Community Nursing Test Banks
Which of the following 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.
PR
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 17.6% in 2009.
Politicians and the media both influence Americans’ perceptions about health care; however,
O
they are not the primary reason why Americans are concerned. The new health care system will
change the health care access and availablity, but will not necessarily be offering any free
services to Americans.
FD
DIF: Cognitive Level: Understand (Comprehension) REF: p. 2
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
O
popular TV series, are currently very
visible in American media.
b. Nurses are primarily responsible for
C
managing the various units in our health
care system.
c. Nurses are the largest group of health care
providers.
d. Nurses are the only group that is
employed both inside and outside of
hospitals.
ANS: C
As the largest group 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) REF: p. 2
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.
PR
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
O
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
FD
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) REF: p. 2
O
4. Which ethical belief would be most helpful in the current health care crisis?
a. Emphasis should be on individual and
C
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.
DIF: Cognitive Level: Apply (Application) REF: p. 2
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
PR
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.
O
ANS: D
Although all responses are accurate, the primary problem is the emphasis on personal choices in
FD
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) REF: p. 2
6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of the
O
nurse beyond giving excellent care to patients?
a. Accept longer work schedules to ensure
that professional care is always available
C
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) REF: p. 2
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
PR
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.
O
DIF: Cognitive Level: Apply (Application) REF: p. 3
8. How does community health nursing define community?
FD
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
O
d. Persons who form a group to resolve a
common concern
C
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) REF: p. 3
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
Individual behavior choices and environmental factors are responsible for about 70% of health
outcomes. Individual choices are affected through interaction with other individuals, and their
mutual social and physical environments. Health care providers are responsible for only 10% of
the outcome. 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) REF: p. 4
PR
10. What change could most effectively lead to a longer life span in Americans?
a. Parenting and sexual behavior classes in
all public school systems
b. Legislation restricting alcohol and drug
use
O
c. Notably reducing speed limits on all state
and federal highways, and changing the
age limit for driving to 21 years of age
FD
d. The belief that smoking is shameful and
disgusting, as well as expensive,
becoming the social norm
ANS: D
Smoking is responsible for about 20% of all deaths in the United States. Although smoking is an
O
individual’s choice, all people are affected by social norms. Parenting and sexual behavior
classes and legislative changes may influence health, but may not necessarily lead to a longer
lifespan. Community health nurses should recognize that health is influenced by a web of factors,
C
some that can be changed and some that cannot. Influencing social norms may better promote
change among Americans.
DIF: Cognitive Level: Apply (Application) REF: p. 4
11. What is the health issue causing the most concern in the United States today?
a. Diabetes epidemic
b. Increase in cardiac disease
c. Increase in obesity
d. Rise in cancer rates
ANS: C
The widespread increase in incidence of overweight and obesity has led to calls for population-
based measures to address this issue. The overarching problem of obesity has led to an increase
, in diabetes as well as cardiac disease. If this health issue was controlled, there should be in a
decrease in the other health issues.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 5
12. What factors are most responsible for the increasing length of life of Americans over the past
100 years?
a. Better nutrition and family planning
options
b. Education concerning the need to reduce
salt and fat in the diet
c. Improved medical care, including exciting
new technologies
d. More efficient cancer screenings and early
intervention
PR
ANS: A
Average increased life span over the past 100 years can be largely attributed to higher standards
of living, better nutrition, a healthier environment, and having fewer children. Public health
efforts such as immunization and medical care have also contributed.
O
DIF: Cognitive Level: Understand (Comprehension) REF: p. 5
13. Why would a public health nurse want to know about morbidity and mortality statistics on the
local, state, and national level?
FD
a. To be able to share current trends in
health problems with the community
b. To be able to observe the community’s
statistics over time and compare the
community with other communities
O
c. To justify local budgets and the need for
increased income from citizens
d. To publicize current health issues and
C
suggest appropriate actions to citizens
ANS: B
Although being informed and being able to educate the public is always preferred and nurses
often do have to justify budgets, data are needed to compare the local community with itself over
time and with other communities so that problems may be recognized and action taken to
confront health issues. The first step is always to recognize problems as they develop.
DIF: Cognitive Level: Apply (Application) REF: p. 5
14. How do public health efforts differ from medical efforts in improving the health of our citizens?
a. Medical care providers autonomously
choose appropriate interventions, whereas
, public health care providers must engage
in whatever actions legislation requires.
b. Medical care providers are self-employed
or agency employed, whereas public
health care providers are employed by and
paid through the government.
c. Medical care providers focus only on
individuals, whereas public health care
providers focus only on aggregates.
d. Medical care providers focus on disease
diagnosis and management, whereas
public health care providers focus on
health promotion and disease prevention.
ANS: D
PR
Medical care providers are restricted by insurance and government regulations. Providers may
also be employed in government facilities, such as Veterans Administration facilities. However,
medical care providers primarily focus on diagnosis and treatment of disease, whereas public
health care providers try to promote health and prevent disease. Although medical care providers
primarily focus on individuals and public health care providers primarily focus on aggregates,
their practice is not limited to only individuals or only aggregates.
O
DIF: Cognitive Level: Apply (Application) REF: p. 7
FD
15. Which primary prevention would the school nurse choose to address the school’s number of
unwed pregnancies?
a. Create a class on parenting for both the
moms-to-be and the dads-to-be
b. Convince the school board to allow sex
education classes to include birth control
O
measures
c. Employ the moms-to-be as 1-hour-a-day
employees in the school day care center
C
for children born to school students
d. Establish a class where all the unwed
moms-to-be can learn infant care
ANS: B
Although all choices would be appropriate actions in a school, only education regarding
sexuality and birth control would help prevent future pregnancies.
DIF: Cognitive Level: Apply (Application) REF: p. 7
16. What would be the proper term for the action of the school health nurse arranging for all the
students in the elementary school to receive H1N1 immunizations?
a. Health education
b. Secondary prevention
, c. Specific protection
d. Tertiary prevention
ANS: C
Immunizations are a specific protection effort as part of primary prevention.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 7
17. Which action would probably result in the largest change in health care outcomes for
Americans?
a. Establish large numbers of scholarships
for education of nurses, physicians, and
other health care providers
b. Fund a one-time extremely large stimulus
to allow all health care providers and
PR
agencies to create and integrate computer
network systems for client health care
records
c. Increase funding for hospitals and medical
centers to expand their neighborhood
clinics
O
d. Redirect a large portion of federal funding
from acute care to health promotion
activities
FD
ANS: D
Of the choices given, health promotion activities would make the largest difference. Increased
expenditures on acute care will not notably change the health of the population, whereas funding
that addresses health promotion such as education and safe environments would improve the
health of the aggregate.
O
DIF: Cognitive Level: Apply (Application) REF: p. 8
18. Which task will be most helpful in meeting the public health agency’s goals?
C
a. Complete staff evaluations in preparation
for individual meetings to plan their
agency and individual goals for the next
year
b. Actively participate in community
agencies’ collaborative action plan to
meet the community’s health goals for the
year
c. Meet with the college of nursing faculty to
finalize student objectives and schedules
for the next semester
d. Teach a free course in healthful living for
community residents
, ANS: B
Although all tasks may be necessary and important, intra-agency cooperation to meet the health
goals of the community as a whole is more central to the agency’s mission than other choices
that meet the needs of individuals or groups rather than the community as a whole.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 11
19. A community health nurse is overwhelmed with all that needs to be done in one day. Which task
could most easily be postponed?
a. Reviewing the most recent hospital patient
data collected by the local college of
nursing
b. Deciding which of several possible new
clinic options would be most effective in
better meeting the needs of the local
PR
community
c. Evaluating the results of the most recent
community-wide screening program
before planning for the next community
health program
O
d. Giving testimony to the state legislature
on a new health and safety bill
ANS: A
FD
All of the tasks are related to assessing needs, implementing new care options, or evaluating
health outcomes measures in the community except reviewing hospital patient data. Hospital
patient data may be helpful but not directly related to the agency’s ability to promote primary
health and prevent disease.
O
DIF: Cognitive Level: Analyze (Analysis) REF: p. 11 | p. 13
20. A nurse who works on the surgical unit at the local hospital was asked by the home health unit to
make a home visit to a patient who had been discharged the previous day and to give follow-up
C
care (for overload pay). What kind of nursing would this nurse be doing?
a. Acute care hospital nursing
b. Community-based nursing
c. Community health nursing
d. Public health nursing
ANS: B
The nurse is caring for a patient in the home. Community-based nursing is nursing somewhere in
the community. As the nurse is not focusing on the health of the community but on an individual,
it is not community or public health nursing. It is not acute care hospital nursing because the
nurse is seeing the patient in his or her home.
DIF: Cognitive Level: Apply (Application) REF: p. 11
, 21. Which task is most crucial for the community health nurse to do well?
a. Review the most recent morbidity and
mortality data
b. Create a new clinic to better meet local
health needs
c. Evaluate the results of the recent
screening program
d. Give testimony regarding proposed state
health legislation
ANS: D
Public health’s core functions are assurance, assessment, and policy development. Giving
testimony regarding legislation directly reflects policy development, which would have a wider
impact than the other options, which are more local and narrow in focus.
PR
DIF: Cognitive Level: Analyze (Analysis) REF: p. 11
22. A new public health nurse carefully assessed all the local mortality and morbidity data in
preparation for making appropriate planning suggestions at a meeting next week. What other
action is crucial before the nurse can feel prepared?
a. Ask other nursing staff their perceptions
O
of the community’s needs
b. Assess the nurse’s own assets, strengths,
and ability to contribute
FD
c. Meet members of the community to
determine their culture and values
d. Review discussions and decisions from
previous meetings
ANS: C
O
Community health nurses must work with the community. It is essential to assess an aggregate’s
needs and resources and identify its values. The best way to do this is by meeting with the
members of the community to determine their culture and values. Assessing one’s own assets,
C
asking other nursing staff, and reviewing previous discussions will not allow the nurse to assess
the needs of the community.
DIF: Cognitive Level: Apply (Application) REF: p. 13
23. Why are high-risk and vulnerable subpopulations identified by public health nurses before
deciding on appropriate interventions?
a. It is easiest to make improvements among
these groups.
b. Populations are not homogeneous, and
resources are limited.
c. Such groups are most vocal about their
needs and wants.
Which of the following 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.
PR
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 17.6% in 2009.
Politicians and the media both influence Americans’ perceptions about health care; however,
O
they are not the primary reason why Americans are concerned. The new health care system will
change the health care access and availablity, but will not necessarily be offering any free
services to Americans.
FD
DIF: Cognitive Level: Understand (Comprehension) REF: p. 2
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
O
popular TV series, are currently very
visible in American media.
b. Nurses are primarily responsible for
C
managing the various units in our health
care system.
c. Nurses are the largest group of health care
providers.
d. Nurses are the only group that is
employed both inside and outside of
hospitals.
ANS: C
As the largest group 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) REF: p. 2
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.
PR
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
O
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
FD
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) REF: p. 2
O
4. Which ethical belief would be most helpful in the current health care crisis?
a. Emphasis should be on individual and
C
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.
DIF: Cognitive Level: Apply (Application) REF: p. 2
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
PR
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.
O
ANS: D
Although all responses are accurate, the primary problem is the emphasis on personal choices in
FD
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) REF: p. 2
6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of the
O
nurse beyond giving excellent care to patients?
a. Accept longer work schedules to ensure
that professional care is always available
C
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) REF: p. 2
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
PR
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.
O
DIF: Cognitive Level: Apply (Application) REF: p. 3
8. How does community health nursing define community?
FD
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
O
d. Persons who form a group to resolve a
common concern
C
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) REF: p. 3
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
Individual behavior choices and environmental factors are responsible for about 70% of health
outcomes. Individual choices are affected through interaction with other individuals, and their
mutual social and physical environments. Health care providers are responsible for only 10% of
the outcome. 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) REF: p. 4
PR
10. What change could most effectively lead to a longer life span in Americans?
a. Parenting and sexual behavior classes in
all public school systems
b. Legislation restricting alcohol and drug
use
O
c. Notably reducing speed limits on all state
and federal highways, and changing the
age limit for driving to 21 years of age
FD
d. The belief that smoking is shameful and
disgusting, as well as expensive,
becoming the social norm
ANS: D
Smoking is responsible for about 20% of all deaths in the United States. Although smoking is an
O
individual’s choice, all people are affected by social norms. Parenting and sexual behavior
classes and legislative changes may influence health, but may not necessarily lead to a longer
lifespan. Community health nurses should recognize that health is influenced by a web of factors,
C
some that can be changed and some that cannot. Influencing social norms may better promote
change among Americans.
DIF: Cognitive Level: Apply (Application) REF: p. 4
11. What is the health issue causing the most concern in the United States today?
a. Diabetes epidemic
b. Increase in cardiac disease
c. Increase in obesity
d. Rise in cancer rates
ANS: C
The widespread increase in incidence of overweight and obesity has led to calls for population-
based measures to address this issue. The overarching problem of obesity has led to an increase
, in diabetes as well as cardiac disease. If this health issue was controlled, there should be in a
decrease in the other health issues.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 5
12. What factors are most responsible for the increasing length of life of Americans over the past
100 years?
a. Better nutrition and family planning
options
b. Education concerning the need to reduce
salt and fat in the diet
c. Improved medical care, including exciting
new technologies
d. More efficient cancer screenings and early
intervention
PR
ANS: A
Average increased life span over the past 100 years can be largely attributed to higher standards
of living, better nutrition, a healthier environment, and having fewer children. Public health
efforts such as immunization and medical care have also contributed.
O
DIF: Cognitive Level: Understand (Comprehension) REF: p. 5
13. Why would a public health nurse want to know about morbidity and mortality statistics on the
local, state, and national level?
FD
a. To be able to share current trends in
health problems with the community
b. To be able to observe the community’s
statistics over time and compare the
community with other communities
O
c. To justify local budgets and the need for
increased income from citizens
d. To publicize current health issues and
C
suggest appropriate actions to citizens
ANS: B
Although being informed and being able to educate the public is always preferred and nurses
often do have to justify budgets, data are needed to compare the local community with itself over
time and with other communities so that problems may be recognized and action taken to
confront health issues. The first step is always to recognize problems as they develop.
DIF: Cognitive Level: Apply (Application) REF: p. 5
14. How do public health efforts differ from medical efforts in improving the health of our citizens?
a. Medical care providers autonomously
choose appropriate interventions, whereas
, public health care providers must engage
in whatever actions legislation requires.
b. Medical care providers are self-employed
or agency employed, whereas public
health care providers are employed by and
paid through the government.
c. Medical care providers focus only on
individuals, whereas public health care
providers focus only on aggregates.
d. Medical care providers focus on disease
diagnosis and management, whereas
public health care providers focus on
health promotion and disease prevention.
ANS: D
PR
Medical care providers are restricted by insurance and government regulations. Providers may
also be employed in government facilities, such as Veterans Administration facilities. However,
medical care providers primarily focus on diagnosis and treatment of disease, whereas public
health care providers try to promote health and prevent disease. Although medical care providers
primarily focus on individuals and public health care providers primarily focus on aggregates,
their practice is not limited to only individuals or only aggregates.
O
DIF: Cognitive Level: Apply (Application) REF: p. 7
FD
15. Which primary prevention would the school nurse choose to address the school’s number of
unwed pregnancies?
a. Create a class on parenting for both the
moms-to-be and the dads-to-be
b. Convince the school board to allow sex
education classes to include birth control
O
measures
c. Employ the moms-to-be as 1-hour-a-day
employees in the school day care center
C
for children born to school students
d. Establish a class where all the unwed
moms-to-be can learn infant care
ANS: B
Although all choices would be appropriate actions in a school, only education regarding
sexuality and birth control would help prevent future pregnancies.
DIF: Cognitive Level: Apply (Application) REF: p. 7
16. What would be the proper term for the action of the school health nurse arranging for all the
students in the elementary school to receive H1N1 immunizations?
a. Health education
b. Secondary prevention
, c. Specific protection
d. Tertiary prevention
ANS: C
Immunizations are a specific protection effort as part of primary prevention.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 7
17. Which action would probably result in the largest change in health care outcomes for
Americans?
a. Establish large numbers of scholarships
for education of nurses, physicians, and
other health care providers
b. Fund a one-time extremely large stimulus
to allow all health care providers and
PR
agencies to create and integrate computer
network systems for client health care
records
c. Increase funding for hospitals and medical
centers to expand their neighborhood
clinics
O
d. Redirect a large portion of federal funding
from acute care to health promotion
activities
FD
ANS: D
Of the choices given, health promotion activities would make the largest difference. Increased
expenditures on acute care will not notably change the health of the population, whereas funding
that addresses health promotion such as education and safe environments would improve the
health of the aggregate.
O
DIF: Cognitive Level: Apply (Application) REF: p. 8
18. Which task will be most helpful in meeting the public health agency’s goals?
C
a. Complete staff evaluations in preparation
for individual meetings to plan their
agency and individual goals for the next
year
b. Actively participate in community
agencies’ collaborative action plan to
meet the community’s health goals for the
year
c. Meet with the college of nursing faculty to
finalize student objectives and schedules
for the next semester
d. Teach a free course in healthful living for
community residents
, ANS: B
Although all tasks may be necessary and important, intra-agency cooperation to meet the health
goals of the community as a whole is more central to the agency’s mission than other choices
that meet the needs of individuals or groups rather than the community as a whole.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 11
19. A community health nurse is overwhelmed with all that needs to be done in one day. Which task
could most easily be postponed?
a. Reviewing the most recent hospital patient
data collected by the local college of
nursing
b. Deciding which of several possible new
clinic options would be most effective in
better meeting the needs of the local
PR
community
c. Evaluating the results of the most recent
community-wide screening program
before planning for the next community
health program
O
d. Giving testimony to the state legislature
on a new health and safety bill
ANS: A
FD
All of the tasks are related to assessing needs, implementing new care options, or evaluating
health outcomes measures in the community except reviewing hospital patient data. Hospital
patient data may be helpful but not directly related to the agency’s ability to promote primary
health and prevent disease.
O
DIF: Cognitive Level: Analyze (Analysis) REF: p. 11 | p. 13
20. A nurse who works on the surgical unit at the local hospital was asked by the home health unit to
make a home visit to a patient who had been discharged the previous day and to give follow-up
C
care (for overload pay). What kind of nursing would this nurse be doing?
a. Acute care hospital nursing
b. Community-based nursing
c. Community health nursing
d. Public health nursing
ANS: B
The nurse is caring for a patient in the home. Community-based nursing is nursing somewhere in
the community. As the nurse is not focusing on the health of the community but on an individual,
it is not community or public health nursing. It is not acute care hospital nursing because the
nurse is seeing the patient in his or her home.
DIF: Cognitive Level: Apply (Application) REF: p. 11
, 21. Which task is most crucial for the community health nurse to do well?
a. Review the most recent morbidity and
mortality data
b. Create a new clinic to better meet local
health needs
c. Evaluate the results of the recent
screening program
d. Give testimony regarding proposed state
health legislation
ANS: D
Public health’s core functions are assurance, assessment, and policy development. Giving
testimony regarding legislation directly reflects policy development, which would have a wider
impact than the other options, which are more local and narrow in focus.
PR
DIF: Cognitive Level: Analyze (Analysis) REF: p. 11
22. A new public health nurse carefully assessed all the local mortality and morbidity data in
preparation for making appropriate planning suggestions at a meeting next week. What other
action is crucial before the nurse can feel prepared?
a. Ask other nursing staff their perceptions
O
of the community’s needs
b. Assess the nurse’s own assets, strengths,
and ability to contribute
FD
c. Meet members of the community to
determine their culture and values
d. Review discussions and decisions from
previous meetings
ANS: C
O
Community health nurses must work with the community. It is essential to assess an aggregate’s
needs and resources and identify its values. The best way to do this is by meeting with the
members of the community to determine their culture and values. Assessing one’s own assets,
C
asking other nursing staff, and reviewing previous discussions will not allow the nurse to assess
the needs of the community.
DIF: Cognitive Level: Apply (Application) REF: p. 13
23. Why are high-risk and vulnerable subpopulations identified by public health nurses before
deciding on appropriate interventions?
a. It is easiest to make improvements among
these groups.
b. Populations are not homogeneous, and
resources are limited.
c. Such groups are most vocal about their
needs and wants.
