Test Bank – Community/Public Health Nursing, 8th Edition (Nies & McEwen)
ISBN: 9780323795319 | Chapters 1-34 | 200 Questions with Answers & Rationales**
---
### Chapter 01: Health – A Community View (Questions 1-30)
**1. Which of the following best describes the primary reason that Americans are concerned about
health care?**
A) Politicians are discussing how to improve health care.
B) The media has provided mixed messages about the health care system.
C) Our national health care costs keep increasing.
D) The new health care system offers free services to Americans.
**Answer: C**
*Rationale:* The primary reason for the focus on health care is the constantly increasing costs, which
cannot be sustained. The costs of caring for the sick accounted for the majority of escalating health
care dollars, increasing from 5.7% of GDP in 1965 to 17.8% in 2015 .
**2. A nurse has begun to lobby with politicians for changes to the health care system. Why is this
involvement important?**
A) Nurses are currently very visible in American media.
B) Nurses are primarily responsible for managing the various units in our health care system.
C) Nurses are the largest segment of health care providers.
D) Nurses are the only group employed both inside and outside of hospitals.
**Answer: C**
*Rationale:* Nurses constitute the largest segment of healthcare workers and are therefore
instrumental in creating a healthcare delivery system that will meet the health-oriented needs of the
people .
**3. What conclusion can be drawn from examining where nurses are currently employed?**
A) There is a trend toward consolidation of health care into large central medical centers.
B) There is an increased emphasis on community-based health care.
C) There is an obvious need to decrease health care costs by cutting positions.
D) Managed care organizations (MCOs) are employing nurses to improve customer relations.
**Answer: B**
,*Rationale:* Nurses are increasingly employed in community settings as opposed to hospitals,
reflecting the move toward community-based care rather than hospital-based tertiary care .
**4. Which ethical belief would be most helpful in the current health care crisis?**
A) Emphasis should be on individual and corporation freedom in the marketplace.
B) Emphasis should be on individual autonomy and freedom of choice.
C) Emphasis should be on social justice and collective responsibility.
D) Emphasis should be on the effectiveness of technology in resolving problems.
**Answer: C**
*Rationale:* Public health recognizes the necessity of collective action in keeping the environment
safe and in egalitarian tradition and vision. An overinvestment in technology and seeking of cures
within the market justice system has stifled the evolution of a health system to protect and preserve
the health of the population .
**5. What is the primary problem seen in Healthy People's emphasis on choosing healthy lifestyle
behaviors?**
A) Emphasis on other lifestyle choices, such as not smoking and minimal use of alcohol or drugs, is
also needed.
B) All of us must work together to make unhealthy behaviors socially unacceptable.
C) It costs more to make healthy choices, such as buying and eating fresh fruits and vegetables.
D) Public policy emphasizes personal responsibility but ignores social and environmental changes
needed for well-being.
**Answer: D**
*Rationale:* The primary problem is the emphasis on personal choices. This ignores the need for
community responsibility and action that addresses environmental or cultural restraints to health .
**6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of the
nurse beyond giving excellent care to patients?**
A) Accept longer work schedules to ensure that professional care is always available.
B) Recognize the need for experienced nurses to mentor new graduates.
C) Support health legislation to improve accessibility and cost of health care.
D) Volunteer to work overtime as needed to ensure maximum quality of care.
**Answer: C**
*Rationale:* The ANA Code of Ethics promotes social reform by focusing on health policy and
legislation to positively affect accessibility, quality, and cost of health care .
,**7. What is the community health nursing definition of health?**
A) Health is a person's goal-directed purposeful process toward well-being or wholeness.
B) Health is an individual's physical, mental, and social well-being, not merely the absence of disease.
C) Health is the mutual adaptation between a person and his or her environment in meeting daily
existence.
D) Health is families and aggregates choosing actions to ensure safety and well-being.
**Answer: D**
*Rationale:* The text stresses that health is not just the result of an individual's choices, but choices
and actions of individuals, families, groups, and communities that lead to better health .
**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 environment.
C) A group of persons who work together to meet common goals.
D) A group of persons who resolve a community concern.
**Answer: B**
*Rationale:* 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) .
**9. What is the primary cause of the current emphasis on disease prevention in community health
nursing?**
A) Nurses prefer to focus on prevention rather than treatment.
B) Disease prevention is more cost-effective than treating disease after it occurs.
C) Politicians have mandated prevention as a national priority.
D) Insurance companies require prevention services for reimbursement.
**Answer: B**
*Rationale:* To help decrease the continued rise in health care costs, the increased emphasis is on
disease prevention rather than high-cost treatment. Prevention is more cost-effective than treating
disease after it occurs .
**10. Which factor has a major influence on a community's health?**
A) Behavior choices made by persons in the community.
B) Number of health care providers and hospitals in the community.
, C) Quality of public safety officers (police officers, firefighters, etc.).
D) The number and credentials of public health officials in the community.
**Answer: A**
*Rationale:* Individual behavior choices are responsible for about 50% of health outcomes. Personal
health behaviors have the single greatest influence on a population's health .
---
### Chapter 02: Historical Factors: Public Health Nursing in Context (Questions 11-30)
**11. Which nurse is credited with founding public health nursing in the United States by establishing
the Henry Street Settlement?**
A) Florence Nightingale
B) Clara Barton
C) Lillian Wald
D) Mary Breckinridge
**Answer: C**
*Rationale:* Lillian Wald founded the Henry Street Settlement in New York City in 1893, which is
considered the birthplace of public health nursing in the United States .
**12. The Sheppard-Towner Act of 1921 provided federal funding for:**
A) Hospital construction
B) Maternal and child health programs
C) Creation of the National Institutes of Health
D) Mandated vaccination for school children
**Answer: B**
*Rationale:* The Sheppard-Towner Act (1921) provided federal funding for maternal and child health
programs, including prenatal and child health clinics. It was an early example of federal involvement
in public health .
**13. The Frontier Nursing Service, founded by Mary Breckinridge, was innovative because it:**
A) Was the first nursing service to require baccalaureate degrees.
B) Provided nurse-midwifery services to rural, underserved populations.
C) Focused exclusively on hospital-based care.
D) Was funded entirely by private donations.
ISBN: 9780323795319 | Chapters 1-34 | 200 Questions with Answers & Rationales**
---
### Chapter 01: Health – A Community View (Questions 1-30)
**1. Which of the following best describes the primary reason that Americans are concerned about
health care?**
A) Politicians are discussing how to improve health care.
B) The media has provided mixed messages about the health care system.
C) Our national health care costs keep increasing.
D) The new health care system offers free services to Americans.
**Answer: C**
*Rationale:* The primary reason for the focus on health care is the constantly increasing costs, which
cannot be sustained. The costs of caring for the sick accounted for the majority of escalating health
care dollars, increasing from 5.7% of GDP in 1965 to 17.8% in 2015 .
**2. A nurse has begun to lobby with politicians for changes to the health care system. Why is this
involvement important?**
A) Nurses are currently very visible in American media.
B) Nurses are primarily responsible for managing the various units in our health care system.
C) Nurses are the largest segment of health care providers.
D) Nurses are the only group employed both inside and outside of hospitals.
**Answer: C**
*Rationale:* Nurses constitute the largest segment of healthcare workers and are therefore
instrumental in creating a healthcare delivery system that will meet the health-oriented needs of the
people .
**3. What conclusion can be drawn from examining where nurses are currently employed?**
A) There is a trend toward consolidation of health care into large central medical centers.
B) There is an increased emphasis on community-based health care.
C) There is an obvious need to decrease health care costs by cutting positions.
D) Managed care organizations (MCOs) are employing nurses to improve customer relations.
**Answer: B**
,*Rationale:* Nurses are increasingly employed in community settings as opposed to hospitals,
reflecting the move toward community-based care rather than hospital-based tertiary care .
**4. Which ethical belief would be most helpful in the current health care crisis?**
A) Emphasis should be on individual and corporation freedom in the marketplace.
B) Emphasis should be on individual autonomy and freedom of choice.
C) Emphasis should be on social justice and collective responsibility.
D) Emphasis should be on the effectiveness of technology in resolving problems.
**Answer: C**
*Rationale:* Public health recognizes the necessity of collective action in keeping the environment
safe and in egalitarian tradition and vision. An overinvestment in technology and seeking of cures
within the market justice system has stifled the evolution of a health system to protect and preserve
the health of the population .
**5. What is the primary problem seen in Healthy People's emphasis on choosing healthy lifestyle
behaviors?**
A) Emphasis on other lifestyle choices, such as not smoking and minimal use of alcohol or drugs, is
also needed.
B) All of us must work together to make unhealthy behaviors socially unacceptable.
C) It costs more to make healthy choices, such as buying and eating fresh fruits and vegetables.
D) Public policy emphasizes personal responsibility but ignores social and environmental changes
needed for well-being.
**Answer: D**
*Rationale:* The primary problem is the emphasis on personal choices. This ignores the need for
community responsibility and action that addresses environmental or cultural restraints to health .
**6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of the
nurse beyond giving excellent care to patients?**
A) Accept longer work schedules to ensure that professional care is always available.
B) Recognize the need for experienced nurses to mentor new graduates.
C) Support health legislation to improve accessibility and cost of health care.
D) Volunteer to work overtime as needed to ensure maximum quality of care.
**Answer: C**
*Rationale:* The ANA Code of Ethics promotes social reform by focusing on health policy and
legislation to positively affect accessibility, quality, and cost of health care .
,**7. What is the community health nursing definition of health?**
A) Health is a person's goal-directed purposeful process toward well-being or wholeness.
B) Health is an individual's physical, mental, and social well-being, not merely the absence of disease.
C) Health is the mutual adaptation between a person and his or her environment in meeting daily
existence.
D) Health is families and aggregates choosing actions to ensure safety and well-being.
**Answer: D**
*Rationale:* The text stresses that health is not just the result of an individual's choices, but choices
and actions of individuals, families, groups, and communities that lead to better health .
**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 environment.
C) A group of persons who work together to meet common goals.
D) A group of persons who resolve a community concern.
**Answer: B**
*Rationale:* 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) .
**9. What is the primary cause of the current emphasis on disease prevention in community health
nursing?**
A) Nurses prefer to focus on prevention rather than treatment.
B) Disease prevention is more cost-effective than treating disease after it occurs.
C) Politicians have mandated prevention as a national priority.
D) Insurance companies require prevention services for reimbursement.
**Answer: B**
*Rationale:* To help decrease the continued rise in health care costs, the increased emphasis is on
disease prevention rather than high-cost treatment. Prevention is more cost-effective than treating
disease after it occurs .
**10. Which factor has a major influence on a community's health?**
A) Behavior choices made by persons in the community.
B) Number of health care providers and hospitals in the community.
, C) Quality of public safety officers (police officers, firefighters, etc.).
D) The number and credentials of public health officials in the community.
**Answer: A**
*Rationale:* Individual behavior choices are responsible for about 50% of health outcomes. Personal
health behaviors have the single greatest influence on a population's health .
---
### Chapter 02: Historical Factors: Public Health Nursing in Context (Questions 11-30)
**11. Which nurse is credited with founding public health nursing in the United States by establishing
the Henry Street Settlement?**
A) Florence Nightingale
B) Clara Barton
C) Lillian Wald
D) Mary Breckinridge
**Answer: C**
*Rationale:* Lillian Wald founded the Henry Street Settlement in New York City in 1893, which is
considered the birthplace of public health nursing in the United States .
**12. The Sheppard-Towner Act of 1921 provided federal funding for:**
A) Hospital construction
B) Maternal and child health programs
C) Creation of the National Institutes of Health
D) Mandated vaccination for school children
**Answer: B**
*Rationale:* The Sheppard-Towner Act (1921) provided federal funding for maternal and child health
programs, including prenatal and child health clinics. It was an early example of federal involvement
in public health .
**13. The Frontier Nursing Service, founded by Mary Breckinridge, was innovative because it:**
A) Was the first nursing service to require baccalaureate degrees.
B) Provided nurse-midwifery services to rural, underserved populations.
C) Focused exclusively on hospital-based care.
D) Was funded entirely by private donations.