Test Bank For Public Health Nursing - Revised Reprint: Population-Centered Health Care In The Community, 8th Edition - Exam Guides | Nursing

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Chapter 01: Population-Focused Practice: TheFoundation of Specialization in Public HealthNursingStanhope: Public Health Nursing, 8th EditionChapter 01: Population-Focused Practice: The Foundation of Specialization in Public Health NursingTest BankMULTIPLE CHOICE1. One of the primary focuses of improving the health of the American people in the twenty-first century is to address:a. Bioterrorism and global health threatsb. Delivery of individual care and hygienec. The need for increased hospital and acute cared. Chronic disease and disability managementANS: AThere are new concerns, and one of the most serious is bioterrorism. The others are not related to public health or are concerns that have been present for many years.DIF: COG: Understanding REF: 4 OBJ: 12. The threat of bioterrorism has the potential to:a. Dissolve community-based programs.b. Cause the health care system to collapse.c. Divert funds from other public safety health care programs.d. Increase the need for shelters.ANS: CBioterrorism may have an impact on the availability of resources for public safety health care programs.DIF: COG: Analyzing REF: 4 OBJ: 13. Population-based preventive programs launched in the 1970s are responsible for increased:a. Use of tobaccob. Use of automobile safety restraintsc. Incidence of hypertensiond. Incidence of obesity

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ANS: BOne outcome of preventive programs launched in the 1970s is the increased use of automobile safety restraints. These programs also are responsible for the decreaseduse of tobacco and improved blood pressure control. None of these programs addressed the incidence of obesity.DIF: COG: Remembering REF: 5 OBJ: 14. The public health nurse must participate in the essential services of public health. These include:a. Monitoring health status by completing a community assessmentb. Diagnosing and investigating health problems in the worldc. Informing, educating, and empowering people about health issuesd. Working in law enforcement to regulate health and ensure safetyANS: CThe public health nurse monitors health status in several ways, completing a community assessment is only one way that health status is monitored. The public healthnurse would not diagnose or solve “world” problems, or work in law enforcement. Rather, the public health care nurse would participate with local regulators toprotect communities and empower people to address health issues.DIF: COG: Understanding REF: 5 OBJ: 15. Which of the following is an example of the mission of public health according to the Institute of Medicine?a. Tracking avian flu outbreaks and doing surveillance in the United Statesb. Providing a flu shot for an elderly person at the health departmentc. Keeping track of alternative therapies in use in the United Statesd. Keeping snake antivenom at the Centers for Disease Control and Prevention in AtlantaANS: AThe Institute of Medicine’s stated mission on public health is “to generate organized community and technical knowledge to prevent disease and promote health.”DIF: COG: Analyzing REF: 7 OBJ: 16. Making sure that essential community-oriented health services are available defines which of the core public health functions?a. Policy developmentb. Assessmentc. Assuranced. Scientific knowledge-based careANS: CPublic health is based on scientific knowledge, but is not a core function. The definition does not fit the terms assessment or policy development.DIF: COG: Applying REF: 7 OBJ: 1

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7. The number and proportion of persons aged 25 or older with less than a high school education is an example of:a. Sociodemographic characteristicsb. Health statusc. Health risk factorsd. Health care resource consumptionANS: AThe number and proportion of people is a demographical characteristic.DIF: COG: Analyzing REF: 8 OBJ: 18. The purpose of public health core functions is to:a. Clarify the role of the government in fulfilling the mission of public health.b. Ensure the safety of populations in receiving quality health care.c. Provide community-based individualized care to every person in the United States.d. Unite public and private providers of care in a comprehensive approach to providing health care.ANS: AAs defined by the Institute of Medicine in its 1988 report The Future of Public Health, assessment, policy development, and assurance are core functions at all levelsof government for the purpose of clarifying the government’s role.DIF: COG: Understanding REF: 7 OBJ: 19. Which of the following statements about public health is accurate?a. Prevention of early deaths can be more effectively accomplished by medical treatment than by public health approaches.b. Expenditures and resources for public health have increased in recent years.c. Historically, gains in the health of populations have been related largely to changes in safety, sanitation, and personal behavior.d. Reform of the medical insurance system is the single change needed to improve the health of Americans.ANS: CChanges, such as immunizations, tobacco use, blood pressure control, and automobile safety, have helped increase the health of communities.DIF: COG: Understanding REF: 7 OBJ: 110. Collecting data and monitoring the health status of the population defines which of the core public health functions?a. Assessmentb. Preventionc. Assuranced. Policy development

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ANS: APrevention is not a core function, assurance is making sure essential services are available, and policy development is needed to provide leadership in developingpolicies. Assessment consists of systematic data collection and monitoring health status.DIF: COG: Applying REF: 7 OBJ: 111. The nurse who compares the rate of teenage pregnancy in various areas of the city is practicing the public health core function of:a. Assuranceb. Assessmentc. Preventiond. Policy developmentANS: BAssessment refers to systematic data collection, which this nurse is doing for teenage pregnancy.DIF: COG: Evaluating REF: 7 OBJ: 112. Public health nurses who develop and implement local public health policies through partnerships with agencies, organizations, and consumers within thecommunity are using which core public health function?a. Assessmentb. Preventionc. Assuranced. Policy developmentANS: DPrevention is not a core function, assurance is making sure essential services are available, and assessment refers to systematic data collection. Policy developmentdeals with developing and implementing health policies.DIF: COG: Applying REF: 7 OBJ: 113. Providing for the availability of essential personal health services for people who would otherwise not receive health care defines which public health corefunction?a. Assessmentb. Preventionc. Assuranced. Policy developmentANS: C

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Assurance deals with the availability of health services. Prevention is not a core function, assessment refers to systematic data collection, and policy developmentrefers to the need to provide leadership in developing health policies.DIF: COG: Applying REF: 7 OBJ: 114. The nurse manager who makes sure that the staff members who work in a local clinic are competent is demonstrating the public health core function of:a. Assuranceb. Assessmentc. Preventiond. Policy developmentANS: AAssurance refers to making sure a competent health care workforce is available.DIF: COG: Evaluating REF: 7 OBJ: 115. The public health nurse analyzes data related to the number and type of United States Environmental Protection agency air quality standards that a communityfailed to meet. This data is an example of using which community health profile indicator?a. Sociodemographic characteristicsb. Health statusc. Health risk factord. Functional statusANS: CBreathing air of poor quality is a risk to health.DIF: COG: Evaluating REF: 8 OBJ: 116. Which is an example of the primary goal of public health?a. Ensuring that a newly diagnosed 40-year-old hypertensive man takes his medicationb. Finding home care for a 70-year-old client recuperating from a hip replacementc. Conducting an infant car seat safety checkd. Contacting a local hospice to admit a terminally ill 60-year-old womanANS: CThe correct answer is concerned with the health of many people, while the other answers address individual interventions.DIF: COG: Evaluating REF: 7 OBJ: 117. The public health workforce should demonstrate competency in which of the following competency categories?a. Financial planning and management

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b. Workforce needs assessmentc. Acute care servicesd. Curriculum developmentANS: AWorkforce needs assessment, acute care services, and curriculum development are not considered categories of core competencies of public health. Rather there areeight categories of competency, which include: analytic/assessment, policy development/program planning, communication, cultural competence, communitydimensions of practice, basic public health sciences, financial planning and management, and leadership and systems thinking.DIF: COG: Understanding REF: 9 OBJ: 218. Public health nursing is a specialty because:a. It has a distinct focus and scope of practice.b. It must be done by a registered nurse with a master’s degree.c. It is focused on disadvantaged citizens.d. It performs interventions at the acute care level.ANS: APublic health nursing has a distinct focus and requires a special knowledge base. The other answers are not characteristics of a specialty.DIF: COG: Understanding REF: 10 OBJ: 219. The necessary basic preparation for public health nursing is a(n) _____ in nursing.a. Associate’s degreeb. Baccalaureate degreec. Master’s degreed. PhDANS: BA BSN is the necessary basic preparation to function as a beginning staff public health nurse.DIF: COG: Remembering REF: 11 OBJ: 220. Public health practitioners prepared at the graduate level should be able to:a. Teach public and community health nursingb. Assess and intervene successfully at the aggregate levelc. Diagnose and treat disease and have prescriptive authorityd. Run for political office as experts in public health policyANS: B

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According to the Consensus Conference, specialists should have assessment skills that allow them to intervene at the aggregate level. Public health practitioners havea broad range of practice areas within public health and are not limited to only nursing and medicine.DIF: COG: Applying REF: 11 OBJ: 221. A public health nurse provides a clinic for HIV-positive citizens in the community. This is an example of:a. Primary preventionb. Secondary preventionc. Tertiary preventiond. Policy makingANS: CThis clinic is for clients who already have a disease process; therefore, it is tertiary prevention.DIF: COG: Applying REF: 11 OBJ: 222. An example of a community health nursing practice is:a. Administrating a flu shot to a client in a physician’s officeb. Conducting a flu shot clinic at a community centerc. Performing a client assessment in a hospitald. Providing supervision of staff in a rehabilitation centerANS: ACommunity health nursing practice focuses on providing individual interventions in the community. Administrating a flu shot to an individual is the only example thatmeets this criterion.DIF: COG: Applying REF: 16 OBJ: 323. Which statement about community health nursing practice is correct?a. It focuses on the delivery of personal health services to individuals and families.b. It provides care to protect the health of the community as a whole.c. It emphasizes the setting where care is provided for clients and families.d. It requires a baccalaureate preparation for practice.ANS: ABy definition, the first option is correct. Public health nursing provides care to protect the health of the community as a whole. Community-based nursing practiceemphasizes the setting where care is provided for clients and families. It is generally assumed that a graduate of any baccalaureate program has the necessary basicpreparation to function as a beginning staff public health nurse; however, this is not a requirement for public health nursing or community health nursing practices.DIF: COG: Understanding REF: 16 OBJ: 3

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24. The term community-based nursing care is applied when implementing which nursing intervention?a. Assessing the health needs of a defined communityb. Providing care to families in a communityc. Promoting the health of an entire communityd. Investigating environmental health problems in a communityANS: BCommunity-based nursing practice is a setting-specific practice whereby care is provided for families where they live, work, and attend school. The focus is on acuteand chronic care and the provision of services. Providing care to families is the only intervention that accurately describes this definition.DIF: COG: Applying REF: 16 OBJ: 325. The nurse who conducts vision screenings on children in the school setting is practicing _____ nursing practice.a. Community-orientedb. Public healthc. Community healthd. Community-basedANS: DThis type of nursing is a setting-specific practice.DIF: COG: Applying REF: 16 OBJ: 326. Which is an example of an aggregate or population?a. Students in a county school systemb. Christians around the worldc. A patient in the intensive care unit at the local hospitald. People who play cards together once a week at private homesANS: AA population or aggregate is a collection of individuals who have one or more personal or environmental characteristics in common. They can be defined in terms ofgeography or a special interest. The clients in the first option share a geographical characteristic.DIF: COG: Applying REF: 12 OBJ: 427. The nurse investigating environmental health problems caused by contaminated ground water is best described as practicing:a. Community-oriented nursingb. Community-based nursingc. Policy development

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d. Tertiary careANS: ACommunity-oriented nursing emphasizes the prevention of disease and disability.DIF: COG: Analyzing REF: 16 OBJ: 428. A population is best defined as a:a. High-risk groupb. School or institutional settingc. Collection of individuals who share at least one common characteristicd. Geographical location within a communityANS: CThe wrong answers are types of populations; they do not define a population.DIF: COG: Remembering REF: 12 OBJ: 429. Population-focused practice focuses on defining the problems or needs of and implementing solutions for:a. Individualsb. Aggregatesc. Communitiesd. Geographical regionsANS: BAggregates are a defined population made up of individuals in communities of a specific geographical region.DIF: COG: Understanding REF: 12 OBJ: 430. Which of the following statements is true with regard to a population focus in public health nursing?a. Priority is given to the highest risk population.b. Direct caregiving is limited to preventive measures, such as administration of immunizations.c. Attention is given to the population or community as a whole, regardless of whether they do or do not access the health care system.d. Only populations outside institutional settings are considered.ANS: CPublic health nurses are concerned with the health of the entire population.DIF: COG: Analyzing REF: 12 OBJ: 431. A public health staff nurse who has a clear understanding of population-focused practice:a. Is frustrated providing care to individuals

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b. Would rather perform population-focused interventionsc. Is able to improve the effectiveness of care providedd. Is considered a public health nurse specialistANS: CPublic health staff nurses who have a clear understanding of population-focused care improve their effectiveness and efficiency of practice; have professionalsatisfaction by seeing how individual care contributes to health at the population level; and appreciate the practice of others who are population-focused specialists.Public health nurse specialists are prepared at the master’s level and function in an administrative role.DIF: COG: Analyzing REF: 17 OBJ: 632. A key opportunity for public health nurses to improve population-focused care is by:a. Assuming traditional nursing rolesb. Influencing public health policyc. Conducting community assessmentsd. Specializing in community-based nursing practiceANS: BPublic health nurses must move into positions in which they can influence policy formation. They must assume positions that are not traditionally considered nursing.Conducting community assessments is part of public health nursing practice, not necessarily a key opportunity to improve practice. Specializing in community-basednursing practice is setting-specific and does not relate to a key opportunity to improve population-focused care.DIF: COG: Analyzing REF: 17 OBJ: 633. Proposed changes to the health care delivery system in the United States will:a. Provide new opportunities for public health specialists.b. Result in isolated care being provided to individuals.c. Emphasize specialty care.d. Increase the utilization of acute care services.ANS: AProposed changes in the health care delivery system will provide new opportunities for public health specialists and result in the creation of new roles within thesystem. The proposed changes will build an integrated system (not isolated), decrease emphasis on acute care services, and focus on health promotion and diseaseprevention.DIF: COG: Analyzing REF: 18 OBJ: 634. Implementing quality performance standards in public health is important because:a. They are used to guide improvement in the public health system.

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b. They rigidly control public health.c. Administrators will not monitor public health at the local level, but instead at the national level.d. They can be used as hiring guidelines for nurses.ANS: AThese standards were developed by the Centers for Disease Control and Prevention in 1998. They set the bar for the level of performance that is necessary to deliveressential public health services.DIF: COG: Applying REF: 9 OBJ: 735. To better address emerging public health issues, a public health nurse enrolls in a course addressing which content area?a. Leadershipb. Ethicsc. Communicationd. FinanceANS: BPublic health workers should be educated in eight content areas to be able to address emerging public health issues and advances in science and policy: informatics,genomics, cultural competence, community-based participatory research, policy, law, global health, and ethics.DIF: COG: Evaluating REF: 9 OBJ: 7MULTIPLE RESPONSE1. Which of the following are considered barriers to public health nursing? Select all that apply.a. The mindset that the only role for the nurse is at the bedside.b. The structures within which nurses work and the process of role socialization within those structures.c. Few nurses receive graduate-level preparation in the concepts and strategies of the disciplines basic to public health.d. The number of job opportunities in the area has been steadily declining.ANS: A, B, CAll are considered barriers to nurses specializing in public health nursing, except the number of job opportunities, which is not declining.DIF: COG: Understanding REF: 18 OBJ: 5Chapter 02: History of Public Health andPublic and Community Health NursingStanhope: Public Health Nursing, 8th EditionChapter 02: History of Public Health and Public and Community Health Nursing

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Test BankMULTIPLE CHOICE1. In the past, population-centered nurses have been called:a. District nursesb. Almshouse nursesc. Soldier nursesd. SistersANS: AIn the past, population-centered nurses have been called public health nurses, district nurses, visitingnurses, school nurses, occupational health nurses, and home health nurses.DIF: COG: Remembering REF: 23 OBJ: 12. Public health practice is an appealing specialty to nurses because of its:a. Interactions with wealthy contributors to secure fundingb. Autonomy and independence of practicec. Ability to locate the source of diseases and cure patientsd. Opportunities to meet a variety of peopleANS: BCommunity health nurses have a long history of autonomous practice, problem solving, and decisionmaking. Community health care nurses engage in the other activities as well, but overall, they havebeen best known for autonomy of practice.DIF: COG: Applying REF: 23 OBJ: 13. The Elizabethan Poor Law of 1601 is similar to which current law?a. Welfareb. Food Stampsc. Medicaidd. MedicareANS: CThe Poor Law guaranteed medical care for poor, blind, and “lame” individuals, similar to Medicaid.DIF: COG: Evaluating REF: 24-25|36 OBJ: 1

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4. Current threats to health in the United States that community health nurses are faced with include:a. Diphtheria, cholera, and hepatitisb. HIV, H1N1 influenza, and bioterrorismc. Avian flu, tuberculosis, and radiationd. Polluted water and airANS: BThe newest threats to health that public health nurses are involved in are HIV, H1N1 influenza, andbioterrorism. Hepatitis is also a current threat, but diphtheria and cholera are not concerns in theUnited States. Avian flu may be a threat, but radiation and tuberculosis are ongoing. Environmentalpollution has been reduced; however, there are pollution issues that do raise concerns.DIF: COG: Understanding REF: 23 OBJ: 25. A colonist working in the public health sector in early colonial North America would likely havefocused on:a. Establishing schools of nursingb. Developing vaccines to administer to large numbers of peoplec. Collecting vital statistics and improving sanitationd. Developing public housing and almshousesANS: CThe other choices are events that happened after the colonial period.DIF: COG: Applying REF: 24 OBJ: 26. The original work of the National Organization for Public Health Nursing has influenced nursingpractice today by:a. Requiring that public health nurses have a baccalaureate degree in nursingb. Standardizing public health nursing educationc. Developing nursing cooperativesd. Opening the Henry Street SettlementANS: BThe National Organization for Public Health Nursing sought to standardize public health nursing.The Henry Street Settlement was already in existence. The baccalaureate degree in nursing was notdeveloped yet.DIF: COG: Applying REF: 29 OBJ: 2

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7. A public health nurse is compiling information about how to promote early detection of breastcancer in women. Which document would most likely provide useful information about this topic?a. The Future of Public Healthb. Healthy People 2020c. Patient Protection and Affordable Care Actd. Scope and Standards of Public Health Nursing PracticeANS: BThe Healthy People documents propose national strategies to improve significantly the health ofAmericans by preventing or delaying the onset of major chronic illnesses, injuries, and infectiousdiseases.DIF: COG: Analyzing REF: 38 OBJ: 28. A major provision of the Social Security Act of 1935 was the establishment of:a. The Frontier Nursing Service to provide nursing service to rural communitiesb. State and local community health services and training of personnelc. District nursing to provide home health care to sick peopled. Community-based settlement housesANS: BTitle VI of the Social Security Act provided funding for expanded opportunities for health protectionand promotion through education and employment of public health nurses. Nurses completededucational programs in public health and funds were provided to assist states, counties, and medicaldistricts in the establishment and maintenance of adequate health services.DIF: COG: Remembering REF: 32 OBJ: 39. Public health nurses are involved in health care reform because reform should:a. Promote the nursing profession.b. Increase funding for public health nursing.c. Address the concerns of nurses.d. Improve health care access and reduce health care costs.ANS: DPublic health nurses have been involved in health care reform for several years. An emphasis ofreform is that health promotion and disease prevention appear to yield reduction in costs andillness/injury incidence while increasing years of healthy life.

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DIF: COG: Applying REF: 38-39 OBJ: 310. A neighborhood health center is researching its origins. Which of the legislative acts most likelyprovided funds for its development?a. Emergency Maternity and Infant Care Act of 1943b. Medicaid legislationc. Social Security Act of 1935d. Economic Opportunity ActANS: DFunding for neighborhood health centers, Head Start, and other community action programs began in1964 with the Economic Opportunity Act.DIF: COG: Analyzing REF: 36 OBJ: 311. What task would have been a responsibility of a nurse who was employed by the Marine HospitalService?a. Setting policy on quarantine legislation for immigrantsb. Establishing hospital-based programs to care for the sick at homec. Identifying and improving environmental conditionsd. Providing health care for merchant seamenANS: DProviding health care to seamen was an early effort by the federal government to improve publichealth. The purpose of the Marine Hospital Service was to secure its maritime trade and seacoastcities.DIF: COG: Analyzing REF: 24 OBJ: 312. A 66-year-old woman is retired and no longer has health insurance through her place ofemployment. Which program would be appropriate for her health insurance needs?a. Medicareb. Medicaidc. Social Securityd. Economic Opportunity ActANS: AThe Social Security Act was amended to include health insurance benefits for the elderly, which isaddressed through Medicare.

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DIF: COG: Analyzing REF: 36 OBJ: 313. Florence Nightingale’s contributions to public health included:a. Caring for the sick, poor, and neglected in institutions and at homeb. Using a population-based approach that led to improved environmental conditionsc. Writing the Elizabethan Poor Law to guarantee medical care for alld. Founding of the district nursing association to provide health care to needy peopleANS: BDuring the Crimean War, Nightingale progressively improved the soldiers’ health by adopting apopulation-based approach that used simple epidemiological measures and greatly decreasedmortality.DIF: COG: Remembering REF: 25 OBJ: 414. Lillian Wald’s major contribution to public health nursing was:a. Founding the American Nurses Associationb. Developing the New York Training Hospital for Nursesc. Creating the Public Health Serviced. Establishing the Henry Street SettlementANS: DLillian Wald established the Henry Street Settlement.DIF: COG: Remembering REF: 27 OBJ: 415. Neighborhood centers that provided health care, education, and social welfare programswere called:a. Settlement housesb. Nursing care centersc. Nurse-managed clinicsd. Public health servicesANS: ASettlement houses were neighborhood centers that provided health care, education, and social welfareprograms. Nursing centers, nurse-managed clinics, and public health services are not necessarily inneighborhoods.DIF: COG: Remembering REF: 27 OBJ: 4

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16. Which topic is most likely to have been discussed when Lillian Wald provided publichealth education?a. Taking and recording blood pressures accuratelyb. Safe and sanitary baby and child carec. Environmental pollutants and their effects on lung diseased. Time management: balancing factory work and the homeANS: BLillian Wald provided health care that included educating the community on health care matters.DIF: COG: Evaluating REF: 26 OBJ: 417. Nurses who provided care to people in their homes and provided that care to several people at atime were called _____ nurses.a. Private dutyb. Visitingc. Public healthd. Community staffANS: BThe visiting nurse cared for several families in a day and helped to make care of the sick poor athome economical, whereas a private duty nurse may live with a family of clients receiving care andwas to be available 24 hours a day.DIF: COG: Remembering REF: 26 OBJ: 518. Which of the trends in health issues in the United States between 1900 and 1955 is accurate?a. There was a rise in chronic disease such as heart disease and cancer.b. There was a rise in communicable disease.c. The crude mortality rate increased dramatically.d. The life span after diagnosis remained the same.ANS: ALeading causes of death in 1955 were heart disease, cancer, and cerebrovascular disease, whereas in1900 they were pneumonia, tuberculosis, and diarrhea/enteritis. The mortality rate decreased by 47%.There was a decrease in communicable disease, and the life span after diagnosis increased.DIF: COG: Understanding REF: 34-35 OBJ: 5

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19. Local health departments were formed in urban areas in the late 1800s to:a. Target environmental hazards associated with crowded living conditions.b. Facilitate interdisciplinary efforts and promote “practical nursing.”c. Provide immunizations and health care services to all citizens.d. Offer public health education to nurses who had finished basic training.ANS: ALocal health departments were formed to handle environmental issues in cities, including problemsassociated with crowded living conditions and dirty streets, and to regulate public baths,slaughterhouses, and pigsties.DIF: COG: Understanding REF: 29 OBJ: 520. The practice of a school nurse in the early twentieth century would have focused on:a. Investigating causes of absenteeismb. Teaching school as well as being a nursec. Promoting nursing as an autonomous practiced. Providing medical treatment to enable children to return to schoolANS: AEarly school nursing focused on investigating causes of absenteeism, not providing medicaltreatment. That was the responsibility of physicians.DIF: COG: Applying REF: 28 OBJ: 521. When comparing the practices of industrial and occupational health nurses, it is noted that:a. Industrial nurses invented new machines to streamline production of medical goods, whereasoccupational health nurses provide care to employees.b. Industrial nurses investigated industrial injuries to improve work conditions, whereas occupationalhealth nurses demonstrate proper body mechanics.c. Industrial nurses treated work related-injuries, whereas occupational health nurses care for familiesin their homes.d. Industrial nurses provided care for workers in their homes, whereas occupational health nursescare for work-related injuries.ANS: DEarly occupational health nursing did not provide care for work-related injuries, but instead focused

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on the care of employees and their families in the home. Contemporary occupational health nursesprovide care for work-related injuries.DIF: COG: Analyzing REF: 28 OBJ: 522. The document, Visiting Nurses in the United States, highlighted the fact that:a. Nurses were trained by Boards of Education.b. Trained nurses adequately covered less densely populated areas.c. Visiting nurse services were concentrated in the northeastern United States.d. Nurses were curing diseases such as tuberculosis and typhoid fever.ANS: CThis report emphasized the fact that visiting nurse services were concentrated in the northeast, whichunderscored the need for rural health.DIF: COG: Remembering REF: 28 OBJ: 623. Which statement is true about African American nurses in public health?a. Certificate and graduate education were more difficult to obtain.b. Cities were the major areas where they practiced.c. They often belonged to the Frontier Nursing Service.d. They were recruited heavily as military nurses.ANS: ADue to segregation, certification and graduate education were more difficult to obtain.DIF: COG: Understanding REF: 30 OBJ: 624. An example of the resourcefulness of a nurse during the time when the Rural Nursing Servicewas operating through the American Red Cross was:a. Using hot bricks, salt, or sandbags to substitute for hot water bottlesb. Testing well water for pollutantsc. Teaching school and developing curricula for rural nursing programsd. Providing post-surgical careANS: AIn providing medical care, rural nurses were resourceful in finding alternatives when they did nothave medical products that were available in urban areas.DIF: COG: Applying REF: 28 OBJ: 6

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25. A nurse working with Mary Breckinridge would have likely assisted with:a. Establishing the Henry Street Settlementb. Developing health programs geared toward improving the health care of the rural populationsc. Blazing a nursing trail through the Rockies, providing nursing care to miners and their familiesd. Teaching birth control measures to large numbers of women in the SouthANS: BMary Breckinridge developed health programs geared toward improving the health care of the ruraland often inaccessible populations in the Appalachian regions of southern Kentucky. Lillian Waldestablished the Henry Street Settlement.DIF: COG: Applying REF: 30 OBJ: 626. Which client would have been most likely to receive care from the Frontier Nursing Service?a. An injured soldierb. A homebound, elderly malec. A woman in labord. A child with measlesANS: CThe Frontier Nursing Service nurses were trained in nursing public health and midwifery andprovided care to rural and inaccessible areas, which led to reduced mortality.DIF: COG: Applying REF: 30 OBJ: 627. A nurse is considering joining the American Public Health Association. What information aboutthis organization should be considered when making this decision?a. APHA focuses on the public health concerns of the medical profession.b. APHA represents concerns of nursing specialty practices.c. APHA provides a forum for nurses to discuss their public health concerns.d. APHA focuses on providing health promotion education to the public.ANS: CAPHA was formed to facilitate interprofessional efforts and promote the “practical application ofpublic hygiene.” The Public Health Section within APHA provides nurses with a forum to discusstheir concerns and strategies. It also serves as a focus of leadership and policy development forcommunity/public health nursing.DIF: COG: Applying REF: 29 OBJ: 6

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28. A nursing student during World War II would likely join which group?a. The Public Health Service of New York Cityb. The Marine Nurse Corpsc. The Frontier Nursing Serviced. The Cadet Nurse CorpsANS: DThe Bolton Act of 1943 established the Cadet Nurse Corps during World War II, which increasedenrollment in schools of nursing at undergraduate and graduate levels.DIF: COG: Analyzing REF: 33 OBJ: 6MULTIPLE RESPONSE1. The impact of World War I on public health nursing included (select all that apply):a. Many communicable diseases were eradicated.b. The depletion of the ranks of public health nurses to the war.c. The feeling that the greatest patriotic duty was to stay at home.d. Expanding nursing services in the community was limited by lack of funding.ANS: B, C, DBoth World Wars I and II depleted the public health nurse population as nurses went off to war. Thefeeling of patriotism extended to the idea that patriotic duty could also be served on the home front.DIF: COG: Understanding REF: 30 OBJ: 6Chapter 03: Public Health and Primary HealthCare Systems and Health Care TransformationStanhope: Public Health Nursing, 8th EditionChapter 03: Public Health and Primary Health Care Systems and Health Care TransformationTest BankMULTIPLE CHOICE1. According to the 1999 Institute of Medicine report, as many as 98,000 deaths each year are causedby:a. Cardiovascular disease

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b. Obesityc. Medical errord. Drug overdoseANS: CIn 2000, it was thought that our health care system was expensive and that access and quality werenot optimal, but we had not considered this important fact: many people die of preventable medicalerrors in the United States.DIF: COG: Remembering REF: 49 OBJ: 12. In the United States, the majority of health care dollars are spent on:a. Prescription drugsb. Hospital carec. Physician servicesd. Public health servicesANS: BThe largest share of health care expenditures goes to pay for hospital care, with physician servicesthe next largest item. The money spent for public health services is significantly lower than the othercategories and prescription drugs accounted for only 10% of expenditures in 2008.DIF: COG: Remembering REF: 46 OBJ: 13. The number of uninsured Americans has dramatically increased because:a. Medicare took over payment of health care costs.b. With a declining population, the costs for health care rose.c. Nursing salaries greatly increased, causing health care costs to rise.d. Health insurance coverage was dropped from employment-based health plans.ANS: DAlthough the majority of Americans continue to obtain health insurance from their employer as abenefit, employment does not guarantee insurance. Employer-sponsored health insurance is sensitiveto both the general economy and changes in health insurance premiums. As costs for insurancepremiums rose, employers either shifted more of these costs to their employees or declined to offeremployment-based health coverage at all.DIF: COG: Understanding REF: 46 OBJ: 1

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4. The primary purpose of the World Health Organization is to:a. Coordinate surveillance at the global level.b. Prevent outbreaks of disease.c. Prevent the transmittal of communicable disease among nations of the world.d. Provide humanitarian support in times of disaster.ANS: AThe World Health Organization, comprised of 192 member countries, is uniquely positioned tocoordinate surveillance and response at the global level.DIF: COG: Understanding REF: 52 OBJ: 15. One of the benefits that a public health agency will experience by choosing to implement theelectronic health record is:a. Facilitation of interprofessional careb. Improved client compliance with medical regimensc. Cost-savings to the agencyd. Compliance with JACHO standardsANS: AThe electronic medical record facilitates interprofessional care in chronic disease management andcoordination of referrals; 24-hour availability of records with downloaded laboratory results and up-to-date assessments; incorporation of protocol reminders for prevention, screening, and managementof chronic disease; improvement of quality measurement and monitoring; and increased client safetyand decline in medication errors.DIF: COG: Applying REF: 52 OBJ: 16. African American females have a higher mortality rate from breast cancer than Caucasian females.This is an example of:a. Projectionb. Disparityc. Racismd. A sentinel eventANS: BDisparities are racial or ethnic differences in the quality of health care, not based on access or clinicalneeds, preferences, or appropriateness of an intervention.

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DIF: COG: Applying REF: 46 OBJ: 17. A nursing program has initiated a recruitment campaign focusing on increasing the minoritystudents in its program. The rationale for this campaign is that:a. The number of minority versus non-minority nurses should be equal.b. Minority health care professionals who share the same culture with the clients may provide moreeffective care.c. The profession should be more diverse.d. Minority nurses can mentor other nurses when providing care for diverse populations.ANS: BThe Pew Commission suggests that increasing minority representation in the health workforce notonly is a commitment to diversity but also will improve the health care delivery system. Minorityhealth professionals can be expected to practice in underserved areas at a greater rate and healthprofessionals who share the same culture and language with the clients they serve can provide moreeffective care.DIF: COG: Applying REF: 51 OBJ: 18. A community health nurse utilizes telehealth because it:a. Enables clients to get nursing care in their homesb. Substitutes for health department delivered carec. Improves access to care in rural areasd. Replaces face-to-face care for those who cannot afford itANS: CTelehealth provides increased access to health care by the use of a computer monitor and telephoneline. It is useful for monitoring clients with chronic disease, but is not a substitute for health care.DIF: COG: Applying REF: 51 OBJ: 19. An 80-year-old woman comes to the community health center with a large bag of medications. Shetells the nurse she can no longer afford these medications because her only income is Social Security.Which statement is the best response by the nurse?a. “Let’s go through these medications and see which ones we can delete.”b. “You can get these medicines at this clinic for free.”c. “Let’s see if we can get some help from Medicare to pay for these medications. I will refer you toour social worker.”

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d. “These medications are important. Do your best to pay for them.”ANS: CThis elderly patient probably is eligible for benefits through Part C, the Medicare Advantageprogram, but often a patient needs help negotiating the system. The Medicare Advantage programincorporates private insurance plans into the Medicare program including HMO and PPO managedcare models and private fee-for-service plans. These plans receive payments from Medicare toprovide Medicare benefits, including hospital, physician, and often, prescription drug benefits.DIF: COG: Evaluating REF: 55 OBJ: 110. Residents of rural communities report that they must travel for long distances to obtain healthcare services. As a result, they seek health care only for emergencies and severe illnesses. Whichaspect of the health care system in the United States is illustrated in this situation?a. Access to careb. Costc. Qualityd. Advances in technologyANS: AFunding to clinics in rural areas has been reduced, leading many rural uninsured individuals to useemergency rooms for many illnesses.DIF: COG: Evaluating REF: 47 OBJ: 111. A nurse exploring a job opportunity at a community health center would expect that the center:a. Would be located in a large metropolitan areab. Provides care only to the economically disadvantagedc. Offers comprehensive primary care services and supportive servicesd. Is used for preventive services such as flu shotsANS: CCommunity health centers serve the entire community for primary health care services, regardless ofincome. They are located in a high need or medically underserved community, which can be urban orrural.DIF: COG: Applying REF: 47-48 OBJ: 2

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12. If a 25-year-old woman visits a community health center to obtain a gynecological examinationand birth control pills, these activities are termed _____ care.a. Tertiary healthb. Public healthc. Primary healthd. Specialized careANS: CBy definition, primary health care includes basic health care services with the emphasis onprevention.DIF: COG: Applying REF: 53 OBJ: 213. A client who receives primary health care services would expect that:a. The care would be provided by a physician.b. Private insurance would be necessary to receive care.c. The emphasis of care provided would be on prevention.d. A referral would be made to a specialist after receiving services.ANS: CThe focus of primary health care is a broad range of services that are designed to be affordable forthe recipients of the care and the governments who provide them. The emphasis of care is onprevention and the means of providing the care is based on practical, scientifically sound, culturallyappropriate, and socially acceptable methods.DIF: COG: Applying REF: 53-54 OBJ: 214. When compared to public health care, primary care is:a. Focused on individualsb. Provided by specialistsc. Self-reliantd. Community focusedANS: APrimary care also is provided by generalists, is dominated by health care professionals, and is notcommunity focused.DIF: COG: Analyzing REF: 53 OBJ: 2

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15. What initiative began as a result of a resolution adopted by the World Health Organization(WHO) in 1977?a. Declaration of Alma Atab. Medicarec. Healthy Peopled. Primary health care movementANS: DThe WHO adopted a resolution accepting the goal of attaining a level of health that permitted allcitizens of the world to live socially and economically productive lives. The name of the resolutionthat was adopted was the Declaration of Alma Ata.DIF: COG: Understanding REF: 53 OBJ: 316. Primary health care in the United States:a. Has dramatically improved since the passage of the Declaration of Alma Atab. Focuses on the use of government-funded insurance programsc. Lacks community participation and a multidisciplinary health care delivery teamd. Utilizes Preferred Provider Organizations to meet needs of the citizensANS: CAlthough primary health care (PHC) has been endorsed by the United States, it faces manychallenges. PHC emphasizes broad strategies, community participation, self-reliance, and amultidisciplinary health care delivery team; however, this is not the primary method of health caredelivery in the United States.DIF: COG: Understanding REF: 54 OBJ: 317. A community health nurse reviews Healthy People 2020 when considering the health needs thatwill be addressed in the community. Which goal would the nurse find in this document?a. Promote healthy behaviors for children.b. Cure cancer.c. Eliminate health disparities.d. Provide primary care to all citizens.ANS: CElimination of preventable disease, disability, injury, premature death; achievement of health equity;elimination of health disparities; and creation of social and physical environments that will promote

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good health and healthy development and behavior at every stage of life are the four major goalscited in Healthy People 2020.DIF: COG: Applying REF: 54 OBJ: 418. When researching advanced practice nursing options, a nursing student discovers that:a. Nurse practitioners may work as independent practitioners.b. Certified nurse midwives have limited prescriptive authority.c. Clinical nurse specialists typically provide primary care services.d. The Doctorate in Nursing Practice emphasizes the importance of research.ANS: ANurse practitioners may work as independent practitioners and can be reimbursed by Medicare orMedicaid for services rendered. Certified nurse midwives have prescriptive authority in some form inall states. Clinical nurse specialists may provide primary care services, but often work inconsultation, research, education, and administration. The Doctorate in Nursing Practice role is aclinical role.DIF: COG: Applying REF: 55 OBJ: 419. A nursing student interviews a member of the local congressional district to learn more about thehealth care system in the United States. Which statement made by the congressman would beaccurate?a. “Managed care was short-lived because too many consumer groups endorsed the plans.”b. “Under managed care, clients had unlimited access to providers of their choice.”c. “Managed care failed because Americans were used to free access to providers of their choice.”d. “Managed care in the United States has been replaced by the Affordable Health Care for AmericaAct.”ANS: CConsumer groups were not only accustomed to freedom of choice and unlimited service, but they didnot like the ideas of short-stay maternity care and denial of bone marrow transplantation for breastcancer patients, thus managed care failed in the United States.DIF: COG: Evaluating REF: 55 OBJ: 420. The federal agency of the public health system that is most involved with the health and welfareof United States citizens is the:

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a. Centers for Medicaid and Medicare Servicesb. Department of Health and Human Servicesc. Public Health Serviced. Secretary for HealthANS: BThe Department of Health and Human Services is charged with regulating health care and overseeingthe health status of Americans.DIF: COG: Understanding REF: 55-56 OBJ: 521. Which program would typically be found in a state health department?a. Senior healthb. Dental servicesc. HIV/AIDS serviced. Mental healthANS: CTypical programs in a state health department include: communicable disease service, HIV/AIDSservice, and budget and finance. Senior health, dental health, and mental health are typically found ina local health department.DIF: COG: Applying REF: 58 OBJ: 522. An expected action by the Department of Homeland Security would be:a. Prevention and protection against terrorist attacksb. Regulation of licensure of medical personnelc. Inspection of the safety of food and cosmeticsd. Regulation of managed care organizationsANS: AThis agency was created after the terrorist attacks of September 11, 2001, to prevent and deterterrorist attacks and to protect against and respond to threats and hazards to the nation.DIF: COG: Applying REF: 58 OBJ: 523. An example of a public health law instituted to protect the health of the community is:a. Requiring all persons to have health insurance coverageb. Administering flu shots in the late fall and early winter

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c. Mandating immunizations for all children entering kindergartend. Monitoring and licensing nuclear power plantsANS: CPublic health laws protect the community. Required immunizations are an example.DIF: COG: Analyzing REF: 56 OBJ: 5MULTIPLE RESPONSE1. What are some of the untoward events categorized in the Institute of Medicine (IOM) report aboutmedical errors? Select all that apply.a. Wrong-site surgeryb. Adverse drug eventsc. Improper transfusionsd. Restraint related deathsANS: A, B, C, DAll of the above—wrong-site surgery, adverse drug events, improper transfusions, and restraint-related deaths—are listed in the IOM report.DIF: COG: Understanding REF: 49 OBJ: 12. Which statement(s) about the health care workforce are true? Select all that apply.a. There is a shortage of nurses in the United States.b. Schools of nursing turn away qualified applicants due to lack of faculty and limitations of clinicalsites.c. More than one million nurses will be needed by 2012 to replace those who are retiring.d. More students are choosing laboratory science, pharmacy technology, and radiology technologyover nursing.ANS: A, B, CAll are true except the last option. The fields listed in it have also seen declining enrollment.DIF: COG: Applying REF: 50 OBJ: 1Chapter 04: Perspectives in Global HealthCareStanhope: Public Health Nursing, 8th Edition

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Test Bank For Public Health Nursing - Revised Reprint: Population-Centered Health Care In The Community, 8th Edition

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