Community and Public Health Nursing, Evidence for Practice 2nd Edition by Gail A. Harkness, Rosanna DeMarco - Test Bank

1. HP 2010 is a guidepost for nurses and interdisciplinary teams in community and public health. What actions would you take to meet the primary goals for HP 2010 in a high-school setting as a resource for the school nurse? (Select all that apply) A) Establish a tobacco cessation program for students and faculty. B) Create a hearing and speech evaluation program. C) Establish a committee to create a self-sustaining sports and physical activity program. D) Create a program to educate staff and students regarding the impact of substance abuse on the student's body and prevention tactics. E) Establish an English as a second language program for students. 2. You have identified the specific indicators and focal areas needed to establish immunization and well-child clinics in a low-income neighborhood. What actions are needed to meet the health outcomes of the project? A) Identify the need in the community for the clinic based on subjective data. B) Develop a plan to meet the cost and promote the benefits of the project. C) Consider the need for the identified neighborhood for health care versus other low- income neighborhoods by interviewing the members of the neighborhood. D) Assume that the neighborhood will welcome the institution of a well-child and immunization clinic. 3. Absenteeism in the local middle school due to illness is increased. The increase is noted to be related to exacerbation of asthma symptoms in the student population. What would you suggest to the school to decrease absenteeism among this population? A) Develop a student/family/faculty-based program dedicated to education and surveillance. B) Develop a policy to exclude students with a diagnosis of asthma from the admission process. C) Create an asthma prevention plan within the school environment, based in the school nurse office. D) Create an education program for faculty related to the prevention of exacerbation of asthma systems. 4. Multiple family units in an underserved neighborhood have children who have not been vaccinated per health guidelines. You research the problem and establish a well-child clinic within walking distance to the neighborhood. The clinic is poorly attended. What changes would you make to revise your program and improve attendance to the clinic? A) Determine whether the location of the clinic is not conducive to attendance. B) Discuss the problem of attendance at the next community council meeting. C) Interview members of the neighborhood to determine why they do not use the Page 1 clinic. D) Discuss the problem with the local minister and request him to discuss the clinic at the next prayer service. 5. The local clinic is dedicated to the well adult and child. It has evening hours and offers varied programs for the community. The programs include smoking cessation, child care, weight loss through nutrition, and blood pressure clinics, to name a few. How would you explain the level of prevention used in this setting to your colleagues? A) Primary prevention B) Secondary prevention C) Tertiary prevention D) Quaternary prevention 6. Utilizing the tenets of secondary prevention, your committee seeks to establish an HIV/AIDS clinic. You state that it is important for the location of the clinic to be associated with the local hospital. The committee states that the cost of the clinic associated with the hospital is higher than one that is free standing. You explain the rationale for your suggestion in the following manner: A) Third-party insurance will reimburse the clinic visits only if the clinic is attached to the hospital. B) The hospital can address programs of care for the clients. C) The hospital will cover the clients only if the clinic is approved by the hospital governance board. D) The hospital will have a vested interest in the success of the clinic. 7. You are working in a facility that provides hospice care for clients with cancer diagnoses. You recognize that the care provided in this facility is tertiary in nature. You ask the student nurse observing your care to develop a plan for her clients that would include the tenets of tertiary prevention. The plan would include the following: (select all that apply) A) Palliative care B) Pain control C) Isolation D) Supportive spiritual development E) Diminished involvement of significant others 8. Mr. Guerra, age 47, a native of Guatemala, is admitted to the hospital with congestive heart failure to the coronary care unit. This is the fourth admission for Mr. Guerra, and the physician feels that the client's inability to adhere to his diet and medication regimen is the reason for his frequent admissions. A referral is made to the community health nurse upon Mr. Guerra's discharge from the Page 2 hospital. You would implement a plan of care that would include A) accommodating the client's needs by providing direct care solutions. B) developing culturally relevant and gender-sensitive interventions. C) teaching the family to adapt their cultural dietary plans to the client's diagnosis. D) assessing the client's financial needs and teaching and obtaining financial assistance as needed. 9. You are invited to conduct a class on December 8. The audience is a group that will attend an AA meeting after the clinic. During the class, you instruct the audience in the basics of nutrition. You answer questions asked by the audience by counseling them. You tell them that they just need to change their behaviors. You lose your audience. What changes would you make to the class to enhance audience participation and learning? A) Use consistent methods of persuasion. B) Offer advice while the participants are passive. C) Encourage the group to participate in the decision making. D) Encourage the group to continue ambivalent behaviors 10. You have decided to use a learning model based on Skinner to change the dietary habits of a diabetic client to enhance compliance with her diet and finger stick blood sugar levels. How would you implement this program? A) Give rewards for a lower blood sugar level and a food diary that reflected moderate dietary compliance. B) Eliminate the reward and punish when the client exhibits reluctance to comply with dietary guidelines. C) Demonstrate positive reinforcement by decreasing dietary guidelines and blood sugar parameters. D) Institute a strict timeline to accomplish goals. 11. You have decided to use the health belief model for your well-elder clinic “walking program.” The walk is to begin each day at 8 PM and each day a different elder is to start a phone tree to remind all to attend. You inform the clients in the clinic that walking will improve their overall health and well-being. Two elders show up the first night and none the second. What information would you gather to explain the failure of the program? (select all that apply) A) The severity of the physical challenge related to the client population B) What stands in the way of taking action toward the goal of health promotion C) The presence or absence of cues needed for the program to achieve success D) The presence or absence of a strong team leader among the elders E) The need to increase persuasion when implementing the program 12. Your committee has established the need for a sick child clinic in an Page 3 impoverished neighborhood. The demographic data have been collected and you are ready to meet with a committee of local businessmen who are willing to support the project financially. The plan is for the committees to combine to facilitate the establishment of the clinic. Using a transtheoretical model, what level of readiness would you determine the committees have achieved? A) Contemplation B) Preparation C) Action D) Relapse 13. Mr. Sandstrom, age 34, is recovering from a below-the-knee amputation secondary to a motor vehicle accident. You meet with the client to update his care plan and Mr. Sandstrom states that he knows that he will walk again. He asks for physical therapy schedules and time lines for prosthetics based on his healing process. Based on your knowledge of the theory of reasoned action, the client's behavior reflects A) an enhanced ability to meet his goals based on his intention and behaviors. B) unrealistic goal setting that is irrational based on the client's diagnosis and behaviors. C) a depression that will complicate the healing process. D) denial of the injury and part of the healing process. 14. James Bates, age 47, and three members of his neighborhood have had their homes robbed and belongings scattered. He contacts the police, and with their assistance, develops a neighborhood watch. The watch is organized and 24 families have been recruited to participate. The watch will be active throughout vacation months and as needed. This organization is representative of A) transtheoretical model. B) theory of reasoned action. C) social learning. D) relapse prevention model. 15. D.A., age 27, comes from a background of physical and sexual abuse. Violence victimization continued with her partners until recently. She is currently in a support group for victims of abuse. Her social background places her at risk for (select all that apply) A) increased safe sex behaviors. B) decreased safe sex behaviors. C) decreased risk for HIV/AIDS. D) increased risk for HIV/AIDS. E) increased risk of depression. Page 4 16. Jacqueline K, age 19, is diagnosed as HIV positive. Which behaviors might be indicators related to noncompliance with her drug regimen and require further assessment? (select all that apply) A) Negative affectivity B) Indifference to self-advocacy in sexual relationships C) Goal oriented related to treatment plan D) Client's expression of concern for the health and well-being of her children E) Client's expression of concern regarding the ability to pay for her medications 17. Carlene, age 32, is an African–American woman diagnosed with HIV. She is here for her 6-month appointment postdiagnosis and treatment. The client states that she has not revealed her diagnosis to her boy friend because she is afraid that he will leave. She expresses feelings of anger because she must put her feelings and illness aside or be abandoned. Carlene's behaviors reflect A) denial of her disease process. B) noncompliance with her drug regimen. C) inability to advocate for herself. D) fear of financial solvency. 18. A woman arrives at your clinic for a routine appointment. She has been HIV positive for 3 years and states she is doing well. She currently is involved in a relationship with a man who is HIV positive. She states that she is not consistent with safe sex practices due to her significant other's preferences and feels uncomfortable asking him to wear a condom. To promote your clients health you state the following: A) “You won't become pregnant because of your drug cocktail.” B) “You will not be protected against other strains of HIV or STIs.” C) “You will both be safe as long he has HIV.” D) “Let's have you both tested for STIs.” 19. Secondary HIV prevention or positive prevention is used when caring for African–American women living with HIV by addressing which of the following behavioral risks? (Select all that apply) A) Interpersonal mistrust B) Financial stability C) Poor adherence to treatment D) Active participation in treatment programs E) Compromised self-advocacy in sexual relationships 20. Sandy, age 43, is an African–American woman who is HIV positive. She has a personal history of abuse, which ended when her husband died 2 years ago. When counseling the client about adherence to her treatment plan, you find her Page 5 intelligent and goal oriented. In addition to education and follow-up regarding her medical needs what other diagnosis should you take into consider when caring for Sandy? A) Cardiac tamponade B) COPD C) PTSD D) Cirrhosis of the liver Page 6 Answer Key 1. A, C, D 2. B 3. A 4. C 5. A 6. B 7. A, B, D 8. B 9. C 10. A 11. A, B, C 12. B 13. A 14. D 15. B, D, E 16. A, B, E 17. C 18. B 19. A, C, D 20. C Page 7A) B) C) D) A) B) C) D) A) B) C) D) A) B) C) D) A) B) C) 1. What is one of the major changes in health care in the 21st century? Patient/client-centered care Decreased use of technology Decreased personal responsibility for health Social determinants of health 2. What is community-based nursing practice? Use of systematic processes to deliver care to individuals, families, and community groups with a focus on promoting, preserving, protecting, and maintaining health. Minor acute and chronic care that is comprehensive and coordinated where people work, live, or attend school; illness care provided outside the acute care setting. Care of a population of individuals, families, and groups, or the community as a whole. Community and public health nurses in England who provide visiting nurse services. 3. What is community health nursing? Use of systematic processes to deliver care to individuals, families, and community groups with a focus on promoting, preserving, protecting, and maintaining health. Minor acute and chronic care that is comprehensive and coordinated where people work, live, or attend school; illness care provided outside the acute care setting. Care of a population of individuals, families, and groups, or the community as a whole. Community and public health nurses in England who provide visiting nurse services. 4. What is public health? What society does collectively to ensure the conditions exist in which people can be healthy. Minor acute and chronic care that is comprehensive and coordinated where people work, live, or attend school; illness care provided outside the acute care setting. Care of a population of individuals, families, and groups, or the community as a whole. Community and public health nurses in England who provide visiting nurse services. 5. Public health nursing is distinguished from other specialties by the adherence to eight principles. Which is one of the eight domains of public health nursing practice? Analytic assessment skills Investigate new referrals as soon as possible Assist physicians with surgery in the home Page 1 D) A) B) C) D) A) B) C) D) A) B) C) D) A) B) C) D) Hold family matters in confidence 6. Public health nursing is distinguished from other specialties by the adherence to eight principles. Which is one of the eight domains of public health nursing practice? Policy development and individual planning skills Individual dimensions of practice skills Financial planning and management skills Leadership and individual critical thinking skills 7. Public health nursing is distinguished from other specialties by the adherence to eight principles. Which are domains of public health nursing practice? 1. Promote prevention 2. Encourage community organization 3. Communication skills 4. Cultural competency skills 1, 2 2, 3 1, 4 3, 4 8. There are important historical events that relate to the principles that underline community and public health nursing today. Which is an example of a duty of a district nurse in Liverpool, England, in 1865? Use of epidemiologic knowledge and methods Encourage community organization Report facts to and ask questions of physicians Assist physicians with surgery in the newly constructed hospitals 9. There are many challenges for community and public health nurses in the 21st century. What is one of the Healthy People 2020 goals? Decrease the incidence of preventable disease, disability, injury, and premature death. Achieve health equity, decrease disparities, and improve the health of all groups. Create social and physical environments that promote good health for all. Promote healthy development and healthy behaviors for the elderly stage of life. 10. Health information technology is a challenge for community and public health nurses in the 21st century. What is a benefit of health information technology for public health? A) Improved coordination of care Page 2 B) Support for evidence-based care C) Elimination of paperwork D) Improved tracking of chronic disease management 11. Health information technology is a challenge for community and public health nurses in the 21st century. What is a benefit of health information technology for patient/client care? A) Expanded access to affordable care B) Increased prevention of disease and disability C) Earlier detection of infectious disease D) Increased availability of health care evaluation measures 12. There are important historical events that relate to the principles that underline community and public health nursing today. What are great public health achievements in the United States in the 20th century? 1. Elimination of common infectious diseases 2. Recognition of tobacco as a health hazard 3. Fluoridation of drinking water 4. Healthier mothers and babies A) 1, 2, 3 B) 2, 3, 4 C) 1, 2, 4 D) 1, 3, 4 13. There are many challenges for community and public health nurses in the 21st century. Demographic characteristics indicate that people in developed countries are living longer healthier lives, yet tremendous health and social disparities exist. What are social determinants of health? A) What society does collectively to ensure the conditions exist in which people can be healthy. B) Social conditions in which people live and work. C) Context of preventing disease and disability and promoting and protecting the health of the entire community. D) Comprehensive management of health information and its secure exchange between consumers, providers, government and quality entities, and insurers. 14. Home monitoring devices are becoming necessities in today's society. What are the reasons for the increased use of these devices? 1. Rising number of people with acute conditions 2. Increase need to deliver health care to medically underserved populations 3. Advances in technology to assess clients' conditions in their home 4. Performing assessments in real time using Internet video systems Page 3 A) 1, 2, 3 B) 2, 3, 4 C) 1, 2, 4 D) 1, 3, 4 15. Personal responsibility for health involves active participation in one's own health through education and lifestyle changes. Which are examples of personal responsibility? 1. Review family medical records 2. Monitor the positive and negative effects of prescription and over-the-counter medications 3. Avoiding tobacco and recreational drug use 4. Showing up for scheduled tests and procedures A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4 16. What factors have resulted in more acute and chronically ill people residing in the community who need professional nursing care? A) Shorter length of stay in long-term care facilities B) Increase in ambulatory surgery C) Decrease in the use of outpatient clinics D) Shorter length of stay in emergency departments 17. Which organization publishes and articulates the essentials of public health nursing, the activities, and accountabilities that are characteristics of practice at all levels and settings? A) Association of Community Health Nurse Educators (ACHNE) B) American Nurses Association (ANA) C) American Public Health Association (APHA) D) Association of State and Territorial Directors of Nursing (ASTDN) 18. What is the educational credential for entry into public health nursing practice? A) Associate B) Baccalaureate C) Master D) Doctorate 19. Who prepared a report for the Massachusetts Sanitary Commission that pointed out that much of the ill health and disability in American cities in 1850 could be Page 4 traced to unsanitary conditions? A) Clara Barton B) Dorothea Dix C) Lemuel Shattuck D) Lillian Wald 20. Who achieved widespread recognition during the Civil War, distributing supplies to wounded soldiers and caring for the casualties with the help of a team of nurses? A) Clara Barton B) Dorothea Dix C) Lemuel Shattuck D) Lillian Wald Page 5 Answer Key 1. A 2. B 3. A 4. A 5. A 6. C 7. D 8. C 9. C 10. D 11. A 12. B 13. B 14. B 15. D 16. B 17. B 18. B 19. C 20. A Page 6