Community health FDU

Question 1

What woman started using concepts of epidemiology and focused on correcting unsanitary conditions? And she also set the foundation for visiting nurses-health promotion?

Answer 1

Florence Nightingale

She also said nursing is a call to service and the moral character of persons entering nursing is important

• she set up the school of nursing
• she had a population based approach that Lead to improvements in environmental conditions

Question 2

What are ways to measure community health?

Answer 2

• infant mortality
• morbidity and mortality rates
• life expectancy
• cancer incidence rates

*fewer resources equals increased infant mortality

Question 3

The steps in the ethical decision making process are similar to steps of:

Answer 3

The nursing process

Question 4

Which ethical principle means to do no harm?

Answer 4

Non -maleficence

Question 5

According to Leininger and Watson the moral idea of nursing is? 
A. Caring 
B. Advocacy
C. Responsibility
D. Accountability

Answer 5

A. Caring
Rationale: the conceptual i action occurred as a response to the technological advances in healthcare science and the desire of nurses to differentiate nursing practice from medical practice

Question 6

3 elements Ethics involve?

Answer 6

Morality
Values
Code of ethics

Question 7

Morality is

Answer 7

To do right and wrong based on societal norms

Question 8

Values is

Answer 8

Beliefs about importance about what is right

Question 9

Code of ethics is

Answer 9

Moral standards for professional practice

Question 10

What is a branch of ethics that examines ethical issues in healthcare?

Answer 10

Medical ethics/bioethics

Question 11

Ethical principals are?

Answer 11

1) non-malificence
2) beneficence
3) social justice
4) health disparities
* autonomy is one an is allowing a person to make decisions in their care (directives)

Question 12

Beneficence means?

Answer 12

Obligation to do the best for the patient and population

Question 13

Social justice means?

Answer 13

Equality of distribution of healthcare services

-fair distribution of benefits among members of society

Question 14

Health disparities are?

Answer 14

Unequal access to healthcare and poorer outcomes in certain groups
Examples: race, gender, ethnicity, disability status, identity

Question 15

Examples of Health disparities?

Answer 15

1) Environment
- access to healthcare, socioeconomic factors, geographical and political factors
2) Sociocultural
- cultural factors, social factors, psychological factors
3) Behavioral factors
- coping factors, health behaviors, psychosocial (risk and resilience)
4) Biological
- genetics, cell function
* poorer, race, ethnicity, culture, and healthcare access are the most common

Question 16

What is the order for making ethical decisions (the decision-making process)?

Answer 16

1. identify issues
2. gather facts related to issues
3. reformulate ethical issues if needed
4. consider appropriate actions/options
5. make decisions and act–> the right action provides the greatest good for all people
6. Evaluate the decision

Question 17

What are the 3 core functions of Community Health?

Answer 17

1. Assessment
   - wrong assessments lead to wrong interventions
2. Policy development
   - you need to be more concerned with the population needs than your own needs
3. Assurance
   - need to make sure essential services are available to people who need services

Question 18

What are social determinants of health?

Answer 18

they are the social conditions in which people live, their income, gender, culture and literacy, home and work environment, support network, social status, and availability of health services (access to care)
- these conditions have an impact on the extent to which a person or community possesses the physical, social, or personal resources necessary to maintain and attain health

Question 19

Patient-centered care considers individuals?

Answer 19

• cultural traditions
• personal preferences
• values
• families
• lifestyles

Question 20

A nurse is caring for an older adult patient who is struggling to manage her type 2 diabetes. The nurse should recognize which social determinants of the patient’s health (select all that apply)?

a. low- income
b. the reading level of 3rd grader
c. medication ineffective due to error in prescription
d. originally from Sudan
e. No family in the area

Answer 20

A, B, D, E

income, literacy, coming from another country and no family support all lead to poor determinants of health

Question 21

What is it called when it involves active participation in one’s own health through education and lifestyle changes?

Answer 21

Personal responsibility of health

Question 22

This is active in U.S communities and works collectively to improve collective community health ?

Answer 22

public health

Question 23

She was from Scotland and traveled on horseback in rural areas to improve child mortality in those areas where access to care was scarce. Her purpose was to reduce pregnancy complications, reduce maternal mortality, reduce stillbirths, reduce infant mortality, and improve health in rural populations.
- She was a frontier nurse in kentucky and led to the profession of nurse-midwifery

Answer 23

Mary Breckinridge

Question 24

Public health nursing looks at what part of the population?

Answer 24

the whole
rationale: the primary focus is promoting the health of the population using knowledge from nursing, social, and public health sciences

Question 25

What are the main areas of practice in public health nursing?

Answer 25

health promotion
health maintenance

• increased health maintenance and increased healthy behaviors = decreased illness and complications

Question 26

What is the goal of public health nursing?

Answer 26

reduce disease through prevention and improve health in the community, both nationally and internationally
- to promote physical and mental health and prevent disease, injury, and disability

Question 27

What is the definition of health?

Answer 27

illness, health, and peak wellness on a continuum, it is fluid and changing
- within a social environment, the state of health depends on goals, potentials, and performance of individuals, families, communities, and societies

Question 28

She formed the henry street settlement -> which is the visiting nurse association in NYC

• she looked at social determinants of health in a community
• she worked with politicians to promote clean environments that were unsanitary
• she worked with community members and educated them on cleanliness within the home and community
• she noticed poor health conditions in the schools and led to having a nurse in the schools, which then there was a decline in sick children
• she assessed communities
• she focused on public health nursing and promoted public understanding through education

Answer 28

Lilian Wald (founder of public health nursing)

*district nursing was formed in the late 1800s

Question 29

What is a nurse who provides to people in their homes and provides to several people at a time?

Answer 29

a visiting nurse

Question 30

Community is?

Answer 30

a collection of people who interact with one another and whose common interests or characteristics form the basis for a sense of unity or belonging

Question 31

What determines the health status of a community?

Answer 31

1. access to healthcare
2. economic conditions
3. social issues
4. environmental issues
5. cultural practices

Question 32

What are some environmental issues that affect a community?

Answer 32

air quality 
drinking water contamination 
housing problems 
high crime rates 
community issues

Question 33

What happens to infant mortality when resources decline?

Answer 33

they increase

* the people are usually poorer and less educated

Question 34

How is public health supported?

Answer 34

tax-supported and have county health departments

Question 35

What are some barriers to healthcare access?

Answer 35

health literacy 
transportation 
mental health and substance abuse
living in rural areas (being far away) 
workforce shortages 
Job doesn't offer insurance 
the high cost of care (can't afford it)
personal preferences 
beliefs about western medicine (natural care)

Question 36

Conduct medical research which allows Americans to live longer and healthier. This agency seeks to enhance health, lengthen life, and reduce illness and disability and is responsible for biomedical and public health research?

Answer 36

National Institute of Health

Question 37

Who funds NIH?

Answer 37

Federal grants

Question 38

The nations health protection agency, saves lives and protects people from health threats, and responds if they arise. It is the leading public health agency and is dedicated to saving lives and protecting the health of Americans, what is this agency (they develop methods to prevent and control disease?

Answer 38

CDC

Question 39

What is the name of the agency ensures safe food and drugs; regulates the manufacturing, labeling, and packaging of foods, drugs, cosmetics, over the counter meds?

Answer 39

FDA

Question 40

Which governmental agency regulates workplace safety?

Answer 40

Department of Labor

Question 41

Provides funding for WIC, regulates the grading and inspection for food?

Answer 41

Department of Agriculture

Question 42

Provides care for federal prisoners?

Answer 42

Department of Justice

Question 43

Administers financial aid programs to the elderly, financially needy, and disabled people; it is the federal agency that is directly involved with the health and healthcare of U.S citizens and refugees/immigrants

Answer 43

Department of Health and Human Services

Question 44

What public health entities are regulated by the U.S federal government (select all that apply)?

a. food
b. medication
c. school health
d. devices
e. environment

Answer 44

A, B, D, E

Question 45

The department of health and human services has identified several areas for which health disparities exist among various demographic groups and need to be addressed (select all that apply) ?

a. infant mortality
b. cancer screening
c. cardiovascular disease
d. diabetes
e. end-stage renal disease

Answer 45

A, B, C, D

and also includes HIV/AIDS and immunizations

Question 46

Direct care (intervention) is ?

Answer 46

Direct care intervention is performed with the patient (interaction with the patient)
Examples: patient teaching, emotional support, any type of physical care (cleaning an incision, administering an injection, ambulating with a patient)

Question 47

Indirect care intervention is?

Answer 47

is performed away from the patient but on behalf of the patient or group of patients.
Example: advocacy, managing the environment, making referrals, collaborating with other members of the healthcare team, making a change of shift report, ensuring the availability of medically needed devices for the patient

Question 48

All 3 levels of preventions (primary, secondary, tertiary) involve?

Answer 48

education, the nurse is always educating the patient

Question 49

What are some essential Public health services?

Answer 49

1. Monitor health and evaluate the services- look at costs, in regards to the individual, families in communities and monitor their health
2. Diagnose and Investigate problems- communicable diseases, results of natural disasters
3. Educate- any form to relay message regarding health to people
4. Mobilize community- work with the community and get them involved, find out what they feel is important
5. Develop policies- based on assessment and needs
6. assurance of competent public health workforce
7. research solutions to problems

Question 50

What are some basic ways to give to people in public health nursing?

Answer 50

shelter
food
medical care
skill competencies in medical care workers

Question 51

A nurse performs a variety of tasks as part of the nurse’s position at a hospital. Which task best exemplifies public health?

a. reading current nursing journals and interpreting the latest research into daily practice
b. instructing a client on how to best care for a suture site at home
c. participating in a video conference call with a client who lives in a remote area
d. facilitating a community-wide smoking cessation program one month out of the year

Answer 51

D

rationale: public health is what society does collectively to ensure the conditions exist in which people can be healthy
- a smoking cessation program is a public health intervention, in that it involves the collective effort of society to improve the health of its members

Question 52

What are the core competencies (8 principles) in nursing (what a nurse needs to be good at)?

Answer 52

Assessment skills 
program planning and policy development 
communication skills 
cultural competency skills 
basic public health practices/skills 
financial planning 
management skills 
leadership skills

Question 53

A nurse is coordinating a plan to bring vaccinations in a cost-effective way to a rural community that currently lacks access to them.  This is an example of which public health intervention? 
A. surveillance 
b. outreach
c. screening 
d. case management

Answer 53

D. case management

rationale: the nurse coordinates a plan or process to bring health services and the self-care capabilities of the client together as a common whole in a cost-effective way

Question 54

What is needed and is a personal responsibility for health in one’s own health through education and lifestyle changes (take charge of your life)?

Answer 54

active participation

Question 55

Nursing is ?

Answer 55

• the protection, promotion, optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human responses, and advocacy in the care of individuals, families, communities, and populations

Question 56

who sets the scope and standards for all professional nursing practice?

Answer 56

ANA

Question 57

The Minnesota public health intervention wheel (conceptual framework)illustrates what?

Answer 57

it is a tool that illustrates what public health nurses do to improve health outcomes

• the wheel is a population-based practice model that encompasses 3 levels of practice ( community, system, and individual/family) and 17 public health interventions
• each intervention (out of the 17) and practice (out of the 3) improve the population health
• the wheel answers the question of what do public health nurses do and delineates public health nursing as a specialty practice of nursing

Question 58

Minnesota public health wheel practices- systems-focused, community-focused, and individual/family-focused?

Answer 58

systems-focused- changes organizations, law, policies, and power structures, the focus is on the system that impacts health

community-focused- changes community norms, attitudes, awareness, practices, and behaviors. This practice level is directed at the entire populations within the communities and is measured in terms of what proportion of the population actually changes

Individual/family-focused- changes knowledge, attitudes, beliefs, practices, behaviors of individuals and families. This level is directed at individuals, alone or as part of a family, class, group

Question 59

Red wedges: Surveillance, disease and health event investigation, outreach and screening

Answer 59

these are implemented in conjunction with one another. the screening follows either surveillance or disease and health event investigation and is often preceded by outreach activities in order to maximize the number of those at risk who actually get screened. Most often screening leads to case-finding, but this intervention could be carried out by itself

Question 60

Green wedges in Minnsesota wheel of interventions: referral and follow up case management, and delegated functions

Answer 60

in practice are often implemented together

Question 61

Blue wedges in the Minnesota intervention wheel: health-teaching, counseling, and consultation?

Answer 61

they are more similar than they are different and work well together

Question 62

Orange wedges in Minnesota intervention wheel: collaboration, coalition building, and community organizing

Answer 62

they are all types of collective action and are most often carried out at systems or community levels of practice

Question 63

Yellow wedges in Minnesota intervention wheel: advocacy, social marketing, and policy development & enforcement

Answer 63

advocacy is often viewed as a precursor to policy development; social marketing is seen by some as a method of carrying out advocacy

Question 64

What level of prevention is TB testing for high-risk groups?

Answer 64

secondary

Question 65

What level of prevention for the provision of shelters for victims of natural disasters?

Answer 65

Tertiary

Question 66

What level of prevention for physical therapy, OT, speech therapy for a patient following a TBI?

Answer 66

Tertiary

Question 67

What level of prevention for providing first aid to a kid that fell off the monkey bars and needs first aid?

Answer 67

Secondary

Question 68

If a secondary level of prevention (care) is not given properly what happens?

Answer 68

The person moves to tertiary prevention as the person needs rehab for the disability

Question 69

What level of prevention is giving immunizations to locals in a community?

Answer 69

Primary

Question 70

What level of prevention do screenings occur?

Answer 70

secondary

Question 71

What level of prevention is the disorder/disease/problem absent?

Answer 71

Primary

Question 72

What level of prevention are the disease/chronic illness present and rehab is needed to avoid exacerbation?

Answer 72

Tertiary

Question 73

Primary Prevention consists of :

Answer 73

vaccines, immunizations, health promotion, prevention of pregnancy, education about safety belts, helmets, safe-sex anything to prevent illness or injury
Risk assessment
Prevention education (can be controversial)
“Safer” sexual & drug use practices
Be careful about labeling, value-laden terms
Vaccinations

Question 74

Secondary prevention consists of:

Answer 74

early diagnosis and prompt interventions that limit disability - identifies risks or hazards and modifies, removes or treats them before a problem becomes more serious intervention fo 1st aid treatment, STD screening
Testing for TB
Looking for early ID of TB 
Testing & counseling for HIV
Post-test counseling
Partner notification/Contact tracing

Question 75

Tertiary prevention consists of:

Answer 75

(population in which disease or injury has already occurred)
rehab (already has the illness, issue), it is the maintenance of issues or illness, shelter for people after natural disasters, spiritual support, palliative care, pain control
Directly observed therapy (DOT)
Non-compliance; have to go to health depart and nurse must observe taking medication - enforced through police law
Management of AIDS in the home
Identify resources
Support groups
Standard Precautions
Learning to live with disease/family living with someone who has the disease

Question 76

What agency or agencies oversee the environment/community?

Answer 76

CDC and the department of health and human services

Question 77

the study of how individuals, groups, organizations, and society allocate and utilize finances, personnel, time, and physical space as components of resources is what?

Answer 77

Economics

• economic tools and other quantitative financial measures are used as a method of evaluating the existing governmental, private programs or the public, and private policy alternatives

Question 78

What is the primary goal of community health?

a. to support and supplement the efforts of the medical profession in the promotion of health and prevention
b. to enhance the capacity of individuals, families, and communities, to cope with their health needs
c. to increase the productivity of the people by providing them with the services that will increase their level of health
d. To contribute to national development through the promotion of family welfare, focusing particularly on mothers and children

Answer 78

b

Question 79

population-focused nursing practice requires which of the following processes?

a. community organizing
b. nursing process
c. community diagnosis
d. epidemiologic process

Answer 79

c. community diagnosis
rationale: it means providing care based on the greater needs of the majority of the population. The greater need is identified through community diagnosis

Question 80

What is the focus of public health nursing?

Answer 80

it focuses on preventative, not curative services

Question 81

In which steps are plans formulated for solving community problems?

a. mobilization
b. community organization
c. community study
d. core group formation

Answer 81

b. community organization

rationale: community assembles together to tackle a health concern (community)

Question 82

Isolation of a child with measles belongs to what level of prevention?

a. Primary
b. secondary
c. tertiary
d. intermediate

Answer 82

A. primary

rationale: is a way to protect those that are not sick(specific disease prevention)

Question 83

What type of family-nurse contact will provide you with the best opportunity to observe family dynamics?

a. clinic consultation
b. group conferences
c. Home visit
d. written communication

Answer 83

c. home visit

rationale: the dynamics are best observed in their natural setting

Question 84

The nurse is locating populations in her region who are exposed to lead-based paint and providing them with information regarding the dangers of lead poisoning. This is an example of which public health interventions?

a. surveillance
b. outreach
c. screening
d. case management

Answer 84

b. outreach

Question 85

Select the great public health achievement in the US in the 20th century?

a. elimination of common infectious diseases
b. recognition of tabacco as a health hazard
c. flouridation of drinking water
d. healthier mothers and babies

Answer 85

B,C,D

Question 86

Personal Responsibility for health involves active participation in one’s own health through education. Which exemplify personal responsibility?

a. reviewing one’s own medical record
b. monitoring the positive and negative effects of prescription and over-the-counter medications
c. avoiding tobacco and recreational drug use
d. showing up for scheduled tests and procedures
e. eating the types of foods one most enjoys

Answer 86

A,B,C,D

Question 87

Which of the following is the main factor that distinguishes public health nursing from other specialties?

a. focus in the competence in nursing practice
b. population- focused practice
c. educational preparation
d. long term care

Answer 87

b. population-focused practice

Question 88

Culture can be defined as:

a. ethnocentric patterns of life
b. a set of values, beliefs, and assumptions about life
c. a changed belief system
d. specific behaviors

Answer 88

b.

Question 89

The philosophy of hospice care includes which of the following?

a. provide the client with all life-sustaining measures
b. provide care only for the client in a health care insitution
c. provide support for clients and families during the dying process
d. provide pain management only

Answer 89

c.

Question 90

Which of the following clients are eligible tor receive home care services (select all that apply)?

a. homebound older adults
b. terminally ill children
c. an individual on a ventilator
d. a client discharged from a same-day surgery facility

Answer 90

a,b, c

Question 91

The first visiting nurse services were established by?

a. local and state health departments
b. wealthy and upper-class women to meet the need of their communities
c. hopital administrators as a means to increase inpatient beds
d. nurses to assure a professional practice environment

Answer 91

d

Question 92

The collection and analysis of standardized patient data allow the Centers for Medicare and Medicaid Services to :

a. penalize agencies with poor outcomes
b. provide financial rewards to agencies that achieve best patient outcomes
c. identify agencies with best practice (they take this and share it with people)
d. provide agencies poor performance from participating in the Medicare program

Answer 92

C. identify agencies with best practice

Question 93

List at least three factors necessary to promote health?

Answer 93

rest
diet
exericse

Question 94

What is the most important step in policy development?

a. convincing the political parties to support the poilcy
b. defining the issue and getting it on the agenda (1st step)
c. determining who has stakes in the policy
d. trying to convince the public to accept the policy

Answer 94

b

Question 95

What must be created before establishing the evaluation plan to determine the success or lack of success of a public health program?

a. set or short and long-term goals
b. decisions on who will collect the data
c. observable and measurable outcomes
d. to insist that the patient have a hospital bed in the home

Answer 95

c. observable and measurable outcomes

Question 96

What is the primary factor in how a hospice nurse makes decisions while giving care in the patient’s home with the caregiver present?

a. make sure the patient had a comfortable, pain-free death
b. to encourage the caregiver and family that they need to address the reality of the patient’s death
c. to prevent the decline of the caregiver’s health
d. to insist that the patient have a hospital bed in the home

Answer 96

c. to prevent the decline of the caregiver’s health

- the caregiver is very important in hospice care just as important as the patient

Question 97

In addition to the factual data such as name, address, diagnosis, what information is of major importance when a new referral for home care is received?

a. the amount of reimbursement the agency will receive
b. the family’s reaction to the home visit
c. the purpose of the referral for the home visit
d. if the patient requires any additional home care services

Answer 97

c. the purpose of the referral for the home visit

Question 98

A patient who is homeless has been admitted to the hospital with multiple health problems. The nursing case manager, physician, social worker, and dietician work together to care for the patient. This interprofessional interaction is referred to as:?

a. collaboration
b. consultation
c. continuity
d. coordination

Answer 98

a. collaboration

Question 99

Ideally, nursing case management planning identifies goals that are:

Answer 99

realistic, measurable, and specific

Question 100

Which represents the correct order of events in the policy-making process?

1) policy formulation
2) policy assessment
3) policy adoption
4) policy implementation
5) policy modification
6) setting an agenda

Answer 100

setting an agenda (example if a group of nurses meet to discuss the number of children that die in hot cars and how likely that they are to gain support from their state legislators policy formulation (after agenda is set, policy can be formulated)
policy adoption (board decides to allow use of cell phones only within certain waiting areas)
policy implementation
policy assessment (to see if the policy is producing favorable outcomes)
policy modification (changes may need to be made to a policy)

Question 101

Factors that increase cost in healthcare economics?

Answer 101

lack of preventative care

• lifestyle and behaviors
• demographics
• medications
• technology
• shift for profit
• fraud- loss of money

Question 102

What is the measurement of Health care economics?

Answer 102

Cost-benefit analysis

what is it? lists all costs and benefits that are expected with intervention during a specific time (if total benefits are greater than costs, the interventions have a net positive value)

Question 103

The nurse applies cost-benefit analysis to the healthcare model. Which costs are the primary concerns of the client? (Select all that apply)

a. total payment for the service
b. out-of-pocket payment
c. suffering and pain
d. actual and direct cost of providing services
e. psychological costs

Answer 103

B. out of pocket payment
C. suffering and pain
E. Psychological costs

clients are interested in their own out-of-pocket payment, as well as the psychological costs, suffering, and pain, which are difficult to quantify yet have long-standing negative effects. The total payment for the service is usually what matters to the payer

Question 104

What are some barriers to healthcare?

Answer 104

1. Insurance- affects the distribution of health care services
2. Poverty- people with income below the poverty level have higher mortality rates than middle-income people
3. Access to care- the inability to afford supplemental insurance, high out of pocket expenses
4. Rationing healthcare- reduces access to care- where care is not provided, public health needs to ensure that essential services are available (assurance)

Question 105

Medicare is for:

Answer 105

People over 65 years old, permanently disabled or on hemodialysis
PartA- hospital care, home care, skilled nursing facility
Part b-
Medigap
Part D

Question 106

Medicare Part B covers:

Answer 106

doctors office, diagnostic tests, PT, some equipment, some outpatient services, (must pay for part B)

Question 107

Medicare Medigap covers:

Answer 107

self pay insurance to covers gap in medicare

Question 108

Medicare Part D covers:

Answer 108

pays a portion of medication cost (prescription coverage)- a person pays for part D and pays a slight copay at doctor visits

Question 109

Medicaid provides:

Answer 109

financial assistance to low-income people, blind and disabled families with dependant children
-financed by Federal and State government
Child health insurance program (CHIP)- state insurance for children whose family does not qualify for Medicaid

Question 110

Problems with Medicaid if you hold Medicaid is:

Answer 110

Inability to find a provider who accepts Medicaid, which limits access to care
High out of pocket expenses

Question 111

The nurse case manager, who refers a 67-year-old patient to a skilled nursing facility for rehabilitative care, knows that it will be billed under which component of medicare?

a. Medicare part A
b. Medicare part b
c. Medicare part D
d. Medigap

Answer 111

A. Medicare part A

Question 112

To treat an infected foot, a patient with Medicare Part A has prescribed a 2-week course of IV antibiotics, wound care, and physical therapy for mobility training. The nursing case manager recommends discharge to:

a. a skilled nursing facility
b. an acute care hospital
c. an acute rehabilitation facility
d. home health services

Answer 112

a. a skilled nursing facility

Question 113

When developing a program offering for patients who are newly diagnosed with diabetes, the nursing case manager demonstrates an understanding of learning styles by?

a. administering pre and post-test assessment
b. allowing attendees time to voice their opinions
c. providing a snack with a low glycemic index
d. utilizing a variety of educational material

Answer 113

d. utilizing a variety of educational materials

Question 114

What are the steps in a risk assessment that identify risk and its effect?

Answer 114

1. Hazard identification–> what is the hazard, or in the air and the hazard is identified as a factor
2. Risk description–> what is the risk
3. Exposure assessment–> how long were you exposed
4. Risk estimation–> epidemiologists will determine the outcome

Question 115

What are two types of risk factors?

Answer 115

Modifiable (can change)

Non-modifiable (can’t change)

Question 116

What are examples of modifiable risk factors?

Answer 116

(behavioral risk factors that can be modified) 
physical inactivity 
obesity and being overweight 
high cholesterol 
smokers 
alcoholics 
high blood pressure 
diabetes type 2 
unhealthy diets
poor sleep quality 
metabolic syndrome 
stress

Question 117

What are examples of non-modifiable risk factors?

Answer 117

gender
genetics- family history
age
ethnicity

Question 118

Major causes of non-communicable diseases are?

Answer 118

use of Tabacco
excessive use of alcohol 
poor diet
lack of exercise 
middle or low income 
*these contribute to heart disease, COPD, diabetes, cancer

Question 119

Risk factors that affect overall health?

Answer 119

• childhood and maternal undernutrition
• inactivity
• addictive substances
• sexual and reproductive health
• environmental risks–> air pollution

Question 120

How can nurses play a role in risk factors?

Answer 120

by playing a role in health promotion and education (this will bring awareness) they will need to educate the families (individually or on a societal level)

Question 121

Which are an example of determinants of health (select all that apply)?

a. living in a community with clean and fluorinated water
b. having a death rate of 500 per 100,00 population
c. living in a neighborhood with a high crime rate
d. smoking two packs of cigarettes day
e. having an infant mortality rate of 95 deaths per 1,000 live births

Answer 121

A, C, D

*determinants of health are factors that affect outcomes of health status, such as physical environment, social environment, health behaviors, and individual health, access to healthcare

Question 122

Which risk factors are associated with overall health in a community?

a. allergy
b. traumatic injury
c. air pollution
d. down syndrome

Answer 122

c. air pollution

Question 123

When caring for people from other countries a nurse must be?

Answer 123

be culturally sensitive/culturally relevant and gender-sensitive

Question 124

How would you improve the attendance of underserved children in a neighborhood where they are not getting immunizations and have not been vaccinated per health guidelines, the clinic is poorly attended, Which would be the nurse’s best action to revise the program and improve attendance in the clinic?

Answer 124

Interview members of the neighborhood to determine why they do not use the clinic

Question 125

Which model/theory is based on avoidance of disease?

Answer 125

The Health Belief Model
- this is more for the individual than the community
Components of the model
a. what is the perceived susceptibility to a disease
b. what is the perceived seriousness of the disease
c. what are the modifying factors (how do you fit in the model)
d. cues to action
e. perceived benefits/barriers
f. self-efficacy (can I do this - looks at their ability to make a health-related change)

Question 126

What is the goal of community health nursing?

Answer 126

to improve practice, keep people healthy, keep the cost down, try to keep expenses down

Question 127

Who came up with the expanded health belief model?

Answer 127

Milio’s framework

• This is more for the public health/community health
• Economic, political, and environmental health determinants
• the range of choices is shaped by government and private policy
• to improve health status choices must be readily available and less costly than health-damaging options
• the range of health-promoting or health-damaging choices available is affected by personal resources
• health deficits result from an imbalance between a population health needs and its health resources

Question 128

The belief that health deficits results from an imbalance between a population’s health needs and its health-sustaining resources is the premise of which theory?

a. Orem’s self-care deficit theory
b. health belief model
c. Milio’s framework
d. Critical Social theory

Answer 128

c. Milio’s framework

Question 129

A public health nurse explores a group of teenagers’ beliefs about the seriousness of eating disorders. The nurse is using which theory?

a. Orem’s self-care deficit theory
b. The health belief model
c. Milios framework
d. Critical social theroy

Answer 129

b. the health belief model

examples are:

• people who believe they won’t get the flu don’t get the vaccine
• people who think they are unlikely to get skin cancer are less likely to wear sunscreen or limit sun exposure
• Perceived barriers are related to the social consequences, danger, discomfort, expense, inconvenience

Question 130

What was the name of the model that promoted a healthy lifestyle?

Answer 130

Pender’s Health Promotion

Purpose–> to promote a healthy lifestyle

Concepts–>

• prior related behaviors
• personal factors
• perceived benefits
• perceived barriers
• perceived self-efficacy (Do they have the motivation)
• interpersonal influences
• commitment (are you committed to this change?)

Question 131

Skinners learner model does what when a person makes progress?

Answer 131

there will be a reward (positive reinforcement) this will encourage the improvements based on a reward system

Question 132

Which most accurately describes “rate”?

a. course of a disease
b. primary measurement used to describe either the occurrence or the existence of a specific state of health or illness
c. probability or likelihood that a disease or illness will occur in a group of people who presently do not have the problem
d. characteristic or event that has been shown to increase the probability that a specific disease or illness will develop

Answer 132

B. the primary measurement used to describe either the occurrence or the existence of a specific state of health or illness

Question 133

US department of health and human services (umbrella) oversees?

Answer 133

CDC
FDA
Centers for Medicaid and medicare
agency for healthcare research and quality
NIH
health resources and service administration

Question 134

What agency overlooks the Legislation and Regulation of Nurses :

Answer 134

Board of Nursing- defines the scope of practice
Grants a license to RN, LPN, and schools of Nursing
Sets educational standards and requirements for license
can deny, suspend or revoke a license

Question 135

Steps in Public Policy formation?

Answer 135

1. define an issue and get it on the agenda
2. Ensure commitment of resources
3. Establish a schedule for implementation
4. Evaluate and analyze the policy

Question 136

Measures of Morbidity and Mortality :

Answer 136

Rates - a measure of the frequency of a health event in a defined population during a specific time

Incidence - describes the occurrence of new cases of a disease or condition in a community over a period of time relative to the size of the population at risk for that disease or condition during that same period of time

Prevalence- all cases (new or in population) only was to come out of it is when you die, prevalence rates are higher with chronic diseases
ex; type of studies to determine prevalence is cross-sectional studies- they examine the relationships between potential causal factors and disease at a specific time and uses a cross-section of a population

mortality rate - a measure of death rates

Question 137

Epidemiologic triad

Answer 137

classic model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment

Question 138

Web of causation

Answer 138

epediomlogical model that strongly emphasizes the concept of multiple causations while de-emphasizing the role of agents in explaining illness

Question 139

Which rate measures the number of people in a given population who have influenza at a given point in time?

a. adjusted
b. indidence
c. prevalence
d. specific

Answer 139

c. prevalence

Question 140

Core Public Health Functions and EBP

Answer 140

1. Assessment- involve the community members in identifying health problems and find new solutions to health problems
2. Policy development- EBP used to develop policies that support community health efforts
3. Assurance- used to monitor health status and to provide health care to high-risk groups in the community, Used to evaluate effectiveness, accessibility, and quality of personnel and services

Question 141

Quality healthcare has what characteristics?

Answer 141

1. Effective- services based on scientific knowledge
2. Safe- avoid errors
3. Timely- reduce harmful delays
4. Client-centred- respond to the individual’s needs
5. Equitable- provide quality care to everyone
6. Efficient- avoid waste

Question 142

Community assessment is a critical process for the future because it can:

a. identify the need for a community commission
b. i identify a method to improve the health of at-risk clients
c. provide a means of grant funding for clinics
d. provide a client base for at-risk neighborhoods

Answer 142

B. identify a method to improve the health of at-risk clients

Question 143

groups, that share common characteristics/ risk-factors that may predispose them to a disease or groups and thier problems that may lead to health problems is called?

Answer 143

aggregates (are in the community)
ex: pregnant teens
HIV clients in a community
*aggregates get together and advocate as a group to help address a public health challenge

Question 144

The community health nurse explores pedestrian access to all healthcare facilities in the community. Which tool would be most helpful in performing this task?

a. Geographical information systems
b. Functional health patterns
c. Epidemiologic model
d. Developmental model

Answer 144

a. geographical information system

Question 145

Define what is in the community and what it consists of ?

Answer 145

• Community is a group of people that share at least one common characteristic in their lives who interact with each other and a common solution is to solve a common problem and they have a sense of member belonging
  1. geographical community (don’t always interact)–> boundaries and physical location that may predispose population to health problems
  2. Aggregates (may interact or not)- groups that share common characteristics/risk factors that may predispose them to a disease they form a group
  3. population of the community–> may or may not interact

Question 146

Physical Status of a community and its effects ?

Answer 146

Biological- vital statistics, incidence and prevalence of disease and death, life expectancy, and risk factors (drug users, smokers, occupational hazards)

Emotional–> consumer satisfaction, crime rates

Social–> communication between community members and community leaders, recreational activities, educational institutions (ex: town meetings, health department)

Question 147

Community Structure –> what are the services and resources :

Answer 147

1. Healthcare facilities in the community–> rehabs, hospitals, clinics (provide WIC, education, and check to see if your baby is getting the right nutrition, this is for low-income women, infants and children)
2. Health department (coordinates a heart disease prevention program for the county in which you live, they routinely meet with citizens and have screenings for heart disease risk factors), voluntary agencies–> county or local (red cross, catholic charities, salvation army)
3. Demographic –> who is your population and you want to gear your interventions to the right population
4. Healthcare personnel–> Drs, nurses, pharmacy, PT, OT, eyes, ears, ENT

Question 148

Process and Function in communities?

Answer 148

organizations–> formation of community partnerships with community groups, ability to collaborate

Effective communications–> ability to compromise with conflict

Groups–> ability to collaborate in the identification of problems

Participation of groups–> in implementing goals-encourages commitment for successful change

Question 149

What do you want to see as health outcomes for a healthy community? A healthy community provides–>

Answer 149

1. accessible and acceptable health services
2. Education
3. A safe and crime-free environment
   * if a community does not have these that can make it an unhealthy community
   - if there are no full size grocery stores then people wont have access to healthy food, if there is crime and assaults it is not safe, if there are no facilities to exercise, people will be unhealthy and if there is no healthcare facilities (the size of the facility matters as well) people wont have access to preventative issues and all have a negative outcome for these people living in the community

Question 150

What are the types of community assessments?

Answer 150

1. windshield assessment–> provides an overview for the community
2. Comprehensive data collection
3. Needs assessment–> consists of data collection, analysis of problems in the community, planning, implementation and evaluating
   * community assessments identify a method to improve the health of at-risk clients
   - they can initiate a neighborhood clinic at low or no cost to the community that is struggling to get their children vaccinated (this puts them at risk)

Question 151

What are some nurse’s roles in community assessment?

Answer 151

a. Teacher–> always educating and teaching people
b. Facilitator–> make referrals to proper care needed for the best outcome
c. Advocate–> to get what you need to accomplish goals
d. Awareness of communities norms, values and beliefs- self-awareness and be culturally sensitive
e. Evaluate and communicate the change- this is what we did and this is why we are doing it

Question 152

Lewin’s Model of Change

Answer 152

1. unfreezing–> unfreeze the status-quo may occur gradually and rapidly (ex: changes in public health in response to COVID 19)
2. Changing–> once the community is aware of need for change, change may begin (ex: if 90% of the community is aware, the next is change)
3. Refreezing–> this is the stabilization, once the change has occurred, adapting to change

Question 153

Community planning after the assessment are

Answer 153

1. Assessment- should include a review of the literature to support the need for intervention
2. PLANNING
   plan for each identified problem
   -prioritize the problems
   -identify measurable goals and objectives (very important)
   -determine intervention level
   -validate intervention according to available resources
3. Intervention and Evaluation
   -follow the initial plan
   -prepare for barriers (unexpected problems)
4. Evaluation- this is important for obtaining additional funds for programs
   -includes the cost-benefit analysis
   -were outcomes achieved
   -share analysis with participants

Question 154

Hill burton act (regarding Federal Health Planning)

Answer 154

improved healthcare in rural areas and introduced systematic health care planning. Each state had an agency to plan for needed hospital analysis

Question 155

what is the knowledge, values, practices, customs, and beliefs of a group and includes a unique meaning and information system, shared by a group?

Answer 155

culture

culture includes language, beliefs (is how they behave), religion, occupation, economics, art, politics, diet (patient says the food is blessed, indicates a cultural belief)

• culture is a learned behavior
• nurses need to be culturally competent

Question 156

What does cultural competence in a nurse look like?

Answer 156

• needs to value diversity
• acquires cultural knowledge
• adapts to diversity
• be open to the client’s ideas and ways of life
• exhibit respect and patience
• being aware of one’s own cultural heritage (self-awareness) –> this is very important
• utilizing an interpreter when one is needed to effectively communicate with the client
• understanding cultures and how they value personal space
• how are decisions made in their culture (as a family, individual)
• how does their culture value time (some are naturally late for appointments)
• nurses need to educate other staff which indicates cultural competence because they can facilitate social change

Question 157

Behavior over time is also called a

Answer 157

functional health pattern

Question 158

Case management goals are:

Answer 158

• ensure access to care
• coordinate services to care
• improve patient functional capacity
• provide alternatives to institutionalism
• provide cost-effective care- prevents duplication and overbilling
• identify high-risk groups that have the potential to improve health by coordinated care

Question 159

case management serves as a means to achieve:

Answer 159

patient wellness and autonomy through advocacy, communication, educations, identification of service resources, and service facilitation
*achieves positive outcomes through patient education, information, ADVOCACY and EMPOWERMENT (it is motivational)

Question 160

In client-focused case mangement is the patient the focus of care?

Answer 160

yes

client-focused case management is focused on the patient and family

Question 161

system-focused case management?

Answer 161

the institution is the focus of allocation of resources and cost attainment

Question 162

What factors played a part in the creation of home health care?

Answer 162

1. development of health insurance
2. rising costs in healthcare
3. Increase in the medical and nursing specialization

Question 163

Who primarily regulates the provisions of Medicaid and Medicare (select all that apply)

a. Insurane companies
b. local government
c. State governments
d. Local governments

Answer 163

c, d

Question 164

Eligibility criteria for medicare for home health services are? (Select all that apply)

a. homebound
b. specific plan of care
c. skilled healthcare needs
d. intermittent care needs
e. continuous 24-hour necessity for care

Answer 164

a. homebound
b. specific plan of care
c. skilled healthcare needs
d. intermittent care refers to situations in which skilled care is needed for several hours during the day, several days during the week, for a specified time period

Question 165

skilled care

Answer 165

involves the professional abilities of a registered nurse or his/her supervised designee (home health aide)

Question 166

a necessity in-home health care means

Answer 166

that the service given by a home care agency is reasonable based on the status of the client

Question 167

how long does Medicare pay for skilled needs for a client in home health care

Answer 167

60 days with appropriate renewals if skilled needs continue to exist

Question 168

intermittent care

Answer 168

2 hours during the day, 3 days during the week, for 60 days

Question 169

The standards of home health nursing practice are;

Answer 169

key elements of the nursing process:

1) assessment by collecting data about the home care client (the physical, environment and family)
2) diagnosis through the analysis of this data
3) outcome identification–> that helps the home care nurse identify nurse-sensitive measures
4) planning in the form of nurse-sensitive interventions directed at the identified outcomes (planning and outcomes need to be time-specific)–> usually 60 days
5) Implementation of nurse-(the direct and indirect care)centered actions in collaboration with clients and families, not with physicians
6) Evaluation–> goal is that the client and family have the information needed to become independent in care

Question 170

From when a physician signs a referral for home health visit, within how many hours from receiving the referral should the nurse plan to make the initial visit to the client?

Answer 170

24 hours

Question 171

What are the phases of a home health visit?

Answer 171

1) initiating the visit/preparation (pre-visit preparation–> purpose of the visit, referral for visit, contact the client before the visit)
2) Home visit/ the actual visit- assess main identifiers (name, address, DOB, mental health issues)assess the environment for safety and follow national safety goals –> medication safety, patient safety with oxygen, environment safety, educating the patient

3) Documentation–> each nursing note should include patient assessment, tasks performed and teaching accomplished, patients response to intervention, progress towards identified outcomes, and plans for the next visit
4) termination of the visit
5) post-visit planning

Question 172

Roles of the case manager

Answer 172

Manager- monitors cost and resources and manages the cost of care

Clinician- develops and manages a plan of care for patients

Consultant- works with a multidisciplinary team

Educator- informs staff and patients of changes

Researcher- identifies quality outcomes and cost

Question 173

Types of Home Health Agencies

Answer 173

Official –> federal, state, county, supported by taxes
Non-profit–> do not pay taxes, Independent home care agencies, hospital-based and voluntary based
Proprietary agencies–> for-profit and pay federal taxes, may be owned by an individual or corporation
Voluntary agencies–> cover gaps in service

Question 174

OASIS (outcome and assessment information set)

Answer 174

Measures the outcomes of adult home care clients (medicare and Medicaid)

• used for quality improvement
• Used to assess (see below)
• the environment
• use of services
• functional status
• support systems
• sociodemographic information
• health status

Question 175

What do nurses want to see as the main outcome for our patients after home health care?

Answer 175

that they can care for themself Independently
functional status is restored
they are self-sufficient with their care

Question 176

Based on Oasis and documentation, what do Medicaid and Medicare use this data for?

Answer 176

determines which agencies are best practice and notices them

Question 177

What is major in community assessment and planning?

Answer 177

collaboration with others

Question 178

Goal of Hospice Nursing?

Answer 178

promote comfort

not cure disease

Question 179

Hospice Nursing notes about it

Answer 179

a. program of care and support for people who have a terminal illness (have to meet criteria- 6 months to live)
b. the focus is on maintaining the quality of each day
c. the CAREGIVER is just as important as the patient
d. a team of professionals provides care for the whole person
e. care is available 24 hours a day

Question 180

Hospice Benefits

Answer 180

Medicare Part A covers the patient if they are 65+ (age)

1. Doctor must certify that an illness is terminal - 6 months or less to live
2. Hospice services can be provided where ever a patient resides
3. Approved hospice services are:
   - MD and nursing services
   - medical equipment and supplies
   - home hospice aide
   - dietary counseling (they will decline in eating over time)
   - grief and loss counseling for family
   - short-term inpatient care for symptom management
   - medication for pain and other symptom control (palliative care)

Question 181

Hospice team members

Answer 181

Patient and family are at the center of care

• physicians
• nurses and nurse practitioners
• counselors
• social workers
• physical and occupational therapy
• hospice aides
• volunteers

Question 182

Hospice care includes services that are reasonable and necessary for the comfort and management of a terminal illness What services might be included (select all that apply)?

a. physician services
b. nursing care
c. Long-term in client pain control
d. Hospice aide service
e. Social worker services

Answer 182

a. physician services
b. nursing care
d. Hospice aide service - to help in home and assist caregiver
e. Social worker service

Question 183

CMO

Answer 183

comfort measures only (example morphine for pain management )

Question 184

A nurse provides palliative care to a client with end-stage renal disease and a chronic upper respiratory infection. Which interventions should be included in palliative care (select all that apply)?

a. providing the client with a foot massage
b. administering ordered analgesics
c. assisting with a kidney transplantation
d. clearing secretions from the clients airway for easier breathing
e. gently stretching the clients arms and legs to preserve the range of motion

Answer 184

A, B, D, E

palliative care is an interdisciplinary team-based care that is focused on the relief of suffering for clients with serious illness
- nursing interventions that help enhance the quality of clients lives, reduce pain and suffering and optimize functionality, and promote appropriate goal setting and decision making are integral to the excellent palliative care

Question 185

A dying patient has constipation, what would the nursing intervention be?

Answer 185

Give the patient lactulose, prune juice, senna are preferable for dying clients

Question 186

T or F

The client or unit of care is the population

Answer 186

T

Question 187

T or F
The primary obligation in ethical principles in public health nursing is to achieve the greatest good for the greatest number of people or the population as a whole

Answer 187

T

Question 188

T or F

The processes used by public health include working with the client as an equal partner

Answer 188

T

Question 189

T or F

primary prevention is the priority in selecting appropriate activities

Answer 189

T

Question 190

T or F
Public Health Nursing focuses on strategies that create healthy environmental, social, and economic conditions in which populations may thrive

Answer 190

T

Question 191

T or F
a public health nurse is obligated to actively identify and reach out to all who might benefit from a specific activity or service

Answer 191

T

Question 192

T or F
Optimal use of available resources to assure the best overall improvement in the health of the population is a key element of practice

Answer 192

T

Question 193

T or F
Collaboration with a variety of other professions, populations, organizations, and other stakeholder groups is the most effective way to promote and protect the health of people

Answer 193

T

Question 194

What are the goals of Health education

Answer 194

• attain optimal health
• prevent health problems
• identify and treat health problems early
• Minimize disability
• Outcome of health education-behavioral changes in the client

Question 195

What are the 4 learning theories

Answer 195

Humanistic
Cognitive
Social learner theory
Developmental theory

Question 196

Humanistic theory (group therapy, obesity program, members of a senior citizen program that want to develop health promotion)

Answer 196

good for adults
helps the group decide (work together)
-person needs to be aware of their values
-educator would help the learner develop the program
- helps an individual develop their potential in a self-directed and holistic manner
-Encourage their self-expression (let them speak)
-describe the influence that feelings, emotions, and personal relationships have on behavior
-Maslow’s hierarchy of needs
-nurse helps them facilitate the group discussion and guide the group as they develop their program

Question 197

Cognitive Theory

Answer 197

• changing thoughts (depressed people-want to increase positive thoughts)
• belief is that by changing thought patterns (maladaptive)and providing information, the learner’s behavior will change
• increase in the person’s knowledge by increasing the person’s ability to think, learn and problem solve

Question 198

Social learning theory (weight watchers-obesity, substance use disorders)

Answer 198

• good for all
• learning is enhanced through the concept of self-efficacy (can I do this), outcome identification, and incentives
• educator can use this theory to change behaviors by enabling a person to change either their expectations about a value or their ability to achieve the desired outcome
• instructs the group on selecting healthy food and exercise

Question 199

Development theory (ex: teaching parents about toddler safety)

Answer 199

consider the developmental level of the learner

• learning occurs with the developmental stages from infancy to old age
• readiness to learn depends on each person’s developmental stage
• learning occurs differently in each developmental period

Question 200

3 Domains of the learner

Answer 200

Cognitive, affective and psychomotor

Question 201

Cognitive Domain (thinking, neuromuscular involvement, knowledge or mental skills)

Answer 201

• assess cognition first
• knowledge and their ability to recall information
• Comprehension–> can they understand information
• Application–> can they use the information that they learned
• Analysis–> breaks information into smaller parts
• synthesis->put parts back together to understand the total message

Question 202

Affective Domain (person attitudes or emotions )

Answer 202

learning is focused on changing a person’s attitudes, beliefs, and values
-learner adapts behaviors of a new value system
-people need support to make changes and reinforce new behaviors
(individual support or support groups)
-active participation
-compliance and willingness to respond

Question 203

The psychomotor domain (skills or physical skills)

Answer 203

this is doing (administering insulin)

• nurse needs to assess a clients intellectual and physical ability to perform a skill
• what is the patient’s ability to fill a syringe (return demonstration)
• need to allow time for the practice of the new skill

Question 204

Concepts of community organization and education

Answer 204

Empowerment and problem-solving skills

• community competence/achieve goals through collaboration
• encourage active participation of a group
• elicit reasons from the community and have them define learning needs

Question 205

Characteristics of an effective educator

Answer 205

• send a clear message
• don’t use medical jargon
• select the appropriate learner format
• create the best learning environment -present information from simple to complex
• inform the learner of the objectives
• stimulate recall of previous learning- connect to new knowledge
• elicit and assess performances (make sure they are getting it)
• assist in the transfer of knowledge (help a diabetic to order out food)
• keep in mind their level of cognition and developmental level
• assess their literacy level

Question 206

Barriers to learning

Answer 206

1. Lack of literacy
   - assess patients age
   - make sure they understand what they are being taught
   - assess language get an interpreter if needed
   - organize teaching into smaller units
   - use visual aids as appropriate (iPad, computer, smartphone)
   - assess hearing ability
   - assess vision
2. Motivation- educators role
   - educator must motivate and be positive
   - praise
   - build confidence in the learner
   - explain how instructions relate to learners goal
   - create positive expectations for success

Question 207

In the 1900s what was the entity was responsible for covering public health nursing?

Answer 207

the government

Question 208

Which governmental agency had the goal of health for all by the year 2000 and has stated, “the development of society, rich or poor can be judged by the quality of its population’s health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantages as a result of ill-health”?

Answer 208

World Health Organization

Question 209

A public health nurse is assessing the community for health needs, health risks, and environmental problems that may affect health. How can the nurse best obtain this data? (Select all that apply.)

a. Survey state and national policy makers
b. Interviews of people in the community
c. Reviewing records from local hospitals
d. Searching public records for health statistics related to the community
e. Conducting a windshield survey of the community environment

Answer 209

a,b,d,e,
Correct Response: Interviews of people in the community, Conducting a windshield survey of the community environment, Survey state and national policy makers, Searching public records for health statistics related to the community

Rationale: In the assessment function, the public health nurse can gather data by interviewing people in the community, conducting surveys, and searching public records for information.

Question 210

The public health nurse is providing CPR training to day care workers at the local community recreation center. What essential service is the public health nurse providing?

a. Enforce laws and regulations to protect health and ensure safety.
b. Link people to needed health services and assure health care is provided.
c. Inform, educate, and empower people about health issues.
d. Ensure competent public and personal health care workforces.

Answer 210

c

Rationale: Ten essentials of public health include ensuring competent public and personal health care workforces. CPR is a requirement for day care workers who care for and monitor the health of children.

Question 211

A tornado has destroyed an area of the local community and destroyed the local water plant. The public health nurses in that area mobilize and coordinate care with the hospital, emergency medical services, and the fire department. What core public health function does this action represent?

a. Assessment
b. Personal services
c. Assurance
d. Policy development

Answer 211

d.
Rationale: At the community level, health nurses collaborate with leaders in the preparation of an emergency preparedness plan under the core function of assurance.

Question 212

A public health nurse is working in the local public health department performing kindergarten screenings and administering immunizations required for school admission. The mother of a client reports reservations about giving her child a vaccination. What is the nurse’s best action?

a. Describe the federal laws governing school children immunizations for school admittance.
b. Provide the mother with information to review on the proposed immunizations for the child.
c. Explain to the mother of the client that immunizations are required by local and state policies.
d. Continue screening of the child and report the refusal to the local school board.

Answer 212

b
Rationale: The state-level government health agencies are responsible for establishing state-wide health policies. The state defines immunization policies for all children entering the public school system. These laws are in place to prevent the spread of communicable diseases. Federal laws pass legislation on federal statutes such as Medicare, Medicaid, and Social Security. Local governments enforce ordinances such as building codes and nuisance ordinances.

Question 213

The public health nurse has identified obesity as a health problem in the community. Which action taken by the nurse demonstrate the core policy development function of public health at the community level?

a. Attending a school board meeting to present current data
b. Tracking rates of obesity in each of the community schools
c. Formal interviews with the director of school nursing
d. Identifying financial resources for nutrition education programs

Answer 213

a.
Rationale: In the policy development function at the community level, the public health nurse recommends training and raises awareness of the issue by bringing information forward to key policy makers.

Question 214

Which publicly funded health care program is aimed to assist families with children who are living in poverty?

a. TRICARE
b. Veteran’s Administration
c. Medicare
d. Medicaid

Answer 214

d

Question 215

Which publicly funded health care program receives funding primarily through the state government?

a. Medicare
b. TRICARE
c. Medicaid
d. Veteran’s Administration

Answer 215

c
Rationale: Medicaid receives funding primarily through the state government. Medicare is federally funded, TRICARE is a program for active duty military and their families, and Veteran’s Administration is a program for veterans and both are federally.

Question 216

State Children’s Health Insurance Plan (SCHIP) was put into place to provide coverage for children who were ineligible for Medicaid due to poverty requirements but unable to access health care with affordable private insurance.

FALSE
TRUE

Answer 216

true

Question 217

A pregnant woman is in the public health clinic for her first prenatal visit. She is currently single, living alone in federal housing, unemployed, and does not have any type of health care coverage. What health care program will the nurse identify to the client to apply for health care coverage?

a. Medicare
b. Women, Infants and Children
c. The Children’s Health Insurance Program Medicare
d. Medicaid

Answer 217

d
Rationale: Medicaid is a part of the Social Security Act Amendments of 1965 that provides medical assistance for children, pregnant women or parents with dependent children, and senior and severely disabled persons. Women, Infants and Children is a supplemental nutrition program.

Question 218

A senior client with Medicare for health care insurance is in the clinic for a checkup of a leg wound that does not seem to be getting better. The health care provider determines the client needs home health services for wound care. The client is concerned about the cost and asks what part of Medicare covers home health services. What would the nurse’s best response be?

a. “Part C”
b. “Part A”
c. “Part C”
d. “Part B”

Answer 218

b
Rationale: Medicare Part A covers in-patient hospitalization, some skilled nursing services, short-term home health, and hospice services to eligible clients. Part B is a supplemental and voluntary medical insurance program paid by the participants. Part C is part of the Medicare policy and allows private insurance companies to provide Medicare benefits. Part D is a prescription benefit plan.

Question 219

How is Medicare funded by paid taxes?

a. From employee state withholdings
b. Via government subsidies of other programs
c. Through employers and employees equally
d. According to employer tax bracket

Answer 219

c
Rationale: Medicare is funded by payroll taxes employers and employees equally pay into the Social Security system along with the interest earned from trust fund investments.

Question 220

The federally funded program Medicare provides free health care for what groups of individuals? (Select all that apply.)

a. Eligible seniors over the age of 65
b. Individuals with kidney failure
c. Families at 100% poverty
d. Children under the age of five
e. Legally disabled persons

Answer 220

a,b,e
Rationale: Mandatory federally health insurance program was established in 1965. It provides federally funded health insurance for persons 65 and older who paid into the Social Security system, certain disabled persons and those diagnosed with end-stage renal disease to receive quality health care that would otherwise be unavailable to them.

Question 221

Which statement best describes policy?

a. Nurses are powerless to determine policies.
b. Policy comprises the actions that are taken to achieve a goal or objective.
c. It is a nurse’s responsibility to adhere to policies.
d. Nurses must support policies.

Answer 221

c
Rationale: Policy is defined as a plan of action or an agenda that outlines steps or actions to implement a stated goal or objective. Policy is also defined as principles that govern an action to achieve a given outcome.

Question 222

Which of the following is the professional value that leads nurses to advocacy?

a. Self-interest
b. Treating all people exactly the same
c. Promoting needs of one while denying others
d. Social justice

Answer 222

d
Rationale: The guiding values of nursing include social justice and that “nurses should act to change those aspects of society that detract from health and well-being.” Nurses are required to hold the responsibility of upholding the values of their society.

Question 223

Advocacy is a moral and professional responsibility and a fundamental role of nursing.

FALSE
TRUE

Answer 223

true

Question 224

A home health nurse is visiting a new client with tuberculosis. The client has refused to take the required medication. What is the nurse’s next best action?

a. Contact the home health agency attorney to determine the specific regulations governing medication compliance in clients with tuberculosis.
b. Call the local police to assist in forcing the medication since it is required by the county and state health codes.
c. Document the medication regimen refusal in the client’s chart and let the client know you will be back to check again tomorrow.
d. Notify the health department director and the health department tuberculosis clinic supervisor the client has refused to take the medication.

Answer 224

a
Rationale: In clients who have active tuberculosis, community health nurse case management is indicated to ensure medication compliance and completion of treatment to prevent the further spread of infection. If a client refuses to comply and is at risk of spreading the infection, then the nurse will need to identify state and local health codes in order to proceed.

Question 225

A community health nurse is at the local recreation center attending a community meeting where members are expressing concern about an upcoming bill on allowing fracking in their community. The community has requested the nurse assist them in preventing the bill from passing. How can the nurse use advocacy to assist the community with this issue? (Select all that apply.)

a. Write local policy makers regarding the communities’ feelings about the issue.
b. Collaborate with community representatives to develop a form letter to contact policy makers.
c. Develop a policy restricting fracking in community.
d. Research problems associated with fracking in communities and provide examples.
e. Locate advocacy groups against fracking and connect the community members with the group.

Answer 225

a,b,d
Rationale: The community health nurse in the role as advocate performs actions on the behalf of the community they serve. Functions include guiding community members in identifying policy makers and influential people in the community, identifying ways to make healthier environments for communities through research, and collaborating with community members on community health issues

Question 226

Residents in the community have voiced concerns regarding a local pond. The pond is stagnant and residents report a higher than normal number of mosquitoes in the neighborhood surrounding the pond. What is the best legal or legislative resource the nurse can access to reduce or eliminate this problem?

a. Contact the local health department legal advisor.
b. Email the state attorney for public health.
c. Search the Internet for information on county ordinances.
d. Call local policy makers.

Answer 226

a
Rationale: This issue is a local issue and the local health department would be the best resource to contact in deciding what actions can be taken to reduce or eliminate this potential health risk.

Question 227

One of the main roles of the public health nurse is advocacy. What is included in the process of advocacy? (Select all that apply.)

a. Contacting payer sources
b. Collecting information
c. Developing action plans
d. Identifying stakeholders
e. taking action

Answer 227

a, c, e
Rationale: Advocacy is a process where the community health nurse is trying to influence outcomes or championing a cause. Advocacy includes identifying the issue, collecting information, identifying influential people, building support, and taking action.

Question 228

When considering cultural influences, how would the nurse interpret a Chinese patient’s lack of eye contact during a discussion about a newly prescribed medication as a sign of what?

a. Depression
b. Misunderstanding
c. Respect
d. Disinterest

Answer 228

c
Rationale: In many cultures (e.g., Native American, Chinese, Haitian), a younger client meeting the gaze of a clinician is a sign of disrespect. However, in other cultures (e.g., white American or German), eye contact is a necessary sign of respect. A clinician from those cultures might misinterpret lack of eye contact as signifying limited understanding, inattention, depression, or noncompliance.

Question 229

What is the initial nursing intervention when conducting a cultural assessment regarding the health beliefs and values of a member of a non-white American culture?

a. Gaining insight into the patient’s cultural world view
b. Establishing an accepting environment
c. Arriving at mutually agreed-upon definitions of health beliefs and values
d. Determining the presence of any existing language or communication barriers

Answer 229

b
Rationale: Whatever method is chosen, it is important to create an atmosphere that encourages the client to tell his or her own story, with all its cultural nuances. Although the remaining options are valuable, they are based on an accepting environment between the nurse and the patient.

Question 230

When considering health views, which statement is the basis for discussions concerning the effect of culture?

a. Cultural world views are responsible for the different beliefs regarding the cause of illness.
b. Cultural world views are seldom concerned with health care issues.
c. The beliefs concerning the causes of illness are shared by most world cultures.
d. Cultures generally share a world view regarding how illness should be treated.

Answer 230

a
Rationale: Different cultural world views tend to reflect different ideas about what causes disease. Beliefs and values are fundamental and differ concerning the origin and treatment of illness as well as the perception of health and wellness.

Question 231

Culture is defined as the behaviors and beliefs characteristic of particular. (Select all that apply)

a. age group
b. ethnic group (ethnicity)
c. nationality
d. social group

Answer 231

all are correct

*all of these shape the concept of culture

Question 232

In preparing a health and wellness care plan for the local senior citizen center, the nurse ensures the consideration of the three universal needs. What are the three universal human needs of the community?

a. Safety and security
b. Satisfaction in life transitions
c. Sense of belonging
d. Social relationships
e. Support for decisions

Answer 232

a,c

Rationale: After basic physiological needs are met including air, food, and water, then people work toward safety and security and the need for a sense of belonging.

Question 233

A community nurse who routinely works in the immunization clinic notes an influx of new patients from Russia. The nurse wants to improve the self-awareness of this new population. What steps can the nurse take to cultivate cultural sensitivity toward this new client population? (Select all that apply.)

a. Provide care to the new population-based on broad cultural values of health.
b. Demonstrate a genuine interest in the lives and culture of the new clients.
c. Interview some of the new members and inquire about cultural values.
d. Acknowledge that differences in culture occur even within a common culture.
e. Perform an Internet search to improve knowledge on the new client population.

Answer 233

b,c

Rationale: There are many ways to improve cultural sensitivity, including interviewing individuals about culture and beliefs, being interested and keeping an open mind, and participating in a cultural event in the community.

Question 234

While providing in-home wound care, the nurse notes the client is frequently vocal and screams at relatives when in pain. In performing a cultural assessment, in what area would the nurse document the frequent outburst and vocalizations?

a. Cultural identification
b. Communication
c. Biological variations
d. Family dynamics

Answer 234

c

Rationale: Biological variations include physical and biological traits that are unique to culture of a population. This can also include how they perceive pain and express pain.

Question 235

A new client is scheduled at the clinic. During the assessment, the nurse notes a circular, dark-pink indention on the client’s abdomen. The nurse is aware the client is not from the United States. What is the nurse’s next best action in assessing this client?

a. Apply pressure to the area to determine if it blanches, then proceed with the assessment.
b. Ask the client to describe usual health beliefs and practices when the client becomes sick.
c. Assess the indention and ask the client the origins of the circular mark on the abdomen.
d. Assume the client performs the cultural practice of cupping and ask when the client last did this.

Answer 235

b

Rationale: A person’s practices regarding health are influenced by beliefs about causes and effects of illness. In order to be effective in providing care for persons from different cultures, community nurses must be accepting of others’ cultural practices.

Question 236

During an intake assessment at the local health department, the nurse asks a Hispanic client where in Mexico they were born. The client becomes angry and reports being were born in Colombia. What is the best action for the nurse to take?

a. Ask the client to provide education on the differences between Hispanics from Mexico versus Colombia.
b. Apologize for the cultural insensitivity and make a mental note to be more careful in the future.
c. Express regret for the assumption and seek a Hispanic nurse to complete the interview process.
d. Explain to the client most of the Hispanic individuals who come to the health department are from Mexico.

Answer 236

b

Rationale: If nurses make a cultural mistake, they should first apologize and admit a limited amount of knowledge, then express a willingness and openness to learn from the mistake.

Question 237

What is the goal of a community health assessment (CHA)? (Select all that apply).

a. Effective assessment of existing community health problems
b. Associating health need with possible community resource
c. Financing the implementation of the community health interventions
d. Identification of community health resources
e. Prioritization of community-focused health interventions

Answer 237

a,b,d,e

Rationale: The goal of a CHA is to identify the community health problems that are the priorities for intervention as well as community resources available to address each health problem or need. Financing the interventions are not a CHA goal.

Question 238

Which factor is considered when determining social determinants of health? (Select all that apply.)

a. Childhood experiences
b. Social policies
c. Place of birth
d. Age
e. Employment history

Answer 238

a,c,d,e

Rationale: The circumstances in which people are born, grow up, live, work, and age and the systems put in place to deal with illness are termed the social determinants of health. These circumstances are in turn shaped by the wider context, including economics, social policies, and politics.

Question 239

What is the source for established national objectives and health outcomes that guide health promotion in the United States?

a. World Health Organization (WHO)
b. The Millennium Development Goals
c. National Prevention Counsel
d. Healthy People 2020

Answer 239

d

Rationale: Healthy People 2020 are national objectives for improved health outcomes that guide the health promotion and disease prevention efforts in the United States. None of the other options has that specific goal.

Question 240

Which ethical principles affect decision-making? select all that apply

a. fairness
b. equality
c. social justice
d. human rights

Answer 240

all are correct and affect decision making

Question 241

A community health nurse is working with the nearby American Indian reservation to develop a program to reduce health disparities. What is a known health disparity of the American Indian that the nurse will want to address?

a. Stroke
b. Heart disease
c. Hypertension
d. Diabetes

Answer 241

d

Rationale: American Indian adults have high rates of diabetes (2 times higher than whites), TB (5 times higher), alcoholism (5 times higher), and higher occurrences of other health problems including unintentional injuries, suicide, and homicide.

Question 242

Which group is more susceptible to health disparities and discrimination in health care systems? (Select all that apply.)

a. Ethnic or racial minorities
b. Individuals in drug treatment programs
c. Unemployed persons
d. Runaway teenagers
e. People who did not finish high school

Answer 242

a, c, d

Rationale: Those at the most risk for health disparities and discrimination in the health care system include the homeless, those who use and abuse drug,s and those who are experiencing financial obstacles

Question 243

A public health nurse is developing a program based on the goals of the government initiative Healthy People 2020. What is a health indicator the nurse may use as a part of the program? (Select all that apply.)

a. Substance abuse
b. Exercise frequency
c. Technology usage
d. Environmental quality
e. Tobacco usage

Answer 243

a,b,e

Rationale: Healthy People 2020 is an ambitious government health iniative with a specific agenda for improving the health of all Americans. According to its premise, the health of the individual is inseparable from the health of the larger community. The achievement of its goals is determined by measuring and comparing many health indicators, such as weight, activity level, lifestyle choices, and environmental and social factors.

Question 244

A public health nurse is developing an educational brochure on diabetes for the community clinic. Which group has a higher propensity toward the health disparities of cancer and diabetes?

a. African American
b. Alaskan natives
c. Asian
d. Algerian

Answer 244

a

Rationale: African Americans have a higher mortality rate compared with the white population. Other health problems for blacks include cardiovascular disease, stroke, cancer, diabetes mellitus, and higher rates of infant mortality.

Question 245

While working in the free clinic, the public health nurse is assessing a migrant farm worker who has an infection of the right hand. The nurse cleans the wound, applies antibiotic cream, and wraps the area to keep it clean. The nurse is conducting an assessment to determine if the client has any contributing factors related to health disparities. Which of these are contributing factors to health disparities? (Select all that apply.)

a. Educational obtainment
b. Part-time employment
c. No means of transportation
d. Language barriers
e. A diagnosis of schizophrenia

Answer 245

c,d,e

Rationale: Access to health care resources, language barriers, and mental health issues are all contributing factors that can directly relate to health disparities. Other factors that positively influence the state of health and being able to maintain health include safe housing, quality education, clean water, food and air, and social support, just to mention a few.

Question 246

What is the primary goal of health promotion?

a. Developing positive health promotion strategies directed toward individuals and communities
b. Providing health care professionals an opportunity to positively affect human health and well-being
c. Implementing health promotion strategies at all three levels of disease prevention among all humans
d. Affecting positive change to the health and well-being of individuals and communities

Answer 246

d

Rationale: Health promotion’s goal is to change health and well-being. Health promotion implements strategies developed in partnership with health professionals, individuals, and communities that includes all three levels of disease prevention.

Question 247

What is the data collected through public health surveillance by the U.S. Centers of Disease Control and Prevention (CDC) ultimately used for?

a. Reduction of morbidity and mortality among the population
b. The development of health-related databases
c. Identification of potential health issues presenting in communities
d. Distribution to state and local health agencies

Answer 247

a

Rationale: Data are systematically collected, analyzed, interpreted, and disseminated so that they can be used to develop activities and programs that will reduce morbidity and mortality and improve health. The remaining options are specific foci that bring about the achievement of the goal of improved health.

Question 248

What is the purpose of an epidemiological predictions and probabilities in relationship to health promotion?

a. Epidemiology relies heavily on predictions and probabilities in its scientific approach to wellness.
b. They determine the focus of health promotion strategies.
c. The need for health promotion has created the need for such data.
d. Predictions and probabilities are used to evaluate the effectiveness of health promotion strategies

Answer 248

b

Rationale: Analysis of epidemiologic data allows for the development of predications based on the statistical conclusions (probabilities). These are the basis for determining the possibility of getting a disease or becoming physically or emotionally challenged. It is this possibility that directs health promotion strategy development. Health promotion did not create the need for these forms of information nor are they used to evaluate health promotion strategies.

Question 249

Health promotion and disease prevention are both focused on which level of intervention?

a. Secondary
b. Multi-level
c. Tertiary
d. Primary

Answer 249

d

Rationale: Health promotion and disease prevention are both focused on primary intervention

Question 250

What is the role of the community health nurse? (Select all that apply.)

a. Administration of medications
b. Sterile dressing changes
c. Community-based health education
d. Provision of direct client care
e. Providing health promotion interventions

Answer 250

c,e

Rationale: Community health nurses provide both health promotion interventions and community-based health education. Teaching has been a critical part of the community health nurse’s role since the origins of the profession, and it frequently is the primary role or function.

Question 251

What areas is health promotion focused on? (Select all that apply.)

a. Developing nursing interventions directed towards people’s resources to maintain well-being
b. Maintaining or improving health of families and communities
c. Reducing risks to health and controlling major causes of disease
d. Studying the causes and effects of disease
e. Assisting with discharge from acute care settings

Answer 251

a,b

Rationale: Health promotion has two components: 1) maintaining or improving the health of families and communities, and 2) developing nursing interventions directed toward people’s resources to maintain and enhance their well-being.

Question 252

The desired outcome of health education is that the learner:

a. suggests alternatives to the nurse’s health promotion strategy.
b. demonstrates permanent behavioral change.
c. recites the nurse’s words verbatim.
d. passes a written examination.

Answer 252

b

Rationale: The goal of health education is for the learner to assimilate new information that promotes a permanent change in behavior. The other options lack evidence of behavioral change as a result of health education.

Question 253

Which statement is true about the community health nurse?

a. Serves as the health expert in the community.
b. Focuses solely on disease prevention in the community.
c. Delegates the task of health promotion to community leaders.
d. Facilitates members of the community to take control of their health.

Answer 253

d

Rationale: The community nurse is not the “expert” but a facilitator, helping community members take responsibility for their health. The nurse will focus on both health promotion and disease prevention and the primary level of prevention.

Question 254

When considering health literacy associated with health risks, what is the public health nurse’s primary concern?

a. Whether the individual or the community needs additional motivation to implement the change
b. Whether the individual or the community choices to implement or ignore the need for change
c. How expensive the implementation of the needed behavioral change will be
d. How beneficial the individual or the community views the change

Answer 254

b

Rationale: Most importantly, nurses in public health practice can observe whether members choose to apply risk information to their lives or ignore it. The other options represent considerations that can affect the process of change.

Question 255

Considering health literacy, what intervention will the nurse implement when providing a patient education on a newly prescribed medication?

a. Supplementing the discussion with written material that patient can keep
b. Providing information regarding the condition the medication is prescribed for
c. Arranging for the family to share in the educational discussion
d. Asking the patient to summarize the information that was provided

Answer 255

d

Rationale: Health literacy is dependent on the patient being able to understand the information provided. A summary by the patient is an excellent way of evaluating understanding. Although the other options support learning, they are not as directly focused on understanding.

Question 256

Which intervention will provide the nurse with the best understanding of a family’s health risks?

a. Assessing how the family and its member go about coping with health risks
b. Asking individual family members to define “health risk” in their own words
c. Engaging the family members in a discussion about health risks
d. Conducting a family-focused health literacy assessment

Answer 256

d

Rationale: The health assessment will be the best means of identifying potential health issues

Question 257

What is included in health literacy? (Select all that apply.)

a. Musical literacy
b. Reading skills
c. Cultural literacy
d. Layman’s literacy
e. Scientific literacy

Answer 257

b,c,e

Rationale: According to the Centers for Disease Control, health literacy is a person’s ability to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions. Reading skills, cultural literacy, and scientific literacy each contribute to health literacy.

Question 258

What is true of clients with low health literacy?

a. They are less likely to use emergency department services.
b. They are more likely to be hospitalized.
c. They are more likely to participate in health screenings.
d. They are less likely to report being in poor health.

Answer 258

b

Rationale: When health literacy is low or limited, a client’s health status and health outcomes are negatively impacted. As a result, clients with low health literacy are more likely to be hospitalized.

Question 259

When working with a patient who is attempting to change a health-related behavior, what will the nurse reinforce? (Select all that apply.)

a. The patient’s ability to make the change
b. The need for the actual change in behavior
c. The amount of time it will take to make the change in behavior
d. The health-related benefits of changing the behavior
e. Problem-solving techniques needed to achieve the change

Answer 259

a,b,d,e,

Rationale: The learning model is a behavior change model emphasizing reinforcement of social competence, problem-solving, autonomy, and sense of purpose. Setting a time table is not typically a focus

Question 260

What is the role of the nurse when using the adult learning model to bring about a change in a patient’s health behaviors?

a. Assessment of the patient’s understanding of the importance of the goal
b. Reinforcement of the goal as the change is being made
c. Determine the patient’s readiness to make the change
d. Role modeling for the patient as the behavior is being changed

Answer 260

b

Rationale: When considering the adult learning model, a goal is established and reinforced by the nurse, with rewards given for partial accomplishment, if necessary. Although the other options may be considered nursing responsibilities, they are not associated with the adult learning model in the change of behaviors.

Question 261

The nurse wants to conduct an assessment that will protect the anonymity of the participants. What is the best tool to use?

a. Survey
b. Task force
c. Interview
d. Open forum

Answer 261

a

Rationale: A survey is similar to an interview in that it asks questions. However, instead of being conducted verbally, it is filled out online or on paper. This can be an advantage as it allows respondents to remain anonymous.

Question 262

The nurse is considering a client’s readiness to learn. Which are considered cognitive factors? (Select all that apply.)

a. Age
b. Occupation
c. Motivation
d. Gender
e. Reading ability

Answer 262

c,e

Rationale: Motivation and reading ability are cognitive factors. Age and gender are physiological factors, and occupation is a psychosocial factor.

Question 263

The nurse is planning to conduct a needs assessment. What methods might the nurse employ to make an assessment? (Select all that apply.)

a. Holding a closed forum
b. Making observations
c. Organizing a task force
d. Conducting a survey
e. Reviewing published literature

Answer 263

c,d,e

Rationale: Conducting a survey, organizing a task force, and reviewing published literature are all reliable assessment methods. An open forum, rather than a closed forum, is another assessment tool that allows group members to hear each other’s concerns, as well as to voice their own concerns or answers.

Question 264

The nurse is considering the qualities of effective adult learners. What qualities are most common among this group? (Select all that apply.)

a. Family-focused
b. Practical
c. Goal-oriented
d. Self-directed
e. Fiscally conscious

Answer 264

b,c,d

Rationale: Adult learners are generally self-directed, goal-oriented, and practical. They bring prior knowledge to the learning sessions, and want to understand how the new information is relevant to their situation or needs

Question 265

The nurse is considering the psychosocial factors that could affect a client’s readiness to learn. Which factors fit this category? (Select all that apply).

a. Family
b. Support person
c. Home
d. Gender
e. Occupation

Answer 265

a,b,e

Rationale: The client’s family, occupation, and support persons are psychosocial factors that influence the client’s readiness to learn. The client’s home is an environmental factor, and the client’s gender is a physiological factor.

Question 266

Which factor contributes to the possibility of relapse back into a negative health behavior? (Select all that apply.)

a. Being in the early stages of change
b. Experiencing a poor support system
c. Being depressed
d. Lacking effective coping skills
e. Dealing with a high degree of personal stress

Answer 266

c,c,d,e

Rationale: Relapse often occurs because of (1) negative emotional states; (2) lack of, or limited, coping skills; (3) decreased motivation; (4) stress; and (5) high-risk experiences. Being in the early stages of change is not considered a relapse factor.

Question 267

When considering social learning theory, what patient-focused issue is considered most important for a person considering a change in a health-related behavior?

a. How difficult it is to make the change
b. Ability to make the change
c. The impact the change will have on health
d. Support of family and friends

Answer 267

b

Rationale: Most importantly, a person must believe in his or her capability to perform the behavior (self-efficacy). Although the other options have impact of the change process, little is achievable is the patient lacks self-confidence.

Question 268

The nurse wants to use the domains of effective teaching to help organize a teaching plan. What domains should the nurse consider? (Select all that apply.)

a. Cognitive
b. Psychomotor
c. Affective
d. Spatial
e. Physical

Answer 268

a,b,c

Rationale: Learning occurs in three areas or domains: cognitive, affective, and psychomotor. The cognitive domain deals with intellectual development, the affective domain deals with values, emotions and beliefs, and the psychomotor domain deals with the actual performance of a new skill.

Question 269

What is the most important role of the community health nurse?

a. Surrogate
b. Advocate
c. Leader
d. Educator

Answer 269

d

Rationale: The most important role of the community/public health nurse is that of a health educator. The nurse engages and inspires learners to effect change in their lives and move toward better health.

Question 270

How can the nurse create an environment that is conducive to learning? (Select all that apply.)

a. promotes free expression.
b. Assert authority and discipline.
c. Ensure that the environment is not too comfortable.
d. Create an atmosphere of helpfulness.

Answer 270

a, d

Rationale: The best way to create an environment that is conducive to learning is to make the environment physically comfortable, and instill an atmosphere of helpfulness, trust, and respect that promotes free expression.

Question 271

What principles can the nurse apply to maximize the teaching-learning process? (Select all that apply.)

a. Limit the use of practical application.
b. Adapt teaching to the client readiness level.
c. Discourage interaction among learners
d. Determine client attitudes toward the subject matter.
e. Make subject matter relevant to the client’s interests.

Answer 271

b,d,e

Rationale: Determining the attitudes of clients to the subject matter, adapting teaching to the clients’ level of readiness, and making the subject matter relevant to the clients’ interests are helpful for the health teaching setting. Practical application should also be incorporated, and interaction among learners should be encouraged.

Question 272

The nurse is asked why it is important to teach psychomotor skills. What statement is the best answer?

a. “Psychomotor skills take more time to teach and it is good use of class time.”
b. “Cognitive skills are reinforced with psychomotor skills.”
c. “It is easier to teach psychomotor skills versus cognitive skills.”
d. “Most health topics involve some sort of “self-care” that the learner will need to do be able to do following the class.”

Answer 272

d

Rationale: Teaching psychomotor skills will make the learner more successful after the class ends. Examples include changing diet and exercise, giving injections, and conducting self-exams.

Question 273

The Learning Model is a behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose.

FALSE
TRUE

Answer 273

true

Rationale: The Learning Model is a behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose.

Question 274

Secondary prevention is maximizing health and wellness through strategies that are set in place before illness or injury is present.

FALSE
TRUE

Answer 274

false

Rationale: Primary prevention is maximizing health and wellness through strategies that are set in place before illness or injury is present. Secondary prevention is maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury.

Question 275

Social learning is a client-centered communication style for eliciting behavior change by helping clients and groups explore and resolve ambivalence.

FALSE
TRUE

Answer 275

false

Rationale: Motivational interviewing is a client-centered communication style for eliciting behavior change by helping clients and groups explore and resolve ambivalence. Social learning is a behavior change model that considers environmental influences, personal factors, and behavior as key components to change.

Question 276

Which nursing model for behavioral change addresses pre-contemplation, contemplation, preparation, action, and maintenance?

a. Social cognitive
b. Transtheoretical
c. Revised health promotion
d. Health belief

Answer 276

b

Question 277

Which benefits of making exercise a habit could be described as “health promotion”? (Select all that apply.)

a. Improves cognitive function
b. Improves strength and balance
c. Reduces the risk of lung cancer
d. Increases longevity
e. Reduces the risk of colon cancer

Answer 277

a,b,d

Rationale: All of these benefits could be described as “health promotion,” except for reduction of cancer. The benefit of reducing cancer is more aptly described as a form of “disease prevention.”

Question 278

What type of disease is the most common, costly, and preventable?

a. Chronic
b. Sexually transmitted
c. Infectious
d. Acute

Answer 278

a

Rationale: Chronic conditions are the most common, costly, and preventable. Tobacco and alcohol use, insufficient exercise, and poor eating habits are responsible for much of the illness, disability, and premature death related to chronic disease.

Question 279

What factors does the Health-Belief Model specify that health-related behavior depends on? (Select all that apply.)

a. Perceived seriousness of illness
b. Perceived susceptibility to illness
c. Interpersonal influences
d. Benefits of taking action.
e. Situational influences

Answer 279

a,b,d

Rationale: The Health-Belief Model is a behavior change model useful for individual, family, or community health-related behavior. Community health nurses use this model to assess individuals and communities regarding their “health beliefs” prior to planning interventions. Interpersonal and situational influences are aspects of the Pender Health-Promotion Model.

Question 280

Which is a strategy the nurse can use for improving wellness in a community?

a. Enacting personal barriers
b. Encouraging dependency
c. Ensuring the status quo
d. Enhancing awareness

Answer 280

d

Rationale: The public health nurse provides awareness through outreach and education in the community. While it’s easy to wish people had healthy behaviors, they will not change if they lack awareness of such behaviors

Question 281

1.assessment

Answer 281

systemic data collection about a population including monitoring the population’s health status and provide/disseminating info about the health of community

Question 282

2. policy development

Answer 282

create policies that support health of the population through leadership and research

Question 283

3. assurance

Answer 283

making sure that essential community-oriented health services are available

Question 284

examples of population

Answer 284

• people in the same neighborhood
• people on a sports team
• nursing students
• sorority

Question 285

what a population focus is in PH nursing?

Answer 285

diagnoses, interventions and treatments are carried out for population

Question 286

what is the primary goal of a community assessment?

Answer 286

identify the health needs of a community

Question 287

factors that influence health status across life cycle

Answer 287

determinants of health

Question 288

what are the 3 components on the intervention wheel?

Answer 288

1. population-based
2. 3 practice levels
3. 17 interventions

Question 289

Which of the 17 interventions is often seen as a precursor to policy development?
A. Advocacy
B. Counseling
C. Case finding
D. Health teaching

Answer 289

A

Question 290

measures the proportion of the population affected by a specific condition in a specific time period

Answer 290

prevalence

Example: all students with the flu during fall 2016
prevalence: measure of all individuals affected by the disease at a particular time

Question 291

what are the steps in environmental assessment?

Answer 291

Use your observational skills (e.g., windshield surveys);
interview community members, your individual clients and the families of your clients.
Review Web-based data on existing exposures, such as air and water pollution monitoring data, drinking water testing, and contaminated soil.

Question 292

what are the 3 domains of learning?

Answer 292

1. cognitive - thinking
2. affective - feeling
3. psychomotor - acting

Question 293

Public Health 3 components

Answer 293

assessment (needs)
assurance (resources)
policy (intervention)

Question 294

population versus aggregate

Answer 294

Population- group of people with common personal or environmental characteristics
ALL elders in a community

Aggregate- subgroup of people within a population
PREGNANT teenagers within a school district

Question 295

Determinants of health

Answer 295

biology 
behavior 
social environment 
physical environment (what is experienced by the senses)
policies and interventions

Question 296

Milio’s framework for prevention (1976) provides a complement to the HBM

Answer 296

and a mechanism for directing attention upstream and examining opportunities for nursing intervention at the population level

Question 297

5 A’s of Health Care Access

Answer 297

availability, accessibility, affordability, acceptability, and accommodation

Question 298

PHN independent and responsible for actions - respects community and individual right to self-determination; maintain privacy, honesty, and fidelity

Answer 298

Autonomy

Question 299

Health Promotion Model (Pender)

Answer 299

actions to improve health using the following drivers-individual characteristics and experiences, behaviors, behavioral outcomes, health promotion, activities involve removing internal and external barriers and promoting public policy to remove barriers
type of model

Question 300

USDHHS

Answer 300

principle government agency that protects the health of our country; under its umbrella are: CMS, CDC, NIH, FDA, SAMHSA

Question 301

THE MISSION OF PUBLIC HEALTH IS

Answer 301

SOCIAL JUSTICE

ENTITLES ALL PEOPLE TO BASIC NECESSITIES SUCH AS ADEQUATE INCOME AND HEALTH PROTECTION AND ACCEPTS COLLECTIVE BURDENS TO MAKE THIS POSSIBLE

CONFLICTS WITH MARKET JUSTICE: ENTITLES PEOPLE TO WHAT THEY HAVE GAINED THROUGH INDIVIDUAL EFFORTS

Question 302

DEFINE HEALTH

Answer 302

A STATE OF COMPLETE WELL-BEING, PHYSICAL, SOCIAL, AND MENTAL, AND NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY (WHO, 1958)

TH EXTENT TO WHICH AN INDIVIDUAL OR GROUP IS ABLE, ON THE ONE HAND, TO REALIZE ASPIRATIONS AN SATISFY NEEDS; AND ON THE OTHER HAND, TO CHANGE OR COPE WITH THE ENVIRONMENT.

• A RESOURCE FOR EVERYDAY LIFE
• NOT AN OBJECTIVE OF LIVING