Chapter 42. Community Health My Nursing Test Banks

Chapter 42. Community Health

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. The inhabitants of Yulupa, California form which of the following?

1)

Aggregate

2)

Community

3)

Population

4)

Vulnerable population

____ 2. A community health nurse prepares for a new assignment. She has been assigned census tracts 131 and 132. This large area crosses the border of two towns and includes 4,000 people. What components of the community must the community health nurse assess prior to beginning her new assignment?

1)

Income levels, health status, and relationships among groups

2)

Structure of the tracts, effectiveness of the community, and current status

3)

Number of clients with health problems compared to the number of healthcare providers

4)

Community organizations and beliefs about their role in the community

____ 3. A community health nurse is evaluating the current health programs in the community. Which of these outcomes would indicate a healthy community?

1)

Ninety percent of members report adequate access to primary care services.

2)

Immunization services are available at hospitals and clinics.

3)

Affordable housing in the community is under construction.

4)

Mortality rates have been stable over the past 5 years.

____ 4. What is the type of nursing with a focus on the community as a whole and the health status of individuals as an aggregate?

1)

School nursing

2)

Community health nursing

3)

Community-oriented nursing

4)

Public health nursing

____ 5. The community health nurse is working with the residents of government-subsidized senior housing. She meets with them regularly to discuss concerns and evaluate whether they receive healthcare that meets their needs. Which of the following nursing roles best describes these actions?

1)

Case manager

2)

Client advocate

3)

Collaborator

4)

Counselor

5)

Educator

____ 6. A community health nurse gathers information about how individuals in a low-income neighborhood perceive the community and its state of health. Which of the following assessment strategies would be appropriate?

1)

Conducting a windshield survey while driving

2)

Reviewing a multitude of community databases

3)

Interviewing residents living on every fifth block

4)

Reviewing demographic data on the community

____ 7. The community health nurse has gathered data about the community. She identifies many weaknesses in the community health system that contributes to poor health outcomes. What should be her next step?

1)

Prioritize the list of problems.

2)

Validate the data.

3)

Assess the interventions she has planned.

4)

Plan the care.

____ 8. The similarities between the Omaha System and the NANDA taxonomy are that both contain which of the following?

1)

Evaluation tools expressed in standardized language

2)

Nursing diagnoses expressed in standardized language

3)

Diagnoses, outcomes, and interventions

4)

Labels that are intended for use in any healthcare setting

____ 9. A nurse serving the community in a public health role would likely perform which of the following functions within a particular community?

1)

Tracking the prevalence of gonorrhea between January and June

2)

Screening for scoliosis among 12- to 14-year-old girls in middle school

3)

Weighing premature infants receiving phototherapy at home

4)

Giving the H1N1 vaccine to fire and police personnel.

____ 10. A community health nurse planning a new program for teen pregnancy prevention designs a community assessment covering the structure of her target. Which of the following areas would she include?

1)

Number of residential and commercial buildings

2)

Demographic data of the residents

3)

Morbidity and mortality rates of the population

4)

Common strategies for conflict resolution

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

____ 1. A community health nurse prepares for a new assignment. She has been assigned census tracts 131 and 132. This large area crosses the border of two towns and includes 4,000 people. As a community health nurse, she recognizes that assignments are based on census tracts because census tracts do which of the following? Choose all that apply.

1)

Define the geopolitical boundaries of a community

2)

Are made up of persons who share a common heritage and customs

3)

Divide populations into smaller groups that can be assessed more readily

4)

Are natural divisions in communities that are based on voting patterns

____ 2. A community health nurse is assigned to work in a different area of the city. Which of the following assessment techniques would she likely use to develop an overview of the community? Choose all that apply.

1)

Windshield survey

2)

Review of demographic data

3)

Physical assessment of a sample of the inhabitants

4)

Review of the records of area providers

____ 3. Which of the following groups represents a vulnerable population? Choose all that apply.

1)

Homeless persons with no known illnesses

2)

Women who have experienced domestic violence

3)

Fifth-grade students at the local elementary school

4)

Persons with type 1 diabetes mellitus

____ 4. Which of the following is a primary intervention? Choose all that apply.

1)

Immunization for meningitis of college-bound students

2)

Safer sex education for high school students

3)

Lobbying for health education in the schools

4)

Tuberculosis screening via PPD testing

____ 5. Identify the nurse who is acting as a community health nurse. Choose all that apply.

1)

School nurse who provides screening and direct care in the elementary school

2)

Parish nurse who offers health education after services each Sunday

3)

Nurse who works for the Red Cross by providing disaster relief

4)

A nurse administering vaccines to inmates in a correctional facility

____ 6. Which of the following interventions has a public health focus? Choose all that apply.

1)

Controlling the blood sugar of a diabetic client with cardiovascular disease

2)

Assisting with the launch of an after-school program in a high-crime neighborhood

3)

Providing an influenza vaccination program for seniors and persons with chronic illness

4)

Offering counseling to the family of a child with severe cognitive deficits

True/False

Indicate whether the statement is true or false.

____ 1. Florence Nightingale is known as the first community health nurse.

Chapter 42. Community Health

Answer Section

MULTIPLE CHOICE

1. ANS: 3

A population is all of the people inhabiting a specified area. In contrast, a community is a group of like-minded individuals or one whose members have a common purpose, and an aggregate has shared characteristics. A vulnerable population is an aggregate with increased risk for poor health outcomes.

PTS: 1 DIF: Moderate REF: V1, p. 1058

KEY: Client need: SECE | Cognitive level: Comprehension

2. ANS: 2

To understand a community and its needs, the nurse must assess the communitys structure, status (the biological, social, and emotional outcome components of the community), and process (overall effectiveness of the community). Income level and demographic data, such as community organizations and healthcare providers, are included in the assessment of the community structure. The number of clients with health problems is only a part of the assessment of the community status.

PTS: 1 DIF: Difficult REF: V1, pp. 1058-1059

KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Analysis

3. ANS: 1

Evidence of health in a community can be judged by examining progress in the focus areas delineated in Healthy People 2020. Access to primary care services is a measurable outcome that provides evidence of effectiveness of health programs. The availability of immunization services at the hospital or at many offices does not provide evidence that these services are being utilized. Similarly, the fact that affordable housing is under construction does not mean that it is being accepted and used nor that enough is being built. Mortality rates may be stable but could be quite high and within unacceptable parameters.

PTS: 1 DIF: Difficult REF: V1, p. 1059

KEY: Nursing process: Evaluation | Client need: SECE | Cognitive level: Application

4. ANS: 4

Public health nursing focuses on the community at large and the eventual effect of the communitys health status on the health of individuals, families, and groups. Community health nursing focuses on the health of individuals, families, and groups and on how their health affects the health of the community. Community-oriented care combines elements of community health nursing and public health. School nursing focuses is optimizing health for a community of students in a school setting.

PTS: 1 DIF: Moderate REF: V1, p. 1060 | V2, p. 1036

KEY: Client need: SECE | Cognitive level: Recall

5. ANS: 3

As a collaborator, the nurse forges partnerships and coalitions that can effectively address common concerns among different communities. In this role, the nurse facilitates discussion to work toward problem resolution. As a case manager, the nurse makes referrals to or collaborates with other health and social agencies. In the client advocate role, the nurse supports the identified or voiced concerns of the client or community. As an educator, the nurse focuses on wellness and disease prevention through patient teaching. A counselor offers practical solutions to resolve problems.

PTS: 1 DIF: Moderate REF: V1, p. 1062

KEY: Nursing process: Interventions | Client need: SECE | Cognitive level: Application

6. ANS: 3

To assess community perceptions, the nurse will need to interact with a cross-section of the community. Interviewing residents is one way to find out about community concerns and opinions. The other methods are assessment strategies that will provide data about the community but do not offer information on how community members view the community.

PTS: 1 DIF: Moderate REF: V1, pp. 1066-1067

KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Application

7. ANS: 1

After a thorough assessment, the nurse compiles a list of community strengths and weaknesses. Once this list is in place, the nurse must prioritize the list considering the client needs, funding, and political feasibility.

PTS: 1 DIF: Moderate REF: V1, p. 1067

KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Analysis

8. ANS: 2

NANDA and the Omaha System both contain nursing diagnoses expressed in standardized language. The Omaha System also contains outcomes and interventions. The Omaha System was developed for use in community settings, whereas NANDA may be used in all settings.

PTS: 1 DIF: Moderate REF: V1, p. 1067

KEY: Nursing process: Diagnosis | Client need: SECE | Cognitive level: Analysis

9. ANS: 1

Public health nursing focuses on the community at large and the eventual effect of the communitys health status on the health of individuals, families, and groups. The goal of public health is to prevent individual disease and disability, in addition to promoting and protecting the health of the community as a whole, such as tracking the prevalence of disease. Activities, such as scoliosis screening, home care, and vaccination program, are examples of community health nursing.

PTS: 1 DIF: Moderate REF: V1, p. 1060

KEY: Nursing process: Interventions | Client need: HPM | Cognitive level: Application

10. ANS: 2

Structure refers to the general characteristics of a community. These include demographic data, such as gender, age, ethnicity, and educational and income levels, as well as data about healthcare services, such as the number of primary care providers or emergency departments in the area.

PTS: 1 DIF: Moderate REF: V1, p. 1059

KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

MULTIPLE RESPONSE

1. ANS: 1, 3

Census tracts are derived from the national census. They typically include 1,500 to 8,000 people. The area of the tract varies based on the density. Census tracts show geopolitical boundaries that are useful to anyone who studies the characteristics and concerns of smaller groups of people.

PTS: 1 DIF: Moderate REF: V1, p. 1058

KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Comprehension

2. ANS: 1, 2

A windshield survey and review of demographic data provide data about the community. She may interview area residents about their experiences or ideas about this community; however, physical examination of a sample of the inhabitants would not give her community-level data. Similarly, she may wish to meet with area providers, but reviewing their records violates HIPAA laws and assumes that the records accurately reflect the health concerns of the population.

PTS: 1 DIF: Moderate REF: V1, p. 1066

KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Application

3. ANS: 1, 2, 4

Vulnerable populations include those with limited economic or social resources, the very young and the very old, those with chronic disease, and people who have experienced abuse or trauma.

PTS: 1 DIF: Moderate REF: V1, pp. 1059-1060

KEY: Nursing process: Assessment | Client need: Physiological Integrity | Cognitive level: Application

4. ANS: 1, 2, 3

Primary interventions are interventions that occur before disease appears. The goal of primary interventions is to promote health and prevent disease. Secondary interventions aim to reduce the impact of the disease process by early detection and treatment. Tertiary interventions aim to halt disease progression and restore client functioning.

PTS: 1 DIF: Moderate REF: V1, p. 1063

KEY: Nursing process: Interventions | Client need: SECE | Cognitive level: Application

5. ANS: 1, 2, 3, 4

Community health nurses function as client advocates, counselors, case managers, educators, and collaborators for patients and their families in the community setting. All of these nurses are working in community health settings.

PTS: 1 DIF: Easy REF: V1, p. 1060 | V1, pp. 1062-1063

KEY: Client need: SECE | Cognitive level: Comprehension

6. ANS: 2, 3

Public health nursing focuses on the community at large and the eventual effect of the communitys health status on the health of individuals and families. Diabetic care is focused on individual health. Family counseling is focused on family health.

PTS: 1 DIF: Moderate

REF: V1, p. 1060; question involves critical thinking with synthesis of information acquired from reading this passage

KEY: Nursing process: Interventions | Client need: HPM | Cognitive level: Application

TRUE/FALSE

1. ANS: F

Florence Nightingale was influential in community health because she established the importance of promoting health by manipulating the environment. Lillian Wald is known as the first community health nurse.

PTS: 1 DIF: Moderate REF: V1, p. 1061 KEY: Cognitive level: Recall

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