Community - Week 1 (Ch 1 2 4) - Evolve Questions Flashcards
Jennifer is a nurse in a family medicine clinic. Today she is assessing Jose, a 4-year-old who is being seen for an earache. The type of nursing Jennifer practices is: A. community-oriented nursing. B. community-based nursing. C. public health nursing. D. tertiary health nursing.
B. community-based nursing.
In community-based nursing, the nurse focuses on “illness care” of individuals and families across the life span. The aim is to manage acute and chronic health conditions in the community, and the practice is family-centered illness care. Community-based nursing is not a specialty in nursing but, rather, a philosophy that guides care in all nursing specialties. Community-oriented nursing has as its primary focus the health care either of the community or populations as in public health nursing (PHN) or of individuals, families, and groups in a community.
DIF: Cognitive Level: Knowledge
REF: Page 2
A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the public health core function of: A. assessment. B. assurance. C. policy development. D. research.
A. assessment.
The three public health core functions are assessment, policy development, and assurance. Assessment is systematic data collection on the population, monitoring the population’s health status, and making information available about the health of the community. Policy development refers to efforts to develop policies that support the health of the population, including using a scientific knowledge base to make policy decisions. Assurance is making sure that essential community-oriented health services are available. These services might include providing essential personal health services for those who would otherwise not receive them. Assurance also includes making sure that a competent public health and personal health care workforce is available.
DIF: Cognitive Level: Knowledge
REF: Page 4
A state agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored elder care programs. The public health core function applied is: A. assurance. B. policy development. C. primary prevention. D. public transportation.
A. assurance.
The public health core function of assurance focuses on the responsibility of public health agencies to be sure that activities are appropriately carried out to meet public health goals and plans. This role requires skill in assessment, investigative functions, collaboration, consultation, and cooperation. Assurance also includes assisting communities to implement and evaluate plans and projects. Policy development refers to efforts to develop policies that support the health of the population, including using a scientific knowledge base to make policy decisions. Primary prevention does not focus on provision of services and a part of assurance is assisting communities to obtain necessary services such as transportation.
DIF: Cognitive Level: Application
REF: Page 4
A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing: A. community-oriented care. B. community-based care. C. secondary care. D. tertiary care.
A. community-oriented care.
Community-oriented nurses emphasize health protection, maintenance, and promotion and disease prevention, as well as self-reliance among clients. Regardless of whether the client is a person, a family, or a group, the goal is to promote health through education about prevailing health problems, proper nutrition, beneficial forms of exercise, and environmental factors such as safe food, water, air, and buildings. Community-based care is nursing care that is provided in a setting. A smoking cessation clinic is an example of primary prevention, not secondary or tertiary.
DIF: Cognitive Level: Application
REF: Page 2
Public health nursing is a specialty with a distinct focus and scope of practice and requires a special knowledge base different from other specialty areas of nursing. A public health nurse would first be interested in:
A. drug treatments for diabetes.
B. populations with the highest rate of diabetes.
C. educational materials for individuals with diabetes.
D. new technology for diabetic care.
B. populations with the highest rate of diabetes.
The primary focus that has differentiated public health nursing from other specialties has been the emphasis on the population rather than on individuals or families. The primary goal of public health—the prevention of disease and disability—is achieved by ensuring that conditions exist in which people can remain healthy. Diabetes care and educational materials are provided to individuals and families by a nurse in the community or institutional setting.
DIF: Cognitive Level: Knowledge
REF: Pages 4-5
A nurse in a clinic that provides direct care services to clients with tuberculosis would be classified as practicing: A. community-based nursing. B. community-oriented nursing. C. institutional nursing. D. public health nursing.
A. community-based nursing.
The nurse practicing as a community-based nurse is more likely to give direct care to people than are nurses who practice from a community-oriented framework. A community-oriented framework includes community-oriented nursing and public health nursing. Institutional nursing care is generally delivered in a hospital or nursing home setting.
DIF: Cognitive Level: Knowledge
REF: Page 11
A school nurse teaches three middle school students with asthma conditions techniques to minimize their incidence of bronchial spasms. This is an application of: A. community-based nursing. B. community-oriented nursing. C. institutional nursing. D. public health nursing.
A. community-based nursing.
The goal of community-based nursing (CBN) is to manage acute or chronic conditions while promoting self-care among individuals and families. In CBN the nursing care is family centered, which means that the nurse works to improve the competencies of families to enable them to take better care of themselves. The nurse pays particular attention to the uniqueness of each family and works to plan the most useful interventions. Nurses practicing in the community and many staff public health nurses focus on providing direct care services, including health education, to persons or families outside of institutional settings, either in the home or in a clinic.
DIF: Cognitive Level: Knowledge
REF: Pages 10-11
In a community clinic that screens and treats individuals for cardiovascular disorders, the nurse practicing public health/population-focused nursing would most likely ascertain:
A. a holistic treatment plan.
B. a specific clinical diagnosis.
C. individual dietary interventions for cardiovascular disorders.
D. the prevalence rate of cardiovascular disorders among various groups.
D. the prevalence rate of cardiovascular disorders among various groups.
A public health nurse in a community clinic engaged in population-focused practice would ask the following questions:
· What is the prevalence rate of the diagnosis or condition among various age, race, and gender groups?
· Which subpopulations have the highest rates of untreated diagnosis or condition?
· What programs could reduce the problem of untreated diagnosis/condition and decrease the risk for further morbidity and mortality?
Public health nurses are typically concerned with more than one subpopulation, and they often deal with the health of the entire community. Assessment, one of the public health core functions, is a logical first step in examining a community setting to determine its health status.
DIF: Cognitive Level: Knowledge
REF: Pages 7-8
In a federally funded preschool program such as Head Start, nursing services that include conducting developmental-level screening for cognitive and psychomotor development of individual children would most likely be considered community-oriented nursing care when:
A. individual results are compared with established standards for children of the same age group.
B. program characteristics are assessed for their effectiveness in making the school population healthier.
C. referral is provided for a child identified with delayed psychomotor development.
D. treatment is initiated for a child with an identified learning disability.
A. individual results are compared with established standards for children of the same age group.\
Within federally funded programs for preschool children, from a community-oriented nursing care perspective, nursing services could be provided to individual children by conducting developmental-level screening tests to evaluate each child’s level of cognitive and psychomotor development in comparison with established standards for children of the same age. This is population-focused service. A community-based nurse may deliver illness care or direct services to individual children. A public health nurse may assess the program’s ability to achieve the overall goal of making its population of children healthier by evaluating the characteristics of the facility, program, and environment for their effectiveness in achieving the goal.
DIF: Cognitive Level: Knowledge
REF: Page 10
The public health nurse deals with the examination of a community setting to determine the community’s health status. Which of the following activities should be considered in the assessment phase? (Select all that apply.)
A. Assisting communities to implement and evaluate plans and projects
B. Building constituencies to work with the community
C. Collecting, analyzing, and disseminating information
D. Evaluating the social, economic, and environmental characteristics of the population
E. Questioning the availability of health services to the community
C. Collecting, analyzing, and disseminating information
D. Evaluating the social, economic, and environmental characteristics of the population
E. Questioning the availability of health services to the community
The core public health function of assessment includes the following:
· Engaging in activities that involve the collection, analysis, and dissemination of information on both the health and health-relevant aspects of a community or specific population
· Questioning, for example, whether the health services of the community are available to the population and are adequate to address needs
· Monitoring the health status of the community or population and the services provided over time
· Evaluating the social, economic, environmental, and lifestyle characteristics and practices of a population as well as the health services and capability available within the community to support good health for the population
DIF: Cognitive Level: Knowledge
REF: Page 8
The term "instructive district nursing" was coined in the nineteenth century to describe the relationship of nursing to: A. health education. B. home health care. C. settlement houses. D. visiting nurse services.
A. health education.
In 1886 in Boston, two women, to improve their chances of gaining financial support for their cause, coined the term “instructive district nursing” to emphasize the relationship of nursing to health education. Other nurses established settlement houses and neighborhood centers, which became hubs for health care and social welfare programs. Home health and visiting nursing evolved at a later time.
DIF: Cognitive Level: Knowledge
REF: Page 18
In the United States, the current system of the local government’s responsibility for providing care for the disenfranchised emerged from:
A. Elizabethan Poor Law
B. Florence Nightingale
C. Public Health Service (PHS)
D. Federal Emergency Relief Administration (FERA)
A. Elizabethan Poor Law
Colonial Americans established systems of care for the sick, poor, aged, mentally ill, and dependent based on the model of the Elizabethan Poor Law. Early county or township government was responsible for the care of all dependent residents, and they were strict about caring for their own residents. In 1918 the U.S. Public Health Service (USPHS) established a division of public health nursing to work in the war effort. The Federal Emergency Relief Administration (FERA) was established during the depression to support nurse employment through increased grants-in-aid for state programs of home medical care.
DIF: Cognitive Level: Knowledge
REF: Pages 15-16
Community-oriented nursing in the twenty-first century has been influenced by historical events and government initiatives that support the approach of: A. caring for the disenfranchised. B. illness care. C. keeping the public healthy. D. preventing acute illness.
C. keeping the public healthy.
The Healthy People program, recent disasters and acts of terrorism, and most recently the Patient Protection and Affordable Care Act of 2010 have brought renewed emphasis on prevention to public and community health nursing. During the late twentieth and early twenty-first century, challenges have continued to trigger growth and change in nursing in the community. Nurses continue to care for the vulnerable populations, provide illness care, and prevent acute illness while delivering care that is safe and high in quality.
DIF: Cognitive Level: Application
REF: Pages 27-28
In 1902 Lillian Wald introduced the concept of school nursing to address the problem of student absenteeism by:
A. enforcing the Department of Health’s rules and regulations.
B. excluding infectious children from the school environment.
C. providing and obtaining medical treatment for absent students.
D. providing shoes and clothing for absent students.
C. providing and obtaining medical treatment for absent students.
In New York City in 1897, school medical examination focused on excluding infectious children from school. By 1902, more than 20% of children might be absent from school on any given day because no one was focused on providing or obtaining medical treatment so that absent children could return to school. Lillian Wald introduced an English innovation by providing nurses for schools. The first school nurses made home visits to teach parents and provide follow-up care to children absent from schools.
DIF: Cognitive Level: Knowledge
REF: Page 19
The historical nursing figure who contributed to establishing the foundation for current community health and nursing in community health by working in military field hospitals using a population-based approach that improved nursing care and environmental conditions was: A. Florence Nightingale. B. Frances Root. C. Lillian Wald. D. Mary Breckinridge.
A. Florence Nightingale.
During the Crimean War (1854-1856), the British military established hospitals for sick and wounded soldiers in Scutari in Asia Minor. The care of the soldiers was poor, with cramped quarters, poor sanitation, lice and rats, not enough food, and inadequate medical supplies. When the British public demanded improved conditions, Florence Nightingale asked to work in Scutari. Because of her wealth, social and political connections, and knowledge of hospitals, the government sent her with a contingent of ladies, hired nurses, and hired servants to Scutari. Using simple epidemiology measures, she documented decreased mortality rates from the beginning of the war to the end of the war. Florence Nightingale progressively improved the soldiers’ health using a population-based approach that improved both environmental conditions and nursing care.
DIF: Cognitive Level: Knowledge
REF: Page 17