Foundations of Nursing in the Community, 3rd Edition Stanhope, Lancaster-Test Bank

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Foundations of Nursing in the Community, 3rd Edition Stanhope, Lancaster-Test Bank

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Foundations of Nursing in the Community, 3rd Edition Stanhope, Lancaster-Test Bank

Stanhope: Foundations of Nursing in the Community: Community-Oriented Practice, 3rd Edition

 

Chapter 2: The History of Public and Community Health and Nursing

 

Test Bank

 

MULTIPLE CHOICE

 

  1. What is an important reason to study nursing history?
a. Fulfill state board of nursing requirements
b. Help meet the necessary credit hours for graduation
c. Meet accreditation requirements
d. Understand the present and plan for tomorrow

 

 

ANS:   D

One of the best ways to make plans for today and tomorrow is to look at the past to see what did and did not work.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 16

 

  1. Why is public health nursing appealing to many nurses?
a. Its autonomy and independence
b. Its focus on acute care and immediately visible outcomes
c. The backup support of other health care professionals
d. The rapport among the nursing staff

 

 

ANS:   A

Inpatient acute care nurses (not public health nurses) focus on acute care with outcomes known fairly quickly. Unlike inpatient nursing, in which there are other health care professionals and staff with whom to interact, public health nursing is known for its autonomy and independence.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 17

 

  1. Which of the following accurately describes the first people to give care in hospitals?
a. Feudal lords used servants with the goal of keeping their peons working.
b. Small towns hired men to care for their citizens.
c. The military employed local men with the goal of enabling soldiers to keep fighting.
d. Religious women in urban areas cared for the sick, poor, and neglected.

 

 

ANS:   D

Most people were responsible for their own services, but religious convents and monasteries established hospitals to care for the elderly, disabled, sick, poor, and neglected.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 17

 

  1. How did the Industrial Revolution result in previous caregiving approaches, such as care by families, friends, and neighbors, becoming inadequate?
a. Economic and political wars resulted in frequent death and injuries.
b. Incredible plagues consistently and constantly swept the European continent.
c. Migration and urbanization resulted in increased demand for care.
d. Caregivers could easily find other employment, so they demanded to be paid.

 

 

ANS:   C

Care became inadequate because of the social changes in Europe, with great advances in transportation, communication, and other technologies. The increased mobility led to migration and urbanization, which in turn led to increased need for care.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 17

 

  1. What event most notably changed health care?
a. Florence Nightingale created the discipline of nursing.
b. Nuns formed into Sisterhoods, who gave care.
c. The order of Sisters of Mercy was established in Dublin.
d. St. Vincent de Paul formed the Dames de Charite.

 

 

ANS:   A

Many events led to improvements in care, but Florence Nightingale revolutionized health care.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 17

 

  1. Why did American citizens become interested in establishing government-controlled boards of health?
a. They were afraid of infectious diseases such as yellow fever.
b. The government could force the poverty-stricken to accept care.
c. Such boards could tax and thereby ensure adequate funds to pay for care.
d. Such a system would allow for accurate records of births and deaths.

 

 

ANS:   A

Threat of disease, especially yellow fever, led to public interest in establishing government-sponsored, or official, boards of health.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 18

 

  1. The Marine Hospital Service was established to protect seacoast cities from epidemics. This service evolved into which of the following?
a. A role model for all later hospitals, beginning in larger cities such as Philadelphia
b. The beginning of the Veterans Administration Medical System
c. The Centers for Disease Control and Prevention
d. The Public Health Service

 

 

ANS:   D

The Marine Hospital Service, established in part because many communicable diseases entered through sea ports, became the Public Health Service.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 17 (Table 2-1)

 

  1. What was the outcome of the Shattuck Report?
a. It began efforts to control alcohol and drug abuse, as well as tobacco use.
b. Environmental sanitation efforts became an immediate priority.
c. It eventually resulted in guidelines for modern public health organization.
d. Local and state governments immediately established boards of health.

 

 

ANS:   C

It took 19 years for the first of Shattucks recommendations to be implemented, but his report was the first effort to create a modern public health organization.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 18

 

  1. Which nurse is famous for creating public health nursing in the United States?
a. Florence Nightingale
b. Frances Root
c. Lillian Wald
d. Mrs. Solomon Loeb

 

 

ANS:   C

Lillian Wald established the Henry Street Settlement and later emerged as the established leader of public health nursing during its early decades.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 19

 

  1. What fact led Lillian Wald to suggest nurses practice in schools?
a. Over 20% of children were absent from school each day.
b. Nurses had to enter the schools to assess and care for the children of families receiving care in their homes.
c. Nurses needed employment, and hospitals did not want to increase their nursing staff.
d. It was less expensive to employ nurses in schools than physicians.

 

 

ANS:   A

In New York City in 1902, more than 20% of children might be absent from school on a single day.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 20

 

  1. In what way did the National Organization for Public Health Nursing differ from all other nursing organizations?
a. Allowed LPNs as well as RNs to join the organization
b. Encouraged nurses who were not public health nurses to join
c. Included both nurses and their lay supporters
d. Used lottery methods to choose its leaders and officers

 

 

ANS:   C

The NOPHN, unlike other professional nursing organizations, included both nurses and their lay supporters. Lay supporters were a source of funding and political support.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 21

 

  1. Why were nurses so unprepared for public health nursing in the early twentieth century?
a. Community health nursing had not yet been created as a field.
b. No one would teach the nurses how to engage in public health activities.
c. Nightingales textbook did not include content on public health nursing.
d. Nurses were educated in diploma schools, which focused on hospital nursing.

 

 

ANS:   D

Nursing school courses taught in diploma schools of nursing emphasized hospital care of patients; thus nurses were unprepared for home visiting.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 21

 

  1. What was the major obstacle to expanding public health nursing during the epidemics and the war efforts in the early twentieth century?
a. Adequate funds were not available.
b. The American Red Cross was meeting the public health needs at the time.
c. Women did not want careers; they wanted to remain homemakers.
d. Women were in the military helping in the cause to win WWI.

 

 

ANS:   A

A lack of adequate funds was the major obstacle to extending nursing services in the community. Wealthy and middle-class supporters were relied on for contributions.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 22

 

  1. Why did the Metropolitan Life Insurance Company establish and retain for several years the first community nursing health program for policyholders?
a. Creating such a service was the morally correct thing to do.
b. Employing nurses directly was less expensive than paying taxes to the city for the same purpose.
c. Having the companys nurses make home visits increased worker morale.
d. Having public health nurses visit policyholders and their families led to a decline in policyholder deaths, thus lowering costs for the insurance company.

 

 

ANS:   D

Metropolitan Life saw an average decline of 7% in the mortality rate of policyholders and almost a 20% decline in the deaths of children. The insurance company attributed this improvement and the associated reduced costs to the visiting nurses.

 

DIF:    Cognitive Level: Knowledge             REF:    pp. 20 (Box 2-1), 22

 

  1. What effect did the passage of the Social Security Act have on nurses?
a. Funding was made available for nurses to learn public health.
b. Funds were available for expanding hospitals (size of hospital and number of beds).
c. Government monies would pay for hospital care of low-income persons.
d. More elderly persons demanded home health care from nurses.

 

 

ANS:   A

The Social Security Act of 1935 tried to overcome the national setbacks of the Depression. Title VI of this act provided funding to expand opportunities for health protection and promotion through education and employment of public health nurses.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 25

 

  1. What is the most crucial factor that determines which programs community agencies emphasize?
a. Comprehensive assessment and planning done in the community
b. Documented needs of the local community
c. Federal funding for priority diseases or groups
d. Nursing staffs expertise and skills

 

 

ANS:   C

Programs are designed to fit funding prioritiesthus the areas supported by Congress determine the categories in which most effort is focused locally.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 25

 

  1. During World War II incredible numbers of nurses volunteered for the war effort, resulting in fewer nurses in the United States. How did hospitals and visiting nurse agencies cope with the shortage?
a. Closed many hospital units due to lack of staff
b. Increased benefits to nurses who would renew their employment contracts
c. Offered high salaries and bonuses to nurses who accepted employment
d. Used nurses aides and other nonprofessionals to give care

 

 

ANS:   D

Without professional nurses, nonnursing personnel gave much of the care, including more than 215,000 certified volunteer nurses aides. Families were also forced to assume more responsibility for care of their family members.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 25

 

MULTIPLE RESPONSE

 

  1. How did Florence Nightingale help bring about community health nursing? Select all that apply.
a. She convinced socially prominent wealthy women to volunteer to give care.
b. She focused on all soldiers and their environment.
c. She interacted with each individual person, assessing his or her needs and acting to meet those needs.
d. She kept careful records on what was done and what were the results.
e. She promoted health using nutrition, rest, and hygienic measures.
f. She stressed the importance of keeping the ill soldiers together so they could support each other emotionally.

 

 

ANS:   B, D, E

Nightingale progressively improved the soldiers health using a population-based approach that improved both environmental conditions and nursing care. Using simple epidemiology measures, she documented a decreased mortality rate to demonstrate the outcomes. Nightingale thought that nursing should promote health and prevent illness, and she emphasized proper nutrition, rest, sanitation, and hygiene

 

DIF:    Cognitive Level: Knowledge             REF:    p. 18

 

  1. The Maternity and Infancy Act provided funds for maternal and child health divisions in state health departments and clearly saved many lives. Why was the program ended? Select all that apply.
a. All newborns were essentially healthy following education to mothers.
b. Most states didnt feel a need for such a program in their state.
c. States disagreed with the federal government concerning the amount of matching funds to be contributed by the states.
d. The AMA felt the federal government was encroaching on medical practice.
e. The AMA charged that the program was too much like socialized medicine.
f. There were too few trained nurses to staff all the programs.

 

 

ANS:   D, E

The American Medical Association (AMA) had concerns that the legislation gave too much power to the federal government and too closely resembled socialized medicine.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 22

 

  1. For what activities is Mary Breckinridge remembered? Select all that apply.
a. She created the first home nursing program in the Western states.
b. She established the Frontier Nursing Service.
c. She increased nursings efforts to care for the urban poor.
d. She introduced the first nurse-midwives in the United States.
e. She obtained the initial donations allowing the first efforts in home health care outside major cities.
f. She was the first nurse employee of the Vermont Marble Company, thereby becoming the first occupational health nurse.

 

 

ANS:   B, D

Mary Breckinridge established the Frontier Nursing Service and introduced the first nurse-midwives into the United States. Lillian Wald obtained the initial donations allowing the first efforts in home health care outside major cities. Ada Mayo Stewart was the first nurse employee of the Vermont Marble Company, thereby becoming the first occupational health nurse.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 22

 

  1. How did nursing education change in the 1950s? Select all that apply.
a. Baccalaureate nursing programs typically included public health nursing concepts.
b. Diploma schools of nursing continued to expand their student numbers.
c. Junior and community colleges began offering nursing programs.
d. Nurses were strongly encouraged to have a scientific basis for their practice.
e. Research became a required course in all nursing programs.
f. The need for more education (more credits) to complete a nursing major became obvious.

 

 

ANS:   A, C

In the 1950s, public health nursing became a required part of most baccalaureate nursing education programs. In 1952, nursing education programs began in junior and community colleges.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 26

 

  1. How did health care and its delivery change during the 1980s? Select all that apply.
a. Funding to public health increased as funding for acute hospital care decreased.
b. Laws began to be passed that discouraged the use of alcohol, drugs, and tobacco.
c. Nurse practitioners were increasingly used to provide care.
d. Public health programs suffered reduced political support, financing, and effectiveness.
e. The National Center for Nursing Research (NCNR) was established.
f. Use of health maintenance organizations was encouraged.

 

 

ANS:   B, C, D, E, F

During the 1980s funding began to shift to meet the costs of acute hospital care, medical procedures, and institutional long-term care. The use of health maintenance organizations was encouraged, and the use of nurse practitioners increased. Consumer and professional advocacy groups urged the passage of laws to prohibit unhealthy practices such as smoking and driving under the influence of alcohol. By the late 1980s, public health had declined in political support, financing, and effectiveness. After a lengthy political battle, the National Center for Nursing Research (NCNR) was established in 1985.

 

DIF:    Cognitive Level: Knowledge             REF:    pp. 227

Stanhope: Foundations of Nursing in the Community: Community-Oriented Practice, 3rd Edition

 

Chapter 10: Evidence-Based Practice

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Which action would be most helpful for the nurse executive to implement evidence-based practice at a community nursing center that serves a large Cuban immigrant population?
a. Have university experts with cultural competency expertise review clinic policies.
b. Have weekly staff meetings for the purpose of discussing which methods seem to work best when helping immigrants.
c. Include Cuban immigrants from the community on the centers advisory board.
d. Send personnel to conferences and seminars that focus on treating Hispanic immigrants.

 

 

ANS:   C

Although all of these options are good, to determine whether practice is serving the needs of the population, the nurse will need to consult the population served. This means that evidence should be applied with input from the community. For example, decisions related to the services to be offered in a nurse-managed clinic should be made with input from the clinics advisory board, which should include community leaders and consumers of the clinics services. Cuban immigrant needs may not be the same as those of Hispanic immigrants from other places such as Mexico or Spain.

 

DIF:    Cognitive Level: Application             REF:    p. 179

 

  1. The nurse has been reading everything she can find on a particular clinical problem, using both the closest medical library and the Internet. What would be the most helpful source if it were available?
a. A journal with a whole issue devoted to research on that clinical problem
b. A randomized controlled clinical trial related to that clinical problem
c. A researcher who has built a career on studying that clinical problem
d. A systematic review related to the clinical problem

 

 

ANS:   D

A systematic review is an approach to identifying, appraising, and synthesizing research evidence to evaluate and interpret all available research that is relevant to a particular research question. Systematic reviews can be accessed from most databases. Systematic reviews require more rigor and contain less opinion of the author than typical reviews of the literature.

 

DIF:    Cognitive Level: Application             REF:    p. 180

 

  1. A school health nurse plans to use evidence-based practice (EBP) to guide the development of health education programs most likely to increase retention of learning in elementary school children. What may be the best way to use EBP in this situation?
a. Ask other school health nurses what they included in their own education programs.
b. Compare and contrast randomized clinical trials related to learning in elementary school children.
c. Develop a series of games to accompany the programs developed to promote health.
d. Seek out and examine health education programs for elementary school children on the Internet.

 

 

ANS:   B

Randomized clinical trials are the gold standard of evidence gathering in EBP.

 

DIF:    Cognitive Level: Application             REF:    p. 180

 

  1. After finding several studies related to the clinical problem, a nurse knows the studies must be evaluated. For the studies to be considered convincing, they should ideally be:
a. Federally supported multiagency clinical studies
b. Multiple high-quality studies with large sample sizes and consistent findings
c. Research studies done by multidisciplinary teams in multiple settings
d. Controlled clinical trials

 

 

ANS:   B

The Agency for Healthcare Research and Quality (AHRQ) reviewed 40 systems used to evaluate the quality of studies and strength of evidence. The report identified three domains for evaluating systems that grade the strength of evidence: quality, quantity, and consistency. The quality of a study refers to the extent to which bias is minimized. Quantity refers to the number of studies, the magnitude of the effect, and the sample size. Consistency refers to studies that have similar findings, using similar and different study designs.

 

DIF:    Cognitive Level: Application             REF:    p. 181

 

  1. For nurses who are familiar with evidence-based practice (EBP) and want to implement EBP into their care of clients, what might be the biggest challenge?
a. Assessing ones current practice and accessing evidence-based resources
b. Convincing administration that EBP is beneficial
c. Distinguishing EBP from practice based on old standards
d. Showing clients that EBP will improve their health outcomes

 

 

ANS:   A

The first step toward implementing evidence-based practice in nursing is recognizing the current status of ones own practice and believing that care based on the best evidence will lead to improved client outcomes. The challenge for the clinician is how to access the evidence and integrate it into practice, thus moving beyond practice based solely on experience, tradition, or ritual.

 

DIF:    Cognitive Level: Application             REF:    p. 181

 

  1. What is the chief group pressuring clinicians to use evidence-based practice (EBP)?
a. Administrators who recognize the cost savings of EBP
b. Insurance companies and other third-party payers
c. Nurses who recognize EBPs increased effectiveness
d. Physicians who recognize EBPs increased effectiveness

 

 

ANS:   B

Much of the pressure to use evidence-based practice comes from third-party payers and is a response to the need to contain costs and reduce legal liability.

 

DIF:    Cognitive Level: Application             REF:    p. 183

 

  1. A nurse in community health has implemented an education program that incorporates computer games to reinforce learning in a community of older adults. Although the research demonstrates evidence of improved retention of information, the nurse experiences exactly the opposite for this group of clients. What is the most likely cause of such poor outcomes?
a. Failure to consider client and setting differences
b. Inadequate incorporation of evidence into practice
c. Inferior quality of the available research evidence
d. The nurses lack of skills in evaluating the evidence

 

 

ANS:   A

EBP cannot be applied as a universal remedy without attention to client differences. When EBP is applied at the community level, best evidence may point to a solution that is not sensitive to cultural issues and distinctions and thus may not be acceptable to the community. For example, computer games may be excellent for younger groups but are often poorly suited for older Americans who may face challenges with learning new technology.

 

DIF:    Cognitive Level: Application             REF:    p. 183

 

  1. A health care provider is concerned about the high number of clients with type 2 diabetes mellitus who have poor glucose control. What would be the best reference for the provider to implement evidence-based practice (EBP) in the management of this problem?
a. Published protocols
b. Current research findings
c. Opinions of colleagues
d. Nursing journals

 

 

ANS:   B

EBP in community-oriented nursing challenges nurses to integrate outcomes of the best evidence into their clinical practice. Current research findings will explicate evidence of most successful interventions. (Randomized clinical trials are the gold standard of research for EBP.) Protocols and opinions often reflect tradition rather than the most current scientific evidence. Although many nursing journals are peer reviewed, many are not and, even if peer reviewed, many are not research based or focused on scientific evidence. Similarly, information from the Internet may or may not be reliable, since the goal of many websites is to sell products rather than to serve as an unbiased source. Determining when the website was last updated would also be helpful in evaluating the sites usefulness.

 

DIF:    Cognitive Level: Application             REF:    p. 183

 

  1. A busy school health nurse concerned over the rising incidence of obesity wants to implement evidence-based practice (EBP) but faces barriers because of time constraints. How might a knowledge manager benefit this nurse?
a. Identifying students who are obese so that they may be closely monitored for weight control success or failure
b. Evaluating best practices to determine those that have the highest success rates for weight control in children
c. Organizing files, scheduling appointments, and handling phone calls to decrease interruptions for the nurse
d. Setting up an obesity management program for children whose body mass index exceeds normal

 

 

ANS:   B

The knowledge managers role is to assist in the implementation of EBP by collecting and disseminating the collective knowledge within an organization; gathering relevant knowledge and applying it to the community; retrieving and evaluating the best evidence for clinical practice within a community; and staying informed about the communitys politics and policy issues. By providing needed information and knowledge to the nurse, the knowledge manager equips the nurse with information needed to develop interventions that are research based to increase the likelihood of success.

 

DIF:    Cognitive Level: Synthesis                REF:    Entire chapter

 

  1. Research demonstrates that exercise is important for general wellness and weight control. How might the school nurse use this information to implement primary prevention?
a. Developing individualized exercise programs for overweight children
b. Drafting policy for increases in noncompetitive physical activity programs
c. Monitoring body mass index in children to identify elevations before they become difficult to manage
d. Notifying parents and/or guardians of their childs height-weight scale in comparison with national norms

 

 

ANS:   B

At the primary prevention level, campaigns to support regular exercise, greater emphasis on school-based physical education programs, and environmental and policy initiatives to create or enhance places for physical activity in communities can make significant contributions to improving the lifestyle of sedentary children. Exercise programs are an example of tertiary prevention. Monitoring BMI in children is an example of secondary prevention. Notifying parents of their childrens height-weight scale increases family awareness but does not meet the definition of a preventive measure.

 

DIF:    Cognitive Level: Application             REF:    p. 182 (Levels of Prevention box)

 

  1. How might a nursing administrator who wishes to develop a work environment conducive to the implementation of evidence-based practice (EBP) best achieve this goal?
a. Conducting market research to determine customer satisfaction with EBP
b. Eliciting opinions from nurses on how EBP will affect workload
c. Purchasing computers and Internet access for use by employees
d. Sending staff to conferences related to incorporation of EBP into practice

 

 

ANS:   C

A lack of computers and Internet access can create a barrier to implementation of EBP in community-based nursing agencies. If these are provided, nurses can quickly access current evidence-based findings and recommendations.

 

DIF:    Cognitive Level: Synthesis                REF:    Entire chapter

 

  1. What are some of the best ways in which nurse managers can facilitate incorporation of evidence-based practice (EBP) in the clinical setting?
a. Eliminating all protocols and standards that are not evidence based
b. Encouraging group reflection on the ideals and expectations of nursing care
c. Referring agency nurses to Internet sources of research findings
d. Supporting nurses using practice-oriented research findings in decision making

 

 

ANS:   D

EBP demands changes. It requires incorporating more practice-oriented research and more collaboration between clinicians and researchers. Emphasis should be on decision making using the varied sources of evidence. The environment and climate must be supportive in order to implement EBP.

 

DIF:    Cognitive Level: Synthesis                REF:    Entire chapter

 

  1. Which action would be most helpful for a nurse in community health to determine the best evidence-based way to address an outbreak of a new infectious disease?
a. Reviewing policies and procedures
b. Reviewing outcomes of clinical trials
c. Reviewing several nursing textbooks
d. Scanning the Internet for information on the disease

 

 

ANS:   B

Research findings, knowledge from basic science, clinical knowledge, and expert opinion should be considered sources of evidence for EBP. The problem with nursing textbooks is that many are not grounded in evidence-based practice, because the concept is relatively new to the United States (as mentioned in the section of the chapter on historical perspectives of EBP). Scanning the Internet for ideas is helpful only if evidence-based practice sites are accessed, and most Internet sites are not EBP sites.

 

DIF:    Cognitive Level: Application

REF:    p. 180 (How To box), p. 181 (How To box)

 

  1. Staff members have agreed to implement evidence-based practice; they have chosen a specific problem and searched the literature. The group has selected the interventions that seem the easiest to implement. What should be the staffs next step?
a. Assessing the quality of the evidence in the literature
b. Deciding how best to orient the staff and community to the proposed changes
c. Eliminating all nursing interventions that are not evidence based
d. Choosing another specific problem for the next literature search

 

 

ANS:   A

After the group has chosen the topic and evaluated the literature for approaches that seem feasible, specific interventions are chosen. The quality of the evidence must be assessed before recommending specific changes or writing a protocol to resolve the problem. Grading the strength of evidence or determining the quality, quantity, and consistency of research studies must be done before making recommendations for practice.

 

DIF:    Cognitive Level: Knowledge

REF:    p. 180 (How To box), p. 181 (How To box)

 

  1. Based on research, what is the best way to increase the number of persons who come to their screening test appointments?
a. Client reminders via telephone, e-mail, or mail
b. Emphasizing long life and happy family when conditions are caught early and treated successfully
c. Pointing out how inexpensive and convenient screening tests are
d. Stressing the dangerousness of the condition if not caught early

 

 

ANS:   A

Client reminders and recalls via mail, telephone, or e-mailor a combination of these strategiesare effective in increasing compliance with screening activities such as those for colorectal and breast cancer.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 182 (Levels of Prevention box)

 

MULTIPLE RESPONSE

 

  1. What might interfere with a nurses decision to increase the evidence base of current nursing practice in an agency? Select all that apply.
a. Colleagues who dont know how to search the literature or critique research
b. Dedication to the history and tradition of the agency
c. Emphasis on conformity over each nurses autonomy in clinical decisions
d. Extensive experience and practice in reading and interpreting research
e. Little or no research published in the clinical area of concern
f. Several meta-analyses in the literature, which lead to inconsistent results

 

 

ANS:   A, E

Barriers to evidence-based practice exist when the following are limited or lacking: time, access to journal articles, search skills, critical appraisal skills, and an understanding of research terminology. Other barriers include miscommunication about the process; inferior or unavailable research or other evidence; unwillingness of organizations to fund research or make decisions based on evidence; and concern that evidence-based practice will decrease emphasis on individual client needs or the nurses clinical decisions.

 

DIF:    Cognitive Level: Application             REF:    p. 182

Stanhope: Foundations of Nursing in the Community: Community-Oriented Practice, 3rd Edition

 

Chapter 20: Health Risks Across the Life Span

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The nurse who wishes to establish a program to decrease the death rate in children will have the greatest likelihood of success by targeting which health problem?
a. Accidents and injuries
b. AIDS
c. Childhood obesity
d. Vaccine-preventable diseases

 

 

ANS:   A

Injuries are the number one cause of death for children (and young adults up to age 21 years) in the United States. Injuries and accidents are the most important causes of preventable disease, disability, and death among children. Most are preventable. Obesity, although a significant problem, is not a common cause of death in children.

 

DIF:    Cognitive Level: Application             REF:    p. 354

 

  1. The nurse who wishes to establish a program to decrease the death rate in adolescents will be most successful if she creates which type of program?
a. Anti-alcohol program
b. Anti-smoking program
c. Careful driving program
d. Safe sex program

 

 

ANS:   C

Motor vehicle accidents are the leading cause of death among children and teenagers.

 

DIF:    Cognitive Level: Application             REF:    p. 354

 

  1. What behavior(s) would be of most concern for the nurse who works with high school students?
a. Alcohol use
b. Risk taking
c. Tobacco use (any form)
d. Unprotected sex

 

 

ANS:   B

Adolescents are rather oblivious to risk, whether this means engaging in unprotected sex, drinking, smoking, driving fast without seatbelts, or other risky behaviors. Use of weapons and interpersonal violence are increasing concerns. Developmentally, children and teenagers cannot visualize the future enough to imagine the consequences of current behaviors.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 354

 

  1. Which child is most at risk for being abused?
a. A 1-year-old
b. A 6-year-old
c. A 9-year-old
d. A teenager

 

 

ANS:   A

Children under 6 years of age represent 85% of fatalities due to abuse; children younger than 1 year account for 41% of abuse-related fatalities.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 355

 

  1. It has been suggested that rather than only list the cause of death (e.g., heart attack) on an autopsy report, the underlying causes should also be listed (e.g., obesity, sedentary lifestyle). If this were enacted, what would be the most common cause of unnecessary death in the United States?
a. Alcohol
b. Guns
c. Tobacco
d. Unprotected sex

 

 

ANS:   C

Smoking has been identified as the most important preventable cause of morbidity and mortality in the United States.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 356

 

  1. For the school nurse who wishes to decrease obesity in children, what would be the most effective action in the community?
a. Lobby legislators to enact stronger legislation regarding school lunches and snack machines in schools.
b. Increase nutrition programs in schools that teach children to make healthy food choices.
c. Involve the entire family in the planning and managing of nutrition, especially when a child in the family is obese.
d. Provide after-school and summer camps that focus on diet and exercise.

 

 

ANS:   C

Interventions need to be based on goals of lifestyle changes for the entire family. The goal is to modify the way the family eats, exercises, and plans daily activities. Although it is important to teach nutrition, exercise, and proper food choice, if the family does not, for example, prepare the proper foods from which they can choose, the childs knowledge is moot.

 

DIF:    Cognitive Level: Application             REF:    p. 357

 

  1. What is the best way to ensure good nutrition in infants?
a. Breastfeeding
b. Feed them only brand-name baby foods
c. Feed them only brand-name cereals
d. Feed them only brand-name formulas

 

 

ANS:   A

Breastfeeding is the preferred method of infant feeding. Breast milk provides appropriate nutrients and antibodies for the infant. Breastfed infants have fewer illnesses and allergies.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 357

 

  1. Which group of homeless people in America is the fastest-growing group?
a. Adolescent runaways
b. Alcoholics and drug abusers
c. Single mothers with two to three children
d. Veterans suffering psychological conditions

 

 

ANS:   C

Families make up the fastest-growing segment of the homeless population; 25% to 40% of homeless are families, often a single mother with two or three children.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 359

 

  1. A young girl has been homeless for at least 3 years. What might the school nurse want to discuss with teachers in relation to the young girl?
a. Awareness of sensitivity to violence
b. Possible developmental delays
c. Need for free lunch program eligibility
d. Normal growth and development needs

 

 

ANS:   B

Children in homeless situations are often not immunized and often suffer from poor nutrition. They have limited or no access to health care. Often there is increased exposure to environmental hazards, violence, and substance abuse. Developmental delays often result from the lack of a supportive environment. In the school setting, developmental delays would be noticeable.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 360

 

  1. A nurse who wants to promote improved health for obese children might engage in what tertiary prevention measure?
a. Establish lifestyle improvement programs through local youth organizations.
b. Evaluate the food intake of a group of children for a 48-hour period.
c. Provide education programs to overweight expectant parents because they are at greater risk for having overweight children.
d. Evaluate the body mass index of children at regularly scheduled well-child exams.

 

 

ANS:   A

Tertiary prevention includes activities aimed to reduce the complications of the disease process. Only lifestyle improvement programs are directed toward preventing problems in children who are already obese. Evaluating food intake and evaluating BMI are types of screening programs (secondary prevention). Providing education programs to overweight expectant parents does not involve children.

 

DIF:    Cognitive Level: Application             REF:    Entire chapter

 

  1. Which description of womens health care is most accurate?
a. Care taken in fostering gynecological and reproductive wellness
b. Health care that assists the transition from girlhood to womanhood and through menopause
c. Health promotion, maintenance, and restoration across a womans life span
d. Management and treatment of conditions unique to the female gender

 

 

ANS:   C

Womens health includes their entire life span and involves health promotion, maintenance, and restoration. This broad emphasis on womens health is in contrast to the traditional view of women solely in terms of their reproductive health or their role in parenting children.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 360

 

  1. What organization has served to advocate for womens health for over 30 years through monitoring and developing national health policy, as well as serving as a clearinghouse for womens health issues?
a. American Academy of Nursings Expert Panel on Womens Health
b. Healthy People 2010
c. National Organization of Women
d. National Womens Health Network

 

 

ANS:   D

In 1974 the National Womens Health Network began to monitor national health policy. This organization serves as a clearinghouse and advocate for womens health issues, and it has played an important role in the development of policy and legislation.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 361

 

  1. Why might it be surprising that men, as a group, are less healthy than women?
a. Men control the finances in most families.
b. Men have control over most decisions.
c. Most medical research has used males as subjects.
d. Most health care providers are male.

 

 

ANS:   C

Historically, men have dominated professions including medicine and research. As a result, the majority of clinical research has focused on male subjects; thus diagnosis, treatment, and prognosis conclusions are accurate for men, but not necessarily for women. The other options are factually inaccuratefor example, most health care providers are nurses and female.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 361

 

  1. What behavior results in men being less healthy than women?
a. Concentration on sports, hunting, and other dangerous recreational choices
b. Employment in stressful positions more so than women
c. Preference to spend money on priorities other than health care
d. Reluctance to visit physicians

 

 

ANS:   D

A major obstacle to improving mens health is their apparent reluctance to consult their primary care provider. Men are not well connected to the health care system. In one study, 33% of men did not have a primary care physician to call on when needed and delayed seeking care, despite signs and symptoms.

 

DIF:    Cognitive Level: Knowledge             REF:    p. 361

 

  1. To improve breast cancer cure rates, where should our health care dollars be focused?
a. Educating women about breast cancer
b. Early detection programs with referral to ongoing access to a care provider
c. Primary prevention programs
d. Tertiary care through long-term follow-up

 

 

ANS:   B

Early detection can promote a cure, whereas late detec

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