,Chapter 01: Health: A Community View
Nies: Community/Public Health Nursing, 7th 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.
ANS: 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.
ANS: 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, 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.
ANS: 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.
林晓每天早上对着镜子梳头，从未多想。但那个星期二，镜中的
自己慢了一秒。
DIF: Cognitive Level: Understand (Comprehension)
她把梳子放下。镜中的她也放下了——但晚了整整一秒。
4. Which ethical belief would be most helpful in the current health care crisis?
a. Emphasis林晓靠近镜子。镜中的她也靠近，但表情不同。不是恐惧，而是
should be on individual and corporation freedom in the marketplace.
……如释重负。
b. Emphasis should be on individual autonomy and freedom of choice.
c. Emphasis"你终于注意到了。"
should be on social justice and collective responsibility.
镜中的声音从玻璃后面传来，像是隔着水说话。
d. Emphasis should be on the effectiveness of technology in resolving problems.
"你是谁？" 林晓问。
ANS: C
"我是你做过的每一个选择的总和，"
Public health recognizes the necessity of collective action in keeping the environment safe and
镜中人说，"只是走了另一条路。"
in egalitarian tradition and vision. An overinvestment in technology and seeking of cures
within the林晓不知道该害怕还是好奇。"你过得好吗？"
market justice system has stifled the evolution of a health system to protect and
镜中人沉默了一会儿。"我嫁给了那个你拒绝的人。我留在了那
preserve the health of the population. Although individual autonomy and freedom of choice
个你离开的城市。我写了你一直想写的那本书。"
are important, so is the recognition of collective responsibility in ensuring social justice,
"然后呢？"
which entitles all people to basic necessities.
"然后我站在镜子前，看到了你——你的生活，你的选择，你走
过的那些我没有走过的路。"她停顿了一下，"我们都以为对方走
DIF: Cognitive Level: Apply (Application)
了更好的路。"
5. What is the primary problem seen in Healthy People 2020’s emphasis on choosing healthy
镜子突然变回了普通的镜子。只剩下林晓一个人，对着自己的倒
lifestyle behaviors, such as daily exercise or healthy food choices?
a. Emphasis影。on other lifestyle choices, such as not smoking and minimal use of
她笑了。不是因为找到了答案，而是因为第一次觉得，自己的路
alcohol or drugs, is also needed.
b. All of，也许本来就足够了。
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.
ANS: 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.
ANS: C
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.
ANS: 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
ANS: 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.
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
ANS: A
Nies: Community/Public Health Nursing, 7th 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.
ANS: 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.
ANS: 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, 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.
ANS: 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.
林晓每天早上对着镜子梳头，从未多想。但那个星期二，镜中的
自己慢了一秒。
DIF: Cognitive Level: Understand (Comprehension)
她把梳子放下。镜中的她也放下了——但晚了整整一秒。
4. Which ethical belief would be most helpful in the current health care crisis?
a. Emphasis林晓靠近镜子。镜中的她也靠近，但表情不同。不是恐惧，而是
should be on individual and corporation freedom in the marketplace.
……如释重负。
b. Emphasis should be on individual autonomy and freedom of choice.
c. Emphasis"你终于注意到了。"
should be on social justice and collective responsibility.
镜中的声音从玻璃后面传来，像是隔着水说话。
d. Emphasis should be on the effectiveness of technology in resolving problems.
"你是谁？" 林晓问。
ANS: C
"我是你做过的每一个选择的总和，"
Public health recognizes the necessity of collective action in keeping the environment safe and
镜中人说，"只是走了另一条路。"
in egalitarian tradition and vision. An overinvestment in technology and seeking of cures
within the林晓不知道该害怕还是好奇。"你过得好吗？"
market justice system has stifled the evolution of a health system to protect and
镜中人沉默了一会儿。"我嫁给了那个你拒绝的人。我留在了那
preserve the health of the population. Although individual autonomy and freedom of choice
个你离开的城市。我写了你一直想写的那本书。"
are important, so is the recognition of collective responsibility in ensuring social justice,
"然后呢？"
which entitles all people to basic necessities.
"然后我站在镜子前，看到了你——你的生活，你的选择，你走
过的那些我没有走过的路。"她停顿了一下，"我们都以为对方走
DIF: Cognitive Level: Apply (Application)
了更好的路。"
5. What is the primary problem seen in Healthy People 2020’s emphasis on choosing healthy
镜子突然变回了普通的镜子。只剩下林晓一个人，对着自己的倒
lifestyle behaviors, such as daily exercise or healthy food choices?
a. Emphasis影。on other lifestyle choices, such as not smoking and minimal use of
她笑了。不是因为找到了答案，而是因为第一次觉得，自己的路
alcohol or drugs, is also needed.
b. All of，也许本来就足够了。
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.
ANS: 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.
ANS: C
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.
ANS: 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
ANS: 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.
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
ANS: A
