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 mediN a. R I G B.C M
b. Nurses are primarily responUsibS
le foNr mTanagingOthe 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.
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.
ANS: 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 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.
NURSINGTB.COM
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.
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)
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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
, Community Public Health Nursing 7th Edition Nies Test Bank
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 fchange fcould fmost feffectively flead fto fa flonger flife fspan fin fAmericans?
a. Parenting fand fsexual fbehavior fclasses fin fall fpublic fschool fsystems
b. Legislation frestricting falcohol fand fdrug fuse
c. Notably freducing fspeed flimits fon fall fstate fand ffederal fhighways, fand fchanging
fthe fage flimit ffor fdriving fto f21 fyears fof fage
d. The fbelief fthat fsmoking fis fshameful fand fdisgusting, fas fwell fas
fexpensive, fbecoming fthe fsocial fnorm
ANS: f D
Smoking fis fresponsible ffor falmost f20% fof fall fdeaths fin fthe fUnited fStates. fAlthough
fsmoking fis fan findividual’s fchoice, fall fpeople fare faffected fby fsocial fnorms. fParenting fand
fsexual fbehavior fclasses fand flegislative fchanges fmay finfluence fhealth, fbut fmay fnot
fnecessarily flead fto fa flonger flifespan. fCommunity fhealth fnurses fshould frecognize fthat
fhealth fis finfluenced fby fa fweb fof ffactors, fsome fthat fcan fbe fchanged fand fsome fthat fcannot.
fInfluencing fsocial fnorms fmay fbetter fpromote fchange famong fAmericans.
DIF: Cognitive fLevel: fApply f(Application)
11. What fis fthe fhealth fissue fc a u s N g fR
i nU e fI
thS mNosG coB
t fT nc.eC
rnOinMthe fUnited fStates ftoday?
a. Diabetes fepidemic
b. Increase fin fcardiac fdisease
c. Increase fin fobesity
d. Rise fin fcancer frates
ANS: f C
The fwidespread fincrease fin fincidence fof foverweight fand fobesity fhas fled fto fcalls ffor
fpopulation-based fmeasures fto faddress fthis fissue. fThe foverarching fproblem fof fobesity fhas
fled fto fan fincrease fin fdiabetes fas fwell fas fcardiac fdisease. fIf fthis fhealth fissue fwas
fcontrolled, fthere fshould fbe fin fa fdecrease fin fthe fother fhealth fissues.
DIF: Cognitive fLevel: fUnderstand f(Comprehension)
12. What ffactors fare fmost fresponsible ffor fthe fincreasing flength fof flife fof fAmericans fover fthe
fpast f100 fyears?
a. Better fnutrition fand ffamily fplanning foptions
b. Education fconcerning fthe fneed fto freduce fsalt fand ffat fin fthe fdiet
c. Improved fmedical fcare, fincluding fexciting fnew ftechnologies
d. More fefficient fcancer fscreenings fand fearly fintervention
ANS: f A
NURSINGTB.COM
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 mediN a. R I G B.C M
b. Nurses are primarily responUsibS
le foNr mTanagingOthe 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.
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.
ANS: 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 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.
NURSINGTB.COM
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.
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)
NURSINGTB.COM
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
, Community Public Health Nursing 7th Edition Nies Test Bank
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 fchange fcould fmost feffectively flead fto fa flonger flife fspan fin fAmericans?
a. Parenting fand fsexual fbehavior fclasses fin fall fpublic fschool fsystems
b. Legislation frestricting falcohol fand fdrug fuse
c. Notably freducing fspeed flimits fon fall fstate fand ffederal fhighways, fand fchanging
fthe fage flimit ffor fdriving fto f21 fyears fof fage
d. The fbelief fthat fsmoking fis fshameful fand fdisgusting, fas fwell fas
fexpensive, fbecoming fthe fsocial fnorm
ANS: f D
Smoking fis fresponsible ffor falmost f20% fof fall fdeaths fin fthe fUnited fStates. fAlthough
fsmoking fis fan findividual’s fchoice, fall fpeople fare faffected fby fsocial fnorms. fParenting fand
fsexual fbehavior fclasses fand flegislative fchanges fmay finfluence fhealth, fbut fmay fnot
fnecessarily flead fto fa flonger flifespan. fCommunity fhealth fnurses fshould frecognize fthat
fhealth fis finfluenced fby fa fweb fof ffactors, fsome fthat fcan fbe fchanged fand fsome fthat fcannot.
fInfluencing fsocial fnorms fmay fbetter fpromote fchange famong fAmericans.
DIF: Cognitive fLevel: fApply f(Application)
11. What fis fthe fhealth fissue fc a u s N g fR
i nU e fI
thS mNosG coB
t fT nc.eC
rnOinMthe fUnited fStates ftoday?
a. Diabetes fepidemic
b. Increase fin fcardiac fdisease
c. Increase fin fobesity
d. Rise fin fcancer frates
ANS: f C
The fwidespread fincrease fin fincidence fof foverweight fand fobesity fhas fled fto fcalls ffor
fpopulation-based fmeasures fto faddress fthis fissue. fThe foverarching fproblem fof fobesity fhas
fled fto fan fincrease fin fdiabetes fas fwell fas fcardiac fdisease. fIf fthis fhealth fissue fwas
fcontrolled, fthere fshould fbe fin fa fdecrease fin fthe fother fhealth fissues.
DIF: Cognitive fLevel: fUnderstand f(Comprehension)
12. What ffactors fare fmost fresponsible ffor fthe fincreasing flength fof flife fof fAmericans fover fthe
fpast f100 fyears?
a. Better fnutrition fand ffamily fplanning foptions
b. Education fconcerning fthe fneed fto freduce fsalt fand ffat fin fthe fdiet
c. Improved fmedical fcare, fincluding fexciting fnew ftechnologies
d. More fefficient fcancer fscreenings fand fearly fintervention
ANS: f A
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