COMMUNITY PUBLIC HEALTH
COMMUNITY/PUBLIC HEALTH NURSING, 8TH EDITION
BY MARY A.NIES (COMPLETE CHAPTERS 1-34)
, COMMUNITY PUBLIC HEALTH
Table of Contents
Chapter 01: HEALTH: A Community View......................................................................................................... 4
Chapter 02: Historical Factors: Community HEALTH Nursing In Context............................................ 18
Chapter 03: Thinking Upstream: Nursing Theories And Population-Focused Nursing Practice . 36
Chapter 04: HEALTH Promotion And Risk Reduction ............................................................................... 46
Chapter 05: Epidemiology .................................................................................................................................. 59
Chapter 06: Community Assessment ............................................................................................................. 77
Chapter 07: Community HEALTH Planning, Implementation, And Evaluation ................................... 89
Chapter 08: Community HEALTH Education............................................................................................... 105
Chapter 09: Case Management........................................................................................................................ 122
Chapter 10: Policy, Politics, Legislation, And Community HEALTH Nursing .....................................132
Chapter 11: The HEALTH Care System .......................................................................................................... 153
Chapter 12: Economics Of HEALTH Care ...................................................................................................... 167
Chapter 13: Cultural Diversity And Community HEALTH Nursing ....................................................... 185
Chapter 14: Environmental HEALTH ............................................................................................................. 203
Chapter 15: HEALTH In The Global Community...........................................................................................215
Chapter 16: Child And Adolescent HEALTH................................................................................................. 226
Chapter 17: Women’s HEALTH ......................................................................................................................... 247
Chapter 18: Men’s HEALTH ............................................................................................................................... 268
Chapter 19: Senior HEALTH ............................................................................................................................. 277
Chapter 20: Family HEALTH ............................................................................................................................ 296
Chapter 21: Populations Affected By Disabilities .......................................................................................312
Chapter 22: Veterans HEALTH ........................................................................................................................ 325
Chapter 23: Homeless Populations .............................................................................................................. 340
Chapter 24: Rural And Migrant HEALTH......................................................................................................355
Chapter 25: Populations Affected By Mental Illness ............................................................................... 375
Chapter 26: Communicable Disease ............................................................................................................. 387
Chapter 27: Substance Abuse ........................................................................................................................ 402
Chapter 28: Violence ..........................................................................................................................................423
Chapter 29: Natural And Man-Made Disasters .........................................................................................437
Chapter 31: Occupational HEALTH ................................................................................................................. 451
Chapter 32: Forensic And Correctional Nursing....................................................................................... 467
Chapter 33: Faith Community Nursing ........................................................................................................ 480
, COMMUNITY PUBLIC HEALTH
Chapter 34: Home HEALTH And Hospice ................................................................................................... 490
, COMMUNITY PUBLIC HEALTH
Chapter 01: HEALTH: A Community View
Nies: Community/Public HEALTH Nursing, 8th Edition
MULTIPLE CHOICE
1. Which 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
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, Which Increased From 5.7% Of The Gross Domestic Product
In 1965 To 17.8% In 2015. Politicians And The Media Both Influence Americans’ Perceptions
About HEALTH Care; However, They Are Not The Primary Reason Why Americans Are
Concerned. The New HEALTH Care System Will Change The HEALTH Care Access And
Availability, But Will Not Necessarily Be Offering Any Free Services To Americans.
DIF: Cognitive Level: Understand (Comprehension)
2. A Nurse Has Begun To Lobby With Politicians For Changes To The HEALTH Care System.
Why Is This Involvement Important?
A. Nurses, As Central Characters In Several Popular TV Series, 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 That Is Employed Both Inside And Outside Of Hospitals.
ANSWER: C
As The Largest Segment Of HEALTH Care Providers, Nurses Are Informed About The Current
HEALTH Care System And All The Problems That Result From People Not Seeking Care Until
They Are Desperately Ill. Nurses, As The American Nurses Association (ANA) Emphasize,
, COMMUNITY PUBLIC HEALTH
Usually Believe That HEALTH Care Is A Right, Not A Privilege. Therefore, Nurses, Whose Work
Is Central To Our Current HEALTH Care Delivery System, Can Also Be Instrumental In Working
Politically To Create A HEALTH Care Delivery System That Will Meet HEALTH Needs. While
Nurses Are In Several Current TV Series And Are Employed Both Inside And Outside Of
Hospitals, Physicians And Other HEALTH Care Providers Are As Well. Nurses Are Often
Managers, But Managers Often Have Other Backgrounds, Such As Business Administration.
DIF: Cognitive Level: Understand (Comprehension)
3. What Conclusion Can Be Drawn From Examining Where Nurses Are 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
Mcos Are Employing Nurses In Many Capacities. Although Hospitals Are Closing And Acute
Care Is Increasingly Found In Central Medical Centers, The Same Trend May Be Seen In An
Increase In Neighborhood-Based Practice Centers. While Positions Are Cut In Most Industries,
HEALTH Care Is Recognized As An Area Where Growth In Employment Is Expected. However,
Nurses Are Increasingly Employed In Community Settings As Opposed To Hospitals. This
Change Reflects The Move Toward Community-Based Care Rather Than Hospital-Based
Tertiary Care. To Help Decrease The Continued Rise In HEALTH Care Costs, The Increased
Emphasis Is On Disease Prevention Rather Than High-Cost Treatment.
DIF: Cognitive Level: Understand (Comprehension)
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
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
, COMMUNITY PUBLIC HEALTH
Cures Within The Market Justice System Has Stifled The Evolution Of A HEALTH System To
Protect And Preserve The HEALTH Of The Population. Although Individual Autonomy And
Freedom Of Choice Are Important, So Is The Recognition Of Collective Responsibility In
Ensuring Social Justice, Which Entitles All People To Basic Necessities.
DIF: Cognitive Level: Apply (Application)
5. What Is The Primary Problem Seen In HEALTHy People 2020’s Emphasis On Choosing
HEALTHy Lifestyle Behaviors, Such As Daily Exercise Or HEALTHy Food Choices?
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 As Opposed To Quick And Cheap Fast-Food Choices.
D. Public Policy Emphasizes Personal Responsibility But Ignores Social And
Environmental Changes Needed For Well-Being.
ANSWER: D
Although All Responses Are Accurate, The Primary Problem Is The Emphasis On Personal
Choices In The HEALTHy People 2020 Objectives. Emphasis On Personal Choices Ignores The
Need For Community Responsibility And Action That Addresses Environmental Or Cultural
Restraints To HEALTH.
DIF: Cognitive Level: Apply (Application)
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
To Clients.
B. Recognize The Need For Experienced Nurses To Mentor New Graduates To Help
Increase And Expand The Number Of Professionals Available.
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
, COMMUNITY PUBLIC HEALTH
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. The Code Does
Not Directly Address Workplace Issues, Such As Work Schedules Or Need For Overtime.
DIF: Cognitive Level: Analyze (Analysis)
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 Or Infirmity.
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
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.
DIF: Cognitive Level: Apply (Application)
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
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). A Particular Phenomenological Group May Or May Not Have Been A
Planned Group—That Is, A Group That Came Together To Resolve A Recognized Common
Problem Or To Meet A Common Goal. However, Of All The Choices, A Group Of Persons Who
Share A Common Identity (Phenomenological Group) And Environment (Which Implies A
Specific Geographic Setting) Is The Broadest And Most Complete Definition.
, COMMUNITY PUBLIC HEALTH
DIF: Cognitive Level: Apply (Application)
9. Which Variable 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 The Public Safety Officers (Police Officers, Firefighters, Etc.)
D. The Number And Credentials Of Public HEALTH Officials In The Community
ANSWER: A
Individual Behavior Choices Are Responsible For About 50% Of HEALTH Outcomes. Individual
Choices Are Affected Through Interaction With Other Individuals, And Their Mutual Social And
Physical Environments. The Number Of HEALTH Care Providers Has Not Played A Major Role
In The HEALTH Outcomes In The Community In Comparison To Individual HEALTH Behaviors.
The Quality Of Public Safety Officers And Number Of Public HEALTH Officials Have Not Been
Identified As Major Contributors To The Determinants Of HEALTH.
DIF: Cognitive Level: Apply (Application)
10. What Change Could Most Effectively Lead To A Longer Life Span In Americans?
A. Parenting And Sexual Behavior Classes In All Public School Systems
B. Legislation Restricting Alcohol And Drug Use
C. Notably Reducing Speed Limits On All State And Federal Highways, And Changing The
Age Limit For Driving To 21 Years Of Age
D. The Belief That Smoking Is Shameful And Disgusting, As Well As Expensive, Becoming
The Social Norm
ANSWER: D
Smoking Is Responsible For Almost 20% Of All Deaths In The United States. Although Smoking
Is An Individual’s Choice, All People Are Affected By Social Norms. Parenting And Sexual
Behavior Classes And Legislative Changes May Influence HEALTH, But May Not Necessarily
Lead To A Longer Lifespan. Community HEALTH Nurses Should Recognize That HEALTH Is
Influenced By A Web Of Factors, Some That Can Be Changed And Some That Cannot.
Influencing Social Norms May Better Promote Change Among Americans.
, COMMUNITY PUBLIC HEALTH
DIF: Cognitive Level: Apply (Application)
11. What Is The HEALTH Issue Causing The Most Concerning The United States Today?
A. Diabetes Epidemic
B. Increase In Cardiac Disease
C. Increase In Obesity
D. Rise In Cancer Rates
ANSWER: C
The Widespread Increase In Incidence Of Overweight And Obesity Has Led To Calls For
Population-Based Measures To Address This Issue. The Overarching Problem Of Obesity Has
Led To An Increase In Diabetes As Well As Cardiac Disease. If This HEALTH Issue Was
Controlled, There Should Be In A Decrease In The Other HEALTH Issues.
DIF: Cognitive Level: Understand (Comprehension)
12. What Factors Are Most Responsible For The Increasing Length Of Life Of Americans Over
The Past 100 Years?
A. Better Nutrition And Family Planning Options
B. Education Concerning The Need To Reduce Salt And Fat In The Diet
C. Improved Medical Care, Including Exciting New Technologies
D. More Efficient Cancer Screenings And Early Intervention
ANSWER: A
Average Increased Life Span Over The Past 100 Years Can Be Largely Attributed To Higher
Standards Of Living, Better Nutrition, A HEALTHier Environment, And Having Fewer Children.
Public HEALTH Efforts Such As Immunization And Medical Care Have Also Contributed.
DIF: Cognitive Level: Understand (Comprehension)
13. Why Would A Public HEALTH Nurse Want To Know About Morbidity And Mortality Statistics
On The Local, State, And National Level?
A. To Be Able To Share Current Trends In HEALTH Problems With The Community
B. To Be Able To Observe The Community’s Statistics Over Time And Compare The
Community With Other Communities
, COMMUNITY PUBLIC HEALTH
C. To Justify Local Budgets And The Need For Increased Income From Citizens
D. To Publicize Current HEALTH Issues And Suggest Appropriate Actions To Citizens
ANSWER: B
Although Being Informed And Being Able To Educate The Public Is Always Preferred And
Nurses Often Do Have To Justify Budgets, Data Are Needed To Compare The Local Community
With Itself Over Time And With Other Communities So That Problems May Be Recognized And
Action Taken To Confront HEALTH Issues. The First Step Is Always To Recognize Problems As
They Develop.
DIF: Cognitive Level: Apply (Application)
14. How Do Public HEALTH Efforts Differ From Medical Efforts In Improving The HEALTH Of Our
Citizens?
A. Medical Care Providers Autonomously Choose Appropriate Interventions, Whereas
Public HEALTH Care Providers Must Engage In Whatever Actions Legislation Requires.
B. Medical Care Providers Are Self-Employed Or Agency Employed, Whereas Public
HEALTH Care Providers Are Employed By And Paid Through The Government.
C. Medical Care Providers Focus Only On Individuals, Whereas Public HEALTH Care
Providers Focus Only On Aggregates.
D. Medical Care Providers Focus On Disease Diagnosis And Management, Whereas Public
HEALTH Care Providers Focus On HEALTH Promotion And Disease Prevention.
ANSWER: D
Medical Care Providers Are Restricted By Insurance And Government Regulations. Providers
May Also Be Employed In Government Facilities, Such As Veterans Administration Facilities.
However, Medical Care Providers Primarily Focus On Diagnosis And Treatment Of Disease,
Whereas Public HEALTH Care Providers Try To Promote HEALTH And Prevent Disease.
Although Medical Care Providers Primarily Focus On Individuals And Public HEALTH Care
Providers Primarily Focus On Aggregates, Their Practice Is Not Limited To Only Individuals Or
Only Aggregates.
DIF: Cognitive Level: Apply (Application)
15. Which Primary Prevention Would The School Nurse Choose To Address The School’s
Number Of Unwed Pregnancies?
A. Create A Class On Parenting For Both The Moms-To-Be And The Dads-To-Be.
COMMUNITY/PUBLIC HEALTH NURSING, 8TH EDITION
BY MARY A.NIES (COMPLETE CHAPTERS 1-34)
, COMMUNITY PUBLIC HEALTH
Table of Contents
Chapter 01: HEALTH: A Community View......................................................................................................... 4
Chapter 02: Historical Factors: Community HEALTH Nursing In Context............................................ 18
Chapter 03: Thinking Upstream: Nursing Theories And Population-Focused Nursing Practice . 36
Chapter 04: HEALTH Promotion And Risk Reduction ............................................................................... 46
Chapter 05: Epidemiology .................................................................................................................................. 59
Chapter 06: Community Assessment ............................................................................................................. 77
Chapter 07: Community HEALTH Planning, Implementation, And Evaluation ................................... 89
Chapter 08: Community HEALTH Education............................................................................................... 105
Chapter 09: Case Management........................................................................................................................ 122
Chapter 10: Policy, Politics, Legislation, And Community HEALTH Nursing .....................................132
Chapter 11: The HEALTH Care System .......................................................................................................... 153
Chapter 12: Economics Of HEALTH Care ...................................................................................................... 167
Chapter 13: Cultural Diversity And Community HEALTH Nursing ....................................................... 185
Chapter 14: Environmental HEALTH ............................................................................................................. 203
Chapter 15: HEALTH In The Global Community...........................................................................................215
Chapter 16: Child And Adolescent HEALTH................................................................................................. 226
Chapter 17: Women’s HEALTH ......................................................................................................................... 247
Chapter 18: Men’s HEALTH ............................................................................................................................... 268
Chapter 19: Senior HEALTH ............................................................................................................................. 277
Chapter 20: Family HEALTH ............................................................................................................................ 296
Chapter 21: Populations Affected By Disabilities .......................................................................................312
Chapter 22: Veterans HEALTH ........................................................................................................................ 325
Chapter 23: Homeless Populations .............................................................................................................. 340
Chapter 24: Rural And Migrant HEALTH......................................................................................................355
Chapter 25: Populations Affected By Mental Illness ............................................................................... 375
Chapter 26: Communicable Disease ............................................................................................................. 387
Chapter 27: Substance Abuse ........................................................................................................................ 402
Chapter 28: Violence ..........................................................................................................................................423
Chapter 29: Natural And Man-Made Disasters .........................................................................................437
Chapter 31: Occupational HEALTH ................................................................................................................. 451
Chapter 32: Forensic And Correctional Nursing....................................................................................... 467
Chapter 33: Faith Community Nursing ........................................................................................................ 480
, COMMUNITY PUBLIC HEALTH
Chapter 34: Home HEALTH And Hospice ................................................................................................... 490
, COMMUNITY PUBLIC HEALTH
Chapter 01: HEALTH: A Community View
Nies: Community/Public HEALTH Nursing, 8th Edition
MULTIPLE CHOICE
1. Which 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
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, Which Increased From 5.7% Of The Gross Domestic Product
In 1965 To 17.8% In 2015. Politicians And The Media Both Influence Americans’ Perceptions
About HEALTH Care; However, They Are Not The Primary Reason Why Americans Are
Concerned. The New HEALTH Care System Will Change The HEALTH Care Access And
Availability, But Will Not Necessarily Be Offering Any Free Services To Americans.
DIF: Cognitive Level: Understand (Comprehension)
2. A Nurse Has Begun To Lobby With Politicians For Changes To The HEALTH Care System.
Why Is This Involvement Important?
A. Nurses, As Central Characters In Several Popular TV Series, 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 That Is Employed Both Inside And Outside Of Hospitals.
ANSWER: C
As The Largest Segment Of HEALTH Care Providers, Nurses Are Informed About The Current
HEALTH Care System And All The Problems That Result From People Not Seeking Care Until
They Are Desperately Ill. Nurses, As The American Nurses Association (ANA) Emphasize,
, COMMUNITY PUBLIC HEALTH
Usually Believe That HEALTH Care Is A Right, Not A Privilege. Therefore, Nurses, Whose Work
Is Central To Our Current HEALTH Care Delivery System, Can Also Be Instrumental In Working
Politically To Create A HEALTH Care Delivery System That Will Meet HEALTH Needs. While
Nurses Are In Several Current TV Series And Are Employed Both Inside And Outside Of
Hospitals, Physicians And Other HEALTH Care Providers Are As Well. Nurses Are Often
Managers, But Managers Often Have Other Backgrounds, Such As Business Administration.
DIF: Cognitive Level: Understand (Comprehension)
3. What Conclusion Can Be Drawn From Examining Where Nurses Are 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
Mcos Are Employing Nurses In Many Capacities. Although Hospitals Are Closing And Acute
Care Is Increasingly Found In Central Medical Centers, The Same Trend May Be Seen In An
Increase In Neighborhood-Based Practice Centers. While Positions Are Cut In Most Industries,
HEALTH Care Is Recognized As An Area Where Growth In Employment Is Expected. However,
Nurses Are Increasingly Employed In Community Settings As Opposed To Hospitals. This
Change Reflects The Move Toward Community-Based Care Rather Than Hospital-Based
Tertiary Care. To Help Decrease The Continued Rise In HEALTH Care Costs, The Increased
Emphasis Is On Disease Prevention Rather Than High-Cost Treatment.
DIF: Cognitive Level: Understand (Comprehension)
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
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
, COMMUNITY PUBLIC HEALTH
Cures Within The Market Justice System Has Stifled The Evolution Of A HEALTH System To
Protect And Preserve The HEALTH Of The Population. Although Individual Autonomy And
Freedom Of Choice Are Important, So Is The Recognition Of Collective Responsibility In
Ensuring Social Justice, Which Entitles All People To Basic Necessities.
DIF: Cognitive Level: Apply (Application)
5. What Is The Primary Problem Seen In HEALTHy People 2020’s Emphasis On Choosing
HEALTHy Lifestyle Behaviors, Such As Daily Exercise Or HEALTHy Food Choices?
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 As Opposed To Quick And Cheap Fast-Food Choices.
D. Public Policy Emphasizes Personal Responsibility But Ignores Social And
Environmental Changes Needed For Well-Being.
ANSWER: D
Although All Responses Are Accurate, The Primary Problem Is The Emphasis On Personal
Choices In The HEALTHy People 2020 Objectives. Emphasis On Personal Choices Ignores The
Need For Community Responsibility And Action That Addresses Environmental Or Cultural
Restraints To HEALTH.
DIF: Cognitive Level: Apply (Application)
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
To Clients.
B. Recognize The Need For Experienced Nurses To Mentor New Graduates To Help
Increase And Expand The Number Of Professionals Available.
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
, COMMUNITY PUBLIC HEALTH
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. The Code Does
Not Directly Address Workplace Issues, Such As Work Schedules Or Need For Overtime.
DIF: Cognitive Level: Analyze (Analysis)
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 Or Infirmity.
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
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.
DIF: Cognitive Level: Apply (Application)
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
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). A Particular Phenomenological Group May Or May Not Have Been A
Planned Group—That Is, A Group That Came Together To Resolve A Recognized Common
Problem Or To Meet A Common Goal. However, Of All The Choices, A Group Of Persons Who
Share A Common Identity (Phenomenological Group) And Environment (Which Implies A
Specific Geographic Setting) Is The Broadest And Most Complete Definition.
, COMMUNITY PUBLIC HEALTH
DIF: Cognitive Level: Apply (Application)
9. Which Variable 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 The Public Safety Officers (Police Officers, Firefighters, Etc.)
D. The Number And Credentials Of Public HEALTH Officials In The Community
ANSWER: A
Individual Behavior Choices Are Responsible For About 50% Of HEALTH Outcomes. Individual
Choices Are Affected Through Interaction With Other Individuals, And Their Mutual Social And
Physical Environments. The Number Of HEALTH Care Providers Has Not Played A Major Role
In The HEALTH Outcomes In The Community In Comparison To Individual HEALTH Behaviors.
The Quality Of Public Safety Officers And Number Of Public HEALTH Officials Have Not Been
Identified As Major Contributors To The Determinants Of HEALTH.
DIF: Cognitive Level: Apply (Application)
10. What Change Could Most Effectively Lead To A Longer Life Span In Americans?
A. Parenting And Sexual Behavior Classes In All Public School Systems
B. Legislation Restricting Alcohol And Drug Use
C. Notably Reducing Speed Limits On All State And Federal Highways, And Changing The
Age Limit For Driving To 21 Years Of Age
D. The Belief That Smoking Is Shameful And Disgusting, As Well As Expensive, Becoming
The Social Norm
ANSWER: D
Smoking Is Responsible For Almost 20% Of All Deaths In The United States. Although Smoking
Is An Individual’s Choice, All People Are Affected By Social Norms. Parenting And Sexual
Behavior Classes And Legislative Changes May Influence HEALTH, But May Not Necessarily
Lead To A Longer Lifespan. Community HEALTH Nurses Should Recognize That HEALTH Is
Influenced By A Web Of Factors, Some That Can Be Changed And Some That Cannot.
Influencing Social Norms May Better Promote Change Among Americans.
, COMMUNITY PUBLIC HEALTH
DIF: Cognitive Level: Apply (Application)
11. What Is The HEALTH Issue Causing The Most Concerning The United States Today?
A. Diabetes Epidemic
B. Increase In Cardiac Disease
C. Increase In Obesity
D. Rise In Cancer Rates
ANSWER: C
The Widespread Increase In Incidence Of Overweight And Obesity Has Led To Calls For
Population-Based Measures To Address This Issue. The Overarching Problem Of Obesity Has
Led To An Increase In Diabetes As Well As Cardiac Disease. If This HEALTH Issue Was
Controlled, There Should Be In A Decrease In The Other HEALTH Issues.
DIF: Cognitive Level: Understand (Comprehension)
12. What Factors Are Most Responsible For The Increasing Length Of Life Of Americans Over
The Past 100 Years?
A. Better Nutrition And Family Planning Options
B. Education Concerning The Need To Reduce Salt And Fat In The Diet
C. Improved Medical Care, Including Exciting New Technologies
D. More Efficient Cancer Screenings And Early Intervention
ANSWER: A
Average Increased Life Span Over The Past 100 Years Can Be Largely Attributed To Higher
Standards Of Living, Better Nutrition, A HEALTHier Environment, And Having Fewer Children.
Public HEALTH Efforts Such As Immunization And Medical Care Have Also Contributed.
DIF: Cognitive Level: Understand (Comprehension)
13. Why Would A Public HEALTH Nurse Want To Know About Morbidity And Mortality Statistics
On The Local, State, And National Level?
A. To Be Able To Share Current Trends In HEALTH Problems With The Community
B. To Be Able To Observe The Community’s Statistics Over Time And Compare The
Community With Other Communities
, COMMUNITY PUBLIC HEALTH
C. To Justify Local Budgets And The Need For Increased Income From Citizens
D. To Publicize Current HEALTH Issues And Suggest Appropriate Actions To Citizens
ANSWER: B
Although Being Informed And Being Able To Educate The Public Is Always Preferred And
Nurses Often Do Have To Justify Budgets, Data Are Needed To Compare The Local Community
With Itself Over Time And With Other Communities So That Problems May Be Recognized And
Action Taken To Confront HEALTH Issues. The First Step Is Always To Recognize Problems As
They Develop.
DIF: Cognitive Level: Apply (Application)
14. How Do Public HEALTH Efforts Differ From Medical Efforts In Improving The HEALTH Of Our
Citizens?
A. Medical Care Providers Autonomously Choose Appropriate Interventions, Whereas
Public HEALTH Care Providers Must Engage In Whatever Actions Legislation Requires.
B. Medical Care Providers Are Self-Employed Or Agency Employed, Whereas Public
HEALTH Care Providers Are Employed By And Paid Through The Government.
C. Medical Care Providers Focus Only On Individuals, Whereas Public HEALTH Care
Providers Focus Only On Aggregates.
D. Medical Care Providers Focus On Disease Diagnosis And Management, Whereas Public
HEALTH Care Providers Focus On HEALTH Promotion And Disease Prevention.
ANSWER: D
Medical Care Providers Are Restricted By Insurance And Government Regulations. Providers
May Also Be Employed In Government Facilities, Such As Veterans Administration Facilities.
However, Medical Care Providers Primarily Focus On Diagnosis And Treatment Of Disease,
Whereas Public HEALTH Care Providers Try To Promote HEALTH And Prevent Disease.
Although Medical Care Providers Primarily Focus On Individuals And Public HEALTH Care
Providers Primarily Focus On Aggregates, Their Practice Is Not Limited To Only Individuals Or
Only Aggregates.
DIF: Cognitive Level: Apply (Application)
15. Which Primary Prevention Would The School Nurse Choose To Address The School’s
Number Of Unwed Pregnancies?
A. Create A Class On Parenting For Both The Moms-To-Be And The Dads-To-Be.
