Community - Week 4 (Ch 12 13 16) - Evolve Questions Flashcards
Migrant workers and their families who reside in a specific mobile home park during the summer months would best be classified as a: A. community. B. group. C. setting of practice. D. target population.
A. community.
In most definitions the concept of community includes people, place/time, and function. Nurses in community health practice regularly need to examine how the personal, geographic, and functional dimensions of community shape their nursing practice with individuals, families, and groups. They can use both a conceptual definition and a set of indicators for the concept of community in their practice. The community is first the setting for practice for the nurse practicing health-promotion and disease-prevention interventions with individuals, families, and groups. Second, the community is the target of practice for the public health nurse whose practice is focused on the broader community rather than on individuals.
DIF: Cognitive Level: Application
REF: Page 212
A nurse in community health contacts three individuals who have had sexual encounters with an individual recently diagnosed with syphilis. The concept basic to community-oriented nursing practice that is best described by this intervention is: A. community. B. community as client. C. individual as client. D. partnership.
B. community as client.
When the community is the client, the results of nursing interventions should produce changes that affect the community as a whole, such as reducing the spread of sexually transmitted diseases (STDs). Although the nurse may work with individuals, families or other interacting groups, aggregates, institutions, or communities, or within a population, the resulting changes are intended to affect the whole community. The community health nurse is not providing care to an individual in this circumstance. It would be ideal if there were some form of partnership in this intervention.
DIF: Cognitive Level: Application
REF: Pages 213-214
The nurse in community health reviews the monthly and year-to-date health service use report for the local community to monitor trends as correlates of the community's health. The nurse is viewing community health through the dimension of: A. partnership. B. process. C. status. D. structure.
D. structure.
Community health has three dimensions: status, structure, and process. The dimension of structure would define the community’s health in terms of community characteristics such as services and resources. Community health in terms of status, or outcome, is the most well-known and accepted approach; it involves biological, emotional, and social parts. The view of community health as the process of effective community functioning or problem solving is well established. In population-centered practice, the nurse and community seek healthful change together.
DIF: Cognitive Level: Application
REF: Page 215
A Hispanic outreach program works with the nurse in community health to train Hispanic health care workers in providing basic services and education within the local Hispanic community. The concept basic to community-oriented nursing practice that is best described by this intervention is: A. community. B. community client. C. community health. D. community partnerships.
D. community partnerships.
Community partnership is necessary because when there is community partnership lay community members have a vested interest in the success of efforts to improve the health of their community. Most changes must aim at improving community health through active partnerships between community residents and health workers from a variety of disciplines. Partnership, as defined here, is a concept that is as essential for nurses to know and use as are the concepts of community, community as client, and community health.
DIF: Cognitive Level: Application
REF: Pages 215-216
While conducting a community health assessment, a nurse in community health meets with local religious leaders to understand the values, norms, perceived needs, and influence structures within the community. This process of data collection can best be described as: A. data gathering. B. data generation. C. data interpretation. D. problem identification.
B. data generation.
Data generation in a community health assessment is the process of developing data that do not already exist through interaction with community members, individuals, families, and groups, such as community knowledge and beliefs, values, goals, perceived needs, norms, problem-solving processes, power, leadership, and influence structures. This activity parallels the assessment phase of the nursing process. Data gathering is the process of obtaining existing, readily available data. Data interpretation is conducted in the analysis phase. All of the steps will assist the nurse in problem identification.
DIF: Cognitive Level: Application
REF: Page 219
Two nurses in community health schedule a day to ride through a low-income community to better understand the community and its boundaries, trends, rhythm, stability, and changes that can affect the health of that community. This direct data collection method is often referred to as: A. composite database. B. participant observation. C. secondary analysis. D. windshield survey.
D. windshield survey.
Five useful methods of data collection are informant interviews, participation observation, windshield survey, secondary analysis of existing data, and surveys. Windshield surveys are the motorized equivalent of simple observation. While driving a car or riding public transportation, the nurse can observe many dimensions of a community’s life and environment through the windshield. A basic method is participant observation, the deliberate sharing, if conditions permit, in the life of a community. In secondary analysis, the nurse uses previously gathered data, such as minutes from community meetings.
DIF: Cognitive Level: Application
REF: Page 220
The nurse in community health identifies an elder abuse problem because of caregiver stress among families in the local community resulting from lack of caregiver support services. The next step in the community-oriented nursing process would be to: A. analyze the community problem. B. establish priorities. C. establish goals and objectives. D. identify intervention activities.
A. analyze the community problem.
After the identification of the community problem(s), the planning phase of the community-oriented nursing process should begin with an analysis of the problem to seek clarification on the nature of the problem, its origins and effects, intervention points, interested parties/change agents, direct and indirect contributing factors, outcomes of the problem, and relationships between problems. Once high-priority problems are identified, relevant goals and objectives are developed, followed by the identification of intervention activities.
DIF: Cognitive Level: Application
REF: Page 223
A nurse in community health is invited to work with a coalition of churches to address safety concerns for children in the local community. The nurse provides training in problem-solving skills, manages conflict, facilitates the process, and provides expertise in interpreting data. This nurse has chosen the implementation role of: A. change agent. B. change partner. C. group leader. D. data collector.
B. change partner.
Content-focused roles often are considered change agent roles, whereas process roles are change partner roles. Change partner roles include enabler-catalyst, teacher of problem-solving skills, and activist advocate. Different roles may be required if the community lacks problem-solving skills or has a history of unsuccessful change efforts. The nurse may have to focus on developing problem-solving capabilities or on making one successful change so that the community becomes empowered to take on the job of promoting change on its own behalf.
DIF: Cognitive Level: Application
REF: Page 226
The nurse in community health defines goals and measurable objectives during the planning phase of a community health intervention. This also marks the beginning of the: A. evaluation phase. B. implementation phase. C. needs assessment. D. problem analysis.
A. evaluation phase.
Evaluation begins in the planning phase, when goals and measurable objectives are established and goal-attaining activities are identified. After implementing the intervention, only the accomplishment of objectives and the effects of the intervention activities have to be assessed. The nurse will evaluate whether the objectives were met and whether the intervention activities were effective.
DIF: Cognitive Level: Application
REF: Page 227
Which of the following best supports the concept of community-oriented nursing practice? (Select all that apply.)
A. Direct nursing care of individuals with tuberculosis (TB)
B. Hospice home care for a terminally ill individual and family
C. Nursing interventions to stop elder abuse
D. Nutrition education programs for teenagers and their families
E. Wound care for a homebound individual
A. Direct nursing care of individuals with tuberculosis (TB)
C. Nursing interventions to stop elder abuse
D. Nutrition education programs for teenagers and their families
Nurses who have a community orientation are often considered unique because of their target of practice. When the location of practice is the community and the focus of practice is the individual or family, the client remains the individual or family, and the nurse is practicing in the community as the setting; this is an example of community based nursing practice. Community-oriented nursing interventions should result in changes that are intended to affect the whole community.
DIF: Cognitive Level: Application
REF: Page 223
A community health nurse involved in care management would most likely:
A. develop, conduct, and evaluate health teaching programs in primary care.
B. manage the staff at a free clinic.
C. monitor the health status, resources, and outcomes for an aggregate.
D. provide immunizations to migrant workers.
C. monitor the health status, resources, and outcomes for an aggregate.
Care management is an enduring process in which a care manager establishes systems and monitors the health status, resources, and outcomes for an aggregate or a targeted segment of the population or a group. Care management strategies include use management, critical paths, disease management, demand management, and case management.
DIF: Cognitive Level: Knowledge
REF: Page 233
When acting as a mediator, the nurse advocate would:
A. choose a new health plan for a client with limited funds.
B. assist new parents in communicating with their health plan regarding well-baby coverage.
C. provide health education to teens who need knowledge about sexually transmitted diseases.
D. set up a doctor’s appointment for an illiterate adult.
B. assist new parents in communicating with their health plan regarding well-baby coverage.
Mediation is an activity in which a third party attempts to provide assistance to those who may be experiencing a conflict in obtaining what they desire. The goal of the nurse advocate as mediator is to help parties understand each other on many levels so that agreement on an action is possible.
DIF: Cognitive Level: Application
REF: Page 239
A parent involved in conflict resolution with her teenager says, "I know that some of your friends stay out until midnight, but I think it is best if you are in at 10 o'clock." This statement, a behavior seen in conflict situations, is an example of: A. negotiation. B. cooperation. C. assertiveness. D. aggressiveness.
C. assertiveness.
Assertiveness is the ability to present one’s own needs and is a behavior often seen in conflict situations. Negotiating is a strategic process used to move conflicting parties toward an outcome. Cooperation is the ability to understand and meet the needs of others. Aggressiveness is a behavior which may be exhibited in a conflict situation.
DIF: Cognitive Level: Application
REF: Page 242
A case manager is concerned that some of the clients at the neighborhood clinic are getting fewer services because of their financial situations. The case manager is confronting the ethical principle of: A. justice. B. veracity. C. deontology. D. beneficence.
D. beneficence.
Beneficence can be influenced when excessive attention to cost supersedes or impairs the nurse’s duty to provide measures to improve health or relieve suffering. Justice, as an ethical principle for case managers, considers equal distribution of health care with reasonable quality. Veracity, or truth telling, is absolutely necessary to the practice of advocacy and building a trusting relationship with a client. Deontology is not an ethical principle that applies to this situation.
DIF: Cognitive Level: Application
REF: Page 245
A community health nurse is working with an uninsured family with two children. The nurse assists the parents in applying for SCHIP benefits and securing an appointment for the children with a community pediatrician that participates in SCHIP. The intervention can best be described as: A. care management. B. case management. C. continuity of care. D. disease management.
B. case management.
Case management is identified as one of the 17 interventions in the scope of practice in community health nursing. Case management is defined as the ability to optimize self-care capabilities of individuals and families and the capacity of systems and communities to coordinate and provide services. Case management, in contrast to the definition of care management, refers to activities implemented with individual clients in a system. Care management includes the concept of disease management.
DIF: Cognitive Level: Application
REF: Page 233
