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Community Exam 4

Terms in this set (72)

Public health nursing
is the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences.
public health nursing
- A focus on the health needs of an entire population
- Assessment of population health using a comprehensive, systematic approach
- Attention to multiple determinants of health
- An emphasis on primary prevention
- Application of interventions at all levels—individuals, families, communities, and the systems that impact their health
Policy competence
means understanding policy and the policy process sufficiently to be able to exert influence on the process and impact policy
Policy analysis
is the technique of understanding a policy from a variety of perspectives.
the rational framework
1. The more clear and measurable this problem definition is, the more specific any policy response can be.
2. The second step in this framework is to understand possible solutions to this policy problem and compare and contrast them to each other in order to determine which is optimal in terms of being politically feasible, easily implemented, and likely to result in the desired outcome.
3. The third step, based on comparing and contrasting the possible policy alternatives, is to select an alternative, implement it, and evaluate for its effectiveness
Kingdon's Framework
Addresses the question of why some issues & not others come to the forefront in policy development
timing of current events
window of opportunity
window of opportunity
period of time in which you have to act before a business opportunity is lost
stake holders
any persons or groups who will be affected by an action
social justice
- is seen as the very foundation of community/public health and C/PHN
- The American Association of Colleges of Nursing (2017) emphasizes that the guiding values of nursing include social justice at all levels of educational preparation, and the ANA Code of Ethics with Interpretive Statements (2015, preface) states that nurses should "act to change those aspects of society that detract from health and wellbeing."
advocacy
can be defined as pleading the case of another or championing a cause
Advocacy can present itself in a variety of ways:
- Self-advocacy: advocating for oneself
- Individual advocacy: pleading the case of others
- Community/public health advocacy: creating awareness of, and generating support for meeting, the community's health needs
- Legislative advocacy: changing or modifying local, state or federal laws
professional advocacy
advocacy on behalf of the profession itself
ANA, AACN, NLN.
Polarization
is the process by which a group is severely split into two or more factions over a political issue. Polarization can be so intense that people perceive one another as good or wicked, depending on their ideological opinions.
Four key messages from The Future of Nursing: Leading Change, Advancing Health (IOM, 2011, p. 4) include the following:
Nurses should:
1. Practice to the full extent of their education and training
2. Achieve higher levels of education and training that promote seamless academic progression
3. Be full partners in redesigning health care
4. Be part of health care policy and planning using data collection and an improved information infrastructure to inform decision making
basis of public health nursing
primary prevention, and social justice, is the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences.
A nurse is reviewing upstream focus of how water is regulated in the community. Which concepts are important to consider in environmental health nursing? Select all that apply.
Chronic health problems
Social determinants of health
Health disparities
Lifestyle factors
Environmental factors
Social determinants of health
Health disparities
The nurse is investigating health hazards, completing surveillance of health issues, and examining causes. The nurse is involved in which core public health function?
Policy development
Assessment
Assurance
Implementation
Assessment
A work environment that is safe and healthy is a right assured to all nurses by:
ecology model for public health.
environmental principles for public health nursing.
the American Nurses Association Scope and Standards of Nursing Practice.
the ANA Principles of Environmental Health for Nursing Practice.
the ANA Principles of Environmental Health for Nursing Practice.
How can the community health nurse best demonstrate collaboration with other professionals to help affect good community health?
Agreeing to respond to a survey that is attempting to identify local community health issues related to water quality
Signing a petition to restrict tobacco smoking in and within 50 feet of the entrance of public buildings
Assuming leadership of a task force to identify environmental health issues related to urban living
Volunteering to take blood pressures at a conference that focuses on community involvement
Assuming leadership of a task force to identify environmental health issues related to urban living
A client states, "My baby always eats the food her grandparents bring from Mexico." When considering environmental health risks, how should the nurse respond?
"Microwaving the food before feeding it to her will help kill any bacteria."
"Let's talk about how safe food is grown and preserved."
"I'd be concerned about the safety of foods coming from outside the United States."
"Be sure to wash the produce well before giving it to her."
"Let's talk about how safe food is grown and preserved."
Where can the nurse look for current guidance regarding health goals that focus on outdoor air quality?
ANA Principles of Environmental Health for Nursing Practice
Healthy People 2020 Environmental Health objectives
Environmental health principles for public health nursing
Association of Community Health Nursing Educators
Healthy People 2020 Environmental Health objectives
A public health nurse is developing a program to improve heart health in the community. On which actions would the nurse focus if using an "upstream approach"? Select all that apply.
Assessing unhealthy food choices in school
Promoting healthy diets
Evaluating available walking and bike paths and exposure to secondhand smoke
Encouraging increased physical activity and smoking cessation
Educating on cancer screening
Assessing unhealthy food choices in school
Evaluating available walking and bike paths and exposure to secondhand smoke
The nurse is working with a family who obtains its meat by hunting game. While identifying health issues, how can the community health nurse demonstrate cultural sensitivity best?
Inquiring about the cultural values that support the custom of hunting their own meat
Accepting as a gift the meat they have killed and preserved
Sharing concerns about the process used to preserve and cook the meat they eat
Discussing their beliefs about the preserving of the meat they eat
Discussing their beliefs about the preserving of the meat they eat
Which nursing intervention by a community health nurse focuses on environmental justice for low-income families with children at risk for developmental delays?
Providing the families with vouchers for produce from local farmers' markets
Educating the parents to the opportunity for free well-baby health care at the local clinic
Having the paint used in older homes and apartments tested for its lead content
Encouraging heating assistance vouchers of low-income families with children
Having the paint used in older homes and apartments tested for its lead content
Which statement, when made by the nurse, demonstrates the precautionary principle?
"Try to avoid air pollution because it can trigger asthma attacks."
"You need to have the well water tested before drinking it."
"Eat a low-fat diet for good heart health."
"You need to avoid breathing secondhand smoke."
"You need to have the well water tested before drinking it."
The statement "Bad air causes bad lungs" demonstrates environmental health from the:
upstream approach.
epigenetics standpoint.
ecologic perspective.
sustainability aspect.
ecologic perspective.
A community health nurse is planning a neighborhood awareness program that focuses on the health risks caused by illegal drug use. The nurse demonstrates an understanding of the principle of participation and its effect on change by first:
inviting members of the community, teachers, clergy, health care professionals, and police to serve on the planning committee.
securing a promise from at least half of the neighborhood's residents to participate in the various activities.
planning a media campaign to convince the residents that change is possible and attainable.
petitioning the local government to provide the money necessary to stage the planned event.
inviting members of the community, teachers, clergy, health care professionals, and police to serve on the planning committee.
What is the primary reason that a nurse carefully selects the information that will be presented to members of a postmyocardial infarction (Ml) support group regarding changes they will be encouraged to make in their current lifestyle?
There is a tremendous amount of misinformation on the topic out there.
The members will need to understand why the changes will be beneficial to them.
There will be only a very limited amount of time for this discussion to occur.
People often experience short attention spans during their post-MI period.
The members will need to understand why the changes will be beneficial to them.
Which is the best way to handle unexpected challenges when teaching a special needs client?
Set limits and expectations prior to beginning the learning session.
Prepare in advance to deal with a variety of common challenges.
Assure the client that learning is the primary goal.
Be firm but flexible when problems occur.
Prepare in advance to deal with a variety of common challenges.
Knowledge-level learning is best suited for which client?
A 5-year-old child who is learning about crossing the street safely
A 20-year-old client who must decide how to make up of a missed dose of medication
A 10-year-old client who needs to describe when the cast is too tight
A 15-year-old client being taught to help manage the type 1 diabetes
A 5-year-old child who is learning about crossing the street safely
When considering a change, the nurse understands the importance of selecting the appropriate goal. Which should the nurse ask?
"Is this something I can really do?"
"How much time will it take to implement this change?"
"What makes me think this will solve the problem?"
"How will I determine if the goal is met?"
"Is this something I can really do?"
A nurse is preparing to teach a prenatal class about maintaining a healthy diet during pregnancy. Which factors should the nurse consider when teaching about this topic? Select all that apply.
Expectations of the learners
Learning styles
Educational background
Motivation for learning
Evaluation of learned concepts.
Learning styles
Educational background
Motivation for learning
The planned change process is as follows:
(1) recognize symptoms, (2) diagnose need, (3) analyze alternative solutions, (4) select a change, (5) plan the change, (6) implement the change, (7) evaluate the change, and (8) stabilize the change
A key consideration to achieving a successful change is that it must:
have a purpose and be planned.
save resources and inspire hope.
easily implemented and timely.
be popular and economic.
have a purpose and be planned.
Which activity is considered the basis of community health nursing practice?
Attending a political rally for a pro health candidate running for local office
Belonging to a community taskforce that is researching health risks among urban poor
Surveying the health needs of newborns from minority populations
Teaching a group of older adults how to personalize an appropriate exercise routine
Teaching a group of older adults how to personalize an appropriate exercise routine
Which statement would be heard during the unfreezing stage of change?
"I really want to stop smoking."
"I've gotten a prescription to help me stop smoking."
"I haven't smoked in over 72 hours."
"I'm so glad I stopped smoking."
"I really want to stop smoking."
Helping a mother recognize the meaning of her newborn's various types of crying is an example of what level of learning?
Analyzing
A nurse is preparing an educational program on cultural perspectives in nursing. The nurse should include that which of the following factors are influenced by an individual's culture? (select all that apply)

Nutritional practices
Family structure
Health care interactions
Veins about illness
Nutritional practices
Family structure
Health care interactions
Veins about illness
A nurse is caring for a client who is from a different culture than himself. When beginning the cultural assessment, which of the following actions should the nurse take?
Gather data about the client's culture beliefs.
. A nurse is using the I PREPARE mnemonic to assess a client's potential environmental exposures. Which of the following questions should the nurse ask when assessing for A in the mnemonic?
What do you do for fun?
A nurse is reviewing information about the local health department to prepare for an interview. Which of the following services should the nurse expect the local health department to provide? (select all that apply)
Providing education to achieve community health goals
Coordinating directives form state personnel
A nurse is conducting health screening at a statewide health fair and identifies several clients who require referral to a provider. Which of the following statements by a lenient indicates a barrier to access health care?
I can't take off during the day, and the local after hours clinic is no longer in operation.
1. A nurse is talking to a client who asks for additional information about hospice. Which of the following statements should the nurse make?
A component of hospice care is to control the client's manifestations..
A school nurse is scheduling visits with a physical therapist for a child who has cerebral palsy. In which of the following roles is the nurse functioning?
Case Manager
An occupational health nurse is consulting with senior management of a local industrial facility. When discussing work-related illness ans injury, the nurse should include which of the following factors as physical agents? (select all that apply)
Noise, Lighting
A newly hired occupational health nurse at an industrial facility is performing an initial workplace assessment. Which of the following information should the nurse determine when should the nurse determine when conducting a work site survey?
Work practices of employees.
A school nurse is planning health promotion and disease prevention activities for the upcoming school year. In which of the following situations is the nurse planning a secondary prevention strategy?
Routinely checking students for pediculosis throughout the school year.
Nursing most effectively contributes financially to political candidates who support nursing issues through:
personal political donations.
contributions to the various political parties.
hospital-based political campaign drives.
the ANA's political action committee (PAC).
the ANA's political action committee (PAC).
Which private organization has been very supportive in advocating the role of nurses as health care reformers?
American Association of Retired Persons (AARP)
Kaiser Family Foundation
Henry Street Settlement House
Robert Wood Johnson Foundation
Robert Wood Johnson Foundation
A community of nurses are interested in influencing health policy regarding client-to-nurse ratios in their state. Which will they find most helpful?
Initially discussing the issue with hospital administrators statewide
Contributing to their local ANA political action committee (PAC)
Introducing the issue to the state House of Representative members
Utilizing the National Nurses United (NNU) as a primary resource
Utilizing the National Nurses United (NNU) as a primary resource
Which historic nursing figure is credited with coining and describing the term "public health nursing"?
Clara Barton
Nancy Pelosi
Mary Brewster
Lillian Wald
Lillian Wald
Which national nursing organization has advocated for health care reform since the 1950s?
American Nurses Association (ANA)
National League for Nursing (NLN)
National Nurses United (NNU)
American Association of Colleges of Nursing (AACN)
American Nurses Association (ANA)
The community health nurse is dealing with housing inequality experienced by low-income urban families. On which would the nurse focus on while advocating?
Increased police presence in low-income housing areas
Simple application process to provide access to low-income housing
Construction of safe, affordable housing in low-income neighborhoods
Shortened waiting periods for those applying for low-income housing
Construction of safe, affordable housing in low-income neighborhoods
How can a community health nurse best ensure the safety and well-being of at-risk populations?
Contribute to research projects that focus on the health and safety of at-risk populations.
Educate the members of the at-risk populations to the concept of social justice.
Advocate for increased federal health care funding.
Engage in interprofessional collaboration.
Engage in interprofessional collaboration
Which is the community nurse engaging in individual advocacy?
Preparing an article for the local newspaper that describes the role of the community nurse
Addressing a local town counsel to provide funding to improve emergency medical services (EMS) that focus on care for older adult
Organizing a "Health Awareness Day" rally at the capitol building in the state's capital
Serving on a committee that is focusing on the writing of new legislation to control the use of pesticides within city limits
Addressing a local town counsel to provide funding to improve emergency medical services (EMS) that focus on care for older adult
The document The Future of Nursing: Leading Change, Advancing Health strongly suggests that nursing's scope of practice barriers should be removed. Which scenario best demonstrates this recommendation?
A community health nurses uses a private grant to improve prenatal care among the local rural poor.
An advance practice nurse is the primary health care provider at a community free clinic.
Nursing educators plan for increased enrollment in a university's baccalaureate degree nursing program.
A public health nurse provides data to a research project that is focusing on the effectives of early development screenings of health outcomes.
An advance practice nurse is the primary health care provider at a community free clinic.
Which areas have the Institute of Medicine (IOM) identified as areas in which the United States compares favorably to the Office of Economic Cooperation and Development Countries? Select all that apply.
Infant mortality and low birth weight
Suicide
Cancer mortality
HIV and AIDS
Elderly survival
Stroke mortality
Injuries ad homicides
Suicide
Cancer mortality
Elderly survival
Stroke mortality
A nurse is creating partnerships to address health needs within the community. THe nurse should be aware that which of the following characteristics must exist for partnerships to be successful (select all that apply)?
Flexibility among partners when considering new ideas
Adherence of partner to ethical principles
Willingness of partners to negotiate roles
Flexibility among partners when considering new ideas
Adherence of partner to ethical principles
Willingness of partners to negotiate roles
A nurse is reviewing the various roles of a community health nurse. Which of the following actions is an example of a nurse functioning as a consultant?
Updating state officials about health needs of the local community.
A case management nurse at an acute care facility is conducting an initial visit with a client to identify needs prior to discharge home. After developing a working relationship with the client, the nurse is engaging in the referral process. Which if the following actions should the nurse take first?
Identify referrals that the client needs
A nurse developing a community health program is determining barriers to community resource referrals. Which of the following factors should the nurse include as an example of a resource barrier?
Costs associated with services
A nurse is working with a client who has systemic lupus erythematosus and recently lost her health insurance? Which of the following actions should the nurse take in the implementation phase of the case management process?
Coordinating services to meet the client's needs.
The nurse is caring for victims of multiple motor vehicle crashes from a landslide caused by a major snow and ice storm. How would the emergency response center classify this disaster?
Complex emergency
Natural disaster
Man-made disaster
Mass-casualty incident
Man-made disaster
During a home visit before the onset of a winter storm, the nurse reviews the client's plan for staying safe and having enough food, water, and medication for at least 3 days. Which level of disaster prevention is this nurse implementing?
Secondary
Primary
Rehabilitation
Tertiary
Primary
The public health nurse is concerned that a community is being threatened of contamination by a Category A biologic agent. What action will the nurse conduct to support primary prevention?
Identify community regions to establish quarantines.
Meet with local hospital officials to ensure adequate medical supplies to treat the infections.
Prepare an instruction sheet identifying the effects of the Category A biologic agents.
Teach hospital nurses methods to disinfect used hospital equipment.
Prepare an instruction sheet identifying the effects of the Category A biologic agents.
Several people are brought to the emergency department after falling 10 feet from an outdoor balcony on an apartment building that collapsed because of poor construction. Which factor does the nurse identify as contributing to this disaster?
Intensity
Host
Environmental
Agent
Agent
A group of survivors from a multiple-apartment complex fire are sitting in the local school cafeteria awaiting news about their homes. Which action should the nurse use to help reduce the survivors' anxiety?
Walk around, talk, and hug the survivors.
Refer questions to the appropriate rescue personnel.
Sit quietly to permit the survivors with time to rest.
Ask the survivors to line up to record everyone's name.
Walk around, talk, and hug the survivors.
The director of nursing is working with other hospital leaders to finalize the organization's disaster plan. What should be included in this plan?
Education to improve community awareness
Support for survivors and families
Assessment forms for acute stress disorder
List of recommended immunizations for victims
Support for survivors and families
The community health nurse is triaging victims of a train derailment. Which victim would need to receive medical attention first?
Unconscious, thready pulse, respiratory rate 10, and gaping thigh wound
Conscious, walking and talking, bloody face, and extremities
Conscious, talking, fractured arm with exposed bone
Unconscious, pulse 24 and irregular, piece of metal impaled in the midchest region
Unconscious, thready pulse, respiratory rate 10, and gaping thigh wound
The public health nurse is planning a program on self-care strategies for community rescue workers. What should the nurse include in this program? Select all that apply.
"Give yourself time to heal."
"Ask for emotional support."
"Use time wisely."
"Reestablish daily routines."
"Abstain from involvement."
"Give yourself time to heal."
"Ask for emotional support."
"Use time wisely."
"Reestablish daily routines."
A nurse is asked to participate with the planning of disaster preparedness for a local community. On which areas will the nurse focus during this phase of disaster management? Select all that apply.
Plans for communication
Evacuation process
Availability of personnel
Medicine and shelter
Rescue and triage
Plans for communication
Evacuation process
Availability of personnel
Medicine and shelter
A nurse is teaching about biologic warfare to a group of nursing students. Which is included in the discussion?
Exchanging of information about anthrax and contaminated food
Discussion related to posttraumatic stress disorder
Conversation about planning for secondary and tertiary prevention
Dialog about the history and factors related to terrorism
Exchanging of information about anthrax and contaminated food
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