Chapter 16: Promoting Healthy Communities

NUR MISC Chapter 16: Promoting Healthy Communities Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 10th Edition MULTIPLE CHOICE 1. What is the goal of the Healthy Communities and Cities initiative? a. Promoting health through community participation b. Reorganizing the current health care system c. Maximizing the cost-benefit ratio of health care d. Improving the quality of care in communities ANS: A The goal of the Healthy Communities and Cities initiative is the promotion of health through community engagement and collaboration. This leads to addressing the health and quality of life for all through a process that includes diverse citizen participation, mobilization of all sections of the community, and community ownership. Reorganization of the current health care system, maximizing the cost-benefit ratio of health care, and improving the quality of care in communities are not part of the Healthy Communities and Cities initiative. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 2. Wearing seat belts is required in many communities. Children of a certain age must be restrained in a car seat or seNaUt bReSlt IwNheGnTriBCiOnMa car. Which of the following best describes what has happened in this community? a. Unilateral action of lawmakers b. Participation in health fairs c. Healthy public policy d. Media interest in protecting the public ANS: C Examples of healthy public policy are seat belt legislation, nonsmoking policies, and immunization policies for school-age children. Participation in health fairs involves providing health education and resources out in the community. Unilateral action of lawmakers does not demonstrate community involvement. Media interest does not create the legislation. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 3. What occurred when the Healthy Communities and Cities concept was brought to the United States? a. The cities chosen for the initial work were Los Angeles and New York City. b. Canada adopted the program at the same time for continuity across borders. c. The same strict guidelines that were implemented in Europe were used. d. Smaller communities and localities were targeted instead of large cities. ANS: D The concept of Healthy Communities was used to incorporate localities that were not necessarily cities. The initial projects were Healthy Cities Indiana and the California Healthy Cities project. Healthy Communities and Cities operate in other parts of the world under different names and national networks have been developed among countries. There are not strict guidelines for implementation of this program. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 4. The Healthy Communities and Cities initiative supports what idea? a. Healthy cities and communities must be both environmentally and socially sustainable. b. Healthy public policy is the responsibility of elected officials. c. Physical environments cannot be changed; thus, strategies must be developed in order to cope with them. d. The World Health Organization (WHO) is the primary source of information for cities. ANS: A Healthy cities and communities must be both environmentally and socially sustainable through a strategy of primary care. Healthy public policy should involve collaboration at all levels. Supportive environments should be created. The WHO originally began this movement, but now sharing occurs among those participating in this initiative. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and ENfUfeRctSivIe NCaGreTEBn.vCiroOnMment: Management of Care 5. A nurse utilizes the Centers for Disease Control and Prevention’s (CDC’s) Healthy Communities Program. Which of the following factors does the nurse recognize that will influence the continuance of this program? a. Time b. Community participation c. Federal involvement d. Technology ANS: B Community participation can influence the continuance of the Healthy Communities and Cities movement. Time, federal involvement, and technology are not as major of factor to continuation as is participation by the community. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 6. Healthy Communities and Cities is based on which of the following premises? a. When people can work out their own locally defined health problems, they will find sustainable solutions to those problems. b. When the health of a community is improved, the focus will be on life expectancy rather than quality of life. c. When health professionals assume a leadership role, the health of the community will improve. d. When cities recruit enough health professionals to care for those needing medical care, the cities health will improve. ANS: A Healthy Cities is based on the premise that when people can work out their own locally defined health problems, they will find sustainable solutions to those problems. Healthy Cities aims to add to quality of life. Healthy Cities focuses on collaboration by all members of the community. Healthy Cities uses a multifaceted approach to problem solving when trying to improve health. DIF: Cognitive level: Understanding TOP: Nursing process: Evaluation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 7. A nurse was involved in the initial implementation of the Healthy Communities and Cities initiative in the United States. Which of the following problems would have most likely been addressed? a. Reduction to the amount of pollutants released into the environment b. Provision of fire and police protection c. Creation of a coalition to address health disparities d. Elimination of crime and violence from the community ANS: C The concept of a healthy community or city is based on the belief that the health of the community is largely influenced by the environment in which people live and that health problems have multiple causes: social, economic, political, environmental, and behavioral. Creation of a coalition engages residents in addressing the problem, which is impacted by multiple factors. The initial aUctivSitiesNof Tthis initOiative focused on the problems of diverse populations. Reduction of the amount of pollutants and provision of fire and police protection do not address problems of diverse populations. Although crime and violence in a community may be decreased, it is not possible to eliminate it. DIF: Cognitive level: Analyzing TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 8. A nurse is implementing interventions to improve the health of the community. Which of the following approaches would be taken by the nurse? a. A top-down approach with rational-empirical problem solving b. A top-down approach with community practice planned by experts c. A bottom-up approach with facilitation of communication d. A bottom-up approach with multisectoral planning and action for health ANS: D A bottom-up approach with multisectoral planning and action for health incorporates community participation. A bottom-up approach uses broad-based community problem solving that includes health professionals, local officials, service providers, and other community members, including those at risk for health problems. The top-down approach describes when professionals and experts tell the citizens what to do rather than involving and asking them. Social planning stresses rational-empirical problem solving, usually by outside professional experts with a top-down approach. This approach does not focus on building community capacity or fostering fundamental social change. DIF: Cognitive level: Applying TOP: Nursing process: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care 9. A nurse is implementing the Community Health Promotion Model. Which of the following underlying principles should the nurse use to facilitate active participation? a. Individuals should work in groups to complete necessary tasks. b. Individuals participating should represent all segments of the population. c. People will work together if they like the leadership. d. People will participate when they see the issues as worthy of their time. ANS: D People participate when they feel a sense of community and see their involvement in the issues as relevant and worthy of their time. This is the second step of the Community Health Promotion Model. There should be a broad-based representation on the planning committee, but it may not represent all segments of the population. The tasks may need to be completed by both groups and individuals. Although the likability of leadership may influence who participates, it most likely will not influence whether they are able to work together. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 10. A nurse is leading a team responsible for evaluating the health of a community using the Community Health Promotion Model. Based on this model, which of the following steps would you expect the nurse to complete? a. Ensuring high technological access before the plan can be implemented b. Soliciting the consent of every member of the community c. Assessing the community d. Restructuring the public health policy in the community ANS: C Assessing the community is one of the nine steps of the Community Health Promotion Model. Restructuring public health policy, soliciting consent of all community members, and ensuring high technological access before implementing the plan are not part of this model. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 11. A nurse performs a community assessment as part of the Community Health Promotion Model. Which of the following best describes the rationale for this action? a. Becoming more acquainted with the multiple factors that influence health status