Community Nursing Online Chapter Questions

1.
CHAPTER 1:
1.ID: 2508918789
Jennifer is a community health nurse in a large metropolitan area. According to the American Nurses
Association's Code of Ethics (2001), community health nurses must align themselves with public
health programs that promote and preserve the health of populations by influencing:
A.
socioeconomic issues.
B.
psychosocial issues.
C.
sociocultural issues.
D.
developmental issues.
The Code of Ethics of the American Nurses Association (2001) promotes social reform by focusing on
health policy and legislation to positively affect accessibility, quality, and cost of health care.
Community health nurses must align themselves with public health programs that promote and
preserve the health of populations by influencing sociocultural issues, such as human rights,
homelessness, violence, and stigma of illness. Directing care toward socioeconomic issues,
psychosocial issues, or developmental issues focuses on individuals, families, or groups, which in turn
contributes to the health of the total population.
DIF: Cognitive level: Knowledge

REF: Page 2
Awarded 1.0 points out of 1.0 possible points.
2.
2.ID: 2508920105
Mary is a nursing student doing her senior project in community health. Part of her assignment is to
conduct an activity that illustrates "social health" within a group in her community. The most
appropriate activity for Mary to organize would be a:
A.
neighborhood block party.
B.
food bank in a local church.
C.
community yard sale.
D.
school fundraiser for the school band.
Social health is a positive interaction among groups with an emphasis on health promotion and illness
prevention. The correct choice is a food bank in a local church because a food program alleviates
problems with hunger and nutrition that affect health. The other options do not relate to health.
DIF: Cognitive level: Application
REF: Page 3
3.
3.ID: 2508920109
It has been estimated that individual behaviors and environmental factors are responsible for what
percentage of all premature deaths in the United States?
A.
20%
B.
40%
C.
50%
D.
70%
According to Orleans and Cassidy (2011), 50% of all premature deaths in the United States are a
result of individual behaviors and environmental factors. According to Mokdad, Marks, Stroup, and
Gerberding (2004), tobacco use leads the list of "actual causes of death" at almost 20% of annual
deaths in the United States.

REF: Page 4
4.
4.ID: 2508920119
Early public health nurse Lillian Wald and her associates were successful in addressing health and
disease in the immigrant community by:
A.
supporting political activities to improve social and environmental conditions
of immigrant families.
B.
administering bedside nursing care to immigrants and their families.
C.
teaching the immigrant family members to provide health care in the home.
D.
obtaining and administering medications to the immigrants and their family members.
These early public health nurses saw that neither administering bedside clinical nursing, including
obtaining and administering medication, nor teaching family members to deliver care in the home
adequately addressed the true determinants of health and disease. They resolved that collective
political activity should focus on advancing the health of aggregates and improving social and
environmental conditions by addressing the social and environmental determinants of health. Wald
and her colleagues (1971) impacted the health of the community by organizing the community,
establishing school nursing, and taking impoverished mothers to testify in Washington, DC.
REF: Page 6
5.
5.ID: 2508920117
Disease prevention activities protect people from disease and the effects of disease. An example of
primary disease prevention is:
A.
teaching people with diabetes how to prevent complications.
B.
administering vaccines to children before kindergarten.
C.
checking the skin of farm workers for signs of skin cancer.
D.
identifying and testing individuals exposed to someone with tuberculosis.
Primary prevention activities prevent a problem before it occurs; an immunization is given to prevent
a disease before it occurs. Secondary prevention refers to early detection and prompt intervention
during the period of early disease pathogenesis, such as checking the skin for signs of skin cancer or
identifying and treating individuals who have been exposed to contagious diseases. Aims of tertiary
prevention are to keep health problems from getting worse, reduce the effects of disease and injury,
and restore individuals to their optimal level of functioning. Examples of tertiary prevention include
teaching prevention of complications from disease or referring a patient with a stroke for
rehabilitation.
REF: Page 7
6.
6.ID: 2508918798
Every 10 years, the U.S. Department of Health and Human Services publishes a national prevention
initiative titled Healthy People. One of the new objectives for Healthy People 2020 is to:
A.
achieve access to preventive services of all Americans.
B.
improve the nation's ability to prevent, prepare for, respond to, and recover
from a major health incident.
C.
reduce health disparities among Americans.
D.
increase independence of older Americans.
One of the new objectives for Healthy People 2020 focuses on preparedness for major health
incidents. Achieving access to preventive services of all Americans and reducing health disparities
among Americans were goals of Healthy People 2000, and increasing the independence of older
Americans was a goal of the original 1979 Healthy People version.
REF: Page 9
7.
7.ID: 2508920100
Which of the following is an example of "community health nursing" rather than "community-based
nursing"?
A.
An RN assisting a doctor in a pediatrician's office
B.
An RN visiting a home-bound patient to monitor for congestive heart failure
C.
An RN reviewing school clinic records to determine which children are not up
to date on their immunizations
D.
An RN dispensing medications in a nursing home
"Community health nursing" focuses on groups of people, with the primary responsibility being the
population as a whole (as with a school). Care typically focuses on health promotion and illness
prevention, such as the nurse who reviews school clinic records to determine which children are not
up to date on their immunizations. "Community-based nursing" is setting specific and emphasizes
care to individuals, often in homes and ambulatory clinics, and typically addresses acute and chronic
health conditions. The other options are examples of nurses providing care to individuals.
REF: Page 11
8.
8.ID: 2508920115
Which of the following entities strives to improve the health of all the public by promoting healthy
lifestyles, preventing disease and injury, and protecting the health of communities?
A.
Managed care organizations (MCOs)
B.
Medicare
C.
Public health system
D.
Affordable Care Act
The Public health system strives to improve the health of entire populations by promoting healthy
lifestyles, preventing disease and injury, and protecting the health of communities. Although MCOs
and government financing entities (Medicare and Medicaid) focus on the health of their clients, they
do not focus on the community and population in general. The focus of the Affordable Care Act is to
mandate health insurance for individuals.
REF: Page 16
9.
9.ID: 2508975564
A variety of health indicators are used by health providers, policy makers, and community health
nurses to measure the health of the community. Indicators that illustrate the health status of a
community and may be useful in analyzing health patterns over time include: (Select all that apply.)
A.
morbidity.
B.
mortality.
C.
birth rates.
D.
life expectancy.
E.
cancer incidence rates.
Some of the more commonly reported health indicators used by health providers, policy makers, and
community health nurses to measure the health of the community are life expectancy, infant
mortality, age-adjusted death rates, and cancer incidence rates. Birth rates do not provide relative
data to measure the health of a community.
REF: Page 5
10.
10.ID: 2508975568
Public health efforts focus on prevention and promotion of population health. The local level of the
health care system provides direct services to community members through community and personal
health services. An example of a health service that targets the larger community, rather than
individuals, is:(Select all that apply.)
A.
providing well-infant care.
B.
a mobile immunization clinic.
C.
condemning or repairing unsafe housing.
D.
encouraging family planning.
E.
airing a weekly public service announcement to remind women to do breast
self-examination.
A mobile immunization clinic, repairing unsafe housing, and airing weekly public service
announcements all target the larger population of a community. Providing well-infant care and
encouraging family planning target individuals.
REF: Page 6
CHAPTER 3:
1.
1.ID: 2508896587
Which of the following statements is NOT true about the "thinking upstream" model of community
health nursing practice?
A.
It is a conceptual model to assist the nurse in community health planning.
B.
It helps to focus the time, energy, and programmatic resources available to community
health nursing clients.
C.
It focuses the nurse on short-term, individual-based nursing interventions.
D.
It focuses the nurse on long-term, "bigger picture" issues related to community health
practice, such as social justice or power.
The upstream model uses the analogy of a river flowing upstream toward the bigger picture to focus
community health nursing practice. This differentiates population-focused and individual-focused
nursing interventions. The community health nurse needs to have a "critical eye" for the bigger
picture to focus time, energy, and resources and provide quality care.
REF: Page 37
2.
2.ID: 2508902606
A microscopic approach to the community health problem of childhood obesity would focus on:
A.
asking an obese child and his or her parent(s) to complete a 24-hour food
diary.
B.
analyzing aggregate Body Mass Indexes (BMIs) of school-age children in a school.
C.
advocating for a change in health policy related to school lunches.
D.
exploring changing cultural changes and societal values related to activity.
A microscopic approach to the conceptualization of the problem of childhood obesity focuses on the
individual child. A macroscopic approach focuses on the societal factors that influence health status.
Analyzing aggregate BMIs, advocating a change in school lunches, and exploring societal and cultural
values related to activity are examples of a macroscopic approach to the community health problem
of childhood obesity.

REF: Pages 38-39
3.
3.ID: 2508902603
Which of the following theories is based on the assumption that individual needs and related activities
are the focus of nursing care?
A.
Orem's self-care deficit theory
B.
The health belief model
C.
Milio's framework
D.
Critical social theory
Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing
interventions required to assist clients to obtain optimal health. The health belief model (HBM)
evolved from the premise that the world of the perceiver determines action. Milio's framework for
prevention (1976) provides a complement to the HBM and a mechanism for directing attention
upstream and examining opportunities for nursing intervention at the population level. Critical social
theory uses societal awareness to expose social inequalities that keep people from reaching their full
potential.
REF: Page 40
4.
4.ID: 2508896591
A community health nurse explores a group of teenagers' beliefs about the seriousness of eating
disorders and their related susceptibility. The nurse is applying principles from which theory?
A.
B.
C.
Milio's framework
D.
The health belief model (HBM) offers indicators of the perceived seriousness, perceived susceptibility,
and cues to action related to specific health behaviors. Orem's self-care deficit theory is based on
individual self-care needs and explains the level of nursing interventions required to assist clients to
obtain optimal health. Milio's framework for prevention (1976) provides a complement to the HBM
and a mechanism for directing attention upstream and examining opportunities for nursing
intervention at the population level. Critical social theory uses societal awareness to expose social
inequalities that keep people from reaching their full potential.

REF: Pages 40-41
5.
5.ID: 2508902608
A major limitation of the health belief model is that the burden of action related to health behaviors is
exclusively on the aggregate.
A.
True
B.
False
A major limitation of the health belief model is that the burden of responsibility for health behaviors is
on the individual client.
REF: Page 41
6.
6.ID: 2508896593
The belief that health deficits result from an imbalance between the population's health needs and its
health-sustaining resources is the premise of which theory?
A.
B.
C.
Milio's framework
D.
Milio's theory demonstrates upstream conceptualization of understanding the community's health
needs and resources; this theory complements the health belief model (HBM). The HBM offers
indicators of the perceived seriousness, perceived susceptibility, and cues to action related to specific
health behaviors. Orem's self-care deficit theory is based on individual self-care needs and explains
the level of nursing interventions required to assist clients to obtain optimal health. Critical social
theory exposes people to inequities to help them reach their full potential.
REF: Page 41
7.
7.ID: 2508896595
The community health nurse is teaching a prenatal class and includes the societal cost of fetal alcohol
syndrome in one of the educational sessions. The nurse is demonstrating an understanding of:
A.
Orem's self-care deficit theory.
B.
the health belief model.
C.
Milio's framework.
D.
critical theoretical perspective.
Critical theoretical perspective exposes people to inequities to help them reach their full potential.
Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing
interventions required to assist clients to obtain optimal health. The health belief model (HBM)
evolved from the premise that the world of the perceiver determines action. Milio's framework for
prevention (1976) provides a complement to the HBM and a mechanism for directing attention
upstream and examining opportunities for nursing intervention at the population level.
REF: Page 43
8.

8.ID: 2508896589
Which of the following nurse leaders formulated the first theory-based conceptual model for nursing
care?
A.
Nancy Milio
B.
Lillian Wald
C.
Florence Nightingale
D.
Dorthea Orem
Most nursing scholars identify Florence Nightingale as the first nurse theorist. Lillian Wald helped
establish community health nursing in the United States. Nancy Milio created the framework for
prevention theory. Dorthea Orem conceptualized the self-deficit theory.

REF: Page 37
9.
9.ID: 2508976466
Using theory to guide community health nursing practice serves to: (Select all that apply.)
A.
guide data collection and interpretation in a clear and organized manner.
B.
provide uniformity in community health nursing practice.
C.
improve community health nursing practice.
D.
validate traditional community health nursing beliefs.
E.
focus the student on factors that are critical to understanding the situation.
Theory-based practice guides data collection and interpretation in a clear and organized manner.
Although using theory makes it easier to plan standardized care for aggregates, the goal of theory is
to improve nursing practice, thereby ensuring quality care. Through the process of integrating theory
and practice, the student can focus on factors that are critical to understanding the situation. The lack
of uniformity in theory definitions reflects the evolution of thought and the individual differences in
the understanding of relationships among theory, practice, and research.
REF: Page 38
10.
10.ID: 2508976470
The use of theory in population-focused community health nursing encourages which of the
following? (Select all that apply.)
A.
A reactive approach to care
B.
A proactive approach to care
C.
Development of population-focused programs
D.
Development of individual-focused health protocols for community use
Theory assists the community health nurse in applying upstream thinking, including a proactive
approach to population-focused care. A reactive or individual approach prevents progress toward "big
picture" initiatives and population-based programs.
REF: Page 39
CHAPTER 4:
1.
1.ID: 2508914645
Receiving immunizations, regular health screenings, and physical exams is an example of:
A.
health promotion.
B.
health protection.
C.
secondary prevention.
D.
health maintenance.
Health protection refers to behaviors in which the individual engages with the intent to prevent
disease, detect disease in early stages, or maximize health. Immunizations and physical examinations
are examples. Green and Kreuter (1991) define health promotion as "any combination of health
education and related organizational, economic, and environmental supports for behavior of
individuals, groups, or communities conducive to health." Secondary prevention refers to early
detection and prompt intervention during the period of early disease pathogenesis, such as checking
the skin for signs of skin cancer or identifying and treating individuals who have been exposed to
contagious diseases. Health maintenance occurs when the individual has changed overt behavior for
more than 6 months and strives to prevent relapse.

REF: Page 50
2.
2.ID: 2508914649
Which of the following "determinants of health" refers to factors that are experienced with the
senses-things that can be seen, touched, heard, and smelled?
A.
Biology
B.
Behaviors
C.
Social environment
D.
Physical environment
The physical environment refers to the things that can be experienced with the senses. The physical
environment can affect health negatively or positively. Biology is an individual's genetic makeup,
family history, and any physical and mental health problems developed in the course of life.
Behaviors are the individual's responses to internal stimuli and external conditions. Social
environment includes interactions and relationships with family, friends, coworkers, and others in the
community.
REF: Page 53
3.
3.ID: 2508914661
Which of the following "determinants of health" would include predisposition to prostate cancer and a
history of depression?
A.
Biology
B.
Behaviors
C.
Social environment
D.
Physical environment
Biology refers to an individual's genetic makeup, family history, and physical and mental health
problems experienced over the course of life. Behaviors are the individual's responses to internal
stimuli and external conditions. Social environment includes interactions and relationships with
family, friends, coworkers, and others in the community. The physical environment refers to the
things that can be experienced with the senses. Biology is an individual's genetic makeup, family
history, and any physical and mental health problems developed in the course of life.
REF: Page 51
4.
4.ID: 2508914653
According to the health belief model, the inconvenience of driving to a gym to exercise is an example
of a:
A.
perceived susceptibility.
B.
perceived barrier.
C.
perceived benefit.
D.
cue to action.
Perceived barriers to action are one's beliefs regarding the tangible and psychological costs of an
advised action and include perceived unavailability, inconvenience, expense, difficulty, or time
regarding health behaviors. Perceived susceptibility is one's belief regarding the chance of getting a
given condition. Perceived benefit is one's belief in the ability of an advised action to reduce the
health risk or seriousness of a given condition. Cues to action are strategies or conditions in one's
environment that activate readiness to take action.
REF: Page 55
5.
5.ID: 2508914655
A man has been smoking for 20 of his 40 years. He smokes a pack of cigarettes daily and states, "My
dad smoked two packs a day and lived to be almost 90. Besides, I'm going to die from something
anyway, so why quit"? He is in which "stage of change" in the transtheoretical model?
A.
Contemplation
B.
Maintenance
C.
Precontemplation
D.
Preparation
In the precontemplation stage of change, the individual has no intention to take an action toward
changing a behavior in the next 6 months. In the contemplation stage, the individual has some
intention to take action toward behavior change in the next 6 months. In the maintenance stage, the
individual has changed overt behavior for more than 6 months. In the preparation stage, the
individual intends to take action within the next month and has taken steps toward behavior change.
REF: Page 56
6.
6.ID: 2508914651
A smoking cessation class stresses increased lung function, money saved that is not spent on
cigarettes, and smelling clean and fresh as benefits to quitting smoking. These support which of the
following concepts?
A.
Perceived barriers
B.
Decisional balance
C.
Precontemplation
D.
Contemplation
In the transtheoretical model, "decisional balance" describes weighing the benefits of a behavior
change against the cost of behavior change. Perceived barriers to action are one's beliefs regarding
the tangible and psychological costs of an advised action and include perceived unavailability,
inconvenience, expense, difficulty, or time regarding health behaviors. In the precontemplation stage
of change, the individual has no intention to take an action toward changing a behavior in the next 6
months. In the contemplation stage, the individual has some intention to take action toward behavior
change in the next 6 months.
REF: Page 56
7.
7.ID: 2508914657
A risk factor refers to a(n):
A.
probability that a specific event will occur in a given time frame.
B.
exposure that is associated with a disease.
C.
systematic way of distinguishing the risks posed by potentially harmful exposures.
D.
proactive process in which individuals participate in behaviors that enable them to
react to actual or potential threats to their health.
A risk factor is an exposure that is associated with incidence of a disease. Risk is the probability that a
specific event will occur in a given time frame. A risk assessment is a systematic way of
distinguishing the risks posed by potentially harmful exposures. A risk reduction is a proactive process
in which individuals participate in behaviors that enable them to react to actual or potential threats to
their health.
REF: Page 56
8.
8.ID: 2508914647
What is the most common chemical dependence in the United States?
A.
Alcohol
B.
Cocaine
C.
Marijuana
D.
Nicotine
Nicotine addiction is the most common form of chemical dependence in the United States. Smokers
who try to quit experience withdrawal symptoms, including anxiety, irritability, and difficulty
concentrating. Alcohol use is very common in our society, but it is not the most common form of
chemical dependence. Cocaine and marijuana are not the most common forms of chemical
dependence in the United States.
REF: Page 58
9.
9.ID: 2508914663
A 22-year-old college student explains to the nurse at the health clinic that she drinks four to five
beers when she goes out with friends on Saturday nights. Otherwise, she rarely drinks during the
week because of her classes, studying, and part-time job. This would be considered:
A.
age- and circumstance-appropriate behavior.
B.
alcoholism.
C.
binge drinking.
D.
excessive drinking.
Binge drinking is defined as drinking five or more drinks on a single occasion for men and four or
more for women. Excessive drinking is drinking more than two drinks per day on average for men or
more than one drink per day for women. This is considered binge drinking, which is not age- or
circumstance-appropriate behavior. Alcoholism is an addiction to alcohol.
REF: Pages 60-61
10.
10.ID: 2508977220
Which of the following is an example of a modifiable risk factor? (Select all that apply.)
A.
Air pollution
B.
Cigarette smoking
C.
Gender
D.
Sexual practices
E.
Diet
Modifiable risk factors are those aspects of a person's health risk over which he or she has control.
Examples include smoking, leading a sedentary or active lifestyle, the type and amount of food eaten,
and the type of activities in which he or she engages. Gender is not changeable. Air pollution can
contribute to some disease processes, but it is not considered to be a direct risk factor.
REF: Page 57
CHAPTER 5:
1.
1.ID: 2508933013
The nurse working in the community is aware that there are different models for studying the
epidemiology of a health condition in a population. One model of investigation of the
interrelationships and characteristics of disease is the epidemiologic triangle. This model analyzes
what three elements?
A.
Incidence, prevalence, and etiology
B.
Agent, host, and environment
C.
Person, place, and time
D.
Virus, bacteria, and fungus
The epidemiologic triangle considers the extent of the host's exposure to the agent, the virulence of
the agent, and the host's genetic or immunologic susceptibility to the agent. Environmental
conditions at the time of exposure are also considered. Examination of these three elements allows
assessment of the problem, determination of protective factors, and evaluation of the vulnerability of
the host to disease. The person-place-time model organized epidemiologists' investigations of the
disease pattern in the community. Answers A and D do not represent an epidemiologic model.

REF: Page 70
2.
2.ID: 2508933021
When chronic disease became a more important cause of death in developed countries, different
epidemiologic models were developed to study the many factors involved in the development of
these health conditions. Which of the following is an example of such a model?
A.
Person-place-time model
B.
Epidemiologic triangle
C.
Web of causation
D.
Wheel model
Chronic disease is marked by a complexity of relationships among causal factors. The web of
causation model illustrates the interrelationships. The person-place-time model organized
epidemiologists' investigations of the disease pattern in the community. The epidemiologic triangle
considers the extent of the host's exposure to the agent, the virulence of the agent, and the host's
genetic or immunological susceptibility to the agent. The wheel model is an example of a model that
stresses the multiplicity of host and environmental interactions.
REF: Page 72
3.
3.ID: 2508933017
In the 1850s, a researcher studied a cholera epidemic among people living in different sections of
London. The researcher who used epidemiologic methods to study the epidemic and used rates as an
epidemiologic tool was:
A.
Joseph Lister.
B.
William Farr.
C.
John Snow.
D.
Edward Jenner.
John Snow is recognized as the researcher who applied epidemiologic methods in the investigation of
a cholera epidemic in London in the 1850s. Joseph Lister is considered the pioneer of antiseptic
surgery. William Farr was a 19th century British epidemiologist who is regarded as a founder of
medical statistics. Edward Jenner developed the smallpox vaccine.
REF: Page 71
4.
4.ID: 2508933027
A community health nurse participating in planning programs for the coming year considers incidence
rates to better understand the needs of the community. Which statement below is the most accurate
explanation of incidence rates?
A.
New cases of a disease or condition in a community over a period of time are
included in incidence rates.
B.
The number of all cases of a specific disease or condition in a population at a given
point in time relative to the population at the same point in time is included in incidence
rates.
C.
Incidence rate refers to the number of new cases of a disease in those exposed to the
disease.
D.
The term incidence rate refers to the percentage of deaths in a specific period of time
from a specific cause.
Incidence rates describe the occurrence of new cases of a disease or condition in a community during
a period of time relative to the size of the population at risk for that disease or condition during that
same time period. In calculating this rate, the numerator is the number of new cases during the
specific period of time, and the denominator consists only of those who are at risk for developing the
disease or condition during the specific period of time. A prevalence rate is the number of all cases of
a specific disease or condition in a population at a given point in time relative to the population at the
same point in time. Attack rates document the number of new cases of a disease in those exposed to
the disease. The percentage of deaths in a specific period of time from a specific cause refers to the
mortality rate.
REF: Pages 74-75
5.
5.ID: 2508933019
An epidemic is occurring in a public health nurse's community, and the nurse is working with the
epidemiologist and other health professionals seeking to identify the causative agent. What phrase
best describes such efforts?
A.
Cohort study
B.
Descriptive epidemiology
C.
Point prevalence study
D.
Analytic epidemiology
Analytic epidemiology may be defined as close examination of identified possible causes of disease
using advanced epidemiologic methods. Cohort studies obtain information about the cause of disease
by establishing a relationship between the presumed causal factors and the effect. The study of the
amount and distribution of disease constitutes descriptive epidemiology. When prevalence rates
describe the number of people with the disease at a specific point in time, they are sometimes called
point prevalences.
REF: Page 83
6.
6.ID: 2508933011
A community nurse is reviewing health statistics to gain a better understanding of a population's
health needs. Crude rates are available for several health occurrences. What statement accurately
describes crude rates?
A.
In calculating a crude rate, the numerator is the size of the population at risk.
B.
In calculating a crude rate, the average population size may be used as
denominator.
C.
The denominator in a crude rate represents the population at risk for the event.
D.
Crude rates are used frequently because they avoid bias in interpretation.
Crude rates are calculated by using the number of events as the numerator. The denominator used
may be the average population size or the population size at midyear and not the population at risk.
Crude rates are subject to certain biases in interpretation.
REF: Page 75
7.
7.ID: 2508933015
The percentage of deaths resulting from a specific cause provides the nurse with information about
areas in which public health programs might make significant contributions in reducing deaths. Select
the statistic often used for this purpose.
A.
Proportionate mortality rate
B.
Crude death rate
C.
Age-adjusted death rate
D.
Standardized mortality rate
Proportionate mortality rate is calculated using the number of deaths resulting from a specific cause
in a specific time period as the numerator and the total number of deaths in the same time period as
the denominator. In crude death rates, the numerator is the number of deaths, and the denominator
is the average population size or the population size at midyear multiplied by a constant. Age
adjustment or standardization reduces bias when there is a difference between the age distributions
of two populations.
REF: Page 76
8.
8.ID: 2508933023
The health literature accessed by the community health nurse often addresses the probability of an
adverse event. What term refers to the likelihood that healthy people exposed to a specific factor will
experience a specific health condition?
A.
Prevalence
B.
Rates
C.
Risk
D.
Incidence
The term risk refers to the probability of an adverse event. Prevalence is the number of all cases of a
specific disease or condition in a population. Rates are arithmetic expressions that help practitioners
consider a count of an event relative to the size of the population from which it is
extracted. Incidence describes the occurrence of new cases of a disease or condition in a community
over a period of time.
REF: Page 77
9.
9.ID: 2508933025
Through epidemiologic investigations, effective prevention measures are often identified. When the
nurse is engaged in providing prevention for the community before disease has developed, the
prevention activities meet the definition for what level of prevention?
A.
Primary
B.
Secondary
C.
Tertiary
D.
Pathogenic
Primary prevention occurs when intervention activities take place before disease development.
Immunization is an example of primary prevention that provides specific protection. Secondary
prevention occurs after pathogenesis, namely screening and physical examinations that are aimed at
early diagnosis. Tertiary prevention focuses on rehabilitation and limitation of disability. Pathogenic
does not describe a type of prevention.

REF: Page 78
10.
10.ID: 2508977290
The public health nurse is working with a specific population and is preparing to participate in a
descriptive epidemiology study. Which of the statements apply to descriptive epidemiology? (Select
all that apply.)
A.
Descriptive epidemiology seeks to answer questions about the amount of
disease in a given population.
B.
Descriptive epidemiology seeks to answer questions about the cause of disease in a
given population.
C.
Descriptive epidemiology seeks to answer questions about the cure for disease in a
given population.
D.
Descriptive epidemiology seeks to answer questions about the distribution of
disease in a given population.
The study of the amount and distribution of disease constitutes descriptive epidemiology. Patterns
identified through descriptive epidemiology may indicate possible causes. When these possible
causes are investigated with different and more advanced epidemiologic methods, this is analytic
epidemiology.
REF: Page 83
CHAPTER 6:
1.
1.ID: 2508933031
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.
An aggregate is a community composed of people who share common characteristics. An aggregate
of people describes the "who" of a community, including personal characteristics and risks. Location
in space and time looks at the geographical location of a community. Social system is the
relationships that community members form with each other. Census tracts facilitate the organization
of resident information in specific community geographic locales.

REF: Page 93
2.
2.ID: 2508933047
Which of the following groups is an example of a community of solution? A group:
A.
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.
A community of solution forms when a common problem unites individuals. The group members may
have little in common other than the desire to address the problems that bring them together. A
geographic community is a group that lives within a specific geographic location. Other types of
communities may be defined by members of the same ethnic background or members that share the
same interests, such as hiking.
REF: Page 93
3.
3.ID: 2508933041
Which of the following sources 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
The official registration records of births, deaths, marriages, divorces, and adoptions form the basis of
data in vital statistics. When compared with previous years, vital statistics provide indicators of
population growth or reduction. Census tracts facilitate the organization of resident information in
specific community geographic locales. National Health Survey Data describes health trends in a
national sample. A needs assessment is completed by the community health nurse to gain
understanding of the community's perspective on health status, the services used or required, and
concerns.
REF: Page 99
4.
4.ID: 2508933039
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 involves the analysis of data to discover the patterns of health and illness distribution in
a population. It also involves conducting research to explain the nature of health problems and
identify aggregates at increased risk. Statistical analysis is a general term for the analysis of data. A
needs assessment is completed by the community health nurse to gain understanding of the
community's perspective on health status, the services used or required, and concerns. Census
information is collected every 10 years by the U.S. Census Bureau to describe the population
characteristics of the nation.
REF: Page 95
5.
5.ID: 2508933033
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.
Community health nurses often perform a windshield surveys by driving or walking through an area
and making organized observations to help gain an understanding of the environmental layout,
including geographic features and the location of agencies, services, businesses, and industries and
to locate possible areas of environmental concern through sight, sense, and sound. A needs
assessment is completed by the community health nurse to gain understanding of the community's
perspective on health status, the services used or required, and concerns. Census information is
collected every 10 years by the U.S. Census Bureau to describe the population characteristics of the
nation. To conduct an informant survey, the community health nurse may gather data by interviewing
key informants in the community. Informants may be knowledgeable residents, elected officials, or
health care providers.
REF: Pages 95-96, 98
6.
6.ID: 2508933045
Which of the following methods 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 are effective for remote and vulnerable segments of a community and for those with
underdeveloped opinions. These sessions can produce greater interaction and expression of ideas
than surveys and may provide more insight into an aggregate's opinions. The community health
nurse may gather some data by interviewing key informants in the community. Informants may be
knowledgeable residents, elected officials, or health care providers. A community forum may be held
to discuss selected questions. A telephone survey may be useful for selected questions.
REF: Pages 101-102
7.
7.ID: 2508933037
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.
The "among" phrase specifies the aggregate that will be the beneficiary of the nurse's action plan.
The identification of the health problem represents a synthesis of all assessment data. The "related
to" phrase describes the cause of the health problem and directs the focus of the intervention. The
health indicators are the supporting data. The "related to" phrase describes the cause of the health
problem and directs the focus of the intervention.

REF: Page 102
8.
8.ID: 2508933035
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
The "related to" phrase describes the cause of the health problem and directs the focus of the
intervention. "Risk for undetected testicular cancer" is the identified problem. "Young men" is the
identified aggregate. "Insufficient knowledge" is the "related to" phrase.
REF: Page 102
9.
9.ID: 2508933049
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.
Inherent in the planning phase of the nursing process is a plan for the intervention and its evaluation.
Epidemiologic data can be useful as a basis for determining success. By comparing baseline data,
national and local data, and other relevant indicators, the nurse can construct benchmarks to gauge
achievement of program objectives. The other options are useful in the assessment phase of the
nursing process.
REF: Pages 102-103
10.
10.ID: 2508977948
The steps in the community assessment process for community health nurses are: (Select all that
apply.)
A.
writing a community diagnosis.
B.
evaluating the outcomes.
C.
collecting assessment data.
D.
identifying the cause of the problem.
E.
planning community interventions.
The steps of the community assessment process for community health nurses are collecting the
assessment data, synthesizing assessment data into diagnostic statements about the community's
health, planning interventions, and evaluating the outcomes. Identifying the cause of the problem
helps with planning the interventions.

REF: Page 102
CHAPTER 7:
1.
1.ID: 2508933059
A community health nurse working as a school health nurse conducted a community assessment and
determined that the focus of programs and health education for the academic year should address
the problem of childhood obesity. In planning, it is important for the nurse to allow time for individual
nursing assessment and education for children who are overweight or obese and to plan classroom
education programs. The nurse is demonstrating an understanding of which important community
health nursing concept?
A.
Health planning
B.
Aggregate health care
C.
Community as client
D.
Use of the nursing process
Community health nurses focus care on health needs of aggregates; however, individual, families,
and groups are important parts of aggregates. Appropriate nursing care and health promotion
planned for aggregates affect individuals and vice versa. Use of the nursing process is one part of
health planning for the community. Health planning is an essential component of community health
nursing practice.

REF: Page 107
2.
2.ID: 2508933069
What legislation resulted in increased consumer involvement in the U.S. health care system and a
review of the allocation of health care resources?
A.
Partnership for Health Program
B.
Hill-Burton Act
C.
Regional Medical Services Programs
D.
National Health Planning and Resources Development Act
The National Health Planning and Resources Development Act addressed the need for the provider
and consumer to be involved in the planning and improving of health services as well as placing the
system of private practice examination. The Partnership for Health Program provided federal grants to
states to establish and administer a local agency program to enact local comprehensive health care
planning. The Hill-Burton Act was passed by Congress to address the need for better hospital access.
The Regional Medical Programs intended to make the latest technology for the diagnosis and
treatment of heart disease, cancer, stroke, and related diseases available to community health care
providers through the establishment of regional cooperative arrangements among medical schools,
research institutions, and hospitals.
REF: Page 117
3.
3.ID: 2508933057
A community health nurse is using the health planning model to improve a client's health. The nurse
prepares for unexpected problems or complications in the client's care. This attention to unexpected
problems takes place during which step?
A.
Assessment
B.
Planning
C.
Intervention
D.
Evaluation
During the intervention step of the health planning model, the nurse must prepare for unforeseen
problems or complications and consider alternatives to meet the client's needs. The nurse gathers
information about the needs of the community during the assessment step. During the planning step,
the nurse determines which problems or needs require intervention and identifies the desired
outcomes or ultimate goals of the interventions. Evaluation determines success or failure of the
project.
REF: Pages 111-112
4.
4.ID: 2508933061
Before participating in health care planning, a community health nurse must understand the concept
of:
A.
community as client.
B.
individual as client.
C.
family as client.
D.
environment as client.
It is essential that community health nurses understand and are comfortable with the concept
"community as client" before participating in health care planning. When focusing on the individual or
family, nurses must remember that these clients are members of a larger population group or
community, and environmental factors influence them.
REF: Page 107
5.
5.ID: 2508933065
The community health nurse understands that a client's health can be negatively or positively
affected by his or her suprasystem. Which of the following correctly describes a client's suprasystem?
The suprasystem includes:
A.
only health-related resources, such as primary care providers and insurance sources.
B.
only non-health-related resources, such as use of public transportation.
C.
all resources available for use by the client, including health-related and nonhealth-related resources.
D.
all official (governmental) agencies used by the client or family, such as the health
department or social services.
The suprasystem includes a variety of organizations and community resources. Some are health
related, such as the presence or absence of hospitals, clinics, primary care providers, or health
centers. Support services such as Meals on Wheels, public transportation, and recreational facilities
are also important. Governmental agencies used by the client are also assessed as part of the
suprasystem.

REF: Page 110
6.
6.ID: 2508933055
Systems theory provides a framework that includes interventions that are possible at the three levels
of prevention. The level of prevention that includes early diagnosis is:
A.
primary prevention.
B.
secondary prevention.
C.
tertiary prevention.
D.
supralevel prevention.
Secondary prevention can include early diagnosis and treatment of diseases that will reduce the
severity of the disease. Primary prevention consists of health promotion and activities that protect the
client from illness or dysfunction. Tertiary prevention applies to irreversible disability or damage and
aims to rehabilitate and restore an optimal level of functioning. Option D is not a type of prevention.
REF: Page 111
7.
7.ID: 2508933067
Public service announcements, dissemination of pamphlets, and focus groups are examples of
measures that can be used by the community health nurse. These are also known as:
A.
levels of intervention.
B.
nursing assessment.
C.
evaluation methods.
D.
nursing interventions.
Public service announcements, dissemination of pamphlets, and focus groups are all types of nursing
interventions that can be used by the community health nurse. Intervention levels apply to
aggregates, communities, or individuals. Assessment includes the collection of data to determine the
needs of the community or aggregate. Evaluation determines the success or failure of a project.
Methods may include verbal or written feedback, surveys, or other tools that measure whether
objectives were met.
REF: Pages 111-112
8.
8.ID: 2508933053
Which of following factors is NOT necessary to consider when determining priorities for health
problem interventions?
A.
The aggregate's preferences
B.
The number of individuals affected by the health problem
C.
The nurse's preferences
D.
The availability resources
Factors that assist the nurse in determining priorities for aggregate health care include the
aggregate's preferences; the number of people affected; the severity of the health problem; and the
available solutions, resources, time, and individuals with skills to help solve the problem. Often the
nurse will prefer to provide information and interventions that he or she is most comfortable with, but
that may not be what is needed most.

REF: Page 110
9.
9.ID: 2508933063
The rationale behind the Patient Protection and Affordable Care Act is to:
A.
put individuals, families, and small business owners in control of their health
care.
B.
increase federal aid to states for hospital facilities.
C.
improve the quality of care in rural areas and introduce systematic statewide health
care planning.
D.
force the implementation of health maintenance organizations.
The act puts individuals, families, and small business owners in control of their health care. The HillBurton Act provided federal aid to states for hospital facilities, resulting in improved quality of care in
rural areas and systematic statewide planning. Implementation of health maintenance organizations
is not required by the Patient Protection and Affordable Care Act.
REF: Page 118
10.
10.ID: 2508978123
The Patient Protection and Affordable Care Act of 2010 includes several elements that involve health
planning. These elements include: (Select all that apply.)
A.
creation of an innovation center within the Centers for Medicare and
Medicaid Services.
B.
provisions of monies for funding community health centers, school-based
clinics, and the National Health Service Corps to improve access to care.
C.
creation of task forces on preventive services and community preventive
services to develop, update, and disseminate evidence-based recommendations
on health care delivery.
D.
establishment of an independent payment advisory board to make proposals
to reduce the growth in Medicare spending.
E.
the establishment of regional cooperative arrangements among medical schools,
research institutions, and hospitals to improve the health manpower and facilities available
to the communities.
Provisions from the Patient Protection and Affordable Care Act of 2010 include:
Creation of task forces on preventive services and community preventive services to develop, update,
and disseminate evidence-based recommendations on health care delivery; establishment of the
National Prevention, Health Promotion, and Public Health Council, an agency that will be charged with
development of a national strategy to improve the nation's health; creation of an innovation center
within the Centers for Medicare and Medicaid Services; and development of a national quality
improvement strategy that will seek to improve delivery of health care services and population
health.
Provision of billions of dollars for funding community health centers, school-based clinics, and the
National Health Service Corps to improve access to care; establishment of an independent payment
advisory board to make proposals to reduce the growth in Medicare spending; and establishment of a
workforce advisory committee to develop a national workforce strategy and to suggest ways to
enhance the workforce supply by supporting education of health professionals through scholarships
and loans.
Regional Medical Programs were intended to establish regional cooperative arrangements among
medical schools, research institutions, and hospitals to improve the health manpower and facilities
available to the communities.
REF: Pages 117-118

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DIF: Cognitive level: Knowledge

DIF: Cognitive level: Knowledge

DIF: Cognitive level: Application

DIF: Cognitive level: Application

Awarded 1.0 points out of 1.0 possible points.

DIF: Cognitive level: Knowledge

DIF: Cognitive level: Application

DIF: Cognitive level: Knowledge

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DIF: Cognitive level: Knowledge

problem and directs the focus of the intervention.

helps with planning the interventions.

DIF: Cognitive level: Application

DIF: Cognitive level: Knowledge

DIF: Cognitive level: Knowledge

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