TEST BANK Test Bank Public Health Nursing: Population-Centered Health Care in the Community 10th Edition ISBN: 9780323611114 by Jeanette Lancaster, Marcia Stanhope

TEST BANK Test Bank Public Health Nursing: Population-Centered Health Care in the Community 10th Edition ISBN: 9780323611114 by Jeanette Lancaster, Marcia Stanhope Test Bank Public Health Nursing: Population-Centered Health Care in the Community 10th Edition ISBN: 9780323611114 by Jeanette Lancaster, Marcia Stanhope Table of Content PART 1. Influencing Factors in Public Health Nursing and Population Health 1. Public health foundations and population health 2. History of public health and public and community health nursing 3. Public health, primary care, and primary health care systems 4. Perspectives in global health care 5. Economics of health care delivery PART 2. Forces Affecting Nurses in the Delivery of Public and Population Health Care Delivery 6. Environmental health 7. Application of ethics in the community 8. Achieving cultural competence in community health nursing 9. Public health policy 10. Evidence-based practice PART 3. Conceptual and Scientific Frameworks Applied to Nursing Practice 11. Population-based public health nursing practice: The intervention wheel 12. Genomics in public health nursing 13. Epidemiology 14. Infectious disease prevention and control 15. Communicable and infectious disease risks PART 4. Community Level Interventions 16. Promoting healthy communities 17. Community as client: Assessment and analysis 18. Building a culture of health to influence health equity within communities 19. Health education principles applied in communities, groups, families, and individuals for healthy change PART 5. Issues and Approaches in Population-Centered Nursing 20. The nurse-led health center: A model for community nursing practice 21. Public health nursing practice and the disaster management cycle 22. Public health surveillance and outbreak investigation 23. Program management 24. Quality management 25. Case management PART 6. Promoting the Health of Target Populations Across the Life Span 26. Working with families in the community for healthy outcomes 27. Family health risks 28. Child and adolescent health 29. Major Health Issues and Chronic Disease Management of Adults Across the Life Span 30. Disability health care across the life span PART 7. Promoting and Protecting the Health of Vulnerable Populations 31. Health equity and care of vulnerable populations 32. Population-centered nursing in rural and urban environments 33. Poverty and homelessness 34. Migrant health issues 35. Teen pregnancy 36. Mental health issues 37. Alcohol, tobacco, and other drug problems 38. Violence and human abuse PART 8. Nurses’ Roles and Functions in the Community 39. Advanced nursing practice in the community 40. The nurse leader in the community 41. The nurse in public health, home health, hospice, and palliative care 42. The nurse in the schools 43. The nurse in occupational health 44. Forensic nursing in the community 45. The nurse in the faith community 46. Public health nursing at local, state, and national levels Chapter 01: Public Health Foundations and Population Health Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 10th Edition MULTIPLE CHOICE 1. What is the primary focus to be addressed concerning the improvement of the health of the American people in the twenty-first century? a. Bioterrorism and global health threats b. Delivery of individual care and hygiene c. The need for increased hospital and acute care d. Chronic disease and disability management ANS: A There are new concerns, and of the most serious are bioterrorism and globally induced infections, such as the avian flu. These threats will divert health care funds and resources from other health care programs to be spent for public safety. The others are not related to public health or are concerns that have been present for many years. DIF: Cognitive level: Understanding TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance 2. A community is concerned about the threat of bioterrorism. Which of the following best describes the basis for this concern? a. Bioterrorism has the potential to dissolve community-based programs. b. This threat could causeNthUeRhSeaIlthNcGaTreBCteOmMto collapse. c. The threat may divert funds from other public safety health care programs. d. Fear of bioterrorism will increase the need for shelters. ANS: C Bioterrorism may have an impact on the availability of resources for public safety health care programs. Because funds are diverted it is possible that community-based programs would be eliminated, the health care system could experience changes, and that there would be an increase in the need for shelter. However, all the remaining options would happen because of the diversion of funds. DIF: Cognitive level: Analyzing TOP: Nursing process: Diagnosis MSC: NCLEX: Physiological Integrity 3. Which statement describes the consequence of the successful implementation of the Affordable Care Act? a. Americans will pay closer attention to their health status. b. Most of the population will be covered by health insurance. c. Public health departments will need to increase the number of nursing positions. d. The prevalence of obesity will decrease. ANS: B One consequence of successful implementation of the Affordable Care Act might be that the majority of the population would be covered by insurance and public health agencies will not need to provide direct clinical services in order to assure that those who need them can receive them. The Affordable Care Act will not directly cause Americans to pay closer attention to their health status or decrease the prevalence of obesity. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 4. The public health nurse (PHN) must participate in the essential services of public health. What is one of the essential services of public health nursing? a. Monitoring health status by completing a community assessment b. Diagnosing and investigating health problems in the world c. Informing, educating, and empowering people about health issues d. Working in law enforcement to regulate health and ensure safety ANS: C The PHN monitors health status in several ways, completing a community assessment is only one way that health status is monitored. The PHN would not diagnose or solve “world” problems, or work in law enforcement. Rather, the PHN would participate with local regulators to protect communities and empower people to address health issues. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 5. A public health department is using the mission of public health as described by the Institute of Medicine when planningNitsRheaIlth pGrogBra.mCminMg. Which of the following activities will most likely be implemented? a. Tracking avian flu outbreaks and doing surveillance in the United States b. Providing a flu shot for an elderly person at the health department c. Keeping track of alternative therapies in use in the United States d. Keeping snake antivenom at the Centers for Disease Control and Prevention in Atlanta ANS: A The Institute of Medicine’s stated mission on public health is “to generate organized community and technical knowledge to prevent disease and promote health.” Tracking avian flu outbreaks and doing surveillance applies this concept at a population level. Providing a flu shot for an elderly person only addresses individual care. Keeping track of the use of alternative therapies does nothing to prevent disease or promote health of the population. Keeping snake antivenom is aimed at disease care for an individual, not health promotion or disease prevention. DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 6. A public health department makes sure that the essential community-oriented health services are available in the community. Which of the following core public health functions is being implemented? a. Policy development b. Assessment c. Assurance d. Scientific knowledge-based care ANS: C Assurance focuses on the responsibility of public health agencies to ensure certain activities have been appropriately carried out to meet public health goals and plans. Policy development seeks to build constituencies that can help bring about change in public policy. Assessment includes activities that involve collecting, analyzing, and disseminating information on both the health status and the health-related aspects of a community or a specific population. Public health is based on scientific knowledge but is not a core function. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 7. What is the purpose of public health core functions? a. Clarifying the role of the government in fulfilling the mission of public health b. Ensuring the safety of populations in receiving quality health care c. Providing community-based individualized care to every person in the United States d. Uniting public and private providers of care in a comprehensive approach to providing health care ANS: A As defined by the Institute of Medicine in its 1988 report The Future of Public Health, assessment, policy development, and assurance are core functions at all levels of government for the purposeNofRclarIifyiGng tBhe.gCoveMrnment’s role. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 8. Which of the following statements about public health is accurate? a. Prevention of early deaths can be more effectively accomplished by medical treatment than by public health approaches. b. Expenditures and resources for public health have increased in recent years. c. Historically, gains in the health of populations have been related largely to changes in safety, sanitation, and food safety. d. Reform of the medical insurance system is the single change needed to improve the health of Americans. ANS: C Fielding and Tilson have asserted that most of the increase in life span has been made through improvements in sanitation, clean water supplies, making workplaces safer, improving food and drug safety, immunizing children, and improving nutrition, hygiene, and housing. Medical treatment has not made as significant of an impact on the life span as public health measures. Funding for public health in recent years has been on a gradual decline. Although reform of the medical insurance system may help improve the health of Americans, there are many other factors that will need to be addressed. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 9. A public health nurse (PHN) collects data and monitors the health status of the population. Which of the following core public health functions is the nurse addressing? a. Assessment b. Prevention c. Assurance d. Policy development ANS: A Assessment consists of systematic data collection and monitoring health status. Prevention is not a core function, assurance is making sure essential services are available, and policy development is needed to provide leadership in developing policies. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 10. The public health nurse (PHN) compares the rate of teenage pregnancy in various areas of the city. Which of the core functions of public health is the nurse addressing? a. Assurance b. Assessment c. Prevention d. Policy development ANS: B Assessment refers to systematic data collection, which this nurse is doing for teenage pregnancy. Prevention is not a core function, assurance is making sure essential services are available, and policy developUmenSt isNneeTded to Oprovide leadership in developing policies. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 11. A public health nurse (PHN) develops and implements local public health policies through partnerships with agencies, organizations, and consumers within the community. Which of the following core public health functions is the nurse addressing? a. Assessment b. Prevention c. Assurance d. Policy development ANS: D Policy development deals with developing and implementing health policies. Prevention is not a core function, assurance is making sure essential services are available, and assessment refers to systematic data collection. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 12. A nurse provides for the availability of essential personal health services for people who would otherwise not receive health care. Which of the public health core functions is the nurse addressing a. Assessment b. Prevention c. Assurance d. Policy development ANS: C Assurance deals with the availability of health services. Prevention is not a core function, assessment refers to systematic data collection, and policy development refers to the need to provide leadership in developing health policies. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 13. The nurse manager makes sure that the staff members who work in a local clinic are competent in their job responsibilities. Which of the public health core functions is being demonstrated? a. Assurance b. Assessment c. Prevention d. Policy development ANS: A Assurance refers to making sure a competent health care workforce is available. Prevention is not a core function, assessment refers to systematic data collection, and policy development refers to the neeUd toSproNvidTe leadeOrship in developing health policies. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 14. Which intervention is the nurse most likely to implement when addressing one of the primary goals of public health? a. Ensuring that a newly diagnosed 40-year-old hypertensive man takes his medication b. Finding home care for a 70-year-old client recuperating from a hip replacement c. Conducting an infant car seat safety check d. Contacting a local hospice to admit a terminally ill 60-year-old woman ANS: C The correct answer is concerned with the health of many people, while the other answers address individual interventions. According to the Core Functions Project, all levels of health care, including population-based public health care, must be funded or the goal of health of populations may never be reached. DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 15. A community health nurse collects data about the number and proportion of persons aged 25 or older with less than a high school education. Which term best describes this type of data? a. Sociodemographic characteristics b. Health status data c. Health risk factors d. Health care resource consumption information ANS: A The number and proportion of people is a sociodemographic characteristic. Health status includes birth and death rates. Health risk factors discuss proportions of populations who have particular health conditions or health risks. Health care resource consumption refers to spending on health care per capita. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 16. The public health nurse (PHN) analyzes data related to the number and type of United States Environmental Protection Agency air quality standards that a community failed to meet. This data is an example of using which community health profile indicator? a. Sociodemographic characteristics b. Health status c. Health risk factor d. Functional status ANS: C Health risk factors discuss proportions of populations who have particular health conditions or health risks; breathing air of poor quality is a risk to health. The number and proportion of people is a sociodemograpUhicSchaNractTeristic. OHealth status includes birth and death rates. Functional status refers to reports of good health status by members of the population. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 17. A nurse is implementing quality performance standards in a public health department. Which statement best describes the importance of this action? a. Quality performance standards are used to guide improvement in the public health system. b. Quality performance standards rigidly control public health. c. Quality performance standards guide administrators to monitor public health at the national level. d. Quality performance standards can be used as hiring guidelines for nurses. ANS: A These standards were developed by the Centers for Disease Control and Prevention in 1998. They set the bar for the level of performance that is necessary to deliver essential public health services (PHSs). These standards were developed around the 10 essential PHSs. They focus on the overall public health system rather than on single organizations and describe an optimal level of performance. They are intended to support a process of quality improvement. State and local communities can assess their performance using certain available tools. They are not meant to control public health or be used for hiring guidelines. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 18. To better address emerging public health issues, a public health nurse (PHN) plans to complete continuing education in this area. Which content areas should be included in the course that is chosen? a. Leadership b. Ethics c. Communication d. Finance ANS: B Public health workers should be educated in eight content areas to be able to address emerging public health issues and advances in science and policy: (1) informatics, (2) genomics, (3) cultural competence, (4) community-based participatory research, (5) policy, (6) law, (7) global health, and (8) ethics. DIF: Cognitive level: Understanding TOP: Nursing process: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care 19. The public health workforce should demonstrate competency in which of the following competency categories? a. Financial planning and management b. Workforce needs assessment c. Acute care services d. Curriculum developmeNntURSINGTB.COM ANS: A Workforce needs assessment, acute care services, and curriculum developments are not considered categories of core competencies of public health. Rather there are eight categories of competency, which include: (1) analytic/assessment, (2) policy development/program planning, (3) communication, (4) cultural competence, (5) community dimensions of practice, (6) basic public health sciences, (7) financial planning and management, and (8) leadership and systems thinking. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 20. Why is public health nursing considered a nursing specialty? a. It has a distinct focus and scope of practice. b. It requires a master’s degree in nursing. c. It is focused on disadvantaged citizens. d. It performs interventions at the acute care level. ANS: A Public health nursing has a distinct focus and requires a special knowledge base. The other answers are not characteristics of a specialty. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 21. The necessary basic preparation for public health nursing is what level of nursing education? a. Associate degree b. Baccalaureate degree c. Master’s degree d. Doctor of Nursing Practice ANS: B A Bachelor of Science in nursing (BSN) is the necessary basic preparation to function as a beginning staff PHN. An Associate degree is not enough for basic preparation. A Master’s degree or Doctor of Nursing Practice degree would be part of preparation for advanced practice. DIF: Cognitive level: Remembering TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 22. A public health nurse (PHN) has been prepared at the graduate level. Which activity should the practitioner be able to complete? a. Teaching public and community health nursing b. Assessing and intervening successfully at the aggregate level c. Diagnosing and treating disease while having earned prescriptive authority d. Running for political office as experts in public health policy ANS: B According to the Consensus Conference, specialists should have assessment skills that allow them to intervene at the aggrUegatSe leNvel.TPublic Ohealth practitioners have a broad range of practice areas within public health and are not limited to only nursing and medicine. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 23. A public health nurse (PHN) provides clinic-based services for HIV-positive citizens in the community. Which term best describe this activity? a. Primary prevention b. Health education c. Tertiary prevention d. Policy making ANS: C This clinic is for clients who already have a disease process; therefore, it is tertiary prevention (preventing deterioration in a patient, a relapse, or disability and dependency by anticipatory nursing and medical care). Primary prevention is using general and specific measures in a population to promote health and prevent the development of disease (incidence) and using specific measures to prevent disease in those who are predisposed to developing a particular condition. Health education would involve providing specific education to this population. Policy making is formulating plans by an organization in order to make decisions. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 24. A nurse is working in the community with an aggregate/population. Who is the nurse most likely to interact with? a. Students in a county school system b. Christians around the world c. A patient in the intensive care unit at the local hospital d. People who drink coffee ANS: A A population or aggregate is a collection of individuals who have one or more personal or environmental characteristics in common. Members of a community who can be defined in terms of geography or a special interest can be seen as constituting a population. The clients in the first option share a geographical and special circumstance (school) characteristic. Christians around the world are too large of a geographical space. A patient cannot be an aggregate/population as there is no one to interact with. People who drink coffee share a common interest but may not share a common geographical location to interact. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 25. How is a population best defined? a. High-risk group b. Those interacting within a school or institutional setting c. Collection of individuals who share at least one common characteristic d. Geographical location wNiUthRinSaIcNomGmTuBCOM ANS: C A population or aggregate is a collection of individuals who have one or more personal or environmental characteristics in common. High-risk groups, school or institutional setting, and geographical location within the community all describe types of populations, not the definition of population. DIF: Cognitive level: Remembering TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 26. Population-focused practice concentrates on defining the problems or needs of and implementing solutions for whom? a. Individuals b. Aggregates c. Communities d. Geographical regions ANS: B Aggregates are a defined population made up of individuals in communities of a specific geographical region. Population-focused practice is implemented with defined populations or subpopulations. This is larger than the scope of individual care but may not address the larger needs of the entire community or geographical region. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 27. A nurse is using a population focus when providing public health nursing care. Which statement best describes the care that is being provided? a. Priority is given to the highest risk population. b. Direct caregiving is limited to preventive measures, such as administration of immunizations. c. Attention is given to the population or community, regardless of whether they do or do not access the health care system. d. Only populations outside institutional settings are considered. ANS: C PHNs are concerned with the health of the entire population. Priority is given to the entire population, not just the group at highest risk or those outside of institutional settings. Direct caregiving is not the focus of public health nursing care. DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 28. A nurse is working in a community health nursing practice setting. Which intervention is the nurse most likely to implement? a. Administering a flu shot to a client in a physician’s office b. Conducting a flu shot clinic at a community center c. Performing a client assessment in a hospital d. Providing supervision of staff in a rehabilitation center ANS: A NURSINGTB.COM Community health nursing practice focuses on the health of individuals, families, and groups and the effect of their health status on the health of the whole community. Administering a flu shot to an individual is the only example that meets this criterion. Performing a client assessment focuses only on individual care, not the community. Providing supervision of staff does not focus on the community. Conducting a flu shot clinic at a community center focuses on protecting the community as a whole and would be considered public health nursing practice. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 29. Which statement about community health nursing practice is correct? a. It focuses on the delivery of personal health services to individuals and families. b. It provides care to protect the health of the whole community. c. It emphasizes the setting where care is provided for clients and families. d. It requires a baccalaureate preparation for practice. ANS: A Public health nursing provides care to protect the health of the community as a whole. Community-based nursing practice emphasizes the setting where care is provided for clients and families. It is generally assumed that a graduate of any baccalaureate program has the necessary basic preparation to function as a beginning staff PHN; however, this is not a requirement for public health nursing or community health nursing practices. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 30. A nurse is implementing community-based nursing care. Which intervention is the nurse most likely to complete? a. Assessing the health needs of a defined community b. Providing care to families in a community c. Promoting the health of an entire community d. Investigating environmental health problems in a community ANS: B Community-based nursing practice is a setting-specific practice whereby care is provided for families where they live, work, and attend school. The focus is on acute and chronic care and the provision of services. Providing care to families is the only intervention that accurately describes this definition. Assessing the health needs of a community, promoting the health needs of an entire community, and investigating environmental health problems in a community would be considered public health nursing practice. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care N R I G B.C M 31. A nurse is conducting vision screenings on children in the school setting. Which type of nursing practice is the nurse performing? a. Community-oriented b. Public health c. Community health d. Community-based ANS: D Community-based nursing practice is a setting-specific practice whereby care is provided for clients and families where they live, work, and attend school. Community-oriented nursing emphasizes the prevention of disease and disability. Public health nursing focuses on the care within the whole community. Community health nursing focuses on the health status of individuals and the effect of their health status on the whole community. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 32. The nurse is investigating environmental health problems caused by contaminated ground water. Which type of nursing practice is being implemented? a. Community-oriented b. Community-based c. Policy development d. Tertiary care ANS: A Community-oriented nursing emphasizes the prevention of disease and disability. Community-based nursing practice is a setting-specific practice whereby care is provided for clients and families where they live, work, and attend school. Policy development seeks to build constituencies that can help bring about change in public policy. Tertiary care focuses on highly specialized medical care. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 33. A public health staff nurse (PHN) who has a clear understanding of population-focused practice, would most likely engage in what activity? a. Volunteering for a local community action coalition b. Performing interventions with individuals in the community c. Improving the effectiveness of care provided d. Considering earning a PHN certification ANS: C Public health staff nurses who have a clear understanding of population-focused care improve their effectiveness and efficiency of practice; have professional satisfaction by seeing how individual care contributes to health at the population level; and appreciate the practice of others who are population-focused specialists. PHN specialists are prepared at the master’s level and function in an administrative role. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: NCLEX: Health ProNmoRtionIanGd MBCenaMnce 34. Public health nurse (PHNs) are looking to improve population-focused care in the community. Which activity best describes a key opportunity for the nurses to accomplish this goal? a. Assuming traditional nursing roles b. Influencing public health policy c. Conducting community assessments d. Specializing in community-based nursing practice ANS: B PHNs must move into positions in which they can influence policy formation. They must assume positions that are not traditionally considered nursing. Conducting community assessments is part of public health nursing practice, not necessarily a key opportunity to improve practice. Specializing in community-based nursing practice is setting-specific and does not relate to a key opportunity to improve population-focused care. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 35. A local senator has proposed changes to the health care delivery system in the United States. Based on current trends, what is most likely to occur? a. There will be new opportunities provided for public health specialists. b. It will result in isolated care being provided to individuals. c. There will be an increased emphasis in specialty care. d. It will increase the utilization of acute care services. ANS: A Proposed changes in the health care delivery system will provide new opportunities for public health specialists and result in the creation of new roles within the system. The proposed changes will build an integrated system (not isolated), decrease emphasis on acute care services, and focus on health promotion and disease prevention. DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care MULTIPLE RESPONSE 1. What are considered barriers to public health nursing? (Select all that apply.) a. The mindset that the only role for the nurse is at the bedside. b. The structures within which nurses work and the process of role socialization within those structures. c. Few nurses receive graduate-level preparation in the concepts and strategies of the disciplines basic to public health. d. The steady decline in the number of job opportunities in the area. e. The inability to equally distribute the increasing funds. ANS: A, B, C Barriers exist in thinking that nurses only work in a hospital at the bedside, the process of role socialization in public health which can be a very autonomous profession, and that few nurses have had advanced eNdUucRaStioInNinGpTuBChOeaMlth. The number of job opportunities continues to increase, but the amount of funding allotted to public health continues to decline. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care Chapter 02: History of Public Health and Public and Community Health Nursing Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 10th Edition MULTIPLE CHOICE 1. In the past, what term was used to identify population-centered nurses? a. District nurses b. Almshouse nurses c. Soldier nurses d. Sisters ANS: A In the past, population-centered nurses have been called public health nurses (PHNs), district nurses, visiting nurses, school nurses, occupational health nurses, and home health nurses. Many women who performed nursing functions in almshouses and early hospitals in Great Britain were poorly educated, untrained, and often undependable. The original soldier nurses worked with Florence Nightingale at Scutari. Various groups of “sisters” have been used throughout history to care for the poor. DIF: Cognitive level: Remembering TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 2. A nurse is working in a public health nursing setting. Which statement best describes why this specialty is appealing to nurses? a. Interactions with wealthNyUcRonStrIibNuGtoTrsBto.sCecOuMre funding b. Autonomy and independence of practice c. Ability to locate the source of diseases and cure patients d. Opportunities to meet a variety of people ANS: B Community health nurses have a long history of autonomous practice, problem solving, and decision making. Community health care nurses engage in the other activities as well, but overall, they have been best known for autonomy of practice. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 3. What are the newest threats to health in the United States that community health nurses deal with? a. Diphtheria, cholera, and hepatitis b. HIV, influenza, and bioterrorism c. Avian flu, tuberculosis (TB), and radiation d. Polluted water and air ANS: B The newest threats to health that PHNs are involved in are HIV, H1N1 influenza, and bioterrorism. Hepatitis is also a current threat, but diphtheria and cholera are not concerns in the United States. Avian flu may be a threat, but radiation and TB are ongoing. Environmental pollution has been reduced; however, there are pollution issues that do raise concerns. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 4. A nurse is working to reform a program that was based on the Elizabethan Poor Law of 1601. Which of the following programs is the nurse most likely working on? a. Welfare b. Food Stamps c. Medicaid d. Medicare ANS: C The Poor Law guaranteed medical care for poor, blind, and “lame” individuals, making it most similar to Medicaid since this program provides medical insurance to these types of individuals. Welfare provides more than health care. Food stamps do not provide medical care. The Medicare program provides medical care to the elderly population. DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 5. In early colonial North America, a colonist worked in the public health sector. Which activity would have most liNkelyRbeIen tGhe fBoc.uCs? M a. Establishing schools of nursing b. Developing vaccines to administer to large numbers of people c. Collecting vital statistics and improving sanitation d. Developing public housing and almshouses ANS: C The early colonial public health efforts included the collection of vital statistics, improvements to sanitation systems, and control of communicable disease introduced through seaports. Establishing schools of nursing, developing vaccines, and developing public housing are all events that happened after the colonial period. DIF: Cognitive level: Remembering TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 6. A nurse was employed by the Marine Hospital Service. Which of the following tasks would have most likely been the responsibility of the nurse? a. Setting policy on quarantine legislation for immigrants b. Establishing hospital-based programs to care for the sick at home c. Identifying and improving environmental conditions d. Providing health care for merchant seamen ANS: D Providing health care to seamen was an early effort by the federal government to improve public health. The purpose of the Marine Hospital Service was to secure its maritime trade and seacoast cities. Marine Hospital Service nurses did not establish policies or hospital programs. They also did not identify and improve environmental conditions as Florence Nightingale did. Their sole purpose was to provide care for this population. DIF: Cognitive level: Applying TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 7. What was Florence Nightingale’s contributions to public health? a. Caring for the sick, poor, and neglected in institutions and at home b. Using a population-based approach that led to improved environmental conditions c. Writing the Elizabethan Poor Law to guarantee medical care for all d. Founding of the district nursing association to provide health care to needy people ANS: B During the Crimean War, Nightingale progressively improved the soldiers’ health by adopting a population-based approach that used simple epidemiological measures and greatly decreased mortality. The focus of her care was on wounded soldiers, not those who were sick, poor, and neglected at homes and institutions. She did not write the Elizabethan Poor Law. William Rathbone founded the district nursing association. DIF: Cognitive level: Remembering TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 8. What was Lillian Wald’s major contribution to public health nursing? a. Founding the AmericanNNuRrsesIAsGsociBCn M b. Developing the New York Training Hospital for Nurses c. Creating the Public Health Service d. Establishing the Henry Street Settlement ANS: D Lillian Wald established the Henry Street Settlement. Isabel Hampton Robb founded the American Nurses Association. Lillian Wald was a graduate of the New York Training Hospital for Nurses. The Public Health Service was established by the federal government. DIF: Cognitive level: Remembering TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 9. A nurse is providing public health education based on the teachings of Lillian Wald. Which of the following topics will the nurse most likely discuss? a. Taking and recording blood pressures accurately b. Safe and sanitary baby and child care c. Environmental pollutants and their effects on lung disease d. Time management: balancing factory work and the home ANS: B Lillian Wald provided health care that included educating the community on health care matters. The focus of most of her work was on health services and health promotion for families and children. Because of her focus on health promotion for families and children, her primary role would not have been taking and recording blood pressures, discussing environmental pollutants (as her focus was not occupational health), or time management (at the time, very few women were working outside of the home). DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 10. Nurses who provided care to people in their homes were referred to as what type of nurses? a. Private duty b. Visiting c. Public health d. Community health ANS: B The visiting nurse cared for several families in a day and helped make care of the sick poor at home economical, whereas a private duty nurse may live with a family of clients receiving care and was to be available 24 hours a day. PHNs focused on care of populations. Community health nurses would be anyone who worked outside of a hospital setting. DIF: Cognitive level: Remembering TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 11. What term was used to identify neighborhood centers that provided health care, education, and social welfare programNs? R I G B.C M a. Settlement houses b. Nursing care centers c. Nurse-managed clinics d. Public health services (PHSs) ANS: A Settlement houses were neighborhood centers that provided health care, education, and social welfare programs. Nursing centers, nurse-managed clinics, and PHSs are not necessarily in neighborhoods. DIF: Cognitive level: Remembering TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 12. A nurse worked in a school setting during the early twentieth century. Which activity would have been the focus of this nurse’s practice? a. Investigating causes of absenteeism b. Teaching school as well as being a nurse c. Promoting nursing as an autonomous practice d. Providing medical treatment to enable children to return to school ANS: A