Study Guide Test 1 Chapter 1 1. Which statement would best describe the similarities and differences between public health and community health. A) “Community health nursing is defined as nursing care that is provided in a community setting, rather than an institutional setting.” B) “Public health nursing is defined as nursing care that is provided in an institutional setting.” C) “Public health nursing is focused on the health of individuals.” D) “Community health nursing can shape the quality of community health services and improve the health of the general public.” (pg 3) 2. Which statement would best describe the difference between public health nursing and community health nursing. A) Public health nursing is focused on the private aspects of health, and community health nursing is focused on the public aspects of health. B) Community health practice refers to a focus on specific, designated communities and is a part of the larger public health effort. (pg 3) C) Public health nursing and community health nursing relate to the very same types of services and perspectives. D) Both public health nursing and community health nursing are practiced exclusively within institutions. 3. Which statement is most accurate about the concept of community. A) A community is a collection of people who share some important features of their lives. (pg 5) B) Community members live in the same geographic location. C) Community members are biologically related. D) A community is made up of people who do not necessarily interact with one another and do not necessarily share a sense of belonging to that group. 4. A) B) C) D) Which statement describes an aggregate. Members of a population share a sense of belonging. Communities and populations are types of aggregates. Individuals of a community are loosely connected. (page 7) Members of an aggregate share a strong bond. 5. A) B) C) D) Which is a community of common interest. The global community Small rural town in a northern state National professional organization (page 5) Counties addressing water pollution 6. A) B) C) What characterizes a community of solution. A health problem affecting the group (page 6) Common goal binding members together Sharing of a similar goal D) Locational boundaries 7. A) B) C) D) Which statement is accurate regarding the health continuum. The distinction between health and illness is well demarcated. Illness refers to a state of being relatively unhealthy. (page 9) The term health is limited to reflect an individual’s state. Treatment of acute conditions reflects the current focus of health care. 8. A) B) C) D) Which statement applies to the concept of the health continuum. Wellness is a relative concept, and illness is a state of being relatively unhealthy. (page 9) A client’s placement on the health continuum is static throughout time. Health is best described as cyclic. The health continuum can only be applied to individuals. 9. A) B) C) D) Which is an example of a health indicators. Cardiac disease Mental health (page 10) Sedentary lifestyle Respiratory disease 10. Which statement best describes the difference between health promotion and disease prevention. A) Health promotion and disease prevention include all efforts that seek to move people closer to optimal well-being or higher levels of wellness. B) Disease prevention differs from health promotion in that disease prevention is targeted toward a specific disease or diseases. (page 14-15) C) Health promotion can be described in terms of primary, secondary, and tertiary prevention. D) The goal of disease prevention is to raise levels of wellness for individuals, families, populations, and communities. 11.A health education program for a group of pregnant teens includes nutrition during pregnancy, helpful exercises, and concerns. This is an example of. A) health promotion (page 14) B) treatment of disorders C) rehabilitation D) evaluation 12.Which of the following activities are primary prevention. Select all that apply. A) Teaching about safe sex practices to high school students B) Encouraging older adults to install safety devices in the bathroom C) Providing regular immunization programs for communicable diseases (page 15) D) Participating in cholesterol screening programs at health fairs E) Providing skin testing for tuberculosis for children over 1 year of age F) Working with a group testing water samples for contamination 13.Which description of community health nursing is most characteristic. A) Focusing on addressing continuous needs B) Working with the client as an equal partner (page 21) C) D) Engaging in tertiary prevention as the priority Encouraging clients to reach out to the nurse 14.A community health nurse is working with other members of a team that will be implementing a citywide immunization program. The nurse coordinating a team’s services and addressing the needs of the population groups to demonstrate. A) involvement of the community B) client participation C) continuity of service (page 2,4) D) plan for follow-up 15.A community health nurse works to ensure the greatest good for the greatest number of people by applying. A) secondary prevention activities B) autonomy C) justice D) utilitarianism (page 18) 16.Using Healthy People 2020 which factor in a plan demonstrates that the targeted population understands the basic information provided during an educational session. A) Self-care B) Health disparities C) Health literacy (page 19) D) Episodic needs 17.Which would be crucial for the community health nurse to address as the priority when dealing with policymakers about the development of community health programs. A) Research-based best practices (page 17) B) Population’s make-up C) Amount of services to be provided D) Scarcity of the available resources 18.Which statement best describes the differences between acute care nursing and community health nursing. A) Use a reactive approach. B) Seek out potential health problems. (page 15) C) Concentrate on the illness end of the continuum. D) Emphasize curative care. 19. A) B) C) D) E) Which activities would be associated with a community health nurse Select all that apply. Examining infants in a city well-baby clinic Caring for elderly stroke victims in their homes Providing emergency care in an acute care facility Carrying out epidemiologic research Participating in health policy analyze (page 3) 20. A) How would the community health nurse define health. The absence of disease B) C) D) The potential to lead a productive life An environment free of toxins A holistic state of well-being (page 8) 21. A) B) C) D) Which client statement reflects an objective dimension of health. “I’m feeling better since I started taking that medication.” “Life is pretty good right now, except for an occasional upset stomach.” “I’m able to wash myself in the morning with just a bit of help.” (page 12) “Sometimes when I wake up, I don’t even want to face the day.” 22. A) B) C) D) Which one of the following is a population-oriented focus. Assess the groups’ relationships looking for a common need. (page 18) Consider the members individually for similarities. Focus on the geographical area of the population. Promote the groups’ dependency on improving health. 23. Which finding suggests that a city most likely needs additional programs. A) Citizens are actively involved in the city’s department of recreation and after-school programs. B) The construction of affordable organized housing developments and communities is nearing completion. C) Approximately one-third of the people are recently unemployed due to the closure of the automotive factory. (page 10) D) Several new recreational facilities for adults and children have been created at several locations. 24. A) B) C) D) E) F) Which actions are included in secondary prevention. Select all that apply. Participating in skin cancer screening programs at health fairs Encouraging parents to install safety devices in electrical outlets Providing annual flu vaccinations Participating in hypertension screening programs at health fairs Providing skin testing for tuberculosis for children over 1 year of age (page 15) Teaching college-age students about the importance of meningococcal vaccinations 25. A) B) C) D) E) F) Which actions are included in secondary prevention. Select all that apply. Encouraging monthly self-breast examinations during a women’s health fair Teaching parents to place infants on their backs to sleep Providing BMI measurements during a health fair Participating in cholesterol screening programs at health fairs (page 15) Educating high-risk community groups about the importance of exercise at a hypertension clinic Teaching elementary students about the importance of using “MyPlate” 26. A) B) C) D) E) F) Which actions are included in secondary prevention. Select all that apply. Encouraging monthly testicular self-examinations during a men’s health fair Teaching preschool children the importance of daily activity Providing height and weight measurements during a health fair Participating in diabetes screening programs at health fairs Educating high school students about safe sex practices Encouraging women to schedule yearly mammograms (page 15) 27. A) B) C) D) E) F) Which actions are included in tertiary prevention. Select all that apply. Developing a nutritional plan of care for clients with eating disorders Developing an exercise plan for COPD clients (page 15) Providing bicycle safety education during a health fair for children Participating in hypertension screenings at health fairs Participating in bone density screenings at health fairs Educating children on swimming safety 28. A) B) C) D) E) F) Which actions are included in tertiary prevention. Select all that apply. Providing a support group for breast cancer survivors Encouraging women to schedule yearly Pap smears Providing height and weight measurements during a health fair Participating in diabetes screening programs at health fairs Educating high school students about bullying Providing a community-based stroke rehabilitation program (page 15) 1. A) B) C) D) Chapter 2 Which statement made demonstrates an assurance activity. “I will be gathering and analyzing information that will affect the health of the people to be served.” “I should provide leadership in facilitating community groups toward meeting their needs and work toward making changes in existing laws.” “I should be involved in activities that ensure necessary services are being provided to the community.” (page 25) “I will be accessing relevant data that enable identification of strengths, weaknesses, and needs within the community.” 2. A) B) C) D) Which assessment action is most important for the community health nurse. Secure the trust of the clients. (page 33) Gather appropriate information. Interact with key community leaders. Use a variety of assessment tools. 3. A) B) C) D) Which activity is most likely involved in policy development. Monitoring health status to identify community health problems Empowering communities about important health issues (page 25) Linking individuals to needed personal health services Ensuring a competent health care workforce is available 4. Collaborating with local community leaders to prepare a community disaster plan is which function. Research Assurance (page 37) Policy development Assessment A) B) C) D) 5. A) B) C) D) 6. A) B) C) D) 7. A) B) C) D) 8. A) B) C) D) 9. Collecting data for several months on the birth weights of newborns to mothers who smoked throughout their pregnancy illustrates which role. Collaborator Manager Researcher (page 33) Clinician Working with police officers, social workers, health educators, and other nurses to promote the health of clients is which role. Clinician Educator Researcher Collaborator (page 32) Activities that the nurse would is involved in are making home visits to families, holding immunization clinics for infants and children, and setting up flu shot clinics for elders. Which role is this. Educator Advocate Clinician (page 37) Manager Planning client care, leading a staff conference, and supervising a new staff member are which role. Advocate Manager (page 30) Collaborator Researcher A) B) C) D) Contacting the local department of social services to help a family attain healthcare assistance is which role. Educator Leader Clinician Advocate (page 37) 10. A) B) C) D) Which action best exemplifies the attributes of the researcher role. Gaining the trust and respect of the staff members Interpreting abstract ideas so others can understand Implementing a staff development program for a technique Evaluating the correlation between variables in specific health conditions (page 30) 11. A) Which statement about the role of educator is true. The educator role has the potential for finding greater receptivity and providing higher-yield results. (page 28) People are unable to recognize the value of health and are not well motivated to achieve higher levels of wellness. It is only possible for a nurse to reach a limited number of persons. B) C) D) The public’s higher level of health consciousness hinders the educator’s role. 12. A) B) Which statement about the importance of the role of collaborator is true. Community health nurses frequently practice in isolation. Successful community health practice depends on multidisciplinary collegiality and leadership. (page 32) Community health nurses must assert themselves as the most powerful person on the health care team to ensure each client receives services that are necessary. It is best for community health nurses to focus on what they, as nurses, can do for their clients. C) D) 13. A) B) C) D) 14. Which statement about the community health nurse’s selection and practice of each role is true. Within a given time, a community health nurse may practice multiple roles. The knowledge that vulnerable populations need someone to guide them through the complexities of the health care system and the nurse can serve as an advocate for them. (page 28) The researcher role for community health nurses involves only the use of quantitative statistics. The leadership role consists solely of managing staff. A) B) C) D) A community health nurse is involved in education, screening, referral, and support for the individuals of a specific religious congregation. The nurse is practicing in which setting. Occupational health nursing Faith community nursing School nursing (page 35) Residential institution nursing 15. A) B) C) D) Which statement is true regarding the home setting. The nurse acts primarily as an educator. The client is viewed within his or her environment. (page 35) Technologically advanced care is limited. The home is being used less frequently today. 16. A) B) C) D) Which facility as an example of ambulatory service setting. Local preschool Halfway house Continuing care center Family planning clinic (page 28) 17. A) B) C) Which of the following is false. “Occupational health nurses are increasing their role as employee advocates.” “Health education is a key function of the occupational health nurse.” “There is a now greater emphasis on the occupational health nurse’s role as a clinician.” (page 27) “Collaboration with other health care providers fosters the offering of better services.” D) 18. A) B) Working as a lobbyist for health legislation for AIDS research at the state capital is an example of which practice setting. Faith community Ambulatory service C) D) Residential institution Community at large (page 36) 19. A) B) C) D) Which statement is true regarding school nursing. “This role of the community health nurse is static in this setting.” “The primary role of school nurses is clinician.” “The practice of school nurses is widening.” (page 30) “School nurses rarely act as advocates.” 20. A) B) C) D) Which problem-solving activity would be most important for the nurse to address first when designing a community health fair. Planning (page 35) Organizing Leading Controlling 21. A) B) C) D) E) F) Which of the following are essential to the role of an advocate. Select all that apply. Assertiveness Ability to plan Ability to negotiate Risk taking (page 37) Holistic view Questioning attitude 22. A) B) C) D) E) F) Which activities apply to the nurse educator role. Select all that apply. Planning seven home visits today Working on a new curriculum for high-risk teens Meeting with colleagues to discuss organizational changes in the office Ordering pamphlets over the Internet to be used in a parenting class (page 37) Tabulating data from surveys distributed to elders during a flu shot clinic Going to social services to speak up for a family in his or her caseload 23. A) B) C) D) E) F) Which activities apply to the nurse manager role. Select all that apply. Orienting three new community health nurses in the agency Attending a strategy meeting for a new service the community will be offering Working with a team to direct a smoking cessation program in public areas Investigating an outbreak of Salmonella in the community Tabulating the findings of exploring immunization practices among teens Reviewing the staff evaluations to assist with planning future in-services (page 37) 24. A) B) C) D) Which community nurse role must be assumed in every situation. “A community health nurse assumes the role of researcher in each situation.” “A community health nurse assumes the role of manager in each situation.” (page 29) “A community health nurse assumes the role of leader in each situation.” “A community health nurse assumes the role of clinician in each situation.” 25. A) B) C) D) E) F) Which are core values of professional behavior that are unique to public health nursing. Select all that apply. Community/population as client Prevention Rehabilitation Partnership Healthy environment Diversity (page 26) 26. A) B) C) D) The local school board is which type of setting. Community at large (page 36) Residential institution Ambulatory service Faith community 27. A) B) C) D) A cardiac rehabilitation nurse practices in which setting. Residential institution Faith community Community at large Ambulatory service (page 36) 28. Which level of prevention incorporates information about the dangers of addiction in a community drug campaign. A) Primary (page 33) B) Secondary C) Tertiary D) Secondary and tertiary 29. A) B) C) D) A clinic on tribal lands is which practice setting. Faith community Ambulatory service (page 33) Residential institution Community at large 30. A) B) C) D) A juvenile group home is which type of setting. Faith community Ambulatory service Residential institution (page 36) Community at large 31. A) B) C) D) Providing health services to groups and populations is which role. Educator role Clinician role (page 27) Advocate role Manager role 32. Which behavior is consistent with the clinic nurse manager role. A) B) C) D) The nurse is providing health education to a group of type 2 diabetics. The nurse is initiating a new screening process for young children who have experienced trauma in the community. The nurse is making a referral to a food pantry for a client who is in need of food. The nurse collaborates with other members of the clinic to evaluate the utilization of resources offered by the clinic. (page 30) Chapter 5 1. A) B) C) D) Which minority group currently represents the largest group. African Americans Hispanic Americans (page 101) Asian Americans American Indians 2. A) B) C) D) To provide culturally sensitive care, the nurse should avoid. Ethnocentrism (page 111) Ethnorelativism Enculturation Ethnicity 3. D) What is the most serious negative effect of a nurse maintaining ethnocentric views but not recognizing or acknowledging this. The nurse fails to understand the views of other cultures because of his or her ethnocentrism. The nurse does not communicate effectively with members of other cultures because of his or her ethnocentrism. (page 101) The nurse’s ethnocentrism causes damage to interpersonal relationships and interferes with the effectiveness of nursing interventions. Nurses are immune to the effects of ethnocentrism. 4. A) B) C) D) Which statement links the concept of shared culture to previous culture knowledge acquired. “Culture can only be inherited, not acquired.” “Culture is a product of aggregate behavior.” (page 103) “Culture is interrelated and dependent.” “Culture is static.” 5. A) B) C) D) Which statement is true regarding the characteristics shared by all cultures. Culture is mostly unexpressed. (page 104) Cultures do not remain static. Culture is a functional and integrated whole. Patterns of cultural behavior are acquired. 6. A) Which statement is correct regarding an interpretation of cultural integration. “A person’s culture is an interrelated and interdependent web of ideas and practices.” (page 103) “In order to describe a person’s culture, it is necessary to describe each trait independently.” A) B) C) B) C) D) 7. A) B) C) D) 8. A) B) C) D) 9. A) B) C) D) 10. A) B) C) D) 11. A) B) C) D) 12. A) B) C) D) “Aspects of a person’s culture are best described as unrelated to other aspects of the person’s culture.” “A person’s culture is an assortment of various customs and traits.” What is the most important reason for the nurse to conduct a cultural assessment. Because it is often assigned by nursing faculty Because usually there is some culturally based reason that causes clients to engage in or avoid certain actions To meet the nurse’s professional learning needs Because understanding the values, beliefs, and practices of a designated cultural group is critical to effective nursing action (page 112) When developing an in-service program for a group of community health nurses about culture, which would the presenter expect to include. All members of a cultural group are alike. Intraethnic variations underscore a population’s cultural diversity. (page 111) Ethnicity has a major impact on the effectiveness of health care. Ethnocentric attitudes are key to working with different cultures. When applying the principles of transcultural nursing, which step must the nurse implement first. Cultivate cultural sensitivity. Develop cultural awareness. (page 110) Learn the client’s group culture. Demonstrate respect for culture. A community health nurse implements a plan of care that combines aromatherapy and acupuncture with medication therapy and surgery is. Holistic health care Folk medicine care Herbalistic health care Integrated health care (page 106) When providing transcultural nursing, which action would be the priority. Examining one’s own culture carefully and recognizing that alternative viewpoints are possible (page 111) Recognizing that cultural values, beliefs, and practices influence people’s health and lifestyles Obtaining health-related information about a cultural group concerning their values, beliefs, and practices Actively and attentively listening to demonstrate respect while learning about other cultures Which action must the nurse take first when working with different cultural groups as an advocate. Prepare to teach clients about the limits and benefits of cultural health practices. Assess the client or family adequately to ascertain their belief system and choices. Individualize caregiving for the client within his or her culture. Be knowledgeable about health care practices and choices. (page 96) 13. A) B) C) D) 14. A) B) C) D) 15. When working with immigrant groups in community health care, which action would be least appropriate. Permit ample time for interviewing to allow time to evaluate beliefs. Develop educational programs to correct misconceptions. Assume that the client has a basic understanding of health issues. (page 96) Ensure an appropriate interpreter for communication if needed. Which action would the nurse take to assist a client with acquiring medication he cannot afford. Ask the health care provider to prescribe a less expensive medication on behalf of the client. (page 109) Ask the health care provider which medications the client could have discontinued. Ask the client if the cultural health practices have a remedy the client could use instead. Contact the pharmaceutical sales representative for sample packs of medications. A) B) C) D) E) In 109 counties, white population share fell below 50% between 2000 and 2018. According the Pew Research Center, between 2000 and 2018, which areas of the United States fell below 50%. Select all that apply. Northeast Southeast Northwest Southwest (page 96) Midwest 16. A) B) C) D) E) Which areas are included to assess social inequities of living conditions. Select all that apply. Housing Arts Media Sexual behavior Life expectancy (page 97) 1. A) B) C) D) 2. A) B) C) D) E) Chapter 6 What was the impact of the Shattuck Report on community health care. “It influenced the speed with which health-focused bills pass the legislature.” “The report set up the organizational structure of the U.S. Public Health Service.” “It emphasized sanitary progress forming the basis for current public health practice.” (page 122) “It deemphasized the issues addressed in the Hebrew hygienic code.” An understanding of which changes affecting morbidity and mortality is needed for planning local services. Select all that apply. High levels of chronic disease Shortened life spans Increased teen pregnancies Abuse of multiple substances Multidrug-resistant diseases (page 123) 3. A) B) C) D) An official health agency differs from others in which way. Voluntary Publicly funded (page 132) Proprietary Privately funded 4. A) Which statement regarding the public health system and its structure and function is false. It offers consultation through national advisory health councils and special advisory committees made up of lay experts. The Public Health Service is ultimately responsible for it. The Secretary of Health and Human Services is an elected position. (page 125) A major function is to administer grants and contracts with other government agencies. B) C) D) 5. A) B) C) D) 6. A) B) C) D) 7. A) B) C) D) 8. A) B) C) D) E) Provision of care to clients in a clinic setting at the local health department is which core public health function. Clinical Assessment Policy development Assurance (page 125) Which one of the following describes a core public health function. Public health nurses practice as partners with other public health professionals within these core functions (page 125) Assessment involves the actual provision of services. Policy development relates to assessment. Assurance means that the public health agency must directly provide the needed services. Which group of actions fulfills the three core public health functions in their proper order. Counting the number of kindergarten students who are fully immunized, encouraging the school officials to exclude children who are not fully immunized, and offering immunization clinics at the school (page 125) Identifying a source of pollution in the community, educating local residents about precautions that should be taken when the pollution exceeds minimum standards, and asking legislators to apply sanctions to the responsible party for the source of pollution Providing prenatal care for pregnant adolescents, determining how many pregnant adolescents currently attend the school, and encouraging school officials to provide an alternative school setting for the pregnant adolescents Lobbying for a citywide ban on smoking in public, providing smoking cessation services in the community, and reviewing mortality data to determine the number of people in the community who die each year from lung cancer Which local voluntary agencies provide services for mothers and their high-risk children. Select all that apply. American Diabetes Association The U.S. Public Health Service The National Institutes of Health Women, Infant, and Children Program (WIC) National Society for Autistic Children (page 123) 9. A) B) C) D) Which one of the following describes the function of a public health agency. Most often have a very specific focus Responsible for promoting and protecting the health of everyone (page 125) Limits employment to nurses and environmental health practitioners Works independently with complete autonomy 10. Which one of the following statements is correct. A)PAHO is a separate agency from WHO. B)UNICEF promotes child and maternal health and welfare globally. (page 134) C)WHO focuses primarily on developing countries. D)USAID is a temporary emergency program. 11. Which legislation resulted in decreasing federal government involvement. A)Social Security Act B)Medicare/Medicaid C)State Children’s Health Insurance Program D)Omnibus Budget Reconciliation Act (page 156) 12. What is the focus of the Social Security Act. A)Increased availability of public health programs (page 134) BIncreased privacy of client information C)Increased services to the poor D)Expanded coverage for children 13. Which is an effect of macroeconomics on health care. A)Quantity of services available B)Consumer’s willingness to buy services C)Comparison of health care spending between two entities (page 138) D)Allocation of the available resources 14. Which points are important regarding Medicare. Select all that apply. A)A state health insurance program for older adults and the disabled. B)Part A covers medically necessary hospitalization. C)Part D covers prescription drug costs. D)Part A is supplementary and voluntary. (page 145) E)Beneficiaries can make changes at any time. 15. Which statement is not accurate regarding the Medicaid program. A)Medicaid has a monthly fee that recipients must pay. (Page 145) B)Medicaid is administered individually by each state. C)Medicaid will provide nursing home services to those over 21 years. D)It is possible to be on both Medicare and Medicaid. 16. A) B) C) D) E) Which statements apply to how trends and issues have influenced health care. Select all that apply. The United States has the most cost-effective health care system in the world. One explanation for the high cost of U.S. Health Care System is the need to practice defensive medicine by ordering excessive tests and x-rays. In the United States, the health-related quality of life is lower than for most other countries. The United States ranks first among all WHO countries on a measure of how respectfully clients are treated. (page 146) In a survey published in 2009, most U.S. physicians identified that their health care system worked well. 17. A) B) C) D) Managed competition is a potential solution for rising health care costs, based on which factor. Promotes cost containment and universal access to health care (page 162) Eliminates burdensome government regulations Reduces state and federal control over health care delivery Discourages consumers from making responsible choices 18. Which factor has contributed the most to discussions about health care rationing over the recent years. Increased life expectancy Decrease in medical staff Increase in health care insurance coverage Decrease in preventive health measures (page 154) A) B) C) D) 19. Which Institute of Medicine (IOM) report focuses on nursing’s role in health care. A) The Future of the Public’s Health in the 21st Century B) For the Public’s Health: Investing in Healthier Future C) To Err is Human: Building a Safer Health System D) The Future of Nursing: Leading Change, Advancing Health (page 123) Chapter 7 1. The worldwide distribution of AIDS is categorized as a(n): A) epidemic. B) pandemic. (Page 174) C) endemic. D) pathogenicity. 2. The epidemiologic triad model addresses. A) Incidence, prevalence, and case fatality B) Health, illness, and injury C) Host, agent, and environment (page 170) D) Immunity, causation, and risk 3. Which is a key component of the host. A) B) C) D) 4. Infectivity Antigenicity Virulence Inherent resistance (page 181) Which statements apply to the concept of causality. Select all that apply. A) Causality is the relationship between cause and effect. B) The chain of causation is the most recent theory of causality. C) The web of causation theory is the most recent theory of causality. D) The chain of causation clearly explains causation in noninfectious disease. E) Epidemiology has changed its view of causality over time. (page 182) 5. What applies to examining the possibility that multiple factors are involved in the development of disease. A) Chain of causation B) Web of causation (page 184) C) Strength of association D) Temporality 6. Which statement is accurate. A) herd immunity only pertains to cows. B) active immunity can be attained via the use of vaccines. C) passive immunity can be attained via the use of vaccines. D) cross-immunity is immunity that causes a person who is immune to one disease to be also immune to a completely different infectious agent. (Page 186) 7. Using the relative risk ratio below, which population would require a major emphasis for risk reduction intervention. A) 0.59 B) 1.13 C) 1.79 D) 2.45 (page 186) 8. Which statements are inaccurate. Select all that apply. A) “Risk is the probability that a disease or unfavorable health condition will develop.” B) “Risk means that the person who has the most negative influences will definitely develop the disease or unfavorable health condition.” C) “Risk refers to positive and negative influences on a person’s likelihood of developing a specific disease.” D) “Risk can be measured using the relative risk ratio, which is based on the ratio of incidence in an exposed group to incidence rate in unexposed group.” E) “Risk is unimportant when determining the most effective points for community health intervention.” (page 186) 9. Children were exposed to chickenpox and show no signs of fever or lesions. They may be in which stage of the disease A) Susceptibility B) Subclinical disease (page 187) C) Clinical disease D) Resolution 10. During which stage of the natural history of a communicable disease would quarantine be most effective. A) Susceptibility stage (page 187) B) Subclinical disease stage C) Clinical disease stage D) Resolution stage 11. Which information is not in census data. A) Occupational status B) Housing quality C) Births recorded (page 191) D) Educational level 12. Which source of information would be most appropriate for data on the use of nursing home services and the common diagnoses of those using these services. National Center for Health Statistics (page 192) Consumer Product Safety Commission Environmental Protection Agency Cancer disease registries A) B) C) D) 13. A) B) C) D) E) Which statements are true about incidence and prevalence. Select all that apply. Prevalence is the number of new cases of a disease or health condition. Incidence is the number of new cases of a disease or health condition. Prevalence refers to all of the people with a particular health condition existing in a given population at a given point in time. Incidence refers to all of the people with a particular health condition existing in a given population at a given point in time. When determining if a disease is endemic in a specific area, the statistic that is most helpful is prevalence. (page 194) 14. A) B) C) D) Which action would be most important for an experimental epidemiologic study. Focus the study on evaluating the cause of a disease. Ensure carefully controlled conditions during the study. (Page 196) Expose both groups to the same factor or condition. Ensure that there are a substantial number of subjects. 15. A) B) C) D) Which statement best explains a case–control observational study. Description of patterns of occurrence of illness and injury in a population Investigation of development of health–illness conditions over a long period of time Studying of a cohort with evaluation of variables associated with the disease or injury Comparison of persons with and without a health–illness condition (page 194) 16. A) B) C) A community trial is. “A type of experimental study conducted at the community level.” (Page 197) “An inexpensive type of analytic research study.” “A study that gathers volunteers for the experimental group.” D) “A way to locate health problems in a variety of communities.” 17. A) B) C) D) Descriptive epidemiology is which type of study. Prevalence study Case–control study Cohort study Count study (page 193) 18. A) B) C) D) Organize the following steps in the epidemiologic study from the first step to the last. 1. Collect the data. 2. Identify the problem. 3. Analyze the findings. 4. Disseminate the findings. 5. Review the literature. 6. Develop conclusions and applications. 7. Design the study. 2, 5, 7, 1, 3, 6, 4 (page 197) 2, 7, 1, 5, 6, 3, 4 5, 2, 7, 1, 3, 6, 4 5, 2, 7, 1, 6, 3, 4 19. A) B) C) D) What is the final step in an epidemiologic research study. Analyze the data. Design the study. Disseminate the findings. (page 197) Review the literature. 20. A) B) C) D) Which statement is accurate. “Humans can be considered a reservoir in the chain of causation.” (Page 182) “Bats are the largest reservoir of malaria identified in the chain of causation.” “The chain of causation begins with the portal of exit.” “The last link in the chain of causation is the agent itself.” 21. A) B) C) D) Which statement is accurate. “Mortality rates are informative for fatal diseases.” “Mortality rates provide information about existing disease in clustered areas.” (Page 194) “Mortality rates are calculated using a population estimate every 10 years.” “Mortality rates indicate the genetic risk of developing a particular disease.” 22. Which approach applies to investigating how many cases of STIs have occurred locally during the past month. Experimental epidemiology Analytical epidemiology Descriptive epidemiology (page 193) Prevalence epidemiology A) B) C) D) Chapter 8 1. Which organization is notified first when reporting the identification of a communicable disease and need for investigation. A) Centers for Disease Control and Prevention (CDC) B) State health department C) Local health department (page 206) D) National Reported Disease list 2. Which statements accurately describe important steps prior to contacting an individual for an interview regarding communicable disease. Select all that apply. A) Review the information received from the news media reporter for completeness. B) Review disease information including the reservoir, incubation period, infectious period, symptoms, and treatment. (page 206) C) Take all appropriate treatments to the interview site. D) Investigate only laboratory-confirmed communicable diseases. E) Eradicate the disease. 3. Which entities are required to report known or suspected cases of reportable diseases in every state in the United States. Select all that apply. A) Physicians, dentists, and nurses B) Laboratory directors C) Any individual who knows of or suspects the existence of a reportable disease D) Medical examiners E) Administrators of schools and child care centers (page 206) 4. The major mode of transmission for hepatitis B is. A) Oral–fecal route B) Exposure to contaminated blood (page 214) C) Airborne droplet nuclei D) Infected rodents, such as mice and rats 5. Lyme disease is most likely transmitted by which mode. A) Vector (page 208) B) Airborne C) Vehicle-borne D) Direct 6. Which of the following are examples of some common vectors. Select all that apply. A) Chemicals B) Mosquitoes C) Salmonella D) Fleas E) Roaches (page 208) 7. Which statements are correct regarding modes of transmission. Select all that apply. A) Direct transmission requires contact with a contaminated inanimate material. B) Indirect transmission is also known as vehicle-borne illness. C) Food- and water-related illnesses are considered to be spread by indirect transmission. D) E) Vector transmission requires contact with a nonhuman carrier such as an animal or insect. Airborne transmission commonly occurs from coughing and sneezing. (page 208) 8. Which actions are the primary level of prevention for communicable disease control. Select all that apply. A) Providing TB skin test to children entering kindergarten B) Administering immunizations to senior citizens C) Teaching kindergarten students to wash their hands D) Encouraging parents to complete their children’s immunizations (page 224) E) Providing chest x-rays to people with positive TB skin tests F) Administering prompt treatment for the symptoms of gonorrhea 9. Which of the following identifies the index case. A) Contact investigation (page 236) B) Screening C) Isolation D) Quarantine 10. Tertiary prevention of communicable disease includes. A) education, immunization, and screening. B) screening, immunization, and isolation and quarantine. C) case and contact investigation, notification, and treatment. D) care and treatment, isolation and quarantine, and safe handling and control of infectious wastes. (Page 235) 11. A) Which factors may contribute to low vaccination levels among adults. Select all that apply. Lack of comprehensive vaccine delivery systems to the public and private sectors for adults (similar to the Vaccines for Children program for children). Lack of statutory requirements for vaccination of adults. Health care providers may lack current information about recommended adult immunizations and may miss opportunities to vaccinate adults during contacts in offices, outpatient clinics, and hospitals. (page 233) Adults fear injections for immunizations but do not worry about adverse effects after vaccination. A multitude of comprehensive vaccination programs exist in settings where healthy adults congregate such as workplaces and other locations. B) C) D) E) 12. A) B) C) D) Pneumococcal vaccine is recommended for which group. 1-year-old children 30-year-old adults who have simple respiratory tract infections Adults over age 65 who have COPD (page 213) Healthy adults in their 50s 13. A) B) Which statement about immunization is most accurate. Immunization is helpful in the spread of all communicable diseases. Immunization cannot provide herd immunity. C) D) Immunization is the process of introducing a form of a disease-causing organism into a person’s system to promote the development of antibodies that will resist the disease. (Page 225) Immunization is the process of administering antibodies to a person. 14. A) B) C) D) Which size induration is positive for TB. 2 mm 3 mm 4 mm 5 mm (page 217) 15. A) B) C) D) An increase in the development of multidrug-resistant tuberculosis is most likely related to. political and social response to declining rates of TB over the past decade. a reduction in funding for surveillance and research. noncompliance with the therapy for the full, recommended period. (Page 219) a premature sense that TB has been defeated. 16. Which statements about the prevention of sexually transmitted infections are true. Select all that apply. Many persons who have HIV infection can stave off AIDS by the use of medications during the HIV stage of the spectrum. Screening programs have actually reduced the incidence of Chlamydia as infected persons are identified and treated. The proper use of condoms prevents transmission of all sexually transmitted infections. Expedited partner treatment can prevent the spread of Chlamydia and gonorrhea. (page 219) It is not possible for a person who has a HSV-2 infection to transmit the infection to other sex partners if sexual contact is only practiced when the person does not have any visible sores. A) B) C) D) E) 17. A) B) C) D) 18. A) B) C) D) 19. Which statement is true about the consequences of biologic terrorism with anthrax and smallpox. Anthrax is not usually spread by person-to-person contact and so is not a good agent of biological terrorism. Smallpox is globally eradicated and therefore does not present a problem. Most adults are immune to smallpox due to routine immunization. There is an 85% fatality rate with inhalational anthrax. (Page 223) Which statement about confidentiality, privacy, and discrimination is the most accurate. It is permissible for a community health nurse to reveal the name and any other personal health information of a person who has a communicable disease to the public health authorities. (Page 237) It is permissible for a community health nurse to tell the contacts of a person who is infected with a communicable disease which disease they have been exposed to and the name of the source. It is permissible for any health care provider to report any cases of known or suspected communicable diseases to the news media. Only the identity of the index case of a communicable disease needs to be protected. Which one of the following is an agent in the cause of an illness. A) Host B) C) D) Portal of exit Infectiousness Virus (page 204) 20. Which type of immunity will be caused by the measles, mumps, and rubella vaccine. A) Acquired B) Passive C) Natural D) Active (page 229) 21. Which of the following is a vector in the spread of disease. A) A contaminated batch of meat B) An infected person C) A used syringe D) A mosquito (page 208) 22. Which situation best describes surveillance. A) Advocating for changes in the state disease reporting requirements B) Educating clients about pneumonia immunizations C) Evaluating the effectiveness of a stroke prevention program D) Obtaining information about occurrence of mumps (page 208) A) B) C) D) Chapter 12 Which source of information would be least appropriate when determining the importance of an issue for a community-based intervention. Special interest groups Client’s concern (page 334) State health department Local community priorities 2. A) B) C) D) Which type of information is in a geographic information system (GIS). Family status (g.336) Past interventions used Previous health problems Areas needing more study 3. D) E) Which change strategies would be most effective in maximizing the cooperation of the target population. Select all that apply. Using only one strategy that the nurse is most familiar with Knowing that as a nurse, the nurse knows more about the health topic than their audience Employing multiple strategies to promote health, prevent disease, and ensure a safe environment for populations Learning about the target population’s beliefs regarding the health topic (Page 333-334) Focusing on health promotion and not disease prevention 4. A) B) Which action would be most important to take next after an appropriate intervention. Develop an intervention based on the nurse’s previous experiences. Review the literature for research on previously attempted interventions. 1. A) B) C) C) D) Access the National Center for Health Statistics Web site for data. Learn about the target population’s beliefs and ideas.(Page 336) 5. A) B) C) D) Which is included to ensure success of a proposed community intervention program. Formal leaders Advisory group (Page 338) Target population Local knowledge 6. A) B) C) D) Which intervention targeting health problems is most likely to be effective. Teaching about prenatal care to a group of men in a men’s homeless shelter Teaching about prenatal care in a home for single mothers (Page 336) Teaching about prenatal care to a group of cub scouts Teaching about prenatal care to a group of senior citizens 7. A) B) C) D) In order to evaluate a health program, which should be the focus when planning the program. Measurement of goal attainment Creation of objectives that are specific, measurable, attainable, relevant, and timely (Page 344) Client satisfaction Measurement of consistency with standards 8. A) B) C) D) Which of these behaviors is most likely changeable. Smoking cessation among a group of people who have smoked for 20 or more years Smoking cessation at a workplace where smoking is common and deeply imbedded Smoking cessation in a school for students who have only recently started smoking (Page 341) Smoking cessation in a public environment where cigarettes are openly sold and persons are allowed to smoke 9. A) B) C) D) Which enabling factor would influence behavior change. Attitudes of the target population Knowledge of the family of the target population Availability of resources (Page 342) Values of the authority figures 10. A) B) C) D) Which model focuses on National Public Health Improvement initiatives. CDC’s model (Page 348) Donabedian model Omaha System model QSEN project 11. A) B) C) D) Which action is the process aspect of quality management. Contribute to the revision of standards.(Page 347) Ensure an adequate amount of resources. Determine additional sources of funding. Review services provided for client needs. 12. A) Which of the following models as the most basic. CDC model B) C) D) Donabedian model (Page 347) Quality and Safety Education for Nurses Omaha System model 13. A) B) C) D) Which model is dynamic with interventions focusing on structure, process, and outcome. Donabedian model (Page 347) QSEN project CDC model Quality Practice Setting Attributes model 14. Seed money to set up a health promotion program for pregnant adolescents is which type of grant. Planning Start-up (Page 352) Management Facility A) B) C) D) 15. A) B) C) D) The grant funding steps in order are. 1. Contact funders. 2. Acquire proposal guidelines. 3. Define the project. 4. Identify the proper funding source. 5. Be aware of submission deadline. 4, 5, 1, 2, 3 3, 4, 1, 2, 5 (Page 353) 3, 1, 2, 4, 5 2, 3, 4, 1, 5 16. A) B) C) D) Which is of following does not apply to the SMART acronym. “S stands for developing short-term outcomes for communities.” (Page 344) “M stands for developing outcomes that are measurable.” “A stands for developing outcomes that are attainable.” “R stands for developing outcomes that are relevant.” 17. A) B) C) D) Which part of a program plan’s pathway logic model refers to evaluation. Activities Outcomes Outputs Impact (Page 344) 18. Which activities are included in logic model before program outcomes can be assessed. Select all that apply. Inputs Impacts Short- term outcomes Long- term outcomes Activities Outputs (page 344) A) B) C) D) E) F) 1. A) B) C) D) Chapter 13 What is an example of a regulatory health policy. Licensure of health professionals (page 361) Federal subsidies for nursing education Benefits for needy groups Allocating resources among groups 2. A) B) C) D) Which outcome is the result of a distributive health policy. Reporting of communicable disease Federal funds for nursing education (Page 361) Medicare Arms control agreement 3. A) B) C) D) Before implementing a new federal policy, what should the nurse do first. Check for any modifications at the state or local level. (page 363) Hold an in-service for staff to educate on the changes. Ensure all office resources reflect the changes. Prepare to educate the community about the new changes. 4. A) B) C) D) Which statement is accurate regarding public health nursing. It is successful because of efficient social marketing techniques. Its solid foundation is based on social justice. (Page 372) Social disparities are almost eliminated due to public health nursing. The best advocate for any client is public health nursing. 5. A) B) C) D) E) Which factors influence creation of health policies. Select all that apply. Facts are given the highest priority. Special interest groups, business, and industry try to control the process. Nurses need to provide input to policy circles through advocacy. Nurses need to provide leadership at decision-making tables. There are power struggles behind all legislation and health care regulation. (Page 358) 6. Which concerns apply to how the United States compares to other countries in providing health care to the country’s citizens. Select all that apply. Burn injuries Suicide Stroke morality Blood pressure control (page 359) Tuberculosis A) B) C) D) E) 7. A) B) C) D) Which result best relates to a social change leading to a health improvement during the first half of the 20th century. Use of seat belts Increased use of motorcycle helmets Increased use of standard precautions Elimination of child labor (Page 366) 8. apply. A) B) C) D) E) A) B) C) D) Which of the following are benefits of joining a professional nursing organization. Select all that They have successfully elevated the nursing professionalism. They have given voice to the inequalities that affect our society. They have developed the paradigms that influence and affect public health. (Page 373) They are regarded as a major player in Washington when discussing health care policy. They have a long and consistent relationship with public policy. 9. Which is the best way for any nurse to advocate for change and exert power. Pursuing an advanced degree Running for state congressional seat Actively participating in a professional nursing organization (Page 373) Becoming a member of a local not-for-profit agency board of directors 10. Power and empowerment in a committee discussion on a health care–based policy are demonstrated by which actions. Select all that apply. A) The legislative group is demonstrating their power to act by the authority given to them through the government process. B) A member of the city council is speaking to the policy makers on behalf of the local community. C) A community group has requested time to comment on how the proposed policy will affect them. D) The city recognizes that the legislators will get to do whatever they want to. E) Some of the individuals in the audience are there because of the encouragement from the PHN to participate in the process. (Page 378) 11. A) B) C) D) Power and empowerment are best achieved by which concept. Partnership with clients (Page 378) Hierarchical relationship Authority over clients Client autonomy 12. Which actions are emphasized for involvement in influencing policy development. Select all that apply. A) Practice to the full extent of education and training. B) Achieve higher levels of education and training. C) Act as full partners, with physicians and other health professionals, in redesigning health care in the United States. D) Improve data collection and an improved information infrastructure to ultimately influence (Page 375) effective workplace planning and policy making. E) Recognize that many nurses are already involved in the regulatory framework development. 13. A) B) C) D) Which points apply to the ACA and its various benefits. Select all that apply. Subsidies are available to assist all families. The plan is to provide health insurance coverage for all U.S. citizens. It increased the coverage available through Health Savings Accounts. It created one central insurance provider to ensure health insurance for everyone. E) 376) Employers have the option to provide insurance or contribute to the marketplace option. (Page 14. A) B) C) D) Which factor should the nurse question first concerning a new policy? “How much does it cost?” “What is the result?” “Why is it in place?” “Who benefits from it?” (Page 366) 15. A) B) C) D) E) Which factors need to be considered for adoption of a policy. Select all that apply. Always put the client first. Successfully influence the legislators. Contact legislators directly or through professional lobbyist. (Page 379) Do not worry about the political aspect. Always follow the proven rational process. 16. A) B) C) D) E) Identify the necessary steps for offering a new policy Select all that apply. Develop potential solutions. Contact appropriate resources. Define the issue. (Page 370-371) Seek endorsements for the suggested policy from administrators. Seek public input. 17. Which mandate of the ACA should the nurse explore first to discover the priorities established to improve overall health. A) The National Prevention Council (Page 376) B) The Office of the Surgeon General C) The State Public Health Department office D) The ANA 18. Put the steps of the process of a bill becoming law in order from start to finish. A) President rejects or accepts or does nothing with the bill. B) Bill goes to representative or senate for discussion and changes made. C) Bill is introduced in one house of Congress. D) Bill is an idea. 4,3,2,1, (Page 363) Chapter 14 1. A) B) C) D) Which action is first when planning an initial home visit to a family. Obtain the basic supplies that will be needed. Gather appropriate educational materials. Contact the family via telephone. Review the referral information. (page 401) 2. A) B) Which action would be most helpful to ensure a successful home visit. Documentation in a timely manner Summarizing the main visit points C) D) Providing incidental teaching Scheduling an appropriate visit time (page 402) 3. While making a family health visit, a relative becomes verbally abusive and increasingly loud. Which action by the nurse would be best. A) Continue the visit with caution. B) Suggest the relative go in another room and take a nap. C) Ask the sober family members to take the visitor home. D) Terminate the visit, making plans for another visit. (page 406) 4. A) B) C) D) E) What is needed when traveling by car to make a home visit. Select all that apply. A full gas tank and well-operating vehicle A map that includes the geographic location where the home visit will be made A cellular telephone (page 404) A bus schedule Exact change 5. Which specific safety measures apply to making a home visit. Select all that apply. A) Plan to reschedule the visit if you find a large group of people assembled between you and the client’s door. B) Immediately leave the home when family members begin to physically fight with one another. C) Enter the residence before you determine that the family you are intending to visit does live there and is home. D) Travel only in pairs for all home visits. E) If someone approaches you and indicates that they want your nursing bag, throw your bag away from where you are and run in the opposite direction. F) Leave an itinerary of your planned travels, the telephone numbers of families you will attempt to visit, and your cellular phone number at your base of operation. (page 404-406) 6. A) B) C) D) Which would lead the nurse to question the health of a family. Role relationships are inflexible. Coping is actively attempted. Family members communicate regularly. The family lacks regular links with the broader community. (page 398) 7. Which principle guides and enhances family nursing practice. A) The nurse should expect that the family will be normal and will not change. B) The nurse should start where the family is at the present time and not the ideal level of functioning. (page 399) C) The nurse should focus on each family member individually. D) The nurse should evaluate the family based on consistency with traditional family patterns. 8. A) B) C) D) Which action would be most appropriate to empower a family to become independent. Focus attention on the problem areas. Do for the family what they cannot. Emphasize the family’s strengths. (page 399) Reinforce positive traits. 9. A) B) C) D) Which action reflects applying an interactional framework to assess a family’s health. View them in terms of the family’s internal relationships. (page 407) Look at them from a life cycle perspective. Evaluate the members’ changing roles and tasks. Assess them as a social system relating to other social systems. 10. A) B) C) D) E) F) Which data is included in a family’s demographics. Select all that apply. Dietary patterns Housing Climate Socioeconomic status Education of members Ethnicity (page 390) 11. A) B) C) D) Which applies to conducting an outcome evaluation? Organization Family progress (page 412) Timing Performance 12. A) B) C) D) Which statement is true regarding a homeless family. Homeless people are incomeless. The family represents the typical persons that are homeless. Families that are homeless are in crisis. (page 390) Children who are homeless have lower risks of behavior problems. Chapter 15 1. A) B) C) D) E) Which factors describe a competent community. Select all that apply. Collaborate effectively identifying community needs and problems. Achieve a working consensus on goals and priorities. Agree on ways and means to implement the agreed-upon goals. Have no health care problems. Collaborate effectively to take the required actions. (page 443) 2. Which are Healthy People 2030 goals for the nation. Select all that apply. A) Create environments to promote good health. B) Involve all stages of life in the promotion of health and quality of life. C) Remove existing disparities and improve health in all groups. D) Increase the quality and length of life free of health challenges. (page 423) E) Healthy People 2020 does not address the health of the nation but does address the health of individuals. 3. A) B) C) D) Which concepts are used to identify the health of a community. Status/people, structure, and process (page 423) Assessment, policy development, and assurance Primary, secondary, and tertiary Function, structure, and process 4. Which factors are vital to assess in determining how best to help the pregnant teenagers in a community. Select all that apply. A) Rate of growth or decline among the pregnant teens B) The specific health needs of the teens C) The best location for a clinic D) Functions of community organizations E) Social class of the community (page 421) 5. A) B) C) D) Which entity is the primary client for community health nursing. Aggregate Agent Community Total system (page 429) 6. A) B) C) D) Which action would be a priority for the community health nurse? Bring in educators to help the clients. Identify the needs of each client who comes through the clinic doors. Work to make healthy choices more accessible. (page 423) Identify which community leaders are most supportive of health care. 7. Which factors are pertinent for Donabedian’s theory structure element dimension. Select all that apply. A) Refer to the community’s services and resources. B) Community associations, groups, and organizations provide a means for accessing needed services. C) Adequacy and appropriateness of health services can be determined by examining patterns of use, number and types of health and social services, and quality measures. D) Demographic data are important indicators of community structure. (page 423) E) Structure is the most common measure of the health of a community. 8. A) B) C) D) Which is the best factor to examine for community health status. Leading causes of death and illness (page 423) Adequacy of health services Socioeconomic distributions Strengths of the community 9. A) B) C) D) Which factor should the nurse emphasize as most important when dealing with the community. Cyclic nature Client focus Interaction (page 423) Flexibility 10. Which initial step should the nurse take after identifying a health care issue that a local coalition of various community members will be the best to handle the situation. A) Conduct a community assessment. B) Identify key players. C) Identify potential members. D) Define goals and objectives. (page 430) 11. A) B) C) D) What is the priority for nurse at a new clinic in a previously underserved area. Study current and firsthand data. (page 432) Identify a pressing problem and pursue a solution. Locate the various subsystems in the community. Conduct a comprehensive survey of the health needs. 12. A) B) C) D) An assets assessment will be important to evaluate which factor of the community. Key informants Strengths of the community (page 447) Specific problem of the community Overall life of the community 13. A group of approximately 10 similar individuals together to obtain information about opinions is which assessment method. A) Survey B) Community forum C) Focus group (page 436) D) Descriptive epidemiology 14. A) B) C) D) What should the nurse remember to do when writing a community diagnosis. Focus primarily on deficits of the community. Use broad statements to guide a range of interventions. Employ a revised nursing diagnosis format. Substitute the terms client, family, group, or aggregate for the word patient. (page 438) 15. A) B) C) D) A plan is created during which stage of the health planning process. Assessment Analysis and design (page 441) Implementation Evaluation 16. A) B) C) D) Formative evaluation focuses on. Process during the actual intervention (page 444) Outcomes of the interventions Development of performance standards Impact on clients’ health 17. best. A) B) C) D) To collect data concerning community the health beliefs, which assessment method would be 18. A) Which source as the most significant for providing data at the local level. CDC Having clients respond to predetermined questions. (page 435) Reviewing current epidemiologic studies. Utilizing GIS technology to collect information. Organizing a town hall meeting to meet with a select group from the community. B) C) D) NIH State health department (page 437) Local nonofficial agencies 19. A) B) C) D) E) Which factors will the nurse utilize when writing objectives. Select all that apply. Specific Money required Achievable Realistic (page 442) Teachable 20. Which model uses three practice priorities and three general categories of nursing interventions. A) Omaha model B) Salmon’s model (page 418) C) Systems model D) Roger’s model 21. Death rates of children between the ages of 0 and 5 years from the Centers for Disease Control and Prevention (CDC) is classified as. A) Local data B) State data C) National data (page 436) D) International data Chapter 16 1. Which is included when designing a community-based program within the context of a global framework. A) Population demographics (page 451) B) Provider characteristics C) Procedures that are covered by insurance D) Physical space 2. A) B) C) D) When applying the Universal Imperatives of Care, which would be the priority. Mortality (page 451) Daily functioning Decision- making Cost 3. Which statements are accurate regarding the context of international community health nursing. Select all that apply. A) Global community health care is complex and is affected by multiple factors relating to geography, history, politics, culture, religion, and economy. B) The types of services that can be provided include a range from providing clinical services to policy making at an international level. C) People’s conception of health, wellness, and illness are static from culture to culture. D) By looking through a computer window, the student is able to see almost anyplace, connect to about any person, and access information about almost any concept. E) The ways in which people view nurses and other health care providers are affected by their attitudes toward women, their culture, and belief systems. (page 474) 4. Which statement about TB most accurately represents the epidemic status of this disease. A) “TB kills about 1.5 million people each year.” (page 44) B) “All persons who are infected by the causative organism become ill and can spread the causative organism to others throughout the remainder of their lifetime.” C) “Three fourths of the world’s population is thought to be currently infected by the causative organism.” D) “The highest number of deaths is in Eastern Europe.” 5. A) B) C) D) Which statement about tuberculosis (TB) is most accurate. TB is not endemic in any countries at present. TB will be eradicated by the current campaign by 2030. TB has a multidrug resistance, which impacts controlling the problem. (page 468) TB affects those in developed countries. 6. Which statement about immunization is true. A) The World Health Organization estimates that a billion more lives could be saved each year with immunizations. B) Vaccines are one of the most cost-effective interventions found in public health. (page 225) C) Half of the world’s children are being reached with essential vaccines. D) In the United States, toddlers are thoroughly vaccinated. 7. Which statement summarizes the World Health Organization. A) The WHO is a UN agency that promotes maternal and child health. B) The WHO is an intergovernmental agency that directs and coordinates authority on international health. (page 459) C) The WHO is an intergovernmental agency that provides technical and epidemiologic assistance. D) The WHO is a UN agency that assists people informing peaceful and inclusive societies. 8. Which statement demonstrates the correct purpose of the WHO’s mission? A) “The WHO collaborates with others in health development to free the world from poverty.” B) “The WHO is a specialized agency that provides economic and humanitarian assistance overseas.” C) “The WHO represents the global interests and concerns of the nursing profession.” D) “The WHO promotes global health by supporting the development efforts of governments, organizations, and universities throughout the world.” (page 476) 9. Which statements about the International Council of Nurses (ICN) are accurate. Select all that apply. A) ICN represents the global interests and concerns of the nursing profession. B) The mission of ICN is to maintain the role of nursing in health care through its global voice. C) ICN has, as members, nursing organizations from 130 countries representing 13 million nurses. (ICN Website) D) E) ICN is a governmental organization. ICN employs Regional Nursing Advisors. 10. Which statement demonstrates how demographic transitions occur in global health. A) “Demographic transitions are based on births, deaths, and migrations.” (page 451) B) “Demographic transitions focus on a high birth rate and high death rate.” C) “Demographic transition is based on a low birth rate as people survived infections and aged with chronic conditions.” D) “Demographic transition is based on the neighborhood and personal lifestyle behaviors.” 11. Which epidemiologic transition uses social issues such as areas that one lives and personal lifestyle behaviors. A) Era of Infectious Diseases B) Ear of Chronic Long-Term Health Conditions C) Era of Social Health Conditions (page 451) D) Era of Global Warming 1. A) B) C) D) E) F) Chapter 18 Which are developmental crises. Select all that apply. A windstorm that damaged 18 homes in a community Grandpa Jones dying at age 82 years A couple getting engaged The Smiths getting a divorce (Page 507) The Jones experiencing a home invasion Seven people dying in an automobile crash 2. Which concepts describe situational crises. Select all that apply. A) A situational crisis is a stressful, disrupting event arising from external circumstances that occur suddenly to a person, group, aggregate, or community. B) Situational crises can be predicted, expected, and planned. C) Situational crises are never positive. D) Situational crises often occur without warning. E) Situational crises occur to people because of where they are in time and space. (Page 507) 3. Which statement about primary prevention for family violence is most accurate. A) The cycle of violence within the family cannot be interrupted. B) Persons who have been victims of family violence will repeat the behavior with others. C) Primary prevention includes planned activities undertaken by the nurse to prevent an unwanted event from occurring. (Page 526) D) It is not possible for the community health nurse to foster healthful practices that will counteract unhealthful influences. 4. Which statement is most accurate regarding the levels of prevention. A) Often people in crisis are temporarily helpless and unable to cope on their own but are receptive to outside influence. (Page 527) B) Secondary prevention interventions include taking action to prevent the unwanted event from occurring. C) Tertiary prevention focuses on moving past the crisis and returning to the precrisis state. D) Primary prevention is the least effective level of intervention in terms of promoting client’s health and containing costs. 5. A) B) C) D) Which is one of the earliest laws enacted. Child Abuse Prevention and Treatment Act (Page 510) Family Violence Prevention and Services Act Keeping Children and Families Safe Act Child Abuse Prevention and Treatment and Adoption Reform Act 6. A) B) C) D) E) F) Which would lead to suspect possible child neglect.? Select all that apply. 15-year-old Lucy misses school once a week to watch her baby sister while mom works. 6-year-old Sam plays in the yard with a sweater on when it is 60 degrees outside. Twins, Bobby and Billy, arrive at school in dirty and smelly clothing most school days. 11-year-old Samantha comes to school without lunch or lunch money each day.(page 511) 9-year-old Tommy misses school two or three times a month due to asthma attacks. 14-year-old Jennifer watches her neighbor’s 2-year-old child every Saturday. 7. When discussing elder abuse with a senior citizen group, which would the community health nurse include. A) Older men experienced abuse at a higher rate than older women. B) Types of elder abuse include physical abuse, emotional abuse, neglect, and exploitation. (Page 522) C) The majority of cases of elder abuse are perpetrated by persons unknown to the victim. D) Elders with dementia are less likely to be abused since they have less social interactions. 8. Which best describes “mandated reporter.” A) The nurse must witness abuse and neglect before being mandated to report. B) The nurse commands that battered women report the abuse. C) The supervising community health nurse is responsible for reporting only known cases of elder abuse. D) The nurse must report any case of known or suspected abuse and neglect in children or older adults. (Page 529) 9. A) B) C) D) Which age group that has suicide as the second leading cause of death. 10- to 34-year olds (Page 523) 9 years and under 35- to 54-year olds 55- to 64-year olds 10. A) B) C) D) When assessing a family in crisis, which action is first. Assess the nature of the crisis. (Page 531) Determine client’s perception. Define available supports. Assess coping abilities. 11. A) B) C) D) Which assessment finding would be classified as neglect. Presence of lice Presence of scabies Lack of weight gain (Page 511) Bruises on lower right extremity Chapter 19 .1. The critical population health indicators affecting the maternal and child population globally and nationally are. Select all that apply. A) Maternal mortality rate B) Infant mortality rate C) HIV/AIDS cases D) Crude mortality rate E) Fetal alcohol syndrome (Page 538-545) 2. When describing low-birth-weight and very-low-birth-weight babies, which statement would the nurse most likely include. A) Low birth weight occurs more often in Whites and Hispanics than African Americans. B) Birth weight is one of the most important predictors of infant mortality. (Page 540) C) The incidence of low birth weight in the United States is decreasing related to the increase in multiple births. D) Recent trends in very-low-birth-weight babies indicate that this area no longer needs attention. 3. Which effects in the newborn are related to alcohol consumption by the mother? Select all that apply. A) Intellectual impairment B) Low birth weight C) Leukemia D) Respiratory distress E) Altered growth and development (Page 543) F) Childhood cancers 4. A) B) C) D) Which finding is common in fetal alcohol spectrum disorder (FASD). Large for gestational age Facial abnormalities (Page 543) Hypoactive behavior Enhanced intellectual development 5. Which roles would the nurse most likely assume to ensure positive outcomes for an adolescent population at the local women’s clinic. Select all that apply. A) Clinician B) Educator C) Counselor D) Provider of referrals (Page 564) E) Friend 6. A) B) Which result is attributable to the WIC program. Increase in expenditures for health care Decrease in rates of large-for-gestational age babies C) D) Reduction in the rates of infant iron deficiency anemia (563) Drop in breast-feeding rates 7. A) B) C) D) Which condition is the major cause of death due to injuries in the 1- to 4-year-old population. Pneumonia Suffocation Drowning (Page 551) Motor vehicle crash 8. A) B) C) D) E) When setting up educational programs for pregnant adolescents, which methods would the nurse most likely implement to promote success. Select all that apply. Classroom lectures Informal group discussions Creative craft sessions Small group games Interactive computer activities (Page 564) 9. A) B) C) D) A screening program for lead exposure would be targeted to which age group. Birth to 11/2-year-olds 1 1/2- to 3-year-olds (Page 552) 3- to 5-year-olds 5- to 7-year-olds 10. Preventive measures for pregnant women at risk for hypertensive disease of pregnancy include. Select all that apply. A) Selecting processed foods for meals B) Ensuring adequate fluid intake C) Obtaining regular exercise D) Limiting fresh fruit intake E) Ensuring adequate time for rest (Page 548) 11.. A) B) C) D) Screening for gestational diabetes occurs at. At 12 weeks’ gestation Between 16 and 18 weeks’ gestation Around 24 weeks’ gestation (Page 548) At 28 weeks’ gestation 12. A) B) C) D) E) Measures to prevent drowning in children include. Encouraging parents to have their children learn how to swim. Limiting the bathwater to 4 to 6 inches for bathing. Keeping children within eyesight when in the water. Eliminating water collection containers around the home. (Page 551) Keeping toilet lids up, in an open position. 13. A) B) C) Which statement applies to teaching about gestational diabetes. “There is an increased risk of hypertension and urinary tract infections.” (Page 548) “It is possible to reverse gestational diabetes during pregnancy.” “Insulin is the treatment of choice for gestational diabetes.” D) “Decreasing the intake of carbohydrates will keep the blood sugar lower.” 1. A) B) C) D) Chapter 20 Children falling within the 45th to 65th BMI percentile for their age are classified as. Underweight Healthy weight (page 583) At risk for overweight Overweight 2. A) B) C) D) Which measure would be most appropriate for programs to address childhood obesity. Encouraging television watching for about 3 hours per day Suggesting that families eat less meals together at home Urging an increase in physical activity daily (page 575) Limiting the intake of unsaturated oils in cooking 3. A) B) C) D) At which age is the first dose of human papillomavirus (HPV) vaccine administered. 9 11 (Page 597) 13 15 4. A) B) C) D) Which statement applies to violence among school-age children and adolescents. teen females commit homicide more frequently than teen males. homicide is the third highest cause of death for all adolescents. (page 580) adolescents account for less than one half of all firearm injuries treated. serious youth violence is unrelated to drugs and guns. 5. For adolescent health promotion, which of the following is addressed by many Healthy People 2030 objectives. A) Self-esteem improvement B) Risk-taking behaviors (Page 590) C) Control of disease D) Behavioral issues 6. A) B) C) D) Which school-based approach is most effective to solve the problem of teenage suicide. Suicide prevention programs with direct interventions (Page 597) Teachers assessing suicide risk among students Promotion of stronger parental control of teens Punitive treatment of teens by the school administration 7. A) B) C) D) Which STI is most common. Syphilis Gonorrhea Chlamydia (Page 597) Herpes simplex virus Chapter 21 1. What is the key aspect for a community’s ability to follow through with health teaching. A) Life expectancy B) Health disparity C) Health literacy (page 610) D) Financial ability 2. Which statement about life expectancy is most accurate. A) The life expectancy for White Americans is 2.8 years greater than for Black Americans. (Page 610) B) The life expectancy for Black Americans is 4.4 years greater than for Hispanic Americans. C) In the United States, life expectancy continues to decline. D) There is a 5-year gap in life expectancy between women and men. 3. Which region has the greatest need for a stroke prevention program. A) North central B) Southeast (page 611) C) Southwest D) Pacific northwest 4. Order these top five causes of unintentional injuries accounting for the majority of adult deaths due to injury in their proper sequence from first to fifth. 1. Fire arms 2. Suffocation 3. Motor vehicle crashes 4. Poisoning 5. Falls A) 1, 3, 5, 2, 4 B) 5, 3, 1, 4, 2 C) 3, 5, 1, 2, 4 D) 3, 1, 4, 5, 2 (page 613) 5. Which is the number one cause of cancer deaths among adults. A) Colon B) Pancreatic C) Esophageal D) Lung (page 612) 6. Which statement is accurate regarding heart disease and women. A) “More women die of breast cancer than heart disease.” B) “Women experience similar symptoms as men.” C) “Hormone replacement therapy protects the heart.” D) “Heart disease is the number one killer of women.” (Page 623) 7. Free mammograms are which level of prevention. A) Primary B) Secondary (page 624) C) D) 8. Tertiary Health promotion A) B) C) D) E) F) G) H) Which disorders are targeted in a screening program with clients with a history of cardiovascular disease (CVD). Select all that apply. Hypertension Coronary heart disease (CHD) Stroke Arrhythmias Peripheral vascular disease Cardiomyopathies (page 611) Valvular heart disease Chronic lower respiratory diseases 9. A) B) C) D) E) Which risk factors in the client’s history support screening for diabetes. Select all that apply. Body mass index of 40 Age greater than 45 years History of gestational diabetes Exercising three times a week Native American race (page 614) Chapter 22 1. Which is most accurate for changes occurring in the older adult population globally, A) The over 85-year age group is the fastest growing segment of the group. (page 639) B) Males have a longer projected life expectancy when compared with females. C) Most countries have adequate numbers of social programs for older adults. D) Adults over age 65 are expected to account for about 25% of the population by 2050. 2. A) B) C) D) E) Which are characteristics of healthy older adults. Select all that apply. They are able to perform functional activities of daily living. They are able to adapt, to continue to handle stress, and to be active in life and living. They maintain the maximum degree of physical, mental, and social vigor. (page 642) They are likely to be dependent on others. They reside in institutions. 3. A) B) C) D) Which range of calories would be most appropriate for an older adult male. 800 to 1,200 calories 1,200 to 1,600 calories (page 643) 1,600 to 2,000 calories 2,000 to 2,400 calories 4. A) B) C) D) Colonoscopy screening is recommended at which frequency. Every year Every 2 years Every 5 years Every 10 years (CDC) 5. A) B) C) D) Which assessment tool is most appropriate for assessing an older adult’s ability to perform activities such as shopping, doing the laundry, using the telephone, and handling finances. Barthel Index Instrumental Activities of Daily Living Scale (page 657) Katz Index of Activities of Daily Living Modified Rankin Scale 6. A) B) C) D) The most common elder abuse perpetrator is. Elder’s adult child Elder’s partner (page 656) Elder’s neighbor Elder’s grandchild 7. Which statement about elder abuse is most accurate. A) Elder abuse is a problem that is underrecognized and underreported. (page 656) B) It is more common for older men to be abused rather than older women. C) If there is long-term domestic violence in an older adult couple, it is not considered elder abuse for the perpetrator to continue to abuse the victim. D) Self-neglect is not considered to be a form of mistreatment. 8. apply. A) B) C) D) E) Which criteria are included to evaluate the effectiveness of older adult programs. Select all that 9. A) B) C) D) E) F) Which are included in a comprehensive set of services. Select all that apply. Adequate financial support Health education Encouragement to spend much time alone Adult day care programs Access to high-quality health care services In-home services (page 657) 10. A) B) C) D) Which statement best summarizes the share of total health spending by age group. Those 65 years and older account for the largest health spending. (page 638) Those under 19 years of age consume the greatest amount of health. There are no differences among the age groups in health spending. The age group of 19 to 34 years are the largest age group but spend the least amount on health. Coordination Accessibility Comprehensive Complex Quality (page 658) Rector, C. L., & Stanley, M. J. (2021). Community and public health nursing: Promoting the public's health. Wolters Kluwer.