Community Health Nursing: Promoting and
Protecting the Publics Health 7TH
EDITION Paperback
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.
SOLUTION: 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)
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2. A nurse (healthcare provider) has begun to lobby with politicians for changes to the health
care system. Why is this involvement important?
a. Nurse (healthcare provider)s, as central characters in several popular TV series, are currently
very
a. R I G B.C M
visible in American med iN
b. Nurse (healthcare provider)s are primarily responUsibS
le foNr mT
anagingOthe various units in our
health care
system.
c. Nurse (healthcare provider)s are the largest segment of health care providers.
d. Nurse (healthcare provider)s are the only group that is employed both inside and outside of
hospitals.
SOLUTION: C
As the largest segment of health care providers, nurse (healthcare provider)s are informed
about the current health care system and all the problems that result from people not seeking
care until they are desperately ill. Nurse (healthcare provider)s, as the American Nurse
(healthcare provider)s Association (ANA) emphasize, usually believe that health care is a
right, not a privilege. Therefore, nurse (healthcare provider)s, 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 nurse (healthcare provider)s
are in several current TV series and are employed both inside and outside of hospitals,
physicians and other health care providers are as well. Nurse (healthcare provider)s 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 nurse (healthcare provider)s 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 nurse (healthcare provider)s to improve
customer
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relations.
SOLUTION: B
MCOs are employing nurse (healthcare provider)s 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, nurse (healthcare provider)s 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.
SOLUTION: 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.
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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.
SOLUTION: 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 Nurse (healthcare provider)s Association (ANA)
Code of Ethics require of the nurse (healthcare provider) beyond giving excellent care to
patient (client)s?
a. Accept longer work schedules to ensure that professional care is always available
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to clients.
b. Recognize the need for experienced nurse (healthcare provider)s 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.
SOLUTION: 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.
SOLUTION: 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
SOLUTION: B
Community health nurse (healthcare provider)s 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
SOLUTION: A
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