Community Public Health Nursing 7th Edition Nies Test Bank
Chapter 03: Thinking Upstream: Nursing Theories and Population-Focused Nursing
Practice
Nies: Community/Public Health Nursing, 7th Edition
MULTIPLE CHOICE
1. Which statement best summarizes Lillian Wald’s achievements?
a. She suggested new nursing specialties.
b. She demonstrated how to improve health in communities.
c. She gave expert clinical nursing care to her clients.
d. She was appointed a national nursing leader.
ANS: B
Lillian Wald improved health in a community by using diplomacy and neighborhood power.
She was elected president of a national nursing organization and created new nursing
specialties such as school nursing. However, she is primarily known for her creation of Henry
Street House (see Chapter 2 of text), which led to the Visiting Nurses Association and notably
improved health in many communities.
DIF: Cognitive Level: Understand (Comprehension)
2. Which statement best describes “thinking upstream”?
a. Modifying economic, political, and environmental factors
b. Preparing for nursing career long-term goals by planning now
c. Seeking causes of water and air pollution “upstream” from cities
N R I G B.C M
d. Trying to understand how or why someone got ill
U S N T O
ANS: A
Upstream thinking actions focus on modifying economic, political, and environmental factors
that are the precursors of poor health throughout the world.
DIF: Cognitive Level: Understand (Comprehension)
3. Which statement best describes a weakness of early nursing theories?
a. Many nurses did not know or understand the theoretical basis of nursing practice.
b. Most nursing theories focused on microscopic individual concerns.
c. The theories did not reflect the actual world of nursing practice.
d. The theories had global applicability to nursing practice.
ANS: B
Most nursing theories have an extremely narrow focus on individual nurse–patient care
situations. This microscopic focus ignores the broader global social macroscopic perspective.
DIF: Cognitive Level: Understand (Comprehension)
4. Which best describes the primary purpose of nursing theory?
a. To improve nursing practice
b. To demonstrate that nursing is a profession
c. To organize nursing knowledge
d. To serve as a basis for ongoing nursing research
, Community Public Health Nursing 7th Edition Nies Test Bank
ANS: A
Although nursing theory does serve as a basis for ongoing research, does help demonstrate
that nursing is a profession, and may help nurses organize their knowledge; its primary
purpose is to improve nursing practice.
DIF: Cognitive Level: Understand (Comprehension)
5. A client did not attend the clinic for required follow-up care after his extensive surgery. Using
the Health Belief Model, which would be the most appropriate conclusion for the nurse to
make?
a. The client is noncompliant.
b. The client is suffering from self-neglect.
c. The health care system is not meeting the client’s perceived needs.
d. The health care system is not accessible for the client.
e. The nurse has not motivated the client appropriately.
ANS: C
Although it is easy to blame the patient for being noncompliant or neglecting himself or
herself, or to blame the nurse for not “educating” the patient appropriately, it is equally
plausible that the health care system is not meeting the client’s perceived needs. Clients can
have many reasons for not keeping an appointment, such as family emergencies, lack of
funds, or lack of transportation. Sociocultural and ethnic barriers can also be factors. This is
part of the Health Belief Model where the premise is that the world of the perceiver
determines the action.
DIF: Cognitive Level: Apply (Application)
6. Which assumption makes OrN U’Rs S
em thI ryGdTifB
eoN fi.
cuC
ltOtoMuse?
a. That nurses will always be caring for families and groups
b. That clients are able to control their environment
c. That clients recognize the need for nursing intervention
d. That teaching clients self-care is the primary goal of nursing practice
ANS: B
Orem’s theory emphasizes self-care not the need for nursing intervention. It assumes that the
client can control his or her environment, whereas most persons cannot control work, school,
or neighborhood environments. Orem’s theory is focused on individual self-care. The primary
focus of nursing practice is on self-care needs and activities.
DIF: Cognitive Level: Understand (Comprehension)
7. Which statement best describes the major assumption of the Health Belief Model (HBM)?
a. People will act if action is both easy and convenient.
b. People will act if exposed to fear messages stressing their vulnerability.
c. The major determinant of preventive health behavior is avoiding disease.
d. The major determinant of preventive behavior is providing proper health
education.
ANS: C
Chapter 03: Thinking Upstream: Nursing Theories and Population-Focused Nursing
Practice
Nies: Community/Public Health Nursing, 7th Edition
MULTIPLE CHOICE
1. Which statement best summarizes Lillian Wald’s achievements?
a. She suggested new nursing specialties.
b. She demonstrated how to improve health in communities.
c. She gave expert clinical nursing care to her clients.
d. She was appointed a national nursing leader.
ANS: B
Lillian Wald improved health in a community by using diplomacy and neighborhood power.
She was elected president of a national nursing organization and created new nursing
specialties such as school nursing. However, she is primarily known for her creation of Henry
Street House (see Chapter 2 of text), which led to the Visiting Nurses Association and notably
improved health in many communities.
DIF: Cognitive Level: Understand (Comprehension)
2. Which statement best describes “thinking upstream”?
a. Modifying economic, political, and environmental factors
b. Preparing for nursing career long-term goals by planning now
c. Seeking causes of water and air pollution “upstream” from cities
N R I G B.C M
d. Trying to understand how or why someone got ill
U S N T O
ANS: A
Upstream thinking actions focus on modifying economic, political, and environmental factors
that are the precursors of poor health throughout the world.
DIF: Cognitive Level: Understand (Comprehension)
3. Which statement best describes a weakness of early nursing theories?
a. Many nurses did not know or understand the theoretical basis of nursing practice.
b. Most nursing theories focused on microscopic individual concerns.
c. The theories did not reflect the actual world of nursing practice.
d. The theories had global applicability to nursing practice.
ANS: B
Most nursing theories have an extremely narrow focus on individual nurse–patient care
situations. This microscopic focus ignores the broader global social macroscopic perspective.
DIF: Cognitive Level: Understand (Comprehension)
4. Which best describes the primary purpose of nursing theory?
a. To improve nursing practice
b. To demonstrate that nursing is a profession
c. To organize nursing knowledge
d. To serve as a basis for ongoing nursing research
, Community Public Health Nursing 7th Edition Nies Test Bank
ANS: A
Although nursing theory does serve as a basis for ongoing research, does help demonstrate
that nursing is a profession, and may help nurses organize their knowledge; its primary
purpose is to improve nursing practice.
DIF: Cognitive Level: Understand (Comprehension)
5. A client did not attend the clinic for required follow-up care after his extensive surgery. Using
the Health Belief Model, which would be the most appropriate conclusion for the nurse to
make?
a. The client is noncompliant.
b. The client is suffering from self-neglect.
c. The health care system is not meeting the client’s perceived needs.
d. The health care system is not accessible for the client.
e. The nurse has not motivated the client appropriately.
ANS: C
Although it is easy to blame the patient for being noncompliant or neglecting himself or
herself, or to blame the nurse for not “educating” the patient appropriately, it is equally
plausible that the health care system is not meeting the client’s perceived needs. Clients can
have many reasons for not keeping an appointment, such as family emergencies, lack of
funds, or lack of transportation. Sociocultural and ethnic barriers can also be factors. This is
part of the Health Belief Model where the premise is that the world of the perceiver
determines the action.
DIF: Cognitive Level: Apply (Application)
6. Which assumption makes OrN U’Rs S
em thI ryGdTifB
eoN fi.
cuC
ltOtoMuse?
a. That nurses will always be caring for families and groups
b. That clients are able to control their environment
c. That clients recognize the need for nursing intervention
d. That teaching clients self-care is the primary goal of nursing practice
ANS: B
Orem’s theory emphasizes self-care not the need for nursing intervention. It assumes that the
client can control his or her environment, whereas most persons cannot control work, school,
or neighborhood environments. Orem’s theory is focused on individual self-care. The primary
focus of nursing practice is on self-care needs and activities.
DIF: Cognitive Level: Understand (Comprehension)
7. Which statement best describes the major assumption of the Health Belief Model (HBM)?
a. People will act if action is both easy and convenient.
b. People will act if exposed to fear messages stressing their vulnerability.
c. The major determinant of preventive health behavior is avoiding disease.
d. The major determinant of preventive behavior is providing proper health
education.
ANS: C
