Chapter 1

Question 1

Goal of Community Health Nursing-

Answer 1

to promote, preserve, and maintain the health of populations by
delivery of health services to individuals, families, and groups in order to influence 􏲤comm􏱍nit􏱏 health􏲥.

Question 2

geopolitical communities -

Answer 2

defined or formed by natural and/or man made boundaries and
include cities, counties, states, and nations. (i.e school, districts, census tracts, zip codes, and
neighborhoods)

Question 3

phenomenological communities-

Answer 3

the place or setting is more abstract, and people share a group
perspective or identity based on culture, values, history, interests, and goals.
o (i.e schools, colleges, and universities; churches, synagogues, and mosques; and various groups
and organizations, such as social networks.

Question 4

Surveillance -

Answer 4

Describes and monitors health events through ongoing and systematic collection, analysis, and interpretation of health data for the purpose of planning, implementing, and evaluating public health interventions.

Question 5

Case management-

Answer 5

Optimizes self-care capabilities of individuals and families and the capacity of systems and communities to coordinate and provide services

Question 6

Coalition building -

Answer 6

Promotes and develops alliances among organizations or constituencies for a common purpose

Question 7

what are the 5 Determinates of health and disease

Answer 7

􏲹 Physical Environment
􏲹 Health Services
􏲹 Social Environment
􏲹 Individual Behavior
􏲹 Biology & Genetics

Question 8

A nurse works hard to develop alliances among various community organizations toward improving health in the community. What are actions such as this called?

a. Building coalitions
b. Collaboration
c. Communication
d. Community cooperation

Answer 8

a. Building coalitions

Question 9

Which variable has a major influence on a comm􏱍nit􏱏􏱚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

Answer 9

ANS: A
Individual behavior choices are responsible for about 50% of health outcomes. Individual choices are affected through interaction with other individuals, and their mutual social and physical environments. The number of health care providers has not played a major role in the health outcomes in the community in comparison to individual health behaviors. The quality of public safety officers and number of public health officials have not been identified as major contributors to the determinants of health.

Question 10

Which are considered the most important determinants of a healthy community? (Select all that apply.)

a. Child-friendly neighborhoods
b. Several different choices of houses of worship
c. Employment opportunities
d. Low crime rate
e. Safe food and water supplies
f. Varied housing choices

Answer 10

ANS: A,D

The public is more concerned with quality-of-life issues, with the most important determinants of a healthy community being low crime rates and a child-friendly neighborhood environment. Although employment opportunities are important, many are low-paying, no-benefit service positions that are inadequate to support family life. Although the food may be expensive, most cities have safe food and water supplies.

Question 11

Indicators of health and illness (AKA. Healthy People 2020)

Answer 11

Access to Health Services
􏲹 Clinical Preventative Services
􏲹 Environmental Quality
􏲹 Injury and Violence
􏲹 Maternal, Infant and Child Health
􏲹 Mental Health
􏲹 Nutrition, Physical Activity, and Obesity
􏲹 Oral Health
􏲹 Reproductive and Sexual Health
􏲹 Social Determinants
􏲹 Substance Abuse
􏲹 Tobacco

Question 12

Healthy People 2020 -

Answer 12

health objectives for Healthy People 2020 were being developed, a total of 12 leading health indicators were identified that reflected the major public health concerns in the United States. Healthy People 2020 serves as a measure for quality of health. The national health goals guide the nurse in developing health promotion strategies to improve individual and community health.

Question 13

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 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.

Answer 13

ANS: D
Although all responses are accurate, the primary problem is the emphasis on personal choices in 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.

Question 14

What are the leading health indicators found in Healthy People 2020? (Select all that apply.)

a. Financial issues
b. Health system issues
c. Individual behaviors
d. Issues related to legal and illegal immigration
e. Legislative issues
f. Physical and social environmental factors

Answer 14

ANS: B, C, F
Ten leading health indicators are identified in Healthy People 2020, including individual behaviors, physical and social environmental factors, and health systems issues. Financial issues, issues related to legal and illegal immigration, and legislative issues are not found in Healthy People 2020.

Question 15

3. Based on Healthy People 2010, what are the two primary goals of Healthy People 2020? (Select all that apply.)

a. Eliminate health disparities.
b. Expand health promotion activities in every community.
c. Improve funding, including diverting funds from other priorities to health care.
d. Improve health outcomes measures to be more consistent with other developed nations􏱚 outcomes.
e. Increase quality and years of healthy life.
f. Reduce mortality and morbidity figures nationwide.

Answer 15

ANS: A,E
As published, the two goals are to increase quality and years of healthy life and eliminate health disparities. Expanding health promotion activities in every community, improving funding and improving health outcomes, and reducing mortality and morbidity are not the primary goals of Healthy People 2020.

Question 16

Which best describes the new national health goals as seen in Healthy People 2020? (Select all that apply.)

a. Achieve a plan for universal basic health care for citizens
b. Create social and physical environments that promote good health
c. Eliminate health disparities
d. Eliminate preventable disease, disability, injury, and premature death
e. Achieve health equity
f. Promote healthy behaviors at every stage of life

Answer 16

ANS: B, D, F
Building on previous iterations, the updated 2020 version has four 􏲤o􏰍er-arching goals􏲥 for 2020: (1) attain high quality, longer lives free of preventable disease, disability, injury, and premature death; (2) achieve health equity, eliminate disparities, and improve the health of all age groups; (3) create social and physical environments that promote good health for all; and (4) promote quality of life, health development, and health behaviors across all life stages. Achieving a plan for universal basic health care for citizens, eliminating health care disparities, and achieving health equity are not seen as national health goals in Healthy People 2020.

Question 17

Which best describes how the federal government determines which projects are awarded special funding for health care?

a. Those that are consistent with societal priorities, such as Healthy People 2020
b. Those that are supported by legislators
c. Those that are written by health care organizations that have special needs
d. Those that are consistent with the state􏱚s long-term health goals

Answer 17

ANS: A
Allocation of federal resources is based on societal priorities, such as Healthy People 2020. Legislative priority, priority within health care organizations, and priority within individual states are not as important for federal funding as the societal priorities outlined in Healthy People 2020.

Question 18

Goal of Public Health efforts focus on

Answer 18

health promotion and disease prevention of the population. 􏲹 It􏱚s described as being population-focused or community-oriented nursing practice

Question 19

Primary prevention

Answer 19

Nutrition education

• Family planning and sex education
• Smoking cessation education
• Communicable disease prevention education
• Education about health and hygiene issues to specific groups (day care workers, restaurant workers)
• Safety education (seat belt use, helmet use)
• Prenatal classes
• Providing immunizations
• Advocating for access to health care, healthy environments

Question 20

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 measures.
c. Employ the moms-to-be as 1-hour-a-day employees in the school daycare center for children born to school students.
d. Establish a class where all the unwed moms-to-be can learn infant care.

Answer 20

ANS: B
Primary prevention relates to activities directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals. Primary prevention consists of two elements: general health promotion and specific protection. Health promotion efforts enhance resiliency and protective factors and target essentially well populations. Specific protection efforts reduce or eliminate risk factors. Although all choices would be appropriate actions in a school, only education regarding sexuality and birth control would help prevent future pregnancies.

Question 21

secondary prevention

Answer 21

Community assessments

• Disease surveillance (communicable diseases)
• Screenings
• Cancer (breast, cervical, testicular, prostate, colorectal)- Mammogram or other imaging; Pap Smear
• Diabetes Mellitus screening
• Hypertension screening
• Hypercholesterolemia
• Sensory impairments
• Tuberculosis (CXR imaging)
• Lead exposure screening
• Genetic disorder/ metabolic deficiencies in newborn (newborn Screenings)
• Control of outbreaks of communicable diseases
• Scoliosis screening

Question 22

Tertiary Prevention- targets populations that have experienced disease or injury and focuses on limiting disability and rehabilitation.

Answer 22

Rehabilitation or recovery from injury

• Nutrition counseling for managing Crohn Disease
• Exercise rehabilitation
• Case management (chronic illness, mental illness)
• Physical and occupational therapy
• Support groups for grieving parents
• Exercise for a client who has hypertension (individual)
• Teach how to perform insulin injections
• Disease management for a person with Diabetes
• Occupational or physical therapy for a patient with spinal cord injury