1. A group of students are reviewing the various historical events associated with the evolution of community health nursing in preparation for a test. They identify the time from 1970 to the present as the era known as community health nursing based on the understanding that which of the following influences contributed most to this change?
A) The settings and the nurses delivering health care in the community
B) Decisions made by the American Nurses Association
C) Decisions made by physicians in a variety of community settings
D) The demand to eliminate the word public from health services
The numbers, increasing variety of settings, and many nurses coming to work in the community settings since the 1970s have contributed most significantly to the change. As a result, professional associations supported the broader term of community health nursing. Physician decisions played no role in the change. The term public health nursing still remains.
2. Before the mid-1800s, early home care nursing was best recognized by which of the following?
A) Technical advances with the Industrial Revolution making major changes
B) Care provided by family members, friends, and religious groups in the home
C) Accomplishments stemming from the work of Florence Nightingale
D) Formal organization of visiting nursing to provide care to the sick poor
Before the mid-1800s, early home care was characterized by care of the sick in the home by family members, friends, and religious groups. Technical advances came after 1850, as did the work of Florence Nightingale and the formal organization of visiting nurses to provide care to the sick poor.
3. Community health nursing has a long history of contributing to the health of populations. Which of the following forms of service would the nurse identify as being most recent?
A) Voluntary home nursing care for the sick poor via district nursing
B) Care provided termed public health nursing
C) Lay and religious groups providing care to the sick poor in their homes
D) Focus on populations with community health nursing seen as a specialty field
The four stages of community health nursing followed from lay and religious groups providing care in the early years before 1850, the more specialized health nurses or district nursing after the mid-1800s, concern for the health of the general public from 1900s to 1970, and finally community health nursing as a specialty with a focus on populations since 1970.
4. Which factor was the most significant feature associated with district nursing?
A) Caring for the sick
B) Teaching hygiene and cleanliness
C) Preventing illness
D) Gathering statistical data
Although district nurses primarily cared for the sick, they also taught cleanliness and wholesome living to their clients. This early emphasis on prevention and health became one of the distinguishing features of district nursing and later of public health nursing. Preventing illness and gathering statistical data were key contributions of Florence Nightingale during the Crimean War of the early 1850s.
5. In their early stages, district nursing was sponsored by which of the following?
A) Religious organizations
B) Private philanthropy
D) Public funding
Early district nursing services were founded by religious organizations that served as their sponsors. Later sponsorship shifted to private philanthropy. Funding came from contributions and fees charged to clients on an ability-to-pay basis. Finally, visiting nursing began to be supported by public money.
6. Which of the following would characterize the public health stage of community health nursing?
A) Voluntary health agencies emphasizing disease prevention
B) Family considered as the primary unit of care
C) Service provision to the sick poor population
D) Primary health care as the key to health for all
The public health nursing stage was characterized by service to the public, with the family targeted as a primary unit of care. Official health agencies, which placed a greater emphasis on disease prevention and health promotion, provided the chief institutional base. Primary health care as the key to health for all characterizes the community health nursing stage.
7. At which time did the focus of district nursing broadened to include the health and welfare of the general public?
A) Beginning of 20th century
B) In the late 19th century
C) Prior to the 1850s
D) By the early 1970s
The focus of district nursing broadened to include the health and welfare of the general public by the beginning of the 20th century or the early 1900s. In the late 19th century, district nurses were ill-prepared to cope with their clients multiple health and social problems resulting from widespread immigration and filled tenement housing that led to inadequate sanitation, unsafe and unhealthy working condition, and barriers adding to poverty and disease. District nursing did not develop until after 1850. The early 1970s is associated with the emergence of community health nursing.
8. A student is planning a presentation about the evolution of public health nursing. As part of the presentation, the student would identify which person as being the first one to use the term public health nursing?
A) Jessie Sleet
B) Lillian Wald
C) Lina Rogers
D) Margaret Sanger
Lillian Wald, a leading figure in the expansion of district nursing, was the first to use the term public health nursing to describe the specialty. Jessie Sleet was credited as being the first Black public health nurse. Lina Rogers was credited with being the first school nurse. Margaret Sanger was the nurse who opened the first birth control clinic in America that eventually resulted in the formation of the International Planned Parenthood Federation.
9. Which of the following are important contributions made by Lillian Wald to the profession of public health nursing? Select all that apply.
A) Demonstrating the effectiveness of placing school nurses in public schools to reduce absenteeism and improve follow-up of problems identified in school children
B) Promoting the use of birth control
C) Convincing the Metropolitan Life Company that nurse intervention could reduce death rates
D) Providing rural frontier nursing to serve mountain families in Kentucky
E) Founding the National Organization for Public Health Nursing (NOPHN)
Ans: A, C, E
Lillian Wald contributed to the profession of public health nursing by demonstrating the effectiveness of placing school nurses in public schools to reduce absenteeism and improve follow-up of problems identified in school children, convincing the Metropolitan Life Company that nurse intervention could reduce death rates, and Founding the National Organization for Public Health Nursing (NOPHN).
10. After a class discussion about the contributions of Lillian Wald to the advancement of community health nursing, which of the following if stated by the class indicates that the discussion was effective?
A) Establishment of family-centered nursing and outreach services in New York City at the turn of the 20th century
B) Use of clean and safe nursing care practices to soldiers during the Crimean War in the 1850s
C) Assistance to high-risk populations experiencing tropical diseases in Central America and the Caribbean in the late 1800s
D) Creation of home nursing services in London, marking the beginning of district nursing in the 1860s
Lillian Wald worked with immigrant families in the Lower East Side of New York City, providing home visits, a neighborhood center, and general sanitation improvement for families and health care services to children in schools. Florence Nightingale was responsible for providing clean and safe nursing care practices to soldiers during the Crimean War. Mary Seacole helped high-risk populations who experienced tropical diseases in Central America and the Caribbean. William Rathbone was responsible for establishing a visiting nurse service for the sick in London.
11. A group of nursing students are studying for an examination on influential nursing leaders involved in the advancement of community health nursing. The students demonstrate that they are prepared for the examination when they identify which person as the first community health nurse in the United States?
A) Frances Root
B) Mary Robinson
C) Mary Seacole
D) Reba Thelin
In the United States, Frances Root was the first community health nurse who was hired by the Womens Branch of the New York Mission in 1877. Mary Robinson was the nurse who cared for William Rathbones wife and was hired by Rathbone to visit the sick poor in their homes in England. Mary Seacole, the Black Nightingale, practiced Creole or Afro-Caribbean medicine in Jamaica and helped populations who experienced tropical diseases in Central America, Panama, and the Caribbean. Reba Thelin was a nurse hired by Johns Hopkins Hospital to visit the homes of tuberculosis clients in 1903.
12. Which of the following nurses openly defied a law that she saw as unjust and eventually resulted in the formation of The International Planned Parenthood Federation?
A) Lillian Wald
B) Florence Nightingale
C) Margaret Sanger
D) Mary Brewster
Margaret Sanger openly defied a law that she saw as unjust (the Comstock Act that prohibited the provision of any information on contraception to women). This defiance eventually resulted in the formation of The International Planned Parenthood Federation. During the same period that Lillian Wald and her contemporaries were working to alleviate the suffering caused by disease and poverty, Margaret Sanger began a different battle. Florence Nightingale wrote a series of papers on the need for home missioners and health visitors and endorsed the view that prevention was better than cure. Mary Brewster was a nurse and a friend of Lillian Wald who both together started the Henry Street Settlement.
13. The community health nurse is preparing a presentation for a group of nursing students about the societal influences on the development of community health nursing. Which factors should the nurse include that have influenced the growth of community health nursing? Select all that apply.
A) Advances in the technology
B) The recognition that one single agent could be considered a cause of illness
C) Access to education being limited to the privileged few
D) Continued increase in the number of women entering nursing because it is recognized as a choice career for women and not men
E) Consumer demand for quality services coupled with community health nurses provision of holistic care
Ans: A, E
Many factors have influenced the growth of community health nursing, including advances in technology, progress in causal thinking (relating disease or illness to its cause and recognition that many factors might contribute to a disease or health disorder), and the consumer movement with consumers demanding quality services. Education is now widely available and is considered a basic right and necessity for a vital society. Changing demographics and the role of women have influenced community health nursing; however, the number of women entering nursing has decreased.
14. Which of the following actions by the community health nurse exemplifies the societal influence of causality on the practice of community health nursing?
A) Using computer-based education programs for client education
B) Engaging in video conferencing to share research findings
C) Identifying multiple factors associated with promoting wellness
D) Developing a plan to address the rapid increase in older adult population
Causal thinking relates disease or illness to its cause and includes areas such as epidemiology; interactions among an agent, host, and environment; and recognition of multiple factors contributing to a disease, health disorder, or wellness. Using computer-based education programs and engaging in video conferencing are examples reflecting the advancement of technology. Developing a plan to address the rapid increase in the older adult population involves application of the change in demographics affecting community health nursing.
15. A community health nurse who is teaching a group of nursing students about the various societal influences on community health nursing is explaining the effects of the consumer movement. Which of the following student responses would lead the community health nurse to determine that the teaching was successful?
A) Individuals are considered passive members of the health care team.
B) Consumers are demanding more coordinated comprehensive care.
C) People are expecting community health nurses to develop new programs.
D) Consumers are identifying a greater need for care by a variety of care providers.
The consumer movement has led to changes in community health nursing. Consumers are demanding more humane, personalized health care, seeking more comprehensive coordinated care. They are viewed as active members of the health care team. The need to develop new programs is a response to the economic forces that have affected the practice of community health nursing. Consumers desire more coordinated care, not care from a variety of care providers.
16. Which of the following most accurately reflects the response of community health nursing to economic forces?
A) Decreased competition with other community health service providers
B) Reduction in available programs and services
C) Development of new services for generating revenue
D) Switch to a more illness-oriented philosophy for service
Economic forces have led community health nursing to respond by developing new revenue-generating services to augment depleted budgets. Other responses include directly competing with other community health service providers and developing new programs and service emphases. Although some public health agencies have been drawn into more illness-oriented services, community health nursing continues to be resourceful in finding ways to foster the communitys optimal health.
17. A prospective nursing student is interested in working in community health nursing after graduation. Which type of education would be most appropriate for this student to choose?
A) Diploma program
B) Associate degree
C) Baccalaureate degree
D) Graduate degree
Community health nursing is a challenging specialty in nursing. The demands of this type of nursing require additional courses in liberal arts and science, along with courses in community health nursing practice as a student. The minimum preparation for community health nurses in many states is a baccalaureate degree. The diploma and associate degree level prepares students for basic nursing practice. Students can build on this basic knowledge by entering a BSN completion program, which will prepare them to enter the specialty of community health nursing. In order to stay current and to build skills in this specialty, advanced courses or a graduate (masters) degree is needed.
18. A community health nurse desires to attain a tenure-track position at a local university to teach community health nursing. Which of the following would this nurse need?
B) Masters degree
C) Doctoral degree
D) Nurse practitioner license
A doctoral degree would be the required education needed to obtain a tenure-track teaching position at a university. Certification provides additional education for specialization and may result in a promotion or higher salary accompanied by additional responsibilities and opportunities. A masters degree can lead to management positions, private community health ownership, agency teaching, or research positions. Nurse practitioners can run well-child clinics and direct a school-based clinic if a school nurse. Advanced practice can open doors into leadership positions in community health nursing.
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