Chapter 06: Community Assessment Nies: Community/Public Health Nursing, 8th Edition

1. Which best describes how care can be appropriately given in a community?

a. Provide individualized care to unique individuals as much as resources allow.

b. Consider the community itself as the "client."

c. Administer care according to the priorities of the local health department.

d. Prioritize care for the sickest populations first.

ANS: B As it is clearly impossible and impractical to give service to each person in a community, the best approach considers the community itself to be the unit of service. The nurse partners with community members to identify community problems and develop solutions to ultimately improve the community's health. The community health nurse does not administer care according to the priorities of the health department or care for the sickest populations first.

2. Which provides the most accurate way to explain community health nursing?

a. Being employed outside a medical center, such as in a physician's office

b. Focusing care on the community as a whole

c. Providing care within the community, rather than a hospital or extended-care facility

d. Working for a public health department.

ANS: B Not only is community a context or place where a community health nurse gives care, but the community as a whole is the focus of the nurse's efforts. Being employed outside a medical center, providing care within the community, and working for a public health department all describe settings where a community health nurse may be employed, but do not demonstrate the emphasis on providing population-focused care.

3. Which activity would be most helpful to a person in whom a serious chronic illness has been diagnosed?

a. Discuss it with a religious leader on a confidential, do-not-tell basis.

b. Join a support group of others with the same illness.

c. Share the diagnosis with coworkers and neighbors to gain sympathy and support.

d. Tell extended family because many diseases have a genetic component.

ANS: B Although a person might choose to do any of these, the most helpful action over the long term is to join a support group with persons having the same diagnosis for mutual learning, sharing of resources, and support. Religious leaders could also be helpful, but many people do not have a religious leader.

4. Which is a major factor in determining which people or groups are most likely to be helpful to a particular individual?

a. Anyone who has time to be available

b. Environmental proximity

c. Same employment responsibilities

d. Similar religious faith

ANS: B Although it is certainly more common to have friends who are similar to ourselves in many ways, those most likely to be called on and respond are those in close environmental proximity. Proximity facilitates the recognition of commonality and the development of cohesion among members.

5. Which best describes how people typically respond when asked of what community are they a member?

a. Geographic community (neighborhood or city)

b. House of worship participants or members

c. Occupational or professional group

d. Those who are devoted to a particular craft or hobby

ANS: A Although individuals might well respond in terms of any of the possible responses, the most common response is in terms of geographic location of one's home or place of residence.

6. Which best describes what community members receive from each other?

a. Safe environment to live and work

b. Entertainment and recreational opportunities

c. Socialization and role fulfillment

d. Useful services such as physicians and medical centers

ANS: C A major feature of a community is the relationships that community members form with one another. These functions provide socialization, role fulfillment, goal achievement, and member support. Not all communities are safe environments, have medical centers, or offer recreational opportunities.

7. An individual lives in a healthy community. Which characteristic would this community most likely display?

a. Ability to adapt and respond to changes

b. Lack of environmental pollution

c. Low unemployment rate

d. Ongoing growth in population

ANS: A The community's ability to respond effectively to changing dynamics and meet the needs of its members indicates productive functioning. A community may or may not be able to control environmental pollution because the pollution is often from outside the community itself. Similarly, employment, or lack thereof, may be due to factors outside the community's control. In many communities, growth is not expected; simply not losing more population is a great achievement.

8. A nurse is helping a community develop its capacity to address future problems. Which activity is the nurse most likely implementing?

a. Addressing problems in priority order

b. Promoting collaboration and team building

c. Developing community competence

d. Providing education about health issues

ANS: C Although such activities are educational, collaborative, and ideally do address problems in some order by priority, building a community's capacity to address future problems is called developing community competence.

9. Which best describes shoe leather epidemiology?

a. Implementing the wheel model of epidemiology

b. Engaging in extensive truth seeking like a detective in the community

c. Traveling throughout the community to absorb an overall impression of it

d. Facilitating sharing of the community's history by community leaders

ANS: C Shoe leather epidemiology refers to establishing hypotheses about the community's health, strengths, and possible problems through the down-to-earth approach of traveling through the area, and observing and interacting with community members. Implementing the wheel model, engaging in truth seeking, and facilitating sharing of the community's history do not demonstrate the process of traveling through the community to absorb its overall impression.

10. A community health nurse wants to obtain an overview of the community, but has limited time and resources. Which method would the nurse most likely use to obtain this information?

a. Engage in a windshield survey

b. Establish a health department committee of community leaders willing to fill out periodic surveys related to various health issues in the community

c. Live in the community for several years

d. Review public health department records from up to 5 years ago

ANS: A The easiest way to obtain an overview of the community is through a windshield survey by driving or walking throughout the area and making organized observations. A group that is willing to respond to surveys and review public health records and that lives in the community would be very helpful but not easy or fast.

11. Which best describes how the U.S. Census Bureau surveys are helpful to a community health nurse?

a. They provide the distribution of age, sex, race, and ethnicity in the community.

b. They document the mortality and morbidity of the community.

c. They ensure that all community residents are involved.

d. They temporarily give employment opportunities to residents.

ANS: A Although they may offer temporary employment to some community residents and ideally all residents are counted, the value of the Census Bureau data is in clarifying the distribution of age, sex, race, and ethnicity of the community, which may also suggest health needs. The Census Bureau does not collect data on mortality and morbidity.

12. A public health nurse wanted statistics on the disability, illness, and other health-related variables for the state. Which would be the best resource for the nurse to obtain the most extensive data?

a. State health department records

b. State department of vital statistics

c. The Centers for Disease Control and Prevention

d. The National Center for Health Statistics

ANS: D The National Center for Health Statistics compiles annual National Health Survey data. It also publishes reports on prevalence of disability, illness, and other health-related variables. It tracks trends by nation, state, and year. The state health department records, state department of vital statistics, and Centers for Disease Control and Prevention will not provide all of the data that the nurse is trying to find

13. Which best describes when a community health nurse would try to collect data on a health issue?

a. When available data exists

b. When data must be purchased from the agency that collects it

c. When there is no source of previously collected data

d. When the data previously collected is available to the public

ANS: C Formal data collection does not exist for all health data. Therefore, many nurses must perform additional data collection, compilation, and analysis. It is not necessary for the nurse to try to collect data on a health issue if there is available existing data, the ability to purchase data, and the nurse is able to use previously collected data that is available for public information.

14. All of the needed objective data on a specific health problem are available for the community health nurse. Which best describes why the nurse would also interview community residents about the health problem?

a. To confirm the accuracy of the previously collected data

b. To emphasize to residents the importance of the health problem

c. To obtain the residents' personal insights and beliefs about the problem

d. To update the previously collected data

ANS: C The nurse must understand the community's perspective on health status, the services used or required, and their concerns. Official data do not capture this type of information. Data collected directly from an aggregate may be more insightful and accurate.

15. A nurse begins to collect information about a particular health problem from community residents. Which potential problem would most likely arise?

a. Residents might become suspicious about why the nurse needs this information.

b. Residents might believe the nurse is becoming intrusive in their personal lives.

c. Residents might wonder why they are being asked about the problem when previous surveys may also have asked about the same problem.

d. Residents might begin to expect service to be given to address the problem.

ANS: D

16. The nurse is interviewing community members as part of a community assessment. Which group of people would the community health nurse most likely want to interview?

a. Bankers who could share economic data on the community

b. Long-time residents who were informal leaders in the community

c. Pastors and other religious leaders who share the faith of the community

d. Realtors who could share housing and living conditions in the community

ANS: B The nurse needs to interview key informants in the community to gather data about the health of the community. Although each group could share some information, the long-time informal leaders would be most knowledgeable about the overall strengths and concerns of the community.

17. A nurse was debating about which approach to use to both obtain data about community needs and encourage community participation in their resolution. Which approach would be most effective in meeting both goals?

a. A community forum, open to all interested residents of the community

b. A community survey mailed to all residents

c. Establishing focus groups with selected participants

d. Conducting in-depth interviews with select community residents

ANS: C All of the responses would be helpful in obtaining information about the community. However, only focus groups promote group interaction and encourage further participation in planning solutions to identified problems.

18. A community health nurse has completed a community assessment and is now writing a community diagnosis for the problem. Which component of the diagnosis will be used to summarize the assessment data of the problem? a. Identification of the health risk b. Evidence supporting the choice of priority c. The aggregate that needs the intervention d. The cause of the identified health problem

ANS: A The identification of the health problem or risk represents a synthesis of all assessment data. The evidence can suggest the magnitude of the problem. The aggregate states who will be the beneficiary of the nurse's action plan. The cause of the health problem directs the focus of the intervention.

19. A community health nurse is trying to determine the success of a planned intervention. Which would the community health nurse most likely examine?

a. Changes in funding made available to the agency to continue their efforts

b. An increase or decrease in the number of persons asking for assistance

c. Current problem data to compare with original baseline data

d. Feedback from community residents

ANS: C

20. A community health nurse found a very small number of families in the community who were desperately in need of basic preventive health services. Which ethical approach supports expending agency resources on these few, but needy, families?

a. Beneficence suggests focusing on the most needy, so resources should be expended on these families.

b. Deontological ethics suggest that the nurse must give priority to the intervention that would have the broadest impact.

c. Utilitarianism (the most good for the largest number) would suggest continuing to focus on broader community needs.

d. Virtue ethics would suggest focusing on these families to support the nurse's own character development.

ANS: A Each response is an accurate portrayal of a branch of ethics. Beneficence and social justice would give moral advantage to the most vulnerable. By caring for these families, the demands of utilitarianism (the most good for the largest number) would also be met as caring for the weakest supports the whole community.

One dimension of a community, which looks at personal characteristics and risks of a group, is called

A. aggregate of people.

B. location in space and time.

C. social system.

D. census tract.

aggregate of people.

Which group is an example of a community of solution?

A. A group that lives within a specific geographic location.

B. concerned with reducing teenage suicides.

C. with the same ethnic background.

D. in which all members enjoy hiking.

concerned with reducing teenage suicides.

Which source of information about a community's health would give the community health nurse information about births, deaths, and marriages and aid in providing indicators of population growth or reduction?

A. Census tracts

B. Vital statistics

C. National Health Survey data

D. Needs assessment

Vital statistics

A community health nurse in the assessment phase of the nursing process conducted research to identify the distribution pattern of breast cancer within a population and the associated risk factors. This is called

A. statistical analysis.

B. needs assessment.

C. census collection.

D. epidemiology.

epidemiology.

One of the first steps in community assessment may involve the community health nurse driving or walking through an area and making observations about such things as environmental layout and location of agencies, hospitals, industries, and so forth. This is called a(n)

A. census survey.

B. needs survey.

C. informant survey.

D. windshield survey.

windshield survey.

Which method of gathering data is most effective for remote and vulnerable segments of a community and for those communities with underdeveloped opinions?

A. Interviewing community informants

B. Community forum

C. Focus groups

D. Telephone surveys

Focus groups

When writing a community diagnosis, the community health nurse notes that the "among" phrase

A. presents a synthesis of all assessment data.

B. provides the supporting data.

C. specifies the aggregate that will benefit from the nurse's plan.

D. describes the cause of the health problem and directs focus of interventions.

specifies the aggregate that will benefit from the nurse's plan.

Identify the etiologic or causal statement component of the following community diagnosis: "There is an increased risk for undetected testicular cancer among young men related to insufficient knowledge about the disease and the methods for preventing and detecting it at an early stage as demonstrated by high rates of late initiation of treatment."

A. Risk for undetected testicular cancer

B. Young men

C. Insufficient knowledge about the disease and methods of prevention

D. High rates of late initiation of treatment

Insufficient knowledge about the disease and methods of prevention

Epidemiologic data can be useful in the planning phase of the community assessment process because they:

A. help discover the patterns of health and illness distribution in a population.

B. help construct benchmarks to gauge achievement of program objectives.

C. identify the aggregate at risk.

D. explain the nature of the health problem.

help construct benchmarks to gauge achievement of program objectives.