Public Health and Community Nursing Exam 1 Review

This set contains exactly $$165$$ practice questions and answers derived from exam review notes focusing on public health, nursing history, ethics, economics, and cultural competency.

Which action would most likely be performed by a public health nurse?

Working with community groups to create policies to improve the environment

Which of the following best defines an aggregate?

A collection of people who share one or more personal or environmental characteristics

Making sure that essential community-oriented health services are available defines which of the core public health functions?

Assurance

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

Emergence of new or drug-resistant infectious diseases; Emphasis on overall health care needs rather than only on acute care treatment; Threat of bioterrorism

Which actions demonstrate effective public health nursing practice in the community? (Select all that apply.)

Epidemiologic investigations examine the environment for health hazards; New services are organized where particular vulnerable populations live; Partnerships are established with community coalitions

The Elizabethan Poor Law of $1601$ is similar to which current law?

Medicaid

What was the outcome of the Shattuck Report?

Guidelines for modern public health organizations were eventually developed

Which of the following accomplishments of today was started within the National Organization for Public Health Nursing?

Standardizing public health nursing education

What information about the American Public Health Association (APHA) should a nurse consider when deciding to join?

APHA provides a national forum for nurses to discuss their public health concerns

Which of the following best explains why a public health nurse is involved in health care reform efforts?

To help improve health care access

A nurse working with Mary Breckinridge would have likely assisted with which tasks? (Select all that apply.)

Developing health programs geared toward improving the health care of the rural populations; Ensuring positive outcomes for pregnancies among women in the Appalachian region

How did nursing education change in the $1950\text{s}$? (Select all that apply.)

Baccalaureate nursing programs typically included public health nursing concepts; Junior and community colleges began offering nursing programs

How did health care and its delivery change during the $1980\text{s}$? (Select all that apply.)

Laws began to be passed that discouraged the use of alcohol, drugs, and tobacco; Nurse practitioners were increasingly used to provide care; Public health programs suffered reduced political support, financing, and effectiveness

Which of the following best describes the cost of health care in the United States?

Health care costs are the highest in the world, but the indicators of health are not the best worldwide

How does managed care attempt to control costs of care?

By requiring families to choose a care provider from the MC network and not allowing access to other services without their provider's permission

Which factor is most important for a nurse to consider when determining which health care services must be offered at a local public health clinic?

Services mandated by the state government

Why would a public health agency want to achieve accreditation? (Select all that apply.)

To improve community relationships; To improve performance and quality; To improve management

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

Foreign-born immigrant population is increasing; Hispanics are the largest minority group population; Mortality for both genders in all age groups declined

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

Citizens are appreciating the quality of life enjoyed in the United States; People often spend a considerable amount of their own money on complementary therapies; The gap between the richest and poorest is widening

What is the nurse's most important ethical action when meeting a newly immigrated family from Botswana whose wife was diagnosed with cancer?

Interviewing the family concerning their perspective of the threat to the family's well-being

Which ethical approach is used by a nurse who suggests family members take turns calling in sick to help an ill relative so it is 'fair' to all?

Principlism

Which ethical approach is used by a nurse who states it is 'the family's decision' regarding who cares for an ill member because 'they know what is best for them'?

Principlism

A physician refuses pain medication for a drug addict, stating suffering will 'build character.' Which ethical theory is being misused?

Virtue ethics

Which of the following is considered the most important goal in nursing today?

Demonstrating caring as the basis of nursing practice

With which ethical approach are Gilligan and Noddings associated?

Feminine ethic

Which of the following would confirm that the nurse's advocacy has been truly successful or effective?

Systematic social changes are made to improve quality of life

How can nurses know whether they have been effective in assessing the community and planning and implementing interventions?

Examine the morbidity and mortality rate of the community

What conclusions can be drawn from a dispute where three nurses use different reasons to determine hospice care for a woman? (Select all that apply.)

Ethical principles can conflict with one another; The nurses are each using different ethical approaches; Each nurse can apply different ethical principles to reach their own ethical decision

Which of the following best describes most Americans' attitude toward immigrants?

Ambivalence because there are no clear solutions about how to address their needs

What term describes the NP changing an immigrant client's penicillin (a 'hot' medicine) to an equally effective antibiotic to provide 'balance'?

Cultural skill

A male nurse stops crossing his leg when he learns Muslim clients are offended by the exposure of the sole of his shoe. What did the nurse exhibit?

Cultural skill

Which of the following questions should the nurse ask during a cultural assessment for a patient from an unfamiliar culture? (Select all that apply.)

Can you tell me where your family is from?; Do you practice a particular religious faith?; Is there anything special we need to know about your food preferences?

Which of the following is demonstrated by a nurse who believes Western health care technology and research is the 'only right way' to provide care?

Ethnocentrism

A nurse examines blood lead levels in school-age children $1\text{ year}$ after an intervention. Which phase of the nursing process is this?

Evaluation

Which of the following are the major sources of air pollution in the United States? (Select all that apply.)

Burning of fossil fuels; Waste incineration; Motor vehicles

Which strategies would a nurse expect to be implemented by a typical state environmental agency? (Select all that apply.)

Acting, through unannounced inspections, to ensure compliance; Monitoring hazardous substances to uphold established standards; Obtaining and analyzing samples to confirm compliance

With which branch of government is a nurse working when lobbying a senator to increase funding for interpreter services?

Legislative branch of government

Why has the federal government traditionally become involved in health care?

The Constitution gives the federal government the power to promote the general welfare

When advocating for more public health nurses, which factor should the nurse emphasize based on NACNEP input?

Providing salaries commensurate with responsibilities

Who is responsible for determining the scope of practice for registered nurses?

State legislators

What is the best time for a nurse to request support for a bill from a local senator who is not on the reviewing committee?

When the bill moves out of committee to be heard by the entire Senate

Which criterion is most likely used to ration health care in the United States?

Ability to pay for services

What must a nurse be knowledgeable about to make decisions regarding the most cost-effective way to allocate health care resources?

Health economics

Which resource should the nurse recommend to a low-income family whose parents do not receive health insurance as an employee benefit?

Medicaid

Which group pays the largest amount for health care in the United States today?

Federal and state government

A Medicare recipient elects a monthly premium for laboratory services and equipment. Which part of Medicare is this?

Part B

A nurse persuades legislators to pass a bill offering health care financial aid to families at risk. Which level of prevention is this?

Primary prevention

In which situations would the federal government provide money through tax relief for private enterprise? (Select all that apply.)

A business pays for part of health insurance premiums for its employees; An employer provides health screenings and immunizations

Which interventions should be implemented to help community members focus on primary preventive health care? (Select all that apply.)

Publicize data on success of health promotion efforts, including cost savings; Establish standards for appropriate screenings at specific intervals

What are major differences in health care today compared with the first half of the $20\text{th century}$? (Select all that apply.)

Consumers are influenced by advertising for specific health care agents or procedures; Education and specialization of personnel have increased

Which of the following best describes community-based nursing?

A practice in which care is provided for individuals and families

Which of the following best describes community-oriented nursing?

Having the goal of health promotion and disease prevention

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

Health care of communities and populations

What was responsible for the dramatic increase in life expectancy during the $20\text{th century}$?

Sanitation and other population-based prevention programs

What intervention is most likely to be implemented to decrease the number of premature deaths in a community?

Promote healthy lifestyle behavior choices among the community members

What is a basic assumption of public health efforts?

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

Which public health nurse most clearly fulfills the responsibilities of the role?

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

Which question is most relevant for a newly employed public health nurse to ask?

Which groups are at the greatest risk for problems?

What is a public health nurse trying to accomplish by encouraging a senior group to write letters to the city council for center funding?

Help the women engage in political action

Why would a public health nurse spend time meeting with community groups to discuss which task should be addressed first?

To work with the groups, not for the groups

What criterion should a public health nurse use when making resource allocation decisions?

The needs of the aggregate rather than a few individuals

Which action best represents public health nursing?

Assessing the effectiveness of the high school health clinic

Why would public health nurses go to an unsafe area under a bridge where homeless persons live?

To assess the needs of the homeless who live there

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

Home care is less expensive; People prefer to receive care in their homes rather than in hospitals

Why would a position as a public health nurse be appealing to a nurse?

Its autonomy and independence

How did the Industrial Revolution make previous family-based caregiving approaches inadequate?

Migration and urbanization resulted in increased demand for care

Which activity would likely have been completed by a public health sector worker in early colonial America?

Collecting vital statistics and improving sanitation

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

They were afraid of infectious diseases such as yellow fever

A nurse employed by the Marine Hospital Service in $1800$ would likely have performed which intervention?

Providing health care for merchant seamen

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

Lillian Wald

What was the focus of a school nurse in the early $20\text{th century}$?

Investigating causes of absenteeism

Why were nurses so unprepared for public health nursing in the early $20\text{th century}$?

Nurses were educated in diploma schools, which focused on care of hospitalized clients

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

Having public health nurses visit policyholders led to a decline in deaths, lowering costs for the insurance company

Which client was most likely to receive care from the Frontier Nursing Service?

A woman in labor

What is the most crucial factor influencing the development of community health programming?

Federal funding for priority diseases or groups

A nursing student during World War II would likely join which group?

The Cadet Nurse Corps

Which document provides the most useful information for a public health nurse on promoting early detection of breast cancer?

Healthy People 2020

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

She focused on all soldiers and their environment; She kept careful records on what was done and what were the results

What is a primary benefit of implementing an electronic health record (EHR) in a public health agency?

Facilitation of interprofessional care

How would a nurse best describe the current health care system in the United States?

It is divided primarily into two components: private health care and public health care

Which of the following best describes ideal primary health care?

Essential care available to all community members, which encourages self-management

What is the best response to an $80\text{-year-old}$ woman who can no longer afford her medications on a Social Security income?

Let's see if we can get some help from Medicare to help you pay for these medications

What assumption can a public health nurse make about a low-income population in Massachusetts compared to other states?

They have access to affordable health care insurance

Where will a public health nurse most likely direct a client who does not have health insurance to receive care?

Community health center

Why have local, state, and federal governmental agencies cooperated more closely in recent years?

Increased focus on emergency preparedness and response

African American females having a higher mortality rate from breast cancer than white females is an example of:

Disparity

Which of the following is generally considered to be nursing's first code of ethics?

Nightingale Pledge

Which of the following best describes a nurse's action when talking to a supervisor about an ethical dilemma?

Justified, because this provides an opportunity to discuss the issue but the nurse maintains responsibility for the decision

What is the first and most crucial step in a generic ethical decision-making process?

Identify the ethical issues and dilemmas

What action should a nurse take when a family declines an elective intervention because it would drastically reduce resources for other members?

Appreciate that the family has made the decision that it feels is best and take no further action if the choice was informed

A nurse states 'It is a wife's responsibility to care for an ill husband' regarding an ethical dilemma. Which approach is this?

Deontological ethics

A nurse states a family 'will fall apart if they don't focus on their family's needs first' during an ethical debate. Which approach is this?

Utilitarianism

What is the dominant issue in ethical debates regarding continuing or withdrawing treatment in acute health care?

Upholding ethical principles

Which approach should a nurse use in personally deciding what the 'right' thing to do is for a patient?

Do whatever the nurse would recommend to anyone in a similar situation

Which premise ethically justifies a demand for immediate medical attention in an Emergency Department?

Our society believes that all persons should be treated equally and that basic needs should be met

What is a major ethical problem with the belief that everyone should receive their fair share and make their own decisions?

With this belief, the needs of society as a whole are ignored

How are ethics and public policies similar?

Both strive for the public good

What is the best response to a nurse who asks why they have to be involved in politics?

Political action is the way you try to fulfill your ethical responsibilities to clients

How can ethics be applied to public health nursing practice?

Ethics is constantly involved in nurses' clinical decisions

A patient from a different culture presents symptoms of an overdose but denies taking more than the label indicated. What is the most likely explanation?

The patient was also taking folk medicines that had many of the same effects as the prescribed medication