% - Correct Answer ANS Correct Ans: C The attack rate is the proportion of persons exposed to an agent who develop the disease. Because 63 of the 70 persons became ill, the attack rate is 63 Correct Ans:70, or 90%.

12. A man is diagnosed with prostate cancer. Which of the following data should the nurse know to answer the man when he asks, What are the chances Ill survive this thing? a. Attack rate b. Case fatality rate c. Cause-specific morbidity rate d. Crude mortality rate - Correct Answer ANS Correct Ans: B The case fatality rate (CFR) is the proportion of persons diagnosed with a particular disorder (i.e., cases) who die within a specified period. The CFR is considered an estimate of the risk for death within that period for a person newly diagnosed with the disease. Persons diagnosed with a particular disease often want to know the probability of surviving. The CFR provides that information.
13. Which of the following statistics is used by countries to compare the success of their health care systems? a. Attack rate b. Infant mortality rate c. Cause-specific morbidity rate d. Cause-specific mortality rate - Correct Answer ANS Correct Ans: B Infant mortality is used around the world as an indicator of overall health and availability of health care services.

16. Which of the following actions would a nurse take to reduce the high incidence of coronary artery disease (CAD) in a community? a. Introduction of a heart-healthy curriculum beginning in the first grade, presentations on diet and exercise for the community at large, and special education sessions for high-risk populations b. Provision of online activities related to prevention of cardiac disease, smoking reduction programs, and blood pressure screenings c. Distribution of handouts, including age-appropriate games, self-assessments, and education on heart- healthy lifestyles; availability of community screenings for hyperlipidemia in persons age 35 and older; and walking programs for those affected with CAD d. Enrollment of clients with CAD into cardiac rehabilitation programs, routine evaluation of effectiveness of CAD treatment regimens, and participation in clinical trials that evaluate interventions for tho - Correct Answer ANS Correct Ans: C Education in schools, the community, and high-risk populations focuses only on primary prevention activities. Online activities focus only on primary and secondary prevention. Efforts focused only on those who already have CAD are not primary prevention. Distributing handouts includes all three levels of prevention to target all members of the population. Targeting all members of the population and implementing all levels of prevention increase the likelihood of positive outcomes for the community as a whole.
17. A school nurse wants to decrease the incidence of obesity in elementary school children. Which of the following describes a secondary prevention intervention that the nurse could implement? a. Giving a presentation on the importance of exercise and physical fitness b. Designing a game in which students select healthy food choices c. Weighing students to identify those who are overweight

d. Putting students on a diet if they weigh greater than 20% of their ideal weight - Correct Answer ANS Correct Ans: C Secondary prevention refers to interventions that increase the probability that a person with a condition will have the condition diagnosed early. Health screenings are the mainstay of secondary prevention. Weighing students and assessing whether the weight is higher than recommended will allow for early intervention so that obesity may be avoided.

18. A nurse advises a client with osteoporosis to have three servings of milk or dairy products daily. Which of the following levels of prevention is being used by the nurse? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Treatment, but not prevention - Correct Answer ANS Correct Ans: C Interventions that prevent worsening of a condition are tertiary prevention activities. In this instance, the client already has a health problem (osteoporosis). By advising adequate dairy intake, the nurse aims to ensure that enough calcium is available to limit worsening of the osteoporosis.
19. A nurse has only a regular blood pressure cuff when conducting a health screening for all of the residents of a community. Which of the following may be lacking when obtaining blood pressure readings? a. Reliability b. Sensitivity