Chapter 01: Community- and Prevention-Oriented Practice to Improve Population

Health

Stanhope: Foundations for Population Health in Community/Public Health Nursing,

5th Edition

MULTIPLE CHOICE

1. Which of the following best describes community-based nursing?

a. A practice in which care is provided for individuals and families

b. Providing care with a focus on the group’s needs

c. Giving care with a focus on the aggregate’s needs

d. A value system in which all clients receive optimal care

ANS: A

By definition, community-based nursing is a setting-specific practice in which care is

provided for “sick” individuals and families where they live, work, and attend school. The

emphasis is on acute and chronic care and the provision of comprehensive, coordinated, and

continuous care. These nurses may be generalists or specialists in maternal–infant, pediatric,

adult, or psychiatric mental health nursing. Community-based nursing emphasizes acute and

chronic care to individuals and families, rather than focusing on groups, aggregates, or

systems.

2. Which of the following best describes community-oriented nursing?

a. Focusing on the provision of care to individuals and families

b. Providing care to manage acute or chronic conditions

c. Giving direct care to ill inNdivRiduaIls wGithBin.thCeirMfamily setting

d. Having the goal of health promotion and disease prevention

ANS: D

By definition, community-oriented nursing has the goal of preserving, protecting, or

maintaining health and preventing disease to promote the quality of life. All nurses may focus

on individuals and families, give direct care to ill persons within their family setting, and help

manage acute or chronic conditions. These definitions are not specific to community-oriented

nursing.

3. Which of the following is the primary focus of public health nursing?

a. Families and groups

b. Illness-oriented care

c. Individuals within the family unit

d. Health care of communities and populations

ANS: D

In public health nursing the primary focus is on the health care of communities and

populations rather than on individuals, groups, and families. The goal is to prevent disease and

preserve, promote, restore, and protect health for the community and the population within it.

Community-based nurses deal primarily with illness-oriented care of individuals and families

acorss the life span. The aim is to amanage acute and chronic health conditions in the

community, and the focus of practice is on individual or family-centered illness care.

Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank

4. Which of the following is responsible for the dramatic increase in life expectancy during the

20th century?

a. Technology increases in the field of medical laboratory research

b. Advances in surgical techniques and procedures

c. Sanitation and other population-based prevention programs

d. Use of antibiotics to fight infections

ANS: C

Improvements in control of infectious diseases through immunizations, sanitation, and other

population-based prevention programs led to the increase in life expectancy from less than 50

years in 1900 to more than 78 years in 2013. Although people are excited when a new drug is

discovered that cures a disease or when a new way to transplant organs is perfected, it is

important to know about the significant gains in the health of populations that have come

largely from public health accomplishments.

5. A nurse is developing a plan to decrease the number of premature deaths in the community.

Which of the following interventions would most likely be implemented by the nurse?

a. Increase the community’s knowledge about hospice care.

b. Promote healthy lifestyle behavior choices among the community members.

c. Encourage employers to have wellness centers at each industrial site.

d. Ensure timely and effective medical intervention and treatment for community

members.

ANS: B

Public health approaches could help prevent premature deaths by influencing the way people

eat, drink, drive, engage in exercise, and treat the environment. Increasing knowledge of

hospice care, encouraging on-site wellness centers, and ensuring timely treatment of medical

conditions do not address theNfUocRusSoIfNimGpTroBv.inCgOovMerall health through health promotion

strategies. This is the major method that is suggested to decrease the incidence of premature

death.

6. Which of the following is a basic assumption of public health efforts?

a. Health disparities among any groups are morally and legally wrong.

b. Health care is the most important priority in government planning and funding.

c. The health of individuals cannot be separated from the health of the community.

d. The government is responsible for lengthening the life span of Americans.

ANS: C

Public health practice focuses on the community as a whole, and the effect of the

community’s health status (resources) on the health of individuals, families, and groups. The

goal is to prevent disease and disability and promote and protect the health of the community

as a whole. Public health can be described as what society collectively does to ensure that

conditions exist in which people can be healthy. The basic assumptions of public health do not

judge the morality of health disparities. The focus is on prevention of illness not on spending

more on illness care. Additionally, individual responsibility for making healthy choices is the

directive for lengthening life span not the role of the government.

7. Which of the following actions would most likely be performed by a public health nurse?

a. Asking community leaders what interventions should be chosen

b. Assessing the community and deciding on appropriate interventions

c. Using data from the main health care institutions in the community to determine

Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank

needed health services

d. Working with community groups to create policies to improve the environment

ANS: D

Although the public health nurse might engage in any of the tasks listed, he or she works

primarily with members of the community to carry out core public health functions, including

assessment of the population as a whole and engaging in promoting health and improving the

environment. The interventions of asking community leaders which interventions should be

chosen, asessing the community and deciding on appropriate interventions, and using data

from health care institutions do not demonstrate the engagement of the community when

making decisions about what the community actually wants and needs.

8. Which of the following public health nurses most clearly fulfills the responsibilities of this

role?

a. The nurse who met with several groups to discuss community recreation issues

b. The nurse who spent the day attending meetings of various health agencies

c. The nurse who talked to several people about their particular health concerns

d. The nurse who watched the city council meeting on local cable television

ANS: B

Any of these descriptions might represent a nurse communicating, cooperating, or

collaborating with community residents or groups about health concerns. However, the nurse

who spent the day attending meetings of various health agencies is the most representative,

because in public health, concerns are addressed from a broader perspective. In public health,

broad concerns of the community should be addressed. Concerns are broader than recreation,

individual concerns are not as important as aggregate priorities, and watching television (a

one-way form of communication) is less effective than interacting with others.

NURSINGTB.COM

9. Which of the following best defines aggregate?

a. A large group of persons

b. A collection of individuals and families

c. A collection of people who share one or more characteristics

d. Another name for demographic group

ANS: C

An aggregate is defined a collection of people who share one or more personal or

environmental characteristics. Members of a community can be defined in terms of either

geography (e.g., a county, a group of counties, or a state) or a special interest (e.g., children

attending a particular school). These members make up a population. The term population

may be used interchangeably with the term aggregate. A large group of persons, a collection

of individuals and families, and another name for demograhpic group are not accurate

definitions of the term aggregate.

10. A registered nurse was just employed as a public health nurse. Which question would be the

most relevant for the nurse to ask?

a. “Which groups are at the greatest risk for problems?”

b. “Which patients should I see first as I begin my day?”

c. “With which physicians will I be most closely collaborating?”

d. “With which nursing assistants will I partner the most?”

ANS: A

Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank

U S N T O

Asking which groups are at greatest risk reflects a community-oriented perspective. The

incorrect responses reflect a focus on individuals rather than a community-oriented

perspective.

11. Making sure that essential community-oriented health services are available defines which of

the core public health functions?

a. Policy development

b. Assessment

c. Assurance

d. Scientific knowledge-based care

ANS: C

Assurance includes making sure that essential community-oriented health services are

available in the community. The definition does not fit the terms assessment, policy

development. Scientific knowledge-based care is not a core function of public health.

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.

12. When talking to a women’s group at the senior citizens’ center, the nurse reminded them that

the only way the center would be able to afford to provide transportation services for them

would be for them to continue to write letters to their local city council representatives

requesting funding for such a service. What was the nurse trying to accomplish through this

action?

a. Ensure that the women did not expect the nurse to solve their problem.

b. Demonstrate that the nursNe uRnderIstooGd tBhe.wComMen’s concerns and needs.

c. Express empathy, support, and concern.

d. Help the women engage in political action.

ANS: D

Public health nurses engage themselves and others in policy development and encourage and

assist persons to communicate their needs to those with the power to take action. The nurse is

demonstrating the role of advocate through this action, it goes beyond merely understanidng

the women’s concern, and instead mobilizes them to take action. This action does not

demonstrate the nurse showing empathy rather the nurse is empowering these women.

13. The public health nurse has a clear vision of what needs to be done and where to begin to

improve the health of the community. Why would the nurse spend time meeting with

community groups to discuss the most important task to be addressed first?

a. To increase the group’s self-esteem

b. To maintain communication links with the groups

c. To make the groups feel good about their contribution

d. To work with the groups, not for the groups

ANS: D

Foundations for Population Health in Community Public Health Nursing 5th Edition Stanhope Test Bank

Historically, health care providers have been accused of providing care for or to people

without actually involving the recipients in the decisions. Public health nursing is a “with the

people”—not a “to the people” or “for the people”—approach to planning. The purpose of

meeting with community groups is not to increase their self-esteem or make them feel good

about their contribution, rather it is to allow them to act for themselves to solve the problems

they are facing. The first task of working with the group should occur before addressing

maintaining communication links.

14. The nurse often has to make resource allocation decisions. Which of the following best

describes the criterion the nurse should use in such cases?

a. The specific moral or ethical principle related to the situation

b. The cheapest, most economical approach

c. The most rational probable outcome

d. The needs of the aggregate rather than a few individuals

ANS: D

The dominant needs of the population outweigh the expressed needs of one or a few people.

All of the choices represent components of a decision that the nurse might consider in

determining the needs of the aggregate.

15. Which of the following actions best represents public health nursing?

a. Assessing the effectiveness of the high school health clinic

b. Caring for clients in their home following their outpatient surgeries

c. Providing care to children and their families at the school clinic

d. Administering follow-up care for pediatric clients at an outpatient clinic

ANS: A

A public health or populationN-fUocRuSseIdNapGpTroBac.hCwOoMuld look at the entire group of children

being served to determine whether available services are effective in achieving the goal of

improving the health of the school population. Caring for clients and their families focuses on

individuals and families and not on the entire population. Public health focuses on care of

populations.

16. Two nurses plan to walk under a huge downtown bridge where various homeless persons live.

Why would the nurses go to such an unsafe area?

a. To assess the needs of the homeless who live there

b. To demonstrate their courage and commitment

c. To distribute some of their own surplus clothes to those who can use them

d. To share with various churches and other charities what is needed