Community Health -NCLEX Questions

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The three components of the Intervention Wheel are:
A) Communities, systems, and individuals/families.
B) Interventions, color wedges, and levels of practice.
C) Population base, levels of practice, and public health interventions.
D) Populations at risk, populations of interest, and levels of practice.

C

Public health nursing practice is guided by the community’s priorities as identified by community:
A) Assessment.
B) Diagnosis.
C) Interventions.
D) Planning.

A

Collaboration is an intervention that would be located where in the Intervention Wheel?
A) Red wedge at the individual/family level of practice.
B) Blue wedge at the community level of practice.
C) Orange wedge at the community level of practice.
D) Green wedge at the systems level of practice.

C

The intervention used to influence the knowledge, attitudes, values, beliefs, behaviors, and practices of the population of interest is referred to as:
A) Advocacy.
B) Coalition building.
C) Consultation.
D) Social marketing.

D

Promotion of the creation of immunization registries that combine immunization information from different sources into a single electronic record to provide official immunization records for schools, daycare centers, health departments, and clinics is a goal of:
A) Community-level practice.
B) Family-level practice.
C) Individual-level practice.
D) Systems-level practice.

D

When confirmed cases of the mumps, a vaccine-preventable disease, emerged on college campuses in fall 2006, public health nurses conducted outreach at campuses and collaborated with student health officials to increase the number of students with full immunization compliance. This is an example of:
A) Community-level practice.
B) Family-level practice.
C) Individual-level practice.
D) Systems-level practice.

A

A nursing diagnosis of Increased risk for delayed development, injury, and disease because of inadequate parenting by a primary parent experiencing depression would most likely indicate that the nursing process is being applied at the _______ level of practice and the _______ level of prevention.
A) Individual/family + secondary.
B) Community + primary.
C) Community + secondary.
D) Individual/family + primary.

A

After consulting with the health department director, a public health nurse collaborates with a housing advocate service and legal counsel on behalf of the nurse’s clients who live in substandard housing under fear of eviction. The nurse is applying the _______ component of the nursing process to a _______ level of practice.
A) Evaluation + systems.
B) Assessment + community.
C) Implementation + systems.
D) Diagnosis + community.

C

A community-level intervention designed to increase the sense of belonging among older community residents at risk for social isolation was implemented by opening a senior center every other Wednesday at a local church that provided lunch and social programs. At the end of 6 months, the attendees were surveyed to determine their experience with the program, barriers to attendance, expansion of their social networks, and involvement in other community activities. This survey allowed the community health nurse to _______ the program and design program improvements.
A) Evaluate the effectiveness of.
B) Assess the expansion needs of.
C) Identify problems with
D) Implement the expansion of.

A

Factors related to the determinants of health identified in Healthy People 2020 include which of the following (select all that apply)?
A) Education and literacy.
B) Genetic endowment.
C) Gender.
D) Culture.
E) Social status.

A,B,C,D,E

A nurse identifies higher-than-normal levels of lead when screening a 3-year-old child. The nurse works with the local health department to put together a team to address the environmental issues responsible for the child’s abnormal lead level. Team members should include the following specialists:
A) Epidemiologist, pediatric specialist, and sanitarian.
B) Laboratory specialist, contractor whose bid for lead reduction work is the lowest, and public health lead reduction specialist.
C) Public health sanitarian, pediatric generalist, and plumbing inspector.
D) Specially trained housing inspector, pediatric specialist, lead-based paint intervention team, and laboratory specialists to test the child’s home and the surrounding neighborhood.

D

An occupational health nurse practitioner’s physical assessment of a factory worker identifies an acute-onset pruritic dermatitis extending over the face, hands, neck, and forearms. The nurse’s priorities should be to:
A) Contact factory senior management, educate workers about their exposure, and clean the area.
B) Contact the Occupational Safety and Health Administration immediately and remove the offending chemical in the work environment.
C) Immediately evacuate the worker’s nearby workspace and treat the worker and other exposed workers.
D) Treat the client and obtain a comprehensive exposure history; if an onsite environmental exposure is suspected as the cause, screen other at-risk workers and ensure that the environmental risk is identified and eliminated.

D

A college health nurse is working with students, faculty, and staff to improve environmental air quality. To address the primary cause of air pollution on campus, the nurse plans a precautionary intervention. Which of the following interventions best demonstrates an appropriate approach?
A) Encourage the use of electric cars and scooters on campus.
B) Increase the use of bicycles, foot-powered scooters, rollerblades, and walking as the primary mode of transportation on campus.
C) Make the entire campus a no-smoking zone.
D) Establish a policy to reduce electricity consumption in university buildings by raising the thermostat to 78 degrees in the summer and lowering the thermostat to 70 degrees in the winter.

B

Campaigns to decrease the inequitable burden of environmental risks on the poor and people of color in the United States strive to apply the ethical principle of:
A) Societal justice.
B) Nonmaleficence.
C) Compliance and enforcement of the Environmental Protection Agency Regulatory Act.
D) Environmental justice.

D

A community health nurse manager has integrated exposure history elements into the assessment practices of the health department that are relevant to the urban industrial community served. This strategy indicates that the nurse manager is aware of the relationship between:
A) Community strengths and weaknesses.
B) Environment and human health/disease.
C) Toxicology studies conducted by the Environmental Protection Agency and the environment.
D) Federal and state environmental regulations.

B

The Superfund Amendments and Reauthorization Act (SARA) increased the involvement of the states and their citizens in the cleanup of toxic waste sites and stressed the importance of permanent remedies and innovative treatment technologies. Another important aspect of this federal legislation was that it:
A) Provided for the appointment of state emergency response commissions.
B) Increased focus on the human health problems related to hazardous waste sites.
C) Established a new safety standard of reasonable certainty of no harm that is to be applied to all pesticides used on food.
D) Reduced the amount of pollution by mandating cost-effective changes in production, operation, and raw materials use.

B

The monitoring and public reporting of air quality in a local community to assist individuals with asthma or other respiratory conditions best illustrates the application of:
A) Compliance and enforcement.
B) Environmental epidemiology.
C) Secondary prevention.
D) Toxicology.

B

When applying the nursing process to environmental health, the nurse would:
A) Conduct an assessment focused on the client’s presenting problem.
B) Coordinate interventions with the primary care provider of record.
C) Examine criteria that are limited to the client’s immediate responses.
D) Include outcome measures that involve mitigation and elimination of the contributing factors.

D

When a nurse evaluates the completeness and accuracy of information made available to community residents regarding the impact of rezoning of land parcels for industrial use, the nurse can best be described as:
A) Advocating for ethical choices.
B) Communicating risk.
C) Controlling environmental damage.
D) Volunteering for service on state boards.

A

The role of the nurse who wants to become more active in environmental health could include which of the following (select all that apply)?
A) Assessing farmworkers for pesticide exposure and providing pesticide risk education.
B) Conducting epidemiologic investigations as a public health nurse.
C) Developing corporate policy to protect workers from unsafe levels of toxic agents.
D) Organizing the local community to encourage landlords to remove lead-based paint.
E) Working as a skilled risk communicator for a local chemical manufacturer.

A,B,C,D,E

Which of the following article titles include(s) an example of epidemiologic distribution and determinants (select all that apply)?
A) Can Operating Room Nurses Measurably Reduce Patient Anxiety?
B) Characteristics of Patients Newly Diagnosed with Tuberculosis
C) Comparison of Postinsecticide Exposure Incidence of Atopic Dermatitis in Migrant Farmworkers and Land-Owning Farmers in Southwestern Utah
D) Postpartum Nurses’ Reaction to Rotating Shifts Compared with Assigned Stable Shift

C

A state public health region reported 39 cases of meningitis in children 15 years of age and younger to date this year. Seven of those children died. The total population of the region is 780,000, of whom 84,000 are children age 15 years old and younger. What is the prevalence proportion of meningitis in this region thus far in the current year?
A) 4.1/100,000
B) 5/100,000
C) 46/100,000
D) 50/100,000

C

A state public health region reported 39 cases of meningitis in children 15 years of age and younger to date this year. Seven of those children died. The total population of the region is 780,000, of whom 84,000 are children 15 years old and younger. What is the age-specific meningitis death rate for children age 15 years and younger for this region to date this year?
A) 0.08/1000
B) 0.46/1000
C) 1/1000
D) 8/1000

A

A state public health region reported 39 cases of meningitis in children 15 years of age and younger to date this year. Seven of those children died. The total population of the region is 780,000, of whom 84,000 are children age 15 years old and younger. Only four cases of meningitis were reported in the public health region during the previous year. No other public health region in the state has an incidence of meningitis that is higher than expected for that region. Based on the information given, the relative frequency of meningitis in the region at this time can best be described as:
A) Endemic.
B) Epidemic.
C) Pandemic.
D) Sporadic.

B

John Snow played a critical role in the development of modern disease surveillance when he:
A) Devised a more statistically valid method of analyzing epidemiologic data.
B) Discovered causal agents for anthrax, tuberculosis, and cholera.
C) Tracked the incidence of tuberculosis in the tenements of New York City.
D) Used geographic mapping to demonstrate the connection between water supply and cholera.

D

A business executive develops flu-like symptoms 1 day after returning by air from a trans-Atlantic 2-day conference that involved lengthy meetings into the evening. The scenario best illustrates the interaction of:
A) Host and agent.
B) Host, agent, and environment.
C) Risk and causality.
D) Morbidity and disease.

B

A nurse teaches an asthmatic client to recognize and avoid exposure to asthma triggers and assists the client’s family in implementing specific protection strategies in the home, such as removing carpets and avoiding pets. This nurse’s activities can best be described as:
A) Comprehensive assessment.
B) Primary prevention.
C) Secondary prevention.
D) Treatment intervention.

B

A nurse is concerned about the accuracy of the purified protein derivative (tuberculin) test in screening individuals with tuberculosis exposure for followup chest radiography. The nurse’s concern is related to which aspect of the test’s validity?
A) Reliability.
B) Sensitivity.
C) Specificity.
D) Variability.

B

Case fatality from breast cancer has decreased in recent years, although the incidence of breast cancer has increased. Descriptive epidemiology would use the component of time to explain this change in terms of:
A) Cyclical patterns.
B) Even-related clusters.
C) Point epidemic.
D) Secular trends.

D

When the association between maternal alcohol use and low birth weight is being studied, the nurse investigator’s failure to consider the variable of smoking could introduce bias into the observed association, because smoking has a correlation with both factors. This effect could best be described as:
A) Causality.
B) Confounding.
C) Information bias.
D) Selection bias.

B

A local health department in the Midwest reports cases of certain diseases to the state health department for inclusion in the National Notifiable Diseases Surveillance System (NNDSS). From the perspective of community-level disease monitoring, which of the following 3-year trends in incidence rates for hepatitis A would be of local, state, and national interest?
A) 1998 = 2/100,000; 1999 = 3/100,000; 2000 = 1/100,000
B) 1998 = 4/100,000; 1999 = 8/100,000; 2000 = 6/100,000
C) 1998 = 12/100,000; 1999 = 8/100,000; 2000 = 31/100,000
D) 1998 = 16/100,000; 1999 = 24/100,000; 2000 = 9/100,000

C

A 6-year-old is brought to the emergency department with a full-body rash and fever. During the nursing assessment, which of the following findings would be most relevant to recognizing the case as potential smallpox rather than varicella?
A) Fever has responded to acetaminophen, and the child is playful when temperature is not elevated.
B) Fever of 101° F was present for several days before the rash appeared.
C) Low-grade fever (100° F or less) has been present ever since the rash became obvious.
D) Rash is primarily on the trunk of the body.

B

A school nurse notes that 60 children have missed days of high school because of pertussis this past year and this rate has been relatively constant for the past 5 years. The nurse plans to work with the community to increase awareness of the seriousness of this disease for children younger than 6 months of age and to raise and maintain the immunization rates, because in this community the pertussis is:
A) Endemic.
B) Epidemic.
C) Pandemic.
D) Sporadic.

A

The World Health Organization (WHO) developed the Five Keys to Safer Food campaign in 2001 to address the problem of foodborne and waterborne diarrheal diseases worldwide. This campaign emphasizes which of the following practices?
A) Keep clean, separate raw and cooked, cook thoroughly.
B) Never use raw, always cook, buy better.
C) Wash, cut, cook, and throw away.
D) Wash, cover, and always refrigerate.

A

An American takes a long-awaited vacation in sunny Mexico, spending days on the beach eating fresh raspberries from a nearby vendor and drinking bottled water. The tourist may be altering:
A) Agent-host-environment interaction.
B) Circadian rhythms.
C) Herd immunity.
D) Host resistance.

A

An example of secondary prevention of infectious disease is:
A) Malaria chemoprophylaxis.
B) Pneumocystis carinii pneumonia chemoprophylaxis for people with AIDS.
C) Quarantine.
D) Restaurant inspections.

C

In an effort to address West Nile virus, a community increased livestock immunization, began a vector control program, and initiated a community campaign to eliminate standing water reservoirs. This best exemplifies communicable disease control through:
A) Health education.
B) Multisystem approach.
C) Improved public health infrastructure.
D) Reduction of environmental hazards.

B

When a situation exists in which there is potential contact with blood or body fluids, health care workers must always perform hand hygiene and wear gloves, masks, protective clothing, and other indicated personal protective barriers. The underlying reason for requiring these practices, known as universal precautions, is that:
A) Blood and body fluids of all clients need to be handled as if they were infected.
B) Effective infection control surveillance programs are in place.
C) Health care settings are reservoirs of infection.
D) Health care workers do not effectively use hand hygiene.

A

Although infectious disease epidemics are still the major cause of death worldwide, they have subsided in the United States because of improvements in nutrition and sanitation, the discovery of antibiotics, and the development of vaccines. Infectious diseases have not vanished, however, and remain a continuing cause of concern. Healthy People 2020 has a number of objectives aimed at reducing these illnesses because of the morbidity, mortality, and costs associated with infectious diseases. One such costly disease trend related to an increase in the performance of invasive diagnostic and surgical procedures, the use of broad-spectrum antibiotics, and treatment with immunosuppressive drugs is the rise of:
A) Escherichia coli 0157:H7.
B) Multisyndrome effect.
C) Hospital acquired infections.
D) Severe acute respiratory syndrome.

C

Emerging infectious diseases may arise as a result of factors operating singly or in combination, and these factors may include which of the following (select all that apply)?
A) Environmental changes.
B) Host behavior.
C) Improved surveillance.
D) Microbial adaptation.
E) Public health infrastructure deterioration.

A,B,D,E

A school nurse is teaching a class of sophomores about the relationship between the risk of sexually transmitted disease (STD) and risk-taking behaviors. A key point to include is:
A) All STDs are easily preventable with consistent condom use.
B) Once a young woman is pregnant, she is no longer at risk for most STDs.
C) STDs are most likely to be transmitted during a student’s initial sexual encounter.
D) Use of alcohol and drugs makes a student more likely to make decisions that result in exposure to and infection with STDs.

D

A client newly diagnosed with human papillomavirus (HPV) infection, herpes simplex virus 2 (HSV-2) infection, and syphilis asks, "Okay, so how do I get rid of all this stuff?" In developing a plan of care, the nurse recognizes that it is essential to address:
A) Correct use of condoms to prevent transmission of all sexually transmitted diseases (STDs).
B) Cures for each of the STDs identified.
C) Risk of skin-to-skin contact in transmitting the identified STDs.
D) Safety of sexual contact in the absence of lesions.

C

A nurse is assigned to teach clients sexually transmitted disease (STD) prevention information. The nurse updates her teaching plan to incorporate new guidelines from the Centers from Disease Control and Prevention (CDC). She includes which of the following as updated information during her next teaching session?
A) Always use spermicides with condoms to reduce the risk of contracting chlamydia or gonorrhea.
B) Condoms can be effective in preventing infections transmitted by fluids from mucosal surfaces but are not always effective in preventing infections transmitted by skin-to-skin contact.
C) Condoms should not be used during oral sex, because they are not effective in preventing transmission of infection.
D) When genital ulcers are present, condoms should be used to prevent the spread of infection.

B

A woman comes to the community health center complaining of increasing lower abdominal pain, fever, and abnormal menses for several months. During the assessment, the client indicates that she is aware that her husband has had multiple sex partners in the past two years. Appropriate intervention by the nurse would be to:
A) Arrange to have the client referred for medical evaluation for pelvic inflammatory disease (PID) and appropriate intervention and treatment.
B) Contact the health department to confirm the spouse’s diagnosis of Chlamydia infection to determine the client’s exposure, give the client antibiotics, and have her return to the clinic if symptoms worsen.
C) Provide sexually transmitted disease (STD) prevention and treatment education and refer the client to the health department for STD screening for gonorrhea and/or Chlamydia infection.
D) Supply the client with nonsteroidal antiinflammatory drugs and caution her to call the after-hours call doctor if her symptoms worsen.

A

The clients most at risk of reactivation of latent infections of tuberculosis (TB) are:
A) Immunocompromised persons, substance abusers, and those with diabetes.
B) Individuals previously treated for TB.
C) Long-term cigarette smokers.
D) Persons with new-onset asthma or emphysema.

A

Community health nurses conducting health education among populations vulnerable to HIV infection should explain the natural history of the infection, including the fact that HIV infection may go undetected during the primary infection stage because:
A) Antibody test results are typically negative.
B) Antibody production by the immune system increases.
C) Incubation period is prolonged.
D) Symptoms include myalgias, sore throats, and rash.

A

A client comes to the local clinic with acute symptoms of fever, nausea, lack of appetite, malaise, and abdominal discomfort. During the course of the assessment, the nurse determines that the client is a health care aide working at a daycare center. These facts are important because:
A) Acute hepatitis B is self-limiting.
B) Hepatitis A outbreaks commonly occur in facilities where staff change diapers.
C) Hepatitis C is a "silent stalker."
D) Individuals with chronic liver disease are at greater risk for hepatitis A.

B

Many behaviors place any individual-regardless of age, gender, ethnicity, or other characteristics-at greater risk for sexually transmitted diseases (STDs). The nurse should include primary prevention interventions in all client encounters through the discussion of:
A) Partner notification.
B) Safer sex.
C) Standard precautions.
D) STD testing.

B

A population-level tertiary prevention intervention typically carried out by nurses caring for those with communicable disease in the community is:
A) HIV test results counseling.
B) Needle exchange.
C) Partner notification.
D) Instruction in standard precautions.

D

A client diagnosed with human papillomavirus (HPV) infection states, "I’m not concerned, I know the warts disappear after a while." The nurse should counsel the client regarding which of the following? Select all that apply.
A) Link between HPV and cervical cancer.
B) Status of HPV infection as a reportable disease.
C) Need to eliminate the warts.
D) Serious complications of HPV infection for men.
E) Lack of cure for HPV infection.

A,C,E

Today, an evidence-based nursing practice can best be defined as which of the following?
A) Approach to the integration of the best research available, nursing expertise, and the preferences/values of the clients served.
B) Concept developed by acute care nurses to ensure the quality of care of hospitalized clients and to challenge managed-care decisions.
C) Concept developed in the early twentieth century to help nurses document the scientific basis of their nursing practice.
D) Framework supporting the use of traditional research as the only basis for making clinical decisions in practice.

A

Community-oriented nurses use evidence-based practice (EBP) most effectively when they:
A) Base care on nationally accepted clinical guidelines, informing clients and community groups that the accepted standards of care need to be universally applied.
B) Base care on nationally accepted clinical guidelines, involve clients in individual care decisions, and include community input when applying evidence in practice.
C) Make client care decisions using the latest nursing research findings.
D) Work with physicians to design client care guidelines for community clinics.

B

A community-oriented nurse seeks to implement evidence-based practice (EBP) in the community clinic’s programs. The best model for the nurse to apply is:
A) Action research and review.
B) Community development.
C) Community research utilization.
D) EBP.

B

A community-oriented nurse introduces a community partnership group to the Healthy People 2020 information access objective to use electronic personal health management tools. This is an example of:
A) Meta-analysis of research evidence.
B) Primary prevention using evidence-based practice (EBP).
C) Secondary prevention using EBP.
D) Tertiary prevention using EBP.

B

When nurses work with communities, "best practices"-the application of the best available evidence to improve practice-must also be:
A) Accessible and diverse.
B) Competent and compliant.
C) Culturally and financially appropriate.
D) Reasonable and deliverable in a timely fashion.

C

Although the definitions of evidence-based practice (EBP) in the literature vary widely, their common thread across all health care disciplines is:
A) Application of the best available evidence to improve practice.
B) Definition of what counts as evidence.
C) Reliance on principles of pathophysiology.
D) Method of transforming research into practice.

A

Examples of the application of evidence-based practice (EBP) to improve public health nursing can be found in research projects designed to test the effectiveness of public health nursing interventions related to the core functions and essential services of public health. These projects are associated with:
A) Agency on Healthcare Research and Quality.
B) Cochrane Database of Systematic Reviews.
C) The Intervention Wheel.
D) U.S. Preventive Services Task Force.

C

When a public health nurse uses evidence-based interventions to evaluate the effectiveness, accessibility, and quality of population-based services within the community, the nurse is addressing the core public health function of:
A) Assessment.
B) Assurance.
C) Policy development.
D) Research.

B

Randomized controlled trials are often inappropriate for evaluating many public health interventions. The most common approach to establishing evidence in public health is the use of:
A) Blinded studies.
B) Case-control studies.
C) Expert opinion.
D) Research synthesis.

B

A community health nurse is revising the agency’s nursing protocols to incorporate current evidence-based practice (EBP) clinical practice guidelines. Common barriers to EBP implementation that could be faced include which of the following (select all that apply)?
A) Disempowerment of nurses in their ability to make clinical decisions.
B) Experienced nurses’ challenging of the need to change long-accepted practices.
C) Lack of knowledge of how to conduct a systematic review of the research literature.
D) Unwillingness of clients to accept changes in familiar agency programs.
E) Urban agency setting with restricted computer resources.

A,B,D,E

Which action by the community-oriented nurse best illustrates a partnership for health?
A) Assisting a school nurse in conducting vision screening of elementary school children.
B) Developing a volunteer program for teaching parenting skills.
C) Helping a group of citizens concerned about potential environmental hazards collect relevant health data and develop needed interventions.
D) Informing a neighborhood council that smoking is its major community health problem.

C

A rural public health nurse is in the first phase of a community assessment to determine the community health status characteristics of the local county. This initial data gathering should most likely begin with which agency?
A) County public health department.
B) National Centers for Disease Control and Prevention.
C) State vital statistics bureau.
D) U.S. Census Bureau.

C

Which community attribute is an indicator of a community’s health status?
A) Mean educational level.
B) Location of health facilities within the community.
C) Ratio of police to citizens.
D) Suicide rate.

D

A community-oriented nurse leader is working with a community partnership to improve access to services for the underserved by planning an expansion of the local community health clinic. This nursing intervention strategy is focused on which of the following community health dimensions?
A) Environment.
B) Health status.
C) Process.
D) Structure.

D

The community practice nurse is preparing to initiate a community partnership with a neighborhood watch association to address teenager street vandalism. The nurse is evaluating the community health dimension of process and seeks to determine the community’s:
A) Commitment to prioritizing and solving health problems.
B) Crime rate and school absenteeism rate.
C) Educational level.
D) Local client-to-provider ratio.

A

The most important aspect of the nursing community assessment phase can best be described as:
A) Analyzing and synthesizing data.
B) Collecting and gathering data.
C) Formulating a community nursing diagnosis.
D) Identifying problem correlates.

C

A rural community health nurse has made sure that male and female lay advisors are involved in the health department’s migrant worker outreach program. The nurse believes this intervention strategy is important because the nurse knows that such individuals can be:
A) People who are influential in approving or vetoing new ideas.
B) Medical professionals within the migrant community.
C) Natural healers within their community.
D) Translators to help overcome language barriers.

A

The community planning board’s evaluation of a community intervention (child immunization campaign) carried out by the health department determined that some progress was made toward the desired outcome (target rate of childhood immunization), but the degree of progress achieved was not sufficient to offset the initial effort in terms of cost and time to launch the campaign. The community determined that the rate gain was not adequate when compared with that achieved through similar initiatives in other communities, which obtained better results by using more efficient strategies. The budget for this program was cut. This community decision best exemplifies which statement about evaluation?
A) Evaluation should start in the planning phase of the nursing process.
B) Evaluation can have unintended consequences.
C) Effectiveness is the only true measure of worthiness.
D) The power to design, judge, or institute change is important.

B

If the community is where nurses practice and apply the nursing process, and the community is the client in that practice, then nurses will want to analyze and synthesize information about:
A) Boundaries, parts, and dynamic processes of the client community.
B) Community health status and structure.
C) Community problems and problem correlates.
D) Role of the nurse and lay advisors in the community partnership.

A

Which of the following are the best argument(s) for supporting community-as-client nursing (select all that apply)?
A) Change for the benefit of the community-client must often occur at several levels.
B) Changes in the health of individuals will affect the health of their communities.
C) The idea of providing health-related care within the community is not new.
D) The impact of the environment on health has long been established.
E) Direct hands-on nursing care delivered to individuals or families in community settings is important.

A,B,C,D

Public health nurses are challenged to respond to public health-related trends of the twenty-first century, which include:
A) Racial, ethnic, and economic health disparities; rise of drug-resistant pathogens; unequal access to health care; and violence.
B) Violence, availability of health care for all, and increasing life expectancy.
C) Health disparities, access issues, and adequate mental health program funding.
D) Rise of drug-resistant organisms, increased life expectancy, societal violence, and more effective disease surveillance.

A

Rapid changes in public health are providing a challenge to public health nurses because there is neither time nor staff to provide nurses with the on-the-job training needed to acquire the core public health competencies required of the public health nurse. This resulted in revisions to the American Nurses Association (ANA)’s Scope and Standards of Public Health Nursing Practice in 2005 that established:
A) Core public health functions as the competency framework.
B) Minnesota Department of Health’s intervention wheel as the practice competencies.
C) Standards for baccalaureate- and master’s-prepared public health nurses.
D) Quad Council principles as the primary framework for practice.

C

A public health nurse in the local health department assists the community in identifying the health need priorities and the services that can best meet these needs in a cost-effective manner. This is an example of the tertiary prevention public health nursing function of:
A) Case finding.
B) Case management.
C) Collaboration.
D) Provision of direct services.

B

State public health agency responsibilities include:
A) Conducting community health assessments.
B) Enforcing public health codes.
C) Monitoring health status.
D) Providing expertise that facilitates evidence-based practice.

C

The public health nurse serves as a bridge between at-risk populations and the community’s health care resources. This role is based on the nurse’s responsibility to:
A) Collect and analyze data on public health programs.
B) Ensure that all populations have access to affordable, quality health care.
C) Monitor and assess critical health status indicators.
D) Provide evidence-based use of resources.

B

If the two major goals of Healthy People 2020 are to be achieved, collaboration is essential for public health nursing practice, and collaboration with existing groups at the local level is encouraged for which of the following reasons?
A) The federal government is ultimately responsible for the health status of the nation.
B) The public demands that the government protect the people.
C) Public health departments do not have the resources to accomplish these goals independently.
D) State health agencies must take a universal approach to achieving objectives.

C

The public health nurse ensures that a local community coalition for improving school lunches takes the time to listen to each stakeholder’s view, develops a common validated language for discussing the initiative, and shares the credit for the success of the initiative. The public health nurse is adhering to the principles of:
A) Collaboration.
B) Partnership.
C) Public health care.
D) Public health nursing.

B

The federal-state-local partnership teams with other organizations to develop and implement responses to identified public health concerns because:
A) Community health is a shared responsibility.
B) Health objectives are defined nationally.
C) Population health is the responsibility of the government.
D) Public health trends focus on bioterrorism.

A

The public health nurse applies knowledge in working with a local school board coalition to develop a helmet safety campaign in the middle and high schools. This best exemplifies which aspect of public health?
A) Core competency.
B) Core function.
C) Nursing role.
D) Standard of practice.

A

The Quad Council of Public Health Nursing identified eight principles that distinguish the public health nursing specialty from other nursing specialties, including which of the following (select all that apply)?
A) Collaboration with other professions, organizations, and entities.
B) Optimal use of available resources.
C) Population-based unit of care.
D) Primary obligation to work for the good of individuals and families.
E) Engagement with clients as an equal partner.

A,B,C,E

In 1988 the Institute of Medicine (IOM) published a report on the future of public health and its mission that defined public health as:
A. What public-private partnerships do to treat vulnerable populations.
B. What the government does to ensure that vital programs are in place.
C. What the U.S. Public Health Service does to prevent disease, promote health, and deliver services.
D. What society does collectively to ensure the conditions in which people can be healthy.

D

A registered nurse is seeking a position as a public health nurse. In reviewing the job description the nurse would expect to find a description of a position that focused on functions such as:
A. Monitoring pregnant teenagers for symptoms of complications of pregnancy.
B. Offering free hypertension screening and treatment referral at local health fairs to low-income, uninsured, community members.
C. Partnering with local seasonal farmworkers to design a program aimed at preventing illness and injury, and advocating for this population with local political and community leaders.
D. Preventing injury among a population of elderly residents in an assisted living facility and treating residents’ chronic illnesses.

C

A public health nurse leader is encountering barriers when trying to shift the public health agency’s efforts to a population-focused practice. The reasons peers are not supportive of the proposed shift to a population focus are most likely related to:
A. Agency colleagues’ push for nurses to focus on population initiatives.
B. Costs associated with staff training and revision of documents.
C. Lack of support from the agency’s funding sources.
D. Opinions that nursing should focus on the provision of direct client care and services.

D

The role and goals of the community health nursing practice can best be described as:
A. Community-based interventions aimed at promoting, preserving, and maintaining the health of populations residing in institutional facilities such as nursing homes.
B. Education of nurses and other staff working in community-based and community-oriented settings to improve the overall effectiveness of their programs to meet client needs.
C. Population-level strategies aimed at promoting, preserving, and maintaining the health of populations through the delivery of personal health care services to individuals, families, and groups in an effort to improve the health of the community as a whole.
D. Activities targeted at improving the health status of clients served by community-based health service agencies such as hospice and home health agencies.

C

A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the core public health function of:
A. Assessment.
B. Assurance.
C. Policy development.
D. Research.

A

The state public health agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored eldercare programs. The public health core function applied is:
A. Assurance.
B. Policy development.
C. Primary prevention.
D. Public transportation.

A

A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing:
A. Community-oriented care.
B. Community-based care.
C. Secondary care.
D. Tertiary care.

A

A community-oriented nurse conducts home visits to new parents to assess the health status of the infant, the parent-child relationship, the parents’ knowledge regarding the care of the infant, and the need for health department and social services referrals to support the needs of the new parents and the infant. This can best be described as an example of:
A. Clinical community health practice.
B. Community-based practice.
C. Population-focused practice.
D. Public health nursing.

A

Nurses should consider opportunities for population-focused practice that result from the rapid transformation of health care delivery from a medical model to a health promotion/disease prevention model. An example of such opportunity is:
A. Operator of a nurse practitioner-run urgent care center in a major retail location.
B. Director of clinical services spanning inpatient and community-based settings that provide a wide range of services to the populations seen by the system.
C. Clinical director of a home health agency.
D. School nurse position in the local high school.

B

Public health nursing specialists are interested in which of the following topic(s)? Select all that apply.
A. Educational materials for individuals with HIV/AIDS.
B. Evaluation of an outreach program for at-risk pregnant teenagers.
C. Community subpopulations with high rates of type 2 diabetes.
D. New technologies to monitor diabetes.
E. Prevalence of hypertension among various age, race, and gender groups.

BCE

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