Community Nurse

Which of the following best
describes community-based nursing

a. A philosophy that guides family-centered illness care
b. Giving care with a focus on the group’s needs
c. Giving care with a focus on the aggregate’s needs
d. Having the goal of giving optimal care to all clients

Which of the following best
describes community-oriented nursing?

a. A practice that focuses on individuals and families
b. Giving care to manage acute or chronic conditions
c. Giving direct care to ill individuals within their family
setting
d. Having the goal of health promotion and disease
prevention

What is the unique primary focus
of public health nursing?

a. Families and groups
b. Illness-oriented care
c. Individuals in their families
d. Promotion of quality of life

Life expectancy increased dramatically during the twentieth century, primarily because of:

a. Findings from medical laboratory research
b. Incredible advances in surgical techniques and procedures
c. Sanitation and other public health activities
d. Use of antibiotics to fight infections

What is the preferred public
health approach to avoid premature deaths in America?

a. Increasing the public’s knowledge concerning hospice care
b. Influencing Americans’ lifestyle behavior choices
c. Requiring employers to have wellness centers in each industrial site
d. Requiring that all prospective parents receive
appropriate prenatal care
e. Timely and effective medical intervention and treatment

What action would be most
typical of a public health nurse?

a. The nurse asks community leaders what interventions should be chosen.
b. The nurse assesses the community and decides on
appropriate interventions.
c. The nurse uses data from the main health care
institutions in the community to determine needed health services.
d. The nurse works with community groups to create policies to improve the community’s environment.

How is an aggregate
defined?

a. A large group of persons
b. A collection of individuals and families
c. A group of persons who share one or more characteristics
d. Another name for demographic group

A registered nurse (RN) was just employed as a public health nurse. Which question might be very relevant as the nurse begins employment?

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. “Who is the nursing assistant to whom I can refer
patients?”

When an RN talked to the women at the senior citizens’ center, the nurse reminded them that the only way the center would be able to afford a driver and van service for those who could no longer drive themselves would be to continue to write letters to their local city council representatives requesting funding for such a service. What was the nurse trying to accomplish?

a. Ensuring that the women did not expect the nurse to solve their problem
b. Demonstrating that the nurse understood the women’s concerns and needs
c. Expressing empathy, support, and concern
d. Helping the women engage in political action

What is a basic assumption of public health efforts?

a. Any 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.

Which public health nurse is most clearly fulfilling responsibilities?

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.

The nurse often has to make resource allocation decisions. What best describes the criterion the nurse
should use in such cases?

a. A specific moral or ethical principle
b. The cheapest, most economical approach
c. The most rational probable outcome
d. The needs of the aggregate rather than a few individuals

Which action best represents public health nursing?

a. Assessing the effectiveness of the large high school
health clinic
b. Caring for clients in their home after their outpatient
surgeries
c. Giving care to children and their families at the school clinic
d. Following up care for pediatric clients at an outpatient clinic

Which public health service represents secondary health prevention?

a. Developing a health education program on the dangers of smoking
b. Providing a diabetes clinic for adults in low-income
housing
c. Providing an influenza vaccination program in a community retirement village
d. Teaching school-age children about the positive effects of exercise

It is very clear to the public health nurse what needs to be done and where to begin to improve the health of
a certain community. So why does this nurse spend time meeting with community groups to discuss what is 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

Two nurses plan to walk under a huge downtown bridge where various homeless persons live. Why would the two nurses go to such an unsafe area?

a. To assess 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 their members need to contribute

What variables have led to a stronger commitment to population-focused services? Select all that apply.

a. Economic turmoil and demand for high-technology care
b. Emergence of new or drug-resistant infectious diseases
c. Emphasis on overall health care needs rather than only on acute care treatment
d. Need to reduce constantly increasing costs of health care
e. Threat of bioterrorism and recent weather disasters
f. Widespread weather disasters (hurricanes, floods) with concurrent illnesses

What actions would demonstrate effective public health nursing practice in the community? Select all that
apply.

a. Epidemiologic investigations examine the environment for health hazards.
b. New services are organized where particular vulnerable populations live.
c. Partnerships are established with community coalitions.
d. Staff members at the public health agency continue to increase in number.
e. The emergency department continues to see more patients each week.
f. The nurses continue to make presentations at the city
council about health needs.

Why are nurses increasingly providing care in clients’ homes rather than in hospitals? Select all that apply.

a. Home care is less expensive.
b. It is much more efficient to give care in the home.
c. Nurses prefer to give home care with individual
attention.
d. People prefer to receive care in their homes rather than in hospitals.
e. People expect hospital staff to act like those in TV dramas and are invariably disappointed.
f. Physicians find it more convenient to visit in the home to educate families about client care.

What is an important reason to study nursing history?

a. Fulfill state board of nursing requirements
b. Help meet the necessary credit hours for graduation
c. Meet accreditation requirements
d. Understand the present and plan for tomorrow

Why is public health nursing appealing to many nurses?

a. Its autonomy and independence
b. Its focus on acute care and immediately visible outcomes
c. The backup support of other health care professionals
d. The rapport among the nursing staff

Which of the following accurately describes the first people to give care in hospitals?

a. Feudal lords used servants with the goal of keeping their peons working.
b. Small towns hired men to care for their citizens.
c. The military employed local men with the goal of enabling soldiers to keep fighting.
d. Religious women in urban areas cared for the sick, poor, and neglected.

How did the Industrial Revolution result in previous caregiving approaches, such as care by families, friends, and neighbors, becoming inadequate?

a. Economic and political wars resulted in frequent death and injuries.
b. Incredible plagues consistently and constantly swept the European continent.
c. Migration and urbanization resulted in increased demand for care.
d. Caregivers could easily find other employment, so they demanded to be paid.

What event most notably changed health care?

a. Florence Nightingale created the discipline of nursing.
b. Nuns formed into Sisterhoods, who gave care.
c. The order of Sisters of Mercy was established in Dublin.
d. St. Vincent de Paul formed the Dames de Charite.

Why did American citizens become interested in establishing government-controlled boards of health?

a. They were afraid of infectious diseases such as yellow fever.
b. The government could force the poverty-stricken to accept care.
c. Such boards could tax and thereby ensure adequate funds to pay for care.
d. Such a system would allow for accurate records of births and deaths.

The Marine Hospital Service was established to protect seacoast cities from epidemics. This service evolved into which of the following?

a. A role model for all later hospitals, beginning in larger cities such as Philadelphia
b. The beginning of the Veterans Administration Medical System
c. The Centers for Disease Control and Prevention
d. The Public Health Service

What was the outcome of the Shattuck Report?

a. It began efforts to control alcohol and drug abuse, as well as tobacco use.
b. Environmental sanitation efforts became an immediate priority.
c. It eventually resulted in guidelines for modern public
health organization.
d. Local and state governments immediately established boards of health.

Which nurse is famous for creating public health nursing in the United States?

a. Florence Nightingale
b. Frances Root
c. Lillian Wald
d. Mrs. Solomon Loeb

What fact led Lillian Wald to suggest nurses practice in schools?

a. Over 20% of children were absent from school each day.
b. Nurses had to enter the schools to assess and care for the children of families receiving care in their homes.
c. Nurses needed employment, and hospitals did not want to increase their nursing staff.
d. It was less expensive to employ nurses in schools than physicians.

In what way did the National Organization for Public Health Nursing differ from all other nursing organizations?

a. Allowed LPNs as well as RNs to join the organization
b. Encouraged nurses who were not public health nurses to join
c. Included both nurses and their lay supporters
d. Used lottery methods to choose its leaders and officers

Why were nurses so unprepared for public health nursing in the early twentieth century?

a. Community health nursing had not yet been created as a field.
b. No one would teach the nurses how to engage in public health activities.
c. Nightingale’s textbook did not include content on public health nursing.
d. Nurses were educated in diploma schools, which focused on hospital nursing.

What was the major obstacle to expanding public health nursing during the epidemics and the war efforts in the early twentieth century?

a. Adequate funds were not available.
b. The American Red Cross was meeting the public health needs at the time.
c. Women did not want careers; they wanted to remain homemakers.
d. Women were in the military helping in the cause to win WWI.

Why did the Metropolitan Life Insurance Company establish and retain for several years the first community nursing health program for policyholders?

a. Creating such a service was the morally correct thing to do.
b. Employing nurses directly was less expensive than paying taxes to the city for the same purpose.
c. Having the company’s nurses make home visits increased worker morale.
d. Having public health nurses visit policyholders and their families led to a decline in policyholder deaths, thus lowering costs for the insurance company.

What effect did the passage of the Social Security Act have on nurses?
a. Funding was made available for nurses to learn public health.
b. Funds were available for expanding hospitals (size of hospital and number of beds).
c. Government monies would pay for hospital care of
low-income persons.
d. More elderly persons demanded home health care from nurses.

What is the most crucial factor that determines which programs community agencies emphasize?

a. Comprehensive assessment and planning done in the
community
b. Documented needs of the local community
c. Federal funding for priority diseases or groups
d. Nursing staff’s expertise and skills

During World War II incredible numbers of nurses volunteered for the war effort, resulting in fewer nurses in the United States. How did hospitals and visiting nurse agencies cope with the shortage?

a. Closed many hospital units due to lack of staff
b. Increased benefits to nurses who would renew their
employment contracts
c. Offered high salaries and bonuses to nurses who accepted employment
d. Used nurse’s aides and other nonprofessionals to give care

How did Florence Nightingale help bring about community health nursing? Select all that apply.

a. She convinced socially prominent wealthy women to
volunteer to give care.
b. She focused on all soldiers and their environment.
c. She interacted with each individual person, assessing his or her needs and acting to meet those needs.
d. She kept careful records on what was done and what were the results.
e. She promoted health using nutrition, rest, and hygienic measures.
f. She stressed the importance of keeping the ill soldiers together so they could support each other emotionally.

The Maternity and Infancy Act provided funds for maternal and child health divisions in state health
departments and clearly saved many lives. Why was the program ended? Select all that apply.

a. All newborns were essentially healthy following education to mothers.
b. Most states didn’t feel a need for such a program in
their state.
c. States disagreed with the federal government concerning the amount of matching funds to be contributed by the states.
d. The AMA felt the federal government was encroaching on medical practice.
e. The AMA charged that the program was too much like socialized medicine.
f. There were too few trained nurses to staff all the
programs.

For what activities is Mary Breckinridge remembered? Select all that apply.

a. She created the first home nursing program in the Western states.
b. She established the Frontier Nursing Service.
c. She increased nursing’s efforts to care for the urban
poor.
d. She introduced the first nurse-midwives in the United States.
e. She obtained the initial donations allowing the first
efforts in home health care outside major cities.
f. She was the first nurse employee of the Vermont Marble Company, thereby becoming the first occupational health nurse.

How did nursing education change in the 1950s? Select all that apply.

a. Baccalaureate nursing programs typically included public health nursing concepts.
b. Diploma schools of nursing continued to expand their student numbers.
c. Junior and community colleges began offering nursing programs.
d. Nurses were strongly encouraged to have a scientific basis for their practice.
e. Research became a required course in all nursing
programs.
f. The need for more education (more credits) to complete a nursing major became obvious.

How did health care and its delivery change during the 1980s? Select all that apply.

a. Funding to public health increased as funding for acute hospital care decreased.
b. Laws began to be passed that discouraged the use of alcohol, drugs, and tobacco.
c. Nurse practitioners were increasingly used to provide care.
d. Public health programs suffered reduced political
support, financing, and effectiveness.
e. The National Center for Nursing Research (NCNR) was established.
f. Use of health maintenance organizations was encouraged.

How would you describe ideal primary health care?

a. Based on a multidisciplinary group of health care
providers that work as a team
b. Essential care available to all community members, which encourages self-management and self-reliance
c. Focused on health promotion and disease prevention for everyone enrolled in the health center
d. Local efforts to meet the Declaration of Alma Ata principles

What is the United States’ approach to the primary health care movement, which includes health policies, social and economic development, and provision of health care?

a. Cooperates fully with member World Health Organization nations in implementing the plan internationally
b. Disagrees that the goal of health is for all citizens to
live socially and economically productive lives
c. Enthusiastically endorses and has attempted to implement the goals in every way possible
d. Has focused primarily on disease prevention and health promotion in selected areas

Medicaid is increasingly using a managed care (MC) model in caring for enrollees. How does this model attempt to control costs of care?

a. By requiring families to use the point of service list of individual practice associates
b. By requiring families to choose a care provider from the MC network and not allowing access to other services without their provider’s permission
c. By moving Medicaid-eligible families onto state Medicare enrollment
d. By refusing permission for families to use urgent care or emergency department services

What determines which health care services are offered at the local level in public health clinics?

a. Local public health clinics are restricted to those
services allowed by federal legislation.
b. Local public health clinics may offer whatever services local taxpayers are willing to pay for.
c. Local public health clinics must follow the recommendations of Healthy People 2010.
d. Local public health clinics must offer whatever services the state mandates they offer.

Which government agency attempts to ensure delivery of health care to communities or aggregates that are
medically underserved?

a. Administration for Children and Families
b. Centers for Disease Control and Prevention
c. Health Resources and Services Administration
d. The National Institutes of Health

Which national agency’s mission is to conduct research on patient care outcomes?

a. Agency for Health Care Research and Quality
b. Federal Agency for Patient Care Outcomes
c. National Center for Nursing Research
d. U.S. Agency for Patient Care Effectiveness

How is the Department of Agriculture promoting the health of U.S. citizens?

a. By collecting surplus food left after mechanical harvests and distributing it to the poor
b. By inspecting food, so no foodborne illnesses can occur
c. In collaboration with others, by providing food or food stamps to needy persons
d. Through direct education and grants to dietitians and nutritionists

Local, state, and federal governmental agencies have started to cooperate and collaborate more closely in
the last few years because of:

a. Administrative pressures to demonstrate improvement in outcomes
b. The need to focus on emergency preparedness and response
c. Taxpayers’ complaints and general unhappiness
d. Pressure to decrease overlap in services and thereby decrease costs

What have managed care organizations done to better balance consumer and purchaser demands and still
maintain their profits?

a. Created alliances, mergers, and joint cooperative
ventures while downsizing
b. Engaged in massive marketing campaigns to increase the number of employers using them
c. Publicized awards and recognition to encourage consumers to demand to use their facilities
d. Purchased newspaper, radio, and TV time to share the problems that they are having in meeting everyone’s demands

The American Nurses Association (ANA) has strongly encouraged reform based on what principle?

a. Electronic medical records and other high-technology interventions to reduce nursing time, effort, and medical errors must be expanded.
b. Nurses must be recognized and rewarded for health
promotion efforts.
c. Nursing research into patient care outcomes must be expanded and funded.
d. We must implement universal access to essential health services for all citizens.

How would health care in the United States be most accurately described?

a. A logical rational approach to meeting expressed needs while still trying to control costs
b. A system in the process of reform as problems have become increasingly apparent
c. Private health care for those with insurance or money and public health care for those without either
d. The best in the world with outstanding research and
high-technology care available to all

Based on previous research, what might be an effective approach to increase enrollment in SCHIP?

a. Explaining the program to children enrolled in public
school systems
b. Handing out SCHIP applications to uninsured children seen in local hospital emergency departments
c. Having a newspaper campaign with information and
applications printed in the newspaper
d. Sending literature about the SCHIP program home with school children each year

Which of the following statements are accurate descriptions of current social and economic trends in
the United States? Select all that apply.

a. Citizens are appreciating the quality of life enjoyed in the United States.
b. Enjoying life is not as important as the need to take
care of oneself.
c. Many families are seeing decreases in family income.
d. Massive and unexpected social and economic changes have occurred.
e. Public health and preventive health care (health
promotion) have become very important.
f. The gap between the richest and the poorest in the United States is becoming narrower.

What do demographic figures suggest about the ways in which the population of the United States is changing? Select all that apply.

a. Approximately 12% of the U.S. population was born in a different country.
b. Hispanics are the largest minority group population.
c. Households consisting primarily of intact families
continue to grow.
d. Mortality for both genders in all age-groups declined.
e. Of the foreign born, most are from Asia.
f. Overall the population of the United States is declining.

Which of the following are evidence that the U.S. health care system is in crisis? Select all that apply.

a. Full-time employees may not have health insurance as a benefit.
b. Incompetent or negligent nurses are an ongoing source of medical errors.
c. Long work hours and provider fatigue are a major factor in medical errors.
d. More punitive measures must be taken to decrease provider errors.
e. The United States spends more on health care than any other country in the world.
f. Universities are not making any effort to expand educational programs for health care providers.

What functions do state health departments typically provide? Select all that apply.

a. Administering Medicaid
b. Assessing the health needs of the state’s citizens
c. Employing and supervising school health nurses
d. Establishing and maintaining free clinics for HIV-positive drug abusers
e. Licensing facilities and personnel
f. Regulating the health insurance industry