18 - Community as Client: Assessment and Analysis Flashcards
A nurse focuses intervention strategies on the structural dimension of community health. Which of the following best describes the focus of these strategies?
a. ) Health services
b. ) Primary prevention
c. ) Health promotion
d. ) Secondary prevention
a.) Health services
The structure of the community is defined in terms of services and resources. The subsystems of community structure consist of physical environment, health and social services, economy, transportation and safety, politics and government, communication, education, and recreation.
Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.
Primary prevention attempts to promote health and provide specific protection from disease.
Health promotion activities are interventions focused on improving one’s health.
A nurse collects data about seat belt usage by interviewing key informants and observing behaviors in the community. Which of the following types of data is being collected?
a. ) Quantitative
b. ) Qualitative
c. ) Focus groups
d. ) Participant observation
b.) Qualitative
Qualitative data is collected through interviews and observation. This data is the descriptions provided by these individuals through interviews.
Quantitative data is the numbers that can be found about the community, such as crime statistics.
A focus group is similar to an interview in that it collects data mainly through asking open-ended questions to participants, but to a small group rather than an individual.
Participant observation refers to the deliberate sharing in the life of a community, such as participating in a local fair or festival, or attending a political or social event.
A nurse is defining the community as part of the community assessment process. Which of the following best describes how the community may be defined? (Select all that apply.)
a. ) Social group determined by geographic boundaries
b. ) Group of people who share common values and interests
c. ) Group of people defined by their interactions
d. ) Individual with a specific health concern
e. ) Individuals with certain interests
a.) Social group determined by geographic boundaries
b.) Group of people who share common values and interests
c.) Group of people defined by their interactions
Community can be defined as many things, including a social group determined by geographical boundaries, a group of people who share common values and interests, and a group of people defined by their interactions. Individuals comprise a community, but would not be an accurate definition of a community.
A community health nurse is conducting informant interviews in a small community. Which of the following would the nurse most likely contact?
a. ) The state department of health for death records
b. ) A local priest for congregation information
c. ) Surrounding communities for crime comparison
d. ) The Centers for Disease Control and Prevention (CDC) for illnesses in the area
b.) A local priest for congregation information
Informant interviews are methods of directly collecting data. County health department nurses and church officials are often good key informants. Key informants need not hold any formal title, but are generally viewed as community leaders by other community members and often have a long history in the community.
The state department of health, surrounding communities, and CDC do not meet the definition of an informant.
A nurse is engaging in the evaluation phase of community health program planning. Which of the following would be part of effective completion of this phase?
a. ) Demonstrate the ability to improve the health of the participants
b. ) Develop measureable objectives and goals before implementation
c. ) Encourage full participation by community members
d. ) Improve the health of the population through the program
b.) Develop measureable objectives and goals before implementation
Evaluation begins in the planning phase, when goals and measurable objectives are established and goal-attaining activities are identified. After implementing the intervention, only the meeting of objectives and effects of the intervening activities have to be assessed.
Participation by community members and improvement of the health of the population may be measured through the evaluation phase, but would not demonstrate completion of this phase. The evaluation phase may determine if the participants’ health improved, but improvement of health is not part of the completion of this phase.
What are the critical attributes in the definition of community?
a. ) Families, groups, and health organizations
b. ) Health needs, geographical boundaries, and target population
c. ) People, place, and functions
d. ) Populations and health resources
c.) People, place, and functions
People, place, and function are the critical attributes in the definition of community. These attributes are found in most definitions of community.
The people are community members or residents; place refers to geographic and time dimensions; and function refers to the aims and activities of the community.
A nurse has identified the boundaries of the community. Which of the following steps should the nurse take next when completing a community assessment?
a. ) Gather relevant existing data and generating missing data
b. ) Plan interventions that benefit the entire community
c. ) Formulate nursing diagnoses
d. ) Evaluate the interventions that were used
a.) Gather relevant existing data and generating missing data
The first step of the community assessment is to define the community. In order to do this, geographic boundaries, the population within the boundaries, the purpose of the assessment, and a data collection plan will be identified. Those inhabiting the community are a primary focus of the assessment. A variety of strategies are used to identify this central core of the community.
The next step involves gathering and generating data to learn more about the community. After the community has been completely assessed then nursing diagnoses can be formulated, interventions planned, and finally interventions evaluated.
A nurse plans on implementing a community-wide influenza immunization program. Which of the following factors should the nurse consider when implementing this program?
a. ) The number of community members who have already received the immunization
b. ) The existence of formal groups in the community
c. ) Public policy that mandates influenza immunization for certain populations
d. ) The community’s readiness to participate in the program
d.) The community’s readiness to participate in the program
The factors that influence implementation in the community are the nurse’s chosen roles, the type of health problem selected as the focus for intervention, the community’s readiness to take part in problem solving, and characteristics of the social change process.
The community’s readiness to participate is more important than public policy, the existence of formal groups in the community, and the number of community members who have already received the vaccine.
A nurse is trying to develop community partnerships. Which of the following interventions would be the most appropriate for the nurse to use?
a. ) Involve the community residents
b. ) Use nurses as the source of information and leadership
c. ) Rely on the power of local officials
d. ) Include a variety of disciplines
d.) Include a variety of disciplines
Community partnerships occur when community residents and health workers come from a variety of disciplines. Partnerships should involve a variety of individuals from various backgrounds. There should be a balance of power and information sharing among all of the participants.
A nurse centers his practice around the principle of doing the greatest good for the greatest number. Which of the following ethical principles is being applied?
a. ) Distributive justice
b. ) Utilitarianism
c. ) Social justice
d. ) Health disparities
b.) Utilitarianism
Utilitarianism means doing the greatest good for the greatest number.
Distributive justice means treating people fairly, and distributing resources and burdens equitably among the members of a society.
Social justice means ensuring that vulnerable groups are included in the equitable distribution of resources.
Health disparities are the inequalities that exist among different populations.
A nurse is writing a nursing diagnosis at the community level using the North American Nursing Diagnosis Association (NANDA) system as a guide. Which of the following diagnoses would most likely be developed?
a. ) Risk of hypertension related to poor diet and sedentary lifestyle
b. ) Risk of obesity among school-age children related to lack of opportunities to engage in physical activity
c. ) Risk of ineffective health maintenance among individuals who do not have access to a primary care provider
d. ) Ineffective coping related to multiple stressors, as evidenced by client crying and stating she has no support system
b.) Risk of obesity among school-age children related to lack of opportunities to engage in physical activity
There are three parts of the NANDA system: (1) identification of the problem or potential problem; (2) its relation to factors, stressors, or health issues; and (3) supporting data that documents the problem.
The “risk of” identifies a specific problem or health risk faced by the community.
“Among” identifies the specific community client with whom the nurse will be working in relation to the identified problem or risk.
“Related to” describes characteristics of the community.
What is the purpose of writing a community nursing diagnosis?
a. ) To assist with developing the evaluation measures for program planning
b. ) To clearly describe the strengths and weaknesses of the community
c. ) To lead to the outcomes and strategies to address and improve the identified health problem
d. ) To increase the likelihood that the problem will be solved
c.) To lead to the outcomes and strategies to address and improve the identified health problem
The community nursing diagnosis, no matter which classification system is used, leads to expected outcomes and evidence-based health promotion strategies to address and improve the problem identified in the diagnosis. This becomes the nursing care plan. The expected outcomes and evaluations derived from the nursing diagnosis systems suggest subsequent evaluation measures for identified needs or problems.
A community assessment describes the strengths and weaknesses of a community. The likelihood of solving a problem is not influenced by writing a community nursing diagnosis.
Which data source provides information about the function of the community?
a. ) Local restaurant
b. ) Elected officials
c. ) County health department
d. ) Civic groups
c.) County health department
Function refers to the aims and activities of the community.
Civic groups and elected officials refer to people.
Local restaurant refers to a place.
A leader of a support group introduces a nurse to its members and discusses the professional relationship he has with the nurse for the past several years. Which of the functions is the leader performing?
a. ) Gatekeeper
b. ) Insider
c. ) Community health workers
d. ) Advocate
a.) Gatekeeper
Gatekeepers refer to formal or informal community leaders who create opportunities for nurses to meet diverse members of the community.
Insiders are those who grew up in the community, have personal ties to the people there or comes from a similar cultural or ethnic background.
Community health workers are not professional or licensed health care providers but are community members from diverse backgrounds who receive training to do health outreach work.
An advocate is someone who speaks up for and supports the needs of the community.
A nurse gathers information about the condition of homes, size of lots, neighborhood hangouts, road conditions, and modes of transportation. Which method of data collection is being used?
a. ) Participant observation
b. ) Windshield survey
c. ) Focus group
d. ) Informant interviews
b.) Windshield survey
Windshield surveys are a method of simple observation, providing a quick overview of a community. By making observations of the community, the nurse is completing a windshield survey.
Participant observation refers to the deliberate sharing in the life of a community, such as participating in a local fair or festival, or attending a political or social event.
A focus group is similar to an interview in that it collects data mainly through asking open-ended questions to participants, but to a small group rather than an individual.
An informant interview is a method of community data collection that involves directed conversation with selected community members.
