Chapter 11- The Nursing Profession and the Community My Nursing Test Banks

Import Settings:

Base Settings: Brownstone Default

Information Field: Client Needs

Information Field: Cognitive Level

Information Field: Difficulty

Information Field: Integrated Process

Information Field: Objective

Information Field: Page and Header

Highest Answer Letter: D

Multiple Keywords in Same Paragraph: No

Chapter: Chapter 11: The Nursing Profession and the Community

Multiple Choice

1. A goal of community nursing is to provide primary prevention from disease. Which of the following nursing actions reflect this goal?

A) A nurse creates a pamphlet discussing heart-healthy foods and distributes it in the neighborhood community center.

B) A nurse starts an intravenous line on a dehydrated baby who has been brought to the emergency department.

C) A nurse performs range-of-motion exercises for a patient in traction.

D) A nurse repositions an elderly patient confined to a wheelchair to avoid the formation of pressure ulcers.

Ans: A

Client Needs: B

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 4

Page and Header: 400, Primary Prevention

Feedback: Primary prevention involves the efforts to prevent disease from ever occurring. Primary prevention can be aimed at stopping the cause of disease. Generalized efforts to educate people regarding healthy diets are aimed at this type of primary prevention. Tertiary prevention focuses on preventing long-term disability and restoring functional capacity, as exemplified by repositioning an immobile patient, rehydrating a patient, or assisting with exercises.

2. A nurse decides to pursue a career in community-based nursing. Which of the following statements represents the environment in which the nurse will be working?

A) Community-based nursing is limited to work in public clinics, schools, and industry.

B) The key to community-based settings is that the nurse is in charge.

C) The nurse serves as an educator, guide, and resource person and determines the action taken by the client.

D) Care in the community is cost-effective.

Ans: D

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 2

Page and Header: 398, Understanding Community-Based Nursing

Feedback: Care in the community is cost-effective and often more acceptable to the client because it causes less disruption in life. It takes place in a wide variety of settings and involves the nurse entering into a collaborative relationship with clients.

3. The movement of a client from acute care to a long-term nursing care facility involves planning to provide continuity of care. What is the term for this type of planning?

A) Discharge planning

B) Comprehensive planning

C) Ongoing planning

D) Transition planning

Ans: D

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 2

Page and Header: 405, Transition Planning

Feedback: Transitions are the movement of the patient from one care environment to another. Transition planning refers to the planning process that takes place to assure that the patients well-being is maintained throughout the time of transition. Organizing this transition from one care setting to another is not termed discharge planning, comprehensive planning, or ongoing planning.

4. A nurse is called into work to perform triage in the aftermath of an earthquake. Which of the following are the expected responsibilities of this nurse?

A) Set up and monitor IV lines.

B) Prepare the emergency room for multiple victims.

C) Screen victims to prioritize treatment.

D) Check available blood products and assist with transfusions.

Ans: C

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 7

Page and Header: 410, Institution and Agency Disaster Response

Feedback: Triage involves the initial screening of victims for the purpose of prioritizing treatment and making the most effective and efficient use of both human and material resources. The other noted tasks are within the scope of disaster nursing but are not triage activities.

5. A client asks a nurse for help in obtaining an alternative healthcare provider. Which of the following is an accurate fact regarding alternative care that the nurse should share with this client?

A) Most alternative healthcare practitioners do not have education-based credentials to practice their medicine.

B) Alternative providers are not usually included in the federal HIPAA legislation that mandates confidentiality in conventional healthcare settings.

C) The cost of alternative therapy is never covered by insurance carriers or healthcare plans.

D) It is easy to find accurate safety and efficacy data for alternative medicine on the Internet.

Ans: B

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Teaching/Learning; Teaching/learning

Objective: 9

Page and Header: 421, Investigate Service Delivery

Feedback: Alternative providers are not normally included in the federal Health Insurance Portability and Accountability Act of 1996 legislation that mandates confidentiality in conventional healthcare settings. Alternative practitioners do not necessarily lack credentials. Accurate online information can be difficult to find and costs for treatment may be covered by some insurance plans.

6. There is an increasing trend for nursing care to move from the hospital setting into the community. Nurses who are to provide excellent care in a community setting should prioritize which of the following?

A) Integrating culture and family into the planning and delivery of care

B) Becoming more assertive in client education and the planning of client care

C) Encouraging clients to limit their interactions with physicians

D) Teaching clients to replace biomedical interventions with complementary therapies

Ans: A

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 1

Page and Header: 398, Understanding Community-Based Nursing

Feedback: The move to community care heightens the importance of family-centered, culturally-competent nursing. Community nursing does not necessarily require that a nurse become more assertive with client. It would be simplistic, and in most cases inappropriate, to guide clients to replace biomedical interventions or avoid doctors.

7. In spite of the important role that hospitals play in American healthcare, there is growing importance of community-based healthcare and community-based nursing. Which of the following statements best conveys a central aspect of the philosophy of community care?

A) The client is in charge of his or her health and healthcare in the community.

B) Nurses maximize their scope of practice in noninstitutional settings.

C) Community settings allow for the greatest number and variety of treatment options.

D) The nurse becomes the key member of the healthcare team in a community setting.

Ans: A

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 2

Page and Header: 398, Understanding Community-Based Nursing

Feedback: A central premise of community healthcare is the fact that patients/clients are in charge. The move toward community care is not motivated by an increased role for nurses. There are a greater number of treatment options in hospitals than in the community, but this fact does not negate the importance of community care.

8. Mr. Hammond is a 70-year-old man with a diagnosis of type 1 diabetes who developed a diabetic foot ulcer earlier this year. He has recently been discharged from the hospital and now requires regular wound care. Karen is a community health nurse who provides wound care for Mr. Hammond twice weekly. Which of Karens actions is most likely to empower Mr. Hammond?

A) Encourage Mr. Hammond to acknowledge his contribution to the development of his wound.

B) Provide information to Mr. Hammond that matches his expressed needs.

C) Encourage Mr. Hammond to involve members of his family in his care.

D) Delegate wound care to Mr. Hammond and reduce the frequency of her visits.

Ans: B

Client Needs: C

Cognitive Level: Application

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 3

Page and Header: 399, Client Empowerment

Feedback: Client empowerment is often fostered by assessing and meeting a clients need for information. Encouraging an acknowledgement of the clients contribution to his or her current health state is beneficial in many circumstances, but it less likely to make the client feel empowered. Similarly, family involvement can be beneficial but does not directly foster empowerment. Empowerment does not necessarily mean that the nurse does less and the client performs his or her own care; delegation may not be appropriate.

9. An elderly female client who resides in the community tends to defer decisions regarding her care to her eldest son. How should the community health nurse respond to the clients reluctance to make independent decisions?

A) Discuss this observation with the client and her son in an open manner and explore alternatives.

B) Organize care so that it takes place at times when the son is not present in the home.

C) Accommodate this aspect of the clients family dynamics when planning and carrying out care.

D) Teach the client assertiveness skills that she can apply in her interactions with her son.

Ans: C

Client Needs: C

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 3

Page and Header: 399, Client Empowerment

Feedback: The nurse should respect the clients desire to organize her care in the way that she prefers. It is not the responsibility of the nurse to reorganize or overcome this familys dynamics.

10. A client with a long-standing diagnosis of chronic obstructive pulmonary disease (COPD) has been enrolled in a disease management program. Which of the following activities will be prioritized in this program?

A) Providing comprehensive and evidence-based care of the clients COPD

B) Creating collaborative relationships between the client and the care team

C) Ensuring that the client qualifies for Medicare and Medicaid

D) Liaising between the client and his health maintenance organization (HMO)

Ans: A

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 5

Page and Header: 401, Disease Management

Feedback: Disease management focuses on providing the best evidence-based care for an individual with a specific chronic illness. This does not necessitate enrollment in an HMO, Medicare, or Medicaid. Collaborative relationships facilitate effective disease management but this is a means to the end of positive health outcomes rather than an end in itself.

11. One of the expressed goals of Healthy People 2020 is to achieve health equity and eliminate disparities. What health indicator can most accurately gauge whether this goal is being achieved?

A) Environmental quality

B) Injury and violence

C) Mental health

D) Access to healthcare services

Ans: D

Client Needs: B

Cognitive Level: Analysis

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 6

Page and Header: 403, Display 11.1

Feedback: Health equity is achieved when all Americans have equitable access to health services and there a fewer disparities in health access and health outcomes. Environmental quality, mental health and injury, and violence are important health indicators but these are less directly indicative of health equity and the elimination of disparities.

12. Nurses have the potential to positively impact the health of communities. Which of the following actions is most likely to improve the health of a community?

A) Publicizing the consequences of unhealthy lifestyles

B) Advocating politically for laws and policies that foster community health

C) Ensuring that nurses are practicing to the full extent of their scope of practice

D) Providing nursing care to individuals who are not patients or clients

Ans: B

Client Needs: B

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 6

Page and Header: 404, Nurses Roles in Supporting Healthy Communities

Feedback: One important role of nurses in the promotion of healthy communities is as a supporter and advocate for political measures that would improve the health of the community. Publicizing negative health outcomes is appropriate in some contexts but this is likely less effective than promoting broad change politically. It is not normally appropriate to provide nursing care for individuals who are not patients or clients. Practicing to the full extent of ones scope of practice is not likely to impact community health in a direct way.

13. A nurse who provides care in an acute medical unit is aware of the importance of thorough discharge planning. The discharge planning process should begin

A) once the patient has stabilized and is assured of positive outcomes.

B) as soon as possible after the patient is admitted.

C) once the patient has received a discharge order from his or her primary care provider.

D) 48 to 72 hours before the projected date of discharge.

Ans: B

Client Needs: A-1

Cognitive Level: Application

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 1

Page and Header: 406, Discharge Planning

Feedback: If possible, discharge planning should begin immediately upon admission.

14. A hospital patient has discussed with the nurse her use of visualization, biofeedback, and relaxation exercises in managing the chronic pain that results from her fibromyalgia. The nurse should recognize this patients use of what category of complementary/alternative medicine (CAM)?

A) Biologically-based practices

B) Manipulative practices

C) Traditional indigenous medicine

D) Mind-body medicine

Ans: D

Client Needs: B

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 8

Page and Header: 413, Tables 11.1 and 11.2

Feedback: Examples of mind-body medicine include relaxation exercises, hypnosis, meditation, dance, prayer, visualization, and biofeedback. Biologically-based practices focus on food and dietary supplements while indigenous medicine applies the collective health knowledge of a particular culture. Manipulative practices involve the systematic application of touch.

15. A hospital patient who suffered a spinal cord injury has expressed an interest in exploring complementary/alternative therapies. The nurse should encourage the patient to begin this process by doing which of the following activities?

A) Asking practitioners of different therapies to provide lists of satisfied clients

B) Asking the patients primary care provider for permission to explore nonbiomedical treatments

C) Finding reliable evidence regarding the safety and effectiveness of therapies

D) Determining whether the patients health insurance would cover the cost of alternative/complementary therapies

Ans: C

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 10

Page and Header: 420, Assess Safety and Effectiveness

Feedback: The first step for an individual interested in complementary/alternative therapies is to assess the safety and effectiveness of the therapy in relationship to his or her own condition. This must precede the identification of specific practitioners or making financial arrangements. Communication with the care team is important, but the patient does not need to seek permission before exploring treatment alternatives.

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