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Terms in this set (160)
Which best describes how care can be appropriately given in a community?
Consider the community itself as the "client."
Which provides the most accurate way to explain community health nursing?
Focusing care on the community as a whole
Which activity would be most helpful to a person in whom a serious chronic illness has been diagnosed?
Join a support group of others with the same illness.
Which is a major factor in determining which people or groups are most likely to be helpful to a particular individual?
Which best describes how people typically respond when asked of what community are they a member?
Geographic community (neighborhood or city)
Which best describes what community members receive from each other?
Socialization and role fulfillment
An individual lives in a healthy community. Which characteristic would this community most likely display?
Ability to adapt and respond to changes
A nurse is helping a community develop its capacity to address future problems. Which activity is the nurse most likely implementing?
Developing community competence
Which best describes shoe leather epidemiology?
Traveling throughout the community to absorb an overall impression of it
A community health nurse wants to obtain an overview of the community, but has limited time and resources. Which method would the nurse most likely use to obtain this information?
Engage in a windshield survey
Which best describes how the U.S. Census Bureau surveys are helpful to a community health nurse?
They provide the distribution of age, sex, race, and ethnicity in the community.
A public health nurse wanted statistics on the disability, illness, and other health-related variables for the state. Which would be the best resource for the nurse to obtain the most extensive data?
The National Center for Health Statistics
Which best describes when a community health nurse would try to collect data on a health issue?
When there is no source of previously collected data
All of the needed objective data on a specific health problem are available for the community health nurse. Which best describes why the nurse would also interview community residents about the health problem?
To obtain the residents' personal insights and beliefs about the problem
A nurse begins to collect information about a particular health problem from community residents. Which potential problem would most likely arise?
Residents might begin to expect service to be given to address the problem.
The nurse is interviewing community members as part of a community assessment. Which group of people would the community health nurse most likely want to interview?
Long-time residents who were informal leaders in the community
A nurse was debating about which approach to use to both obtain data about community needs and encourage community participation in their resolution. Which approach would be most effective in meeting both goals?
Establishing focus groups with selected participants
A community health nurse has completed a community assessment and is now writing a community diagnosis for the problem. Which component of the diagnosis will be used to summarize the assessment data of the problem?
Identification of the health risk
A community health nurse is trying to determine the success of a planned intervention. Which would the community health nurse most likely examine?
Current problem data to compare with original baseline data
A community health nurse found a very small number of families in the community who were desperately in need of basic preventive health services. Which ethical approach supports expending agency resources on these few, but needy, families?
Beneficence suggests focusing on the most needy, so resources should be expended on these families.
Which best describes the aspects central to the definition of community?
Geographic boundaries at a point in time
Persons who band together to address a shared problem
The name the people have given themselves
Which is a central function unique to community health nursing?
Gathering appropriate comprehensive assessment data on the community
Incorporating epidemiological approaches throughout the nursing process
Being willing to contribute to health policy development
Which are considered the most important determinants of a healthy community?
Low crime rate
Which from vital statistics records is useful to community health nurses?
Documentation of the mortality and morbidity of the local community
Indication of whether the total population is growing or declining
Records of occurrence of congenital malformations
Which best describes what Lillian Wald suggested in regards to providing care to individuals and families?
Public health nurses should recognize the larger social and economic forces that
the family cannot control.
Which best describes why it is important for the nurse to be knowledgeable about the community when providing care to individuals?
Individuals and families are strongly influenced by the community and environment around them.
Which best describes how the Health Planning Model for care of aggregates differs from the customary nursing process applied to the care of an individual?
The nurse must first decide on and define the aggregate to receive care.
A nurse is using a systems framework when caring for individuals, families, and aggregates in the community. Which best describes an aspect that would be more challenging when caring for an aggregate as opposed to caring for an individual?
Analyzing power and decision-making within the system
A nurse is caring for an aggregate as his or her client. Which task would the nurse complete first?
Identify the nurse's own strengths and preferences.
A nurse decided that a high-risk aggregate most needed education about diabetes. Which would be the best approach when teaching the group?
Involve participants in small group activities applying the information.
A community health nurse has determined that the number one priority is to help families in which one member has diabetes. Which action would be most appropriate to maximize services to persons with diabetes?
Meet with the diabetic organization to see how the public health department can augment what it is offering.
A nurse is determining the needs of a selected aggregate. Eight percent of the aggregate has diabetes. Which best describes the action that should be taken next to determine if this should be a priority?
Review the literature to determine the national and state diabetic rate.
A nurse has assessed an aggregate, determined the priority health needs, and decided on what intervention to offer. Which will best determine if the intervention will be successful?
Determination of the aggregate's perspective of the need for the intervention
Which action must a nurse take to be successful in addition to the typical assessment, diagnosing, and planning directly related to the intervention project?
Advocate for community empowerment throughout the process.
A nurse found that several professionals resented time spent interacting with and teaching clients. Which describes the most likely underlying motivation for resisting client involvement?
Empowering others shifts power from the experts to the community.
A nurse assessed carefully and created a comprehensive intervention plan including primary, secondary, and tertiary care for individuals and families. Which factor may the nurse have overlooked?
Are there adequate resources for such a project?
Which must be created before establishing the evaluation plan for a health project?
Observable and measurable objectives
A nurse had all the details carefully arranged for a project: location, speaker, seating arrangement, refreshments, handouts, visual aids, and students to distribute and collect evaluation sheets. Which aspect of the project may be a problem?
Something totally unexpected and unplanned for happened.
A nurse starts to collect evaluative data for a major health project one month after it starts. Which best describes the purpose of this data collection?
Formative evaluation allows the nurse to make changes if needed.
Which best describes where the majority of time is spent by a community health nurse?
Caring for individuals
Which best describes the principal outcome of the Hill-Burton Act?
Increased number of hospital beds
Which best describes the primary purpose of the Heart Disease, Cancer, and Stroke Amendments of 1965?
To increase the availability of high technology in health care
Which best describes a flaw of many of the health care bills passed during the last four decades?
They avoided interfering with the current health care approach and did not improve problems of access or duplication of efforts.
Which describes why the National Health Planning and Resources Development Act of 1974 was unsuccessful in its efforts to increase accessibility and acceptability, improve quality, and constrain rising costs?
The law did not affect the current health care delivery system.
Which best describes the first efforts at improving community health?
Environmental planning of water and sewer systems
Which is the most important component of the Planning Approach to Community Health (PATCH) model?
Community participation throughout the process
Which best describes the purpose of the Assessment Protocol for Excellence in Public Health (APEX-PH)?
An evaluation process involving both community and public organizations
Which is the most important phase of the Mobilizing for Action through Planning and Partnership (MAPP) model?
Mobilize the community to become involved
Which best describes why states will increasingly monitor and report on quality and cost of health care?
Congress has been unsuccessful in reducing health care costs.
Which approach has been suggested to improve the functioning of local and national health planning?
Increase nursing involvement.
Which best describes the provisions of the Affordable Care Act (ACA) of 2010?
It required all U.S. citizens to be covered by health insurance.
It prohibited insurance companies from denying coverage because of pre-existing
It reduced expenses for families by capping out-of-pocket expenses.
A nurse would like to quickly and easily learn more about an aggregate. Which sources of information would be best for the nurse to use to quickly and easily become informed about an aggregate?
Interview people who have previously been involved with the aggregate
Review any available records or previously gathered data
Try to find a few key informants and ask for their input
Which would be the most appropriate indicator for determining the needs of an aggregate?
Demand for services as seen in the behaviors of the chosen aggregate members
Experts' determination of what is needed in the situation
Obvious health disparities between the advantaged and disadvantaged populations
Verbalized expression of need from the chosen aggregate
A nurse has completed a community health project. Which actions must be performed by the nurse?
Ensure that adequacy and appropriateness of the intervention are measured.
Be certain the efficiency and cost benefits are measured.
Communicate follow-up recommendations to the community.
Which important events related to health care occurred during the Reagan administration?
Decrease in both federal control and federal funding
Implementation of Medicare funding based on diagnosis-related groups
Suggestions to shift costs and reduce costs
A nurse has instructed a client several times what he needs to do to get better, but the client has not followed these instructions. Which offers the best explanation for this behavior?
Barriers prevent action.
Which best describes one of the most fundamental nursing principles suggested by Nightingale?
Engage in health teaching.
Which best describes why health education in the community is more effective than health education in a hospital or clinic?
The setting is familiar and comfortable to participants.
A nurse is implementing a comprehensive and entertaining educational program. Which action must the nurse complete first?
Develop an open and trusting relationship with participants.
Which best describes why community health education programs are important?
It provides a way to reinforce voluntary behavior changes.
Which is most likely to determine if a health education program will create change?
Amount of input and participation by learners
A nurse is selecting goals for an educational program. Which method should be used?
The target audience must determine their needs and priorities.
A nurse is planning a health education program in the community. Which consideration must be made by the nurse?
The sociopolitical cultural context of the community's environment
Which is the best way to assess if learning has occurred?
There is a long-term change in knowledge and behavior.
Which led to the creation of the health belief model
Attempting to understand why people did not flock to free health care
Which needs to be considered when using the Health Belief Model (HBM)?
Which factor is found in the Health Belief Model (HBM) but not in Pender's Health Promotion Model (HPM)?
Personal threat as motivator
Which best describes the primary purpose of both the Health Belief Model (HBM) and Health Promotion Model (HPM) models?
To help explain why individuals do or do not engage in health actions
Which method is most consistent with Freire's approach to empowerment?
Encouraging active participation and dialogue in critical reflection
A nurse is teaching diabetic self-care in a small group. Which is the first action the nurse should take?
Listen carefully to understand participants' issues.
A nurse who is providing education spends more time being quiet than giving information. Which best explains this behavior?
The nurse is listening to the group's dialogue to identify problems.
Which best describes the goal of participatory action research?
Social change resulting from stakeholders' strategies
A nurse is asked, "Why are you so rarely in the department office?" Which would be the most appropriate response?
"I have to be where the people are."
A very busy day is planned at a community health fair, and a nurse spends time greeting and meeting each person who walks in. Which best describes the rationale for this action?
To immediately establish a friendly relationship and a level of trust
A nurse is trying to improve on providing culturally effective care in the community. Which behavior would be most effective to meet this goal?
Exhibiting sensitivity to individual differences resulting from culture and
A nurse is using the Framework for Developing Health Communications to create a health program in the community. Which is the first step the nurse would take?
Target the program to meet the audience's learning needs as they perceive them
A nurse wants to make sure that the teaching materials and the communication channels being planned for use during an educational program will be effective. Which action should the nurse take?
Pretest the materials with members of the target group to obtain feedback
Which best describes the operational definition of "health literacy" in the United States?
Knowing how to access and use information to make health decisions
When handed the consent form to sign before treatment could be given, a client looked at the nurse and said, "I'm sorry; I forgot my glasses today." Which action should be taken by the nurse?
Wonder if the patient might have difficulty with reading and therefore summarize the content of the form for the client
A nurse is trying to determine a client's reading level. Which action should be taken by the nurse?
Ask the client how he or she would rate his or her ability to read.
During a health education program, a nurse continues to ask questions and encourages
attendees to contribute examples from their own lives relevant to the discussion. Which best
describes the rationale for the nurse's action?
To allow the participants to learn by doing through active participation
A nurse is helping clients to change their behavior. Which would be most effective?
Counseling through the Ask, Advise, Assess, Assist, and Arrange approach
Which best describes what Knowles says is especially typical of adult learners?
Learning draws on the learner's previous life experiences.
Sharing experiences with others enriches and motivates learning.
They want information related to current developmental tasks.
Which can be found in both the Health Belief Model (HBM) and Pender's Health Promotion Model?
Cues to action
Which variables are missing from both the Health Belief Model (HBM) and Health Promotion Model (HPM)?
Ignoring the impact of being socially and politically disenfranchised
Inaccessibility of health services
Omitting the influence of social, structural, and physical environmental factors
A nurse involved with a community group told peers that the group was learning networking, negotiating, lobbying, and information seeking. Which provides the best explanation for why the nurse is not working toward a noticeable improvement in health status for the group?
There are ways that these skills will be useful throughout the participants' life span.
There are no immediate solutions to the current health problems in most communities.
A nurse is teaching a coworker about effective strategies to use when providing health education. Which suggestions would most likely be included?
Be encouraging and give positive feedback for helpful comments
Review and summarize the key points at periodic intervals
Incorporate demonstrations, illustrations, and real-life examples
Which statement best summarizes Lillian Wald's achievements?
She demonstrated how to improve health in communities.
Which statement best describes "thinking upstream"?
Modifying economic, political, and environmental factors
Which statement best describes a weakness of early nursing theories?
Most nursing theories focused on microscopic individual concerns.
Which best describes the primary purpose of nursing theory?
To improve nursing practice
A client did not attend the clinic for required follow-up care after his extensive surgery. Using the Health Belief Model, which would be the most appropriate conclusion for the nurse to make?
The health care system is not meeting the client's perceived needs.
Which assumption makes Orem's theory difficult to use?
That clients are able to control their environment
Which statement best describes the major assumption of the Health Belief Model (HBM)?
The major determinant of preventive health behavior is avoiding disease.
Which assumption of the Health Belief Model (HBM) is problematic?
People have both free will and access to health resources.
A nurse is using Milio's framework for prevention to improve the health of clients. Which would the nurse most likely implement?
Create appropriate national health policies.
A nurse is using Milio's approach when caring for a client. Which advantage will the nurse experience?
It will encourage the assessment of the personal and societal resources of the
Which health-related variable is examined by the critical theoretical perspective?
A nurse is using the critical theoretical perspective in daily nursing practice. Which activity would the nurse most likely complete?
Expose social values underlying the health care system.
A nurse is using Healthy People 2020 as a guide to improve the health and well-being of the community. Which strategy would the nurse most likely implement?
Address the root causes of health problems.
Which is most closely associated with morbidity and mortality outcomes?
A nurse has accepted a new position in a public health department. Which characteristic is crucial to the nurse's success?
Listening and showing respect
A nurse is using a macroscopic approach when providing care. Which would the nurse most likely demonstrate?
Providing testimony to legislators concerning proposed legislation
A nurse is using Milio's framework to promote healthy eating choices among members of the community. Which intervention would the nurse most likely implement?
Promote legislation to increase taxation on unhealthy food choices.
A nurse has a broad, aggregate focus when providing care to clients. Which best describes how this approach will help improve client outcomes?
Empowers decision-making based on both individual and community goals, needs, and priorities
Encourages allocation of time for population-focused preventive efforts
A community health nurse is using the Health Belief Model (HBM) as a basis for providing client care. Which best describes the problems associated with using the HBM?
It ignores the need to reduce health system barriers to action.
The choice and the burden for acting are entirely with the client.
A nurse is using the critical theoretical perspective in practice. Which best describes how the nurse would respond when a client suggests that the physician prescribe a widely advertised medication for tension and anxiety?
Can you tell me what is going on in your life right now?
What have you tried in the past to relieve tension and anxiety?
According to the critical theoretical perspective, which should be held responsible for many of the illnesses of Americans today?
Advertisers who market sugar- and fat-saturated food products
Alcoholic beverage manufacturers, marketers, and sellers
Manufacturers of products that increase morbidity and mortality
Tobacco manufacturers who sponsor sports events
A nurse reviewed information before meeting with the community residents who were attending a program on healthful living. Which best describes the action by the nurse?
A 50-year-old woman comes to the clinic for her first mammogram. Which best describes the action of this client?
Which is the best definition of health?
Complete state of well-being
A nurse was becoming frustrated. She had given her client extensive information on his health problem, but the client continued to be noncompliant in making needed changes. Which principle had the nurse forgotten?
Information, while necessary, will not motivate people to change.
The nurse working with a client to change behavior to maximize health asked the client to bring his family to the next visit. Which best describes why the nurse wants the family to come with the client?
To evaluate the family's approval of the proposed changes
A nurse is using the theory of reasoned action when working with a client to exercise on a regular basis. Which would be the easiest way for the nurse to determine if the client will engage in this activity?
The client's intention to exercise regularly
A nurse is using the theory of planned behavior when working with a client to change her behavior and improve her health. Which consideration should be made by the nurse?
The client's belief about factors that may facilitate or impede the behavior
Some people believe that the air within their workplace makes them ill. Which premises support this belief?
They consistently feel worse on workdays and weeks without holidays.
It is rumored that there is something in the workplace that is causing persons employed there to feel ill. Which action would be most appropriate for the nurse to take?
Assess the risk, including identifying any toxic substance.
Which risk factors are least subject to modification?
Which best describes why risk reduction is of such importance in the United States today?
The leading causes of death are all related to lifestyle choices.
Which is the cause of most preventable deaths in the United States?
A nurse is completing a health history with a client. Which question would be most important to include?
What kinds of tobacco do you use daily?
During a health history, the client looked confused and said, "But everybody drinks, like at parties and such. How much drinking do you think is too much?" Which would be most appropriate response by the nurse?
"Per day, no more than one drink for women and two drinks for men."
Which best describes the reason why so many Americans are obese?
For many people, caloric intake is more than needed for their physical activity.
Based on statistics, which group is probably more physically active?
A group of highly paid college graduates
A young couple is searching for a home in a new neighborhood. Which neighborhood would most likely promote a healthy lifestyle?
One with high walkability
Which factors have a profound, if sometimes unrecognized, impact on one's health?
Adequate resources to allow easy access to health services
Interpersonal relationships with family and friends
Local, state, and national policies
Physical neighborhood where one works and lives
A nurse is using Pender's model to explain what influences individuals to pursue health promotion activities. Which factors would be examined?
A belief that one can change one's behaviors
Environmental choices possible
The rewards one believes will result if action is taken
What one's family and peers believe should be done
A nurse is using the Health Belief Model to help a client improve lifestyle choices. Which interventions would the nurse most likely implement?
Examine the individual's perceptions of his or her health in relation to current
lifestyle behavior choices.
Review how lifestyle changes can reduce risk and improve the client's life.
Share statistics regarding the probability of health problems and their seriousness if
action is not taken.
Use communication channels to send reminders of action currently needed.
A nurse was becoming frustrated. It had been 2 weeks, and although the client had verbalized that the best time of day to take a 15-minute walk was early in the morning, the client had not begun to exercise. Which principles of the Transtheoretical Model had the nurse forgotten?
A decision to act always occurs before action begins.
Behavior change is difficult and takes time.
Which actions have been effective in reducing problems related to alcohol use?
Enforcement of ban on sales of alcohol to minors
Increased taxes on alcoholic beverages
A nurse asks a client how she has been sleeping. Which best describes the rationale behind this question?
Many adults report sleep problems or occasional lack of sleep.
Many important functions occur during sleep.
Which best describes the primary reason that Americans are concerned about health care?
Our national health care costs keep increasing.
A nurse has begun to lobby with politicians for changes to the health care system. Why is this involvement important?
Nurses are the largest segment of health care providers.
What conclusion can be drawn from examining where nurses are employed?
There is an increased emphasis on community-based health care.
Which ethical belief would be most helpful in the current health care crisis?
Emphasis should be on social justice and collective responsibility.
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?
Public policy emphasizes personal responsibility but ignores social and
environmental changes needed for well-being.
What responsibility does the American Nurses Association (ANA) Code of Ethics require of the nurse beyond giving excellent care to patients?
Support health legislation to improve accessibility and cost of health care.
What is the community health nursing definition of health?
Health is families and aggregates choosing actions to ensure safety and well-being.
How does community health nursing define community?
A group of persons who share a common identity and environment
Which variable has a major influence on a community's health?
Behavior choices made by persons in the community
What change could most effectively lead to a longer life span in Americans?
The belief that smoking is shameful and disgusting, as well as expensive,
becoming the social norm
What is the health issue causing the most concern in the United States today?
Increase in obesity
What factors are most responsible for the increasing length of life of Americans over the past 100 years?
Better nutrition and family planning options
Why would a public health nurse want to know about morbidity and mortality statistics on the local, state, and national level?
To be able to observe the community's statistics over time and compare the
community with other communities
How do public health efforts differ from medical efforts in improving the health of our citizens?
Medical care providers focus on disease diagnosis and management, whereas public health care providers focus on health promotion and disease prevention.
Which primary prevention would the school nurse choose to address the school's number of unwed pregnancies?
Convince the school board to allow sex education classes to include birth control
What would be the proper term for the action of the school health nurse arranging for all the students in the elementary school to receive H1N1 immunizations?
Which action would probably result in the largest change in health care outcomes for Americans?
Redirect a large portion of federal funding from acute care to health promotion activities.
Which task will be most helpful in meeting the public health agency's goals?
Actively participate in community agencies' collaborative action plan to meet the
community's health goals for the year.
A community health nurse is overwhelmed with all that needs to be done in one day. Which task could most easily be postponed?
Reviewing the most recent hospital patient data collected by the local college of
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 discharged the previous day and to give follow-up care (for overload pay). What kind of nursing would this nurse be doing?
Which task is most crucial for the community health nurse to do well?
Give testimony regarding proposed state health legislation.
A new public health nurse carefully assessed all the local mortality and morbidity data in preparation for making appropriate planning suggestions at a meeting next week. What other action is crucial before the nurse can feel prepared?
Meet members of the community to determine their culture and values.
Why are high-risk and vulnerable subpopulations identified by public health nurses before deciding on appropriate interventions?
Populations are not homogeneous, and resources are limited.
A nurse works hard to develop alliances among various community organizations toward improving health in the community. What are actions such as this called?
After completing a master's degree, a nurse took a course in marketing. Should the agency reimburse the nurse's tuition costs?
Yes, the nurse could use such information in social marketing for the agency.
Which factor is most responsible for differences in an individual's health?
Individual's education and income
What are the leading health indicators found in Healthy People 2020?
Health system issues
Physical and social environmental factors
What historically have been public health nurses' two most important priorities?
Engaging in political activity to improve living conditions
Working with the community to confront health issues and poverty
Based on Healthy People 2010, what are the two primary goals of Healthy People 2020?
Eliminate health disparities.
Increase quality and years of healthy life.
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