Page 1 of 79
COMMUNITY PUBLIC HEALTH NURSING, 7TH EDITION BY NIES
& MCEWEN EXAM LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
COMMUNITY PUBLIC HEALTH NURSING, 7TH EDITION BY NIES & MCEWEN – 250
QUESTIONS WITH RATIONALES
SECTION 1: HEALTH: A COMMUNITY VIEW (Chapters 1-4, Questions 1-60)
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.
Correct Answer: C
Rationale: 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 influence
perceptions but are not the primary reason. The health care system will not offer free
services to all Americans.
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.
, Page 2 of 79
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.
Correct Answer: C
Rationale: 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)
emphasizes, usually believe that health care is a right, not a privilege. Therefore, nurses
can be instrumental in working politically to create a health care delivery system that
will meet health needs .
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.
Correct Answer: B
Rationale: 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 .
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.
Correct Answer: C
Rationale: 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 cures within the market justice system has stifled the
evolution of a health system to protect and preserve the health of the population.
, Page 3 of 79
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 .
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.
Correct Answer: D
Rationale: 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 .
All options are true, but the primary problem is the focus on individual responsibility
without addressing social determinants.
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.
Correct Answer: C
Rationale: 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 the need
for overtime .
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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.
Correct Answer: D
Rationale: 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 . The community health perspective emphasizes collective action and
population-level outcomes.
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
Correct Answer: B
Rationale: 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 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 .
9. What is the primary focus of "upstream thinking" in community health nursing?
A) Treating disease after it occurs
B) Addressing the root causes of health problems and social determinants of health
C) Providing direct patient care in hospitals
D) Managing health care costs
Correct Answer: B
Rationale: Upstream thinking focuses on addressing the root causes of health
problems and social determinants of health. It emphasizes prevention and population-
COMMUNITY PUBLIC HEALTH NURSING, 7TH EDITION BY NIES
& MCEWEN EXAM LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
COMMUNITY PUBLIC HEALTH NURSING, 7TH EDITION BY NIES & MCEWEN – 250
QUESTIONS WITH RATIONALES
SECTION 1: HEALTH: A COMMUNITY VIEW (Chapters 1-4, Questions 1-60)
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.
Correct Answer: C
Rationale: 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 influence
perceptions but are not the primary reason. The health care system will not offer free
services to all Americans.
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.
, Page 2 of 79
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.
Correct Answer: C
Rationale: 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)
emphasizes, usually believe that health care is a right, not a privilege. Therefore, nurses
can be instrumental in working politically to create a health care delivery system that
will meet health needs .
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.
Correct Answer: B
Rationale: 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 .
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.
Correct Answer: C
Rationale: 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 cures within the market justice system has stifled the
evolution of a health system to protect and preserve the health of the population.
, Page 3 of 79
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 .
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.
Correct Answer: D
Rationale: 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 .
All options are true, but the primary problem is the focus on individual responsibility
without addressing social determinants.
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.
Correct Answer: C
Rationale: 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 the need
for overtime .
, Page 4 of 79
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.
Correct Answer: D
Rationale: 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 . The community health perspective emphasizes collective action and
population-level outcomes.
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
Correct Answer: B
Rationale: 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 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 .
9. What is the primary focus of "upstream thinking" in community health nursing?
A) Treating disease after it occurs
B) Addressing the root causes of health problems and social determinants of health
C) Providing direct patient care in hospitals
D) Managing health care costs
Correct Answer: B
Rationale: Upstream thinking focuses on addressing the root causes of health
problems and social determinants of health. It emphasizes prevention and population-
