NSG 442 : Global Public Health Exam 1 (Test Bank) UPDATED 2023, Colorado State University-Pueblo.

NSG 442 Global Public Health Exam 1 1: Community and Prevention–Oriented, Population-Focused Practice: The Foundation of Specialization in Public Health Nursing • State the mission of and core functions of public health and the essential public health services and the quality performance standards program in public health. • Describe specialization in public health nursing and other nurse roles in the community and the practice goals of each. • Contrast clinical nursing practice with population focused practice in the community. • Describe what is meant by community-oriented, population-focused practice. • State key opportunities for community and prevention-oriented, population-focused practice. Review Questions 1. In 1988, the Institute of Medicine (IOM) published a report on the future of public health and its mission that defined public health as: a. what public-private partnerships do to treat vulnerable populations. b. what the government does to ensure that vital programs are in place. c. what the U.S. Public Health Service does to prevent disease, promote health, and deliver services. d. what society does collectively to ensure the conditions in which people can be healthy. 2. A registered nurse is seeking a position as a public health nurse. In reviewing the job description, the nurse would expect to find a description of a position that focused on functions such as: a. monitoring pregnant teenagers for symptoms of complications of pregnancy. b. offering free hypertension screening and treatment referral at local health fairs to low-income, uninsured, community members. c. partnering with local seasonal farmworkers to design a program aimed at preventing illness and injury, and advocating for this population with local political and community leaders. d. preventing injury among a population of elderly residents in an assisted living facility and treating residents’ chronic illnesses. 3. A public health nurse leader is encountering barriers when trying to shift the public health agency’s efforts to a populationfocused practice. The reasons peers are not supportive of the proposed shift to a population focus are most likely related to: a. agency colleagues’ push for nurses to focus on population initiatives. b. costs associated with staff training and revision of documents. c. lack of support from the agency’s funding sources. d. opinions that nursing should focus on the provision of direct client care and services. 4. The role and goals of the community health nursing practice can best be described as: a. community-based interventions aimed at promoting, preserving, and maintaining the health of populations residing in institutional facilities such as nursing homes. b. education of nurses and other staff working in community-based and community-oriented settings to improve the overall effectiveness of their programs to meet client needs. c. population-level strategies aimed at promoting, preserving, and maintaining the health of populations through the delivery of personal health care services to individuals, families, and groups in an effort to improve the health of the community as a whole. GeekBano d. activities targeted at improving the health status of clients served by community-based health service agencies such as hospice and home health agencies. 5. A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the core public health function of: a. assessment. b. assurance. c. policy development. d. research. 6. The state public health agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored eldercare programs. The public health core function applied is: a. assurance. b. policy development. c. primary prevention. d. public transportation. 7. A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing: a. community-oriented care. b. community-based care. c. secondary care. d. tertiary care. 8. A community-oriented nurse conducts home visits to new parents to assess the health status of the infant, the parent-child relationship, the parents’ knowledge regarding the care of the infant, and the need for health department and social services referrals to support the needs of the new parents and the infant. This can best be described as an example of: a. clinical community health practice. b. community-based practice. c. population-focused practice. d. public health nursing. 9. Nurses should consider opportunities for population-focused practice that result from the rapid transformation of health care delivery from a medical model to a health promotion/disease prevention model. An example of such opportunity is: a. operator of a nurse practitioner-run urgent care center in a major retail location. b. director of clinical services spanning inpatient and community-based settings that provide a wide range of services to the populations seen by the system. c. clinical director of a home health agency. d. school nurse position in the local high school. MULTIPLE RESPONSE 1. Public health nursing specialists are interested in which of the following topic(s)? (Select all that apply.) a. Educational materials for individuals with HIV/AIDS b. Evaluation of an outreach program for at-risk pregnant teenagers c. Community subpopulations with high rates of type 2 diabetes d. New technologies to monitor diabetes e. Prevalence of hypertension among various age, race, and gender groups 2: History of Public Health and Community Health Nursing • Interpret the focus and roles of public health nurses through an historical approach. • Trace the ongoing interaction between the practice of public health and that of nursing. GeekBano • Discuss the dynamic relationship between changes in social, political, and economic contexts and nursing practice in the community. • Outline the professional and practice impact of individual leadership on population-centered nursing, especially the leadership of Florence Nightingale and Lillian Wald. • Identify structures for delivery of nursing care in the community such as settlement houses, visiting nurse associations, official health organizations, and schools. • Recognize major organizations that contributed to the growth and development of population-centered nursing. Review Questions 1. In 1925, Mary Breckenridge established the Frontier Nursing Service (FNS) based on a system of care used in the highlands and islands of Scotland. Changes in public support for community and public health nursing and away from individual commitment and private financial support led to innovations in health care delivery in the twentieth century, especially for underserved populations. One of Breckenridge’s innovative contributions to health care in the United States was: a. establishment of the Federal Emergency Relief Administration. b. introduction of the first nurse-midwifery training. c. introduction of the nursing process. d. introduction of occupational health nursing. 2. The most important contribution made by Florence Nightingale to community-oriented nursing was: a. development of the settlement house concept as a strategy to improve urban health standards. b. expansion of the role of nursing to include health-promotion practices. c. founding of the first district nursing association in England. d. introduction of professional schools of nursing in the United States. 3. The Social Security Act of 1935 was designed to prevent the reoccurrence of the problems of the depression. Title VI of this act provided funding for expanded opportunities for health protection and promotion. The most relevant strategy related to this objective for public health nursing was: a. establishment of an FNS. b. provision of funding to support employment and education. c. provision of funding for research and investigation of disease. d. institution of a district nursing model. 4. In 1902, Lillian Wald introduced the concept of school nursing to address the problem of school absenteeism. The primary model for the school nurse program was to work with children in the schools and make home visits for the purpose of: a. enforcing the department of health’s rules and regulations. b. excluding infectious children from the school environment. c. providing and obtaining medical treatment for absent students. d. providing shoes and clothing for students. 5. From a historical perspective, the post-Depression shift in the U.S. Congress to the practice of categorical funding that provides federal money for priority diseases or groups has to this day produced a negative effect on the delivery of health care services that can best be described as: GeekBano a. adoption of 2-year associate degree nursing programs. b. exclusion of home-based care from health insurance coverage. c. national preference service model that neglects emerging problems. d. rise in hospital-based care. 6. During the Depression of the 1930s, many federal agencies attempted to support the employment of basic nurses by increasing the demand for existing and new nursing services that meet the needs of the increasing ranks of impoverished individuals. Although this facilitated rapid program expansion for recipient public health agencies and gave many nurses a taste of public health, the specialty of public health nursing was negatively affected by: a. decrease in focus on the community as the unit of service. b. increase in the scope of fundamental services. c. increase in field experience. d. decrease in the need for training and supervision. 7. The Association of Community Health Nurse Educators has called for increased graduate programs to educate PHN leaders, educators, and researchers in such areas as: a. immigrant and migrant health. b. natural and human-made disasters. c. automobile safety for children. d. student health. MULTIPLE RESPONSE 1. In the middle of the nineteenth century, there was increased national interest in addressing public health problems and improving urban living conditions. Which of the recommendations of the Shattuck Report in Massachusetts represented major innovations in public health during that period? (Select all that apply.) a. Establishment of state health departments and local health boards in every town b. Promotion of environmental sanitation and collection of vital statistics c. Steps to decrease preventable disease and control smoking and alcohol use d. Targeting of efforts solely on environmental hazards e. Provision of supplemental food to low-income persons 2. The poor environmental conditions experienced by immigrants in tenement houses and sweatshops were familiar features of urban life across the northeastern United States and the upper Midwest. Which of the following factors assisted community-oriented nursing pioneers, such as Lillian Wald, in developing approaches and programs to solve the health care and social problems of the times? (Select all that apply.) a. Community health’s focus on teaching and prevention b. Establishment of settlement houses c. Establishment of the town and country nursing services in large cities d. Lack of public interest in limiting disease e. Middle and upper class fear of diseases 3. The early pioneers in public health nursing were instrumental in the founding of the National Organization for Public Health Nursing (NOPHN) in 1912. This organization served as the dominant force in public health nursing until 1952 and sought to standardize public health nursing education to ensure that nurses received more than hospital-oriented training. Other major accomplishments included what initiatives? (Select all that apply.) a. Collaborated to secure health insurance reimbursement for nursing services, such as postdischarge nursing care at home b. Established public health nursing programs for military outposts in World War I GeekBano c. Provided matching funds to establish maternal and child health divisions in state health departments d. Responded to the 1918 worldwide influenza pandemic in the United States e. Supported nurse employment through increased grants-in-aid for state programs of home medical care 3: The Changing U.S. Health and Public Health Care Systems • Describe the events and trends that influence the status of the health care system. • Discuss key aspects of the private health care system. • Compare the public health system to primary care. • Explain the model of primary health care. • Assess the effects of health care and insurance reform on health care delivery. • Evaluate the changes needed in public health and primary care to have an integrated health care delivery system. Review Questions 1. Primary health care (PHC) differs from primary care in which of the following ways? a. PHC encourages community participation. b. PHC focuses on prevention and cure. c. PHC is defined more narrowly. d. PHC is the primary method of health care delivery in the United States. 2. A nurse has been newly appointed as commissioner of the state health department services. The programs the nurse will oversee will most likely include: a. administration of Medicare reimbursement rates and eligibility determination. b. programs involving citizens in the local community, including sanitation and communicable disease contact tracing. c. disaster response, health care financing and administration of programs such as Medicaid, and establishment of health codes. d. monitoring of drugs and over-the-counter products available for sale and use by consumers. 3. The goal of the PHC system is to achieve the objective “Health for All in the 21st Century,” set forth by the World Health Organization (WHO). The major barrier to achieving this objective in the United States is that: a. global indicators are not applicable to the United States. b. Healthy People 2020 is not consistent with the Declaration of Alma-Ata. c. PHC is not the primary delivery method for health care in the United States. d. the U.S public health system is not structured to provide PHC. 4. The U.S. public health system is operated at three distinct levels with collaboration and interface across all levels. The agency that assumes the responsibility for regulating health care and overseeing the health status of Americans is the: a. Department of Homeland Security. b. U.S. Department of Health and Human Services (USDHHS). c. local health department. d. state department of health. 5. The major factor that drives the current discussions about a Medicare shortfall in the middle of the twenty-first century is: a. diversity of the U.S. health care workforce. b. longevity of the U.S. population. c. percentage of elderly in the U.S. population. d. percentage of foreign-born in the U.S. population. 6. The local nurse-managed community health center initiative is providing community-based primary and preventive care as well as specialty care, community screenings, local health assessments, health education, and health care coordination, targeted to medically uninsured individuals regardless of ability to pay. This initiative best describes a system of: a. managed care. b. primary care. GeekBano c. PHC. d. private health care. 7. A factor that strongly influences the success of a PHC system is: a. participation of the community members in the design, implementation, and evaluation of the initiative. b. assurance of access to care for every woman and child from pregnancy through childhood. c. each entity’s sense of urgency regarding the evaluation of indicators. d. cure orientation of the private sector of health care delivery in the United States. MULTIPLE RESPONSE 1. The American health care system will continue to evolve and change. Which of the following groupings of health care trends will have the greatest influence on the health care transformation process at the present time? (Select all that apply.) a. Aging of the population and medical technology advances b. Funding levels, political structure, and professional licensure requirements c. Longevity, population diversity, and funding sources d. Managed care, workforce shortages, and level of education of the population 2. Benefits of an electronic health record in the public health system include: (Select all that apply.) a. 24-hour availability of health records. b. ease of referral coordination. c. reduction in medication errors. d. increased privacy. e. consistently reliable internet resources. 3. The most important features of the Affordable Health Care for America Act of 2010 that the community-oriented nurse needs to understand to provide resource information to clients are that the Act: (Select all that apply.) a. transforms the health care system from a sick care system to health care system. b. uses piecemeal approach to strengthen the safety net. c. replaces the rational equitable health care system. d. provides insurance reform. e. increases access to affordable health care insurance.