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Foundations for Population Health in

Community Public Health Nursing 5th
Edition Stanhope
Test Bank

Chapter01:Community-andPrevention-
OrientedPracticetoImprovePopulationHealth
Stanhope:FoundationsforPopulationHealthinCommunity/PublicHealthNursing,5th
Edition

MULTIPLECHOICE

1. Whichofthefollowingbestdescribescommunity-basednursing?
a. Apracticeinwhichcareisprovidedforindividualsand families
b. Providingcarewithafocusonthegroup’sneeds
c. Givingcarewithafocus ontheaggregate’sneeds
d. Avaluesysteminwhichallclientsreceiveoptimalcare
ANS:A
By definition, community-based nursing is a setting-specific practice in which care
isprovided for “sick” individuals and families where they live, work, and attend school.
Theemphasis is on acute and chronic care and the provision of comprehensive, coordinated,
andcontinuous care. These nurses may be generalists or specialists in maternal–infant,
pediatric,adult, or psychiatric mental health nursing. Community-based nursing emphasizes
acute andchronic care to individuals and families, rather than focusing on groups,
aggregates, orsystems.

2. Whichofthefollowingbestdescribescommunity-orientednursing?
a. Focusingontheprovisionofcaretoindividualsandfamilies
b. Providingcareto manageacuteor chronicconditions
c. Giving direct careto ill inNdivRiduaIlswGithB
USNT in.thCeirO
Mfamily setting
d. Havingthegoalofhealthpromotionanddiseaseprevention
ANS:D
By definition, community-oriented nursing has the goal of preserving, protecting,
ormaintaininghealthandpreventingdiseasetopromotethequalityoflife.Allnursesmayfocuson
individuals and families, give direct care to ill persons within their family setting, and
helpmanage acute or chronic conditions. These definitions are not specific to community-
orientednursing.

3. Whichofthefollowing isthe primaryfocus ofpublichealthnursing?

a. Familiesandgroups
b. Illness-orientedcare
c. Individualswithinthefamilyunit
d. Healthcareof communitiesandpopulations
ANS:D
In public health nursing the primary focus is on the health care of communities
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andpopulationsratherthanon individuals,groups,and families.Thegoalis

topreventdiseaseandpreserve, promote, restore, and protect health for the community and the
population within it.Community-based nurses deal primarily with illness-oriented care of
individuals and familiesacorss the life span. The aim is to amanage acute and chronic health
conditions in thecommunity,and thefocus of practiceis on individualorfamily-centeredillness
care.

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4. Which of the following is responsible for the dramatic increase in life expectancy during
the20thcentury?
a. Technologyincreasesinthefieldofmedicallaboratoryresearch
b. Advancesinsurgicaltechniquesandprocedures
c. Sanitationandotherpopulation-basedpreventionprograms
d. Useofantibioticstofightinfections
ANS:C
Improvements in control of infectious diseases through immunizations, sanitation, and
otherpopulation-based prevention programs led to the increase in life expectancy from less
than 50years in 1900 to more than 78 years in 2013. Although people are excited when a new
drug isdiscovered that cures a disease or when a new way to transplant organs is perfected, it
isimportant to know about the significant gains in the health of populations that have
comelargelyfrom public health accomplishments.

5. Anurseisdeveloping aplan todecreasethenumber

ofprematuredeathsinthecommunity.Whichofthefollowing interventions wouldmost likely
beimplemented by thenurse?
a. Increasethe community’sknowledgeabouthospicecare.
b. Promotehealthylifestylebehaviorchoicesamongthecommunitymembers.
c. Encourageemployerstohavewellness centers ateachindustrialsite.
d. Ensure timely and effective medical intervention and treatment for
communitymembers.
ANS:B
Publichealthapproachescouldhelppreventprematuredeathsbyinfluencingtheway peopleeat,
drink, drive, engage in exercise, and treat the environment. Increasing knowledge
ofhospicecare,encouragingon-sitewellnesscenters,andensuringtimelytreatmentof medical
conditions do not address theNfU
ocRusSoIfNGpTroBv.
im inCovMerall health through health promotion
gO
strategies.This isthemajormethod that issuggested todecreasetheincidenceof premature
death.

6. Whichofthefollowing is abasic assumption ofpublichealth efforts?

a. Healthdisparitiesamonganygroupsaremorallyandlegallywrong.
b. Healthcareisthemostimportantpriorityin governmentplanningandfunding.
c. Thehealthof individualscannotbe separatedfrom thehealthof thecommunity.
d. ThegovernmentisresponsibleforlengtheningthelifespanofAmericans.

ANS:C
Publichealthpractice focusesonthecommunityasawhole,andthe effectofthe
community’s health status (resources) on the health of individuals, families, and groups.
Thegoal is to prevent disease and disability and promote and protect the health of the
communityas a whole. Public health can be described as what society collectively does to
ensure thatconditionsexistin whichpeoplecan behealthy. Thebasic assumptionsof
publichealthdonotjudge the morality of health disparities. The focus is on prevention of illness
not on spendingmore on illness care. Additionally, individual responsibility for making
healthy choices is thedirectiveforlengtheninglifespan not theroleof thegovernment.

7. Whichofthe followingactionswould mostlikelybeperformedbyapublic healthnurse?

a. Askingcommunityleaderswhatinterventionsshouldbechosen
b. Assessingthecommunityanddecidingonappropriateinterventions
c. Usingdatafromthemainhealthcareinstitutionsinthecommunitytodetermine

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neededhealthservices
d. Workingwith communitygroups tocreate policiesto improvethe environment
ANS:D
Although the public health nurse might engage in any of the tasks listed, he or she
worksprimarily with members of the community to carry out core public health functions,
includingassessment of the population as a whole and engaging in promoting health and
improving theenvironment. The interventions of asking community leaders which
interventions should bechosen, asessing the community and deciding on appropriate
interventions, and using datafrom health care institutions do not demonstrate the engagement
of the community whenmakingdecisions about what thecommunityactually wants and needs.

8. Which of the following public health nurses most clearly fulfills the responsibilities of
thisrole?
a. Thenursewhometwithseveral groupstodiscusscommunityrecreationissues
b. Thenursewhospent the day attending meetingsof varioushealth agencies
c. Thenursewhotalked toseveral peopleabout theirparticularhealthconcerns
d. Thenursewho watchedthecity councilmeetingonlocalcable television
ANS:B
Any of these descriptions might represent a nurse communicating, cooperating,
orcollaborating with community residents or groups about health concerns. However, the
nursewho spent the day attending meetings of various health agencies is the most
representative,becauseinpublichealth,concerns
areaddressedfromabroaderperspective.Inpublichealth,broad concerns of the community
should be addressed. Concerns are broader than recreation,individual concerns are not as
important as aggregate priorities, and watching television (aone-wayform ofcommunication)
isless effective than interactingwith others.
9. Whichofthe followingbest definesaggregate?
a. Alargegroupof persons
b. Acollectionofindividualsandfamilies
c. Acollectionofpeoplewhoshareoneormore characteristics
d. Anothername fordemographicgroup
ANS:C
An aggregate is defined a collection of people who share one or more personal
orenvironmental characteristics. Members of a community can be defined in terms of
eithergeography (e.g., a county, a group of counties, or a state) or a special interest (e.g.,
childrenattending a particular school). These members make up a population. The term
populationmaybeusedinterchangeably withthe term aggregate. A largegroupofpersons,
acollectionof individuals and families, and another name for demograhpic group are not
accuratedefinitionsof theterm aggregate.

10. Aregisterednursewasjustemployed asapublichealthnurse. Whichquestion

wouldbethemostrelevant forthe nurseto ask?
a. “Whichgroupsareatthe greatestriskforproblems?”
b. “WhichpatientsshouldIseefirstasIbeginmyday?”
c. “Withwhichphysicians willIbemost closelycollaborating?”
d. “WithwhichnursingassistantswillIpartnerthemost?”
ANS:A

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

Theincorrect responses reflect a focus on individuals rather than a community-
orientedperspective.

11. Making sure that essential community-oriented health services are available defines which
ofthecorepublichealth functions?
a. Policydevelopment
b. Assessment
c. Assurance
d. Scientificknowledge-basedcare
ANS:C
Assurance includes making sure that essential community-oriented health services
areavailablein the community.Thedefinition does notfit
thetermsassessment,policydevelopment. Scientific knowledge-based care is not a core function
of public
health.Assessmentissystematicdatacollectiononthepopulation,monitoringthepopulation’shealth
status, and making information available about the health of the community.
Policydevelopment refers to efforts to develop policies that support the health of the
population,includingusing ascientificknowledgebaseto makepolicy decisions.

12. Whentalkingtoawomen’sgroupatthesenior citizens’center,thenurseremindedthemthatthe only

way the center would be able to afford to provide transportation services for themwould be
for them to continue to write letters to their local city council representativesrequesting
funding for such a service. What was the nurse trying to accomplish through thisaction?
a. Ensurethat the womendid not expectthenursetosolve their problem.
b. Demonstrate that thenursNeuR nderIstooGd the
B.wComOMen’sconcerns and needs.
USNT
c. Expressempathy,support,andconcern.
d. Helpthewomenengageinpoliticalaction.
ANS:D
Public health nurses engage themselves and others in policy development and encourage
andassistpersonsto communicatetheirneeds tothosewith thepower totake action.
Thenurseisdemonstrating the role of advocate through this action, it goes beyond merely
understanidngthe women’s concern, and instead mobilizes them to take action. This action
does notdemonstratethenurseshowing empathyrather thenurseis empoweringthesewomen.

13. Thepublichealthnursehasaclearvision ofwhatneeds tobedone and whereto

begintoimprove the health of the community. Why would the nurse spend time meeting
withcommunitygroups to discussthemost importanttask to beaddressed first?
a. Toincreasethegroup’sself-esteem
b. Tomaintaincommunicationlinkswiththe groups
c. Tomakethe groupsfeelgood abouttheircontribution
d. Toworkwiththegroups,notforthegroups
ANS:D

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Historically, health care providers have been accused of providing care for or to
peoplewithoutactuallyinvolvingtherecipientsinthedecisions.Publichealthnursingisa“withthep
eople”—not a “to the people” or “for the people”—approach to planning. The purpose
ofmeeting with community groups is not to increase their self-esteem or make them feel
goodabout their contribution, rather it is to allow them to act for themselves to solve the
problemsthey are facing. The first task of working with the group should occur before
addressingmaintainingcommunication links.

14. Thenurseoften hastomakeresource allocation decisions.Whichofthe

followingbestdescribesthecriterion thenurseshould usein such cases?
a. Thespecificmoralor ethicalprinciplerelated tothesituation
b. Thecheapest,mosteconomicalapproach
c. Themostrationalprobable outcome
d. Theneeds of theaggregate ratherthanafew individuals
ANS:D
Thedominant needsof thepopulation outweightheexpressedneeds ofone orafewpeople.All of
the choices represent components of a decision that the nurse might consider
indeterminingthe needs ofthe aggregate.

15. Whichofthefollowingactionsbestrepresentspublichealth nursing?

a. Assessingtheeffectivenessof thehighschool healthclinic
b. Caringforclientsintheir homefollowingtheiroutpatientsurgeries
c. Providingcaretochildren andtheirfamilies atthe schoolclinic
d. Administeringfollow-upcareforpediatricclientsatanoutpatient clinic
ANS:A
A public health or populationN-fU
ocRuS
seI
dNapGpT
roB
ac.hCwOoM
uld look at the entiregroup of children
beingservedtodeterminewhetheravailableservices areeffectiveinachievingthegoal of
improvingthehealthoftheschoolpopulation.Caringforclientsandtheir familiesfocuses
onindividuals and families and not on the entire population. Public health focuses on care
ofpopulations.

16. Twonursesplan towalkunder ahuge downtownbridgewherevarious

homelesspersonslive.Whywould the nurses goto such an unsafearea?
a. Toassess the needs ofthehomeless who livethere
b. Todemonstratetheir courageandcommitment
c. Todistributesomeoftheir ownsurplus clothesto thosewho canusethem
d. Tosharewith variouschurchesand othercharitieswhat isneeded
ANS:A
In most nursing practices, the client seeks out and requests assistance. In public
healthnursing,thenurseoftenreachesouttothosewhomightbenefitfrom
aserviceorintervention,beginning with assessment of needs. The other answers reflect
responses where the nurse istryingto giveassistancetothis populationthat mayor maynot
behelpful orwelcomed.

MULTIPLERESPONSE

1. Which of the following variables have led to a stronger commitment to population-

focusedservices? (Select all that apply.)

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a. Economicturmoilanddemandforhigh-technology care
b. Emergenceofnewordrug-resistantinfectiousdiseases
c. Emphasisonoverall healthcareneeds ratherthanonlyonacute caretreatment
d. Threatofbioterrorism
ANS:B,C, D
Asoverall health needsbecome thefocus ofcareintheUnitedStates,astrongercommitmentto
population-focused services is emerging. Threats of bioterrorism, anthrax scares, and
theemergence of modern-day epidemics have drawn attention to population-focused safety
andservices. Economic turmoil and demand for high-technology care have not contributed to
astronger commitment to population-focused services, rather it has occurred as overall
healthneedshavebecome thefocus of care.

2. Whichofthefollowingactionsdemonstrateeffectivepublichealthnursingpracticeinthecomm
unity?(Select all that apply.)
a. Epidemiologicinvestigationsexaminetheenvironmentforhealthhazards.
b. Newservicesareorganizedwhereparticularvulnerablepopulationslive.
c. Partnershipsareestablishedwithcommunitycoalitions.
d. Staffmembersatthepublichealthagency continuetoincreaseinnumber.
ANS:A,B,C
Evidence that public health nurses are practicing effectively in the community would
includeorganizing services where people live, work, play, and learn; working in partnerships
and
withcoalitions;andparticipatinginepidemiologicstudies.Increasingnumberofstaffdoesnothavear
elationship to theeffectiveness of publichealthnursing practice.
3. Whyarenursesincreasinglyproviding carein clients’homesratherthaninhospitals?(Select
all that apply.)
a. Homecareisless expensive.
b. Itismuch moreefficientto givecareinthehome.
c. Nursesprefertogivehome carewithindividualattention.
d. Peopleprefertoreceive carein theirhomesratherthanin hospitals.
ANS:A,D
An increasing number of clients are receiving care in the home because it is less
expensiveand clients prefer to receive care in familiar and comfortable settings. It is not more
efficientnormoreconvenient, sincetraveltimehastobeconsidered. Nursesdiffer as
totheirpreferredemploymentsetting.

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