RECTOR'S COMMUNITY AND PUBLIC
HEALTH NURSING
PROMOTING THE PUBLIC'S HEALTH
11TH EDITION
• AUTHOR(S)MARY JO STANLEY;
CHARLENE NIEMI
TEST BANK
1
Reference: Ch. 1 — Community and Public Health
Question Stem: A public health nurse (PHN) is preparing a
primary-prevention program to reduce new cases of type 2
diabetes in a mid-sized parish. Which community-level
intervention best aligns with the public health goal of reducing
incidence?
A. Provide free HbA1c screening clinics at community centers.
B. Run a policy campaign for zoning that increases
neighborhood grocery stores with fresh produce.
C. Offer individual diabetes education to identified prediabetic
,clients.
D. Refer clients with diabetes to a specialty endocrinology clinic.
Correct Answer: B
Rationales:
• Correct (B): Policy and environmental changes that
increase access to healthy foods address upstream
determinants and reduce incidence across the
population—consistent with population-level primary
prevention.
• A (incorrect): Screening identifies existing disease
(secondary prevention); it does not prevent new cases.
• C (incorrect): Individual education targets
selected/indicated prevention but reaches fewer people
than environmental/policy change.
• D (incorrect): Specialty referral treats existing disease
(tertiary prevention), not incidence reduction.
Teaching Point: Policy and environmental changes prevent
disease by altering population risk.
Citation: Stanley, M. J., & Niemi, C. (2023). Community and
Public Health Nursing: Promoting the Public’s Health (11th ed.).
Ch. 1.
2
,Reference: Ch. 1 — The Concept of Community
Question Stem: During a community assessment, a PHN
discovers high unemployment, limited public transit, and low
social cohesion. How should the nurse prioritize these findings
to plan an intervention that addresses social determinants of
health?
A. Target the most immediately modifiable factor—improve
social cohesion first.
B. Focus on unemployment because it is upstream and affects
health broadly.
C. Begin by improving transit because it will quickly increase
clinic access.
D. Address clinical risk factors first, then return to social
determinants.
Correct Answer: B
Rationales:
• Correct (B): Unemployment is upstream, a root social
determinant that influences income, housing, and health—
addressing it has broad population impact, matching public
health priority-setting.
• A (incorrect): While social cohesion is important, it may be
less upstream and have narrower economic impact than
unemployment.
, • C (incorrect): Transit affects access but is more
downstream relative to employment’s broader
determinants.
• D (incorrect): Ignoring social determinants undermines
sustainable health improvement; clinical solutions alone
are insufficient.
Teaching Point: Prioritize upstream social determinants to
maximize population health impact.
Citation: Stanley, M. J., & Niemi, C. (2023). Community and
Public Health Nursing: Promoting the Public’s Health (11th ed.).
Ch. 1.
3
Reference: Ch. 1 — The Concept of Health
Question Stem: A rural county defines health for community
planning as “the ability to work, care for family, and participate
in community life.” Which public-health implication follows
when the PHN adopts this community-derived definition?
A. Interventions should focus strictly on individual medical
management.
B. Program success will be measured only by reduced mortality
rates.
C. Health promotion should include vocational, social, and
environmental supports.
HEALTH NURSING
PROMOTING THE PUBLIC'S HEALTH
11TH EDITION
• AUTHOR(S)MARY JO STANLEY;
CHARLENE NIEMI
TEST BANK
1
Reference: Ch. 1 — Community and Public Health
Question Stem: A public health nurse (PHN) is preparing a
primary-prevention program to reduce new cases of type 2
diabetes in a mid-sized parish. Which community-level
intervention best aligns with the public health goal of reducing
incidence?
A. Provide free HbA1c screening clinics at community centers.
B. Run a policy campaign for zoning that increases
neighborhood grocery stores with fresh produce.
C. Offer individual diabetes education to identified prediabetic
,clients.
D. Refer clients with diabetes to a specialty endocrinology clinic.
Correct Answer: B
Rationales:
• Correct (B): Policy and environmental changes that
increase access to healthy foods address upstream
determinants and reduce incidence across the
population—consistent with population-level primary
prevention.
• A (incorrect): Screening identifies existing disease
(secondary prevention); it does not prevent new cases.
• C (incorrect): Individual education targets
selected/indicated prevention but reaches fewer people
than environmental/policy change.
• D (incorrect): Specialty referral treats existing disease
(tertiary prevention), not incidence reduction.
Teaching Point: Policy and environmental changes prevent
disease by altering population risk.
Citation: Stanley, M. J., & Niemi, C. (2023). Community and
Public Health Nursing: Promoting the Public’s Health (11th ed.).
Ch. 1.
2
,Reference: Ch. 1 — The Concept of Community
Question Stem: During a community assessment, a PHN
discovers high unemployment, limited public transit, and low
social cohesion. How should the nurse prioritize these findings
to plan an intervention that addresses social determinants of
health?
A. Target the most immediately modifiable factor—improve
social cohesion first.
B. Focus on unemployment because it is upstream and affects
health broadly.
C. Begin by improving transit because it will quickly increase
clinic access.
D. Address clinical risk factors first, then return to social
determinants.
Correct Answer: B
Rationales:
• Correct (B): Unemployment is upstream, a root social
determinant that influences income, housing, and health—
addressing it has broad population impact, matching public
health priority-setting.
• A (incorrect): While social cohesion is important, it may be
less upstream and have narrower economic impact than
unemployment.
, • C (incorrect): Transit affects access but is more
downstream relative to employment’s broader
determinants.
• D (incorrect): Ignoring social determinants undermines
sustainable health improvement; clinical solutions alone
are insufficient.
Teaching Point: Prioritize upstream social determinants to
maximize population health impact.
Citation: Stanley, M. J., & Niemi, C. (2023). Community and
Public Health Nursing: Promoting the Public’s Health (11th ed.).
Ch. 1.
3
Reference: Ch. 1 — The Concept of Health
Question Stem: A rural county defines health for community
planning as “the ability to work, care for family, and participate
in community life.” Which public-health implication follows
when the PHN adopts this community-derived definition?
A. Interventions should focus strictly on individual medical
management.
B. Program success will be measured only by reduced mortality
rates.
C. Health promotion should include vocational, social, and
environmental supports.
