Foundations of Nursing in the Community 4th Edition, Stanhope Test Bank

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Foundations of Nursing in the Community 4th Edition, Stanhope Test Bank


Test Bank Foundations Nursing Community 4th Edition, Stanhope


Chapter 01: Community-Oriented Nursing and Community-Based Nursing
1. Which of the following best describes community-based nursing?
a. A philosophy that guides family-centered illness care
b. Providing care with a focus on the groups needs
c. Giving care with a focus on the aggregates needs
d. A value system in which all clients receive optimal care
2. Which of the following best describes community-oriented nursing?
a. Focusing on the provision of care to individuals and families
b. Providing care to manage acute or chronic conditions
c. Giving direct care to ill individuals within their family setting
d. Having the goal of health promotion and disease prevention
3. Which of the following is the primary focus of public health nursing?
a. Families and groups
b. Illness-oriented care
c. Individuals within the family unit
d. Promotion of quality of life
4. Which of the following is responsible for the dramatic increase in life expectancy during the twentieth century?
a. Technology increases in the field of medical laboratory research
b. Advances in surgical techniques and procedures
c. Sanitation and other public health activities
d. Use of antibiotics to fight infections
5. A nurse is developing a plan to decrease the number of premature deaths in the community. Which of the following interventions would most likely be implemented by the nurse?
a. Increase the communitys knowledge about hospice care.
b. Promote healthy lifestyle behavior choices among the community members.
c. Encourage employers to have wellness centers at each industrial site.
d. Ensure timely and effective medical intervention and treatment for community members.
6. Which of the following is a basic assumption of public health efforts?
a. Health disparities among any groups are morally and legally wrong.
b. Health care is the most important priority in government planning and funding.
c. The health of individuals cannot be separated from the health of the community.
d. The government is responsible for lengthening the life span of Americans.
7. Which of the following actions would most likely be performed by a public health nurse?
a. Asking community leaders what interventions should be chosen
b. Assessing the community and deciding on appropriate interventions
c. Using data from the main health care institutions in the community to determine needed health services
d. Working with community groups to create policies to improve the environment
8. Which of the following public health nurses most clearly fulfills the responsibilities of this role?
a. The nurse who met with several groups to discuss community recreation issues
b. The nurse who spent the day attending meetings of various health agencies
c. The nurse who talked to several people about their particular health concerns
d. The nurse who watched the city council meeting on local cable television
9. Which of the following best defines aggregate?
a. A large group of persons
b. A collection of individuals and families
c. A group of persons who share one or more characteristics
d. Another name for demographic group
10. A registered nurse was just employed as a public health nurse. Which question would be the most relevant for the nurse to ask?
a. Which groups are at the greatest risk for problems?
b. Which patients should I see first as I begin my day?
c. With which physicians will I be most closely collaborating?
d. With which nursing assistants will I partner the most?

Chapter 02: The History of Public Health and Public and Community Health Nursing
1. A nurse is considering applying for a position as a public health nurse. Which of the following would be a reason this position would be appealing?
a. Its autonomy and independence
b. Its focus on acute care and immediately visible outcomes
c. Its collaboration with other health care professionals
d. Its flexibility and higher wages
2. The Elizabeth Poor Law of 1601 is similar to which current law?
a. Welfare
b. Food stamps
c. Medicaid
d. Medicare
3. 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.
4. A colonist is working in the public health sector in early colonial America. Which of the following activities would have likely been completed?
a. Establishing schools of nursing
b. Developing vaccines to administer to large numbers of people
c. Collecting vital statistics and improving sanitation
d. Developing public housing and almshouses
5. 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.
6. A nurse was employed by the Marine Hospital Service in 1800. Which of the following interventions would the nurse most likely have completed?
a. Setting policy on quarantine legislation for immigrants
b. Establishing hospital-based programs to care for the sick at home
c. Identifying and improving environmental conditions
d. Providing health care for merchant seamen
7. What was the outcome of the Shattuck Report?
a. Efforts to control alcohol and drug abuse, as well as tobacco use, were initiated.
b. Environmental sanitation efforts became an immediate priority.
c. Guidelines for modern public health organizations were eventually developed.
d. Local and state governments established boards of health after its publication.
8. Which of the following nurses is famous for creating public health nursing in the United States?
a. Florence Nightingale
b. Frances Root
c. Lillian Wald
d. Mrs. Solomon Loeb
9. Which of the following would have been the focus of a school nurse in the early 20th century?
a. Investigating causes of absenteeism
b. Teaching school as well as being a nurse
c. Promoting nursing as an autonomous practice
d. Providing medical treatment to enable children to return to school
10. A nurse is reviewing the original work of the National Organization for Public Health Nursing. Which of the following accomplishments of today was started within this organization?
a. Requiring that public health nurses have a baccalaureate degree in nursing
b. Standardizing public health nursing education
c. Developing nursing cooperatives
d. Opening the Henry Street Settlement

Chapter 03: The U.S. Health and Public Health Care Systems
1. A public health agency is planning to implement the electronic health record. Which of the following is a benefit of this choice?
a. Facilitation of interprofessional care
b. Improved client compliance with medical regimens
c. Cost savings to the agency
d. Compliance with JCAHO standards
2. A community health nurse is trying to increase enrollment in SCHIP. Which of the following interventions would be most effective?
a. Explaining the program to children enrolled in public school systems
b. Handing out SCHIP applications to uninsured children seen in local hospital emergency departments
c. Having a newspaper campaign with information and applications printed in the newspaper
d. Sending literature about the SCHIP program home with schoolchildren each year
3. A nurse is explaining the health care system in the United States to a group of physicians visiting from South America. How would the nurse best describe the current health care system?
a. It is a logical, rational approach to meeting expressed needs while still trying to control costs.
b. It is a system in the process of reform as problems have become increasingly apparent.
c. It is divided primarily into two components: private health care and public health care.
d. It is the best in the world with outstanding research and high-technology care available to all.
4. Which of the following best describes ideal primary health care?
a. Based on a multidisciplinary group of health care providers that work as a team
b. Essential care available to all community members, which encourages self-management
c. Focused on health promotion and disease prevention for everyone enrolled in the health center
d. Local efforts to meet the Declaration of Alma Ata principles
5. How does managed care attempt to control costs of care?
a. By encouraging families to use the point of service list of individual practice associates
b. By requiring families to choose a care provider from the MC network and not allowing access to other services without their providers permission
c. By moving Medicaid-eligible families onto state Medicare enrollment
d. By refusing permission for families to use urgent care or emergency department services
6. An 80-year-old woman comes to the community health care facility with a large bag of medications. She tells 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. Lets go through these medications and see which ones we can delete.
b. You can get these medicines at this clinic for free.
c. Lets see if we can get some help from Medicare to help you pay for these medications.
d. These medications are important. Do your best to pay for them.
7. A nurse is determining which health care services must be offered at a local public health clinic. Which of the following factors is most important for the nurse to consider?
a. Data available from the most recent community assessment
b. Suggestions from community members about what is needed
c. Recommendations of Healthy People 2020
d. Services mandated by the state government
8. A nurse is planning to conduct research on patient care outcomes. Which of the following agencies would the nurse use as a resource?
a. Agency for Health Care Research and Quality
b. Federal Agency for Patient Care Outcomes
c. National Center for Nursing Research
d. U.S. Agency for Patient Care Effectiveness
9. How does the Department of Agriculture promote the health of U.S. citizens?
a. By collecting surplus food left after mechanical harvests and distributing it to the poor
b. By inspecting food, so no foodborne illnesses can occur
c. By collaborating with others to provide food or food stamps to needy persons
d. By providing direct education and grants to dietitians and nutritionists
10. Which of the following best describes why local, state, and federal governmental agencies have started to cooperate and collaborate more closely in the last few years?
a. Increased administrative pressures to demonstrate outcomes
b. Increased focus on emergency preparedness and response
c. Increased taxpayers complaints and general unhappiness
d. Increased pressure to decrease overlap in services

Chapter 04: Ethics in Community Health Nursing Practice
1. When and by whom was nursings first code of ethics written?
a. 1893, by Lystra Gretter
b. 1950, by the ANA House of Delegates
c. 1953, by the International Council of Nurses (ICN)
d. 2001, by the ANA House of Delegates
2. A nurse didnt know what to do when faced with a particular ethical dilemma because an option that would have a good outcome didnt seem possible. The nurse decided to talk to the agency supervisor and decide what action to take. Which of the following best describes the nurses actions?
a. Appropriate, because the supervisor is responsible for the nurses choices
b. Intelligent, because the supervisor has access to resource persons (clergy, physicians, administrators) who might know of options the nurse hadnt considered
c. Justified, because this provides an opportunity to discuss the issue but the nurse maintains responsibility for the decision
d. Wise, because the supervisor would be more knowledgeable concerning agency priorities and traditional practices
3. Which of the following is the first and most crucial step in the ethical decision-making process?
a. Assess the context or environment in which the decision must be made.
b. Consider the various ethical principles or theories.
c. Identify the ethical concerns.
d. Make a decision and act on it.
4. A nurse is asked to meet with a family who recently emigrated from Botswana (Africa). After the clinical doctor tells the husband the wifes diagnosis of breast cancer, the family thanks the physician and starts to leave. Ethically, which of the following is the nurses most important action?
a. Emphasizing that the family must set up a surgical appointment for the wife immediately
b. Assessing the familys current living situation, including insurance and other assets
c. Educating the family concerning the usual treatment and the prognosis of breast cancer
d. Interviewing the family concerning their perspective of the threat to the familys well-being
5. The nurse learns that a family has decided not to accept medical intervention for a health care problem because paying for the care would drastically reduce the familys resources and ability to meet the needs of other family members. Ethically, which of the following actions should be taken by the nurse?
a. Appreciate that the family has made the decision that it feels is best and take no further action if it is clear the family has made an informed choice.
b. Stress that each individual in society has a right to health care and the family will have to create some way to raise funds for the needed treatment.
c. Talk to the media to see whether a campaign to raise funds for the family can be created.
d. Try to convince the agency to give the care for free, even if it means economic stress for the agency, because the medical need is obvious.
6. Some nurses are debating about the appropriate action to take in relation to a particular family. The father is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, It is a wifes responsibility to care for an ill husband. Which of the following ethical approaches is being used by this nurse?
a. Consequentialism
b. Communitarianism
c. Deontological ethics
d. Principlism
7. Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, The whole family is being affected and will fall apart if they dont focus on their familys needs first before anything else. Which of the following ethical approaches is being used by this nurse?
a. Communitarianism
b. Deontological ethics
c. Principlism
d. Utilitarianism
8. Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, But it doesnt have to be an either/or situation. Perhaps each family member could take a turn calling in sick just 2 or 3 days. That way they could all take a turn at helping and yet not upset their employers. Wouldnt that be fair? Which of the following ethical approaches is being used by this nurse?
a. Communitarianism
b. Deontological ethics
c. Principlism
d. Utilitarianism
9. Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, Its not up to us; its the familys decision. They know what is best for them. Which of the following ethical approaches is being used by this nurse?
a. Communitarianism
b. Deontological ethics
c. Principlism
d. Utilitarianism
10. Which of the following is the dominant issue in ethical debate around an issue such as continuing or withdrawing treatment in acute health care?
a. Doing what is best for the community
b. Doing what is best for the family
c. Obeying legal mandates
d. Upholding ethical principles

Chapter 05: Cultural Influences in Nursing in Community Health
1. Which of the following best describes most Americans attitude toward immigrants?
a. Ambivalence because there are no clear solutions about how to address their needs
b. Strongly negative because immigrants take jobs that native-born Americans could have instead
c. Strongly positive because immigrants bring useful job skills and often join previous family members already in the United States
d. Strong opposition to further immigration because of the increasing population in the United States
2. A nurse is about to despair. Earlier in the week, she carefully taught a patient from a different culture exactly how much medication to take and emphasized the importance of taking the correct amount. However, the patient is back in the hospital today with symptoms of an overdose, although the patient denies taking more than the label indicated. Which of the following is the most likely explanation?
a. The patient was taking more mediation in the hope of getting well faster.
b. The patient was also taking folk medicines that had many of the same effects and perhaps some of the same ingredients as the prescribed medication.
c. The patient truly did not understand and thought the dose being taken was correct.
d. The patient had a unique response to the medication and should have a smaller dose ordered.
3. A nurse wishes to develop cultural competence. Which of the following actions should the nurse take first?
a. Complete a survey of all the various ethnicities represented in the nurses community.
b. Consider how the nurses own personal beliefs and decisions are reflective of his or her culture.
c. Invite a family from another culture to join the nurse for an event.
d. Study the beliefs and traditions of persons living in other cultures.
4. A nurse is caring for a client of another culture. Which of the following actions would be most appropriate for the nurse to take?
a. Alter personal nonverbal behaviors to reflect the cultural norms of the client.
b. Keep all behaviors culturally neutral to avoid misinterpretation.
c. Rely on friendly gestures to communicate caring for the client.
d. Avoid any pretense of prejudice by treating the client in the same way as any other client.
5. A male nurse had a habit of sitting with the lower part of one leg resting over the knee of his opposite leg when collecting a clients history. He stopped doing this around Muslim clients after being told that Muslims were offended when he exposed the sole of his foot (shoe) to their face. Which of the following was exhibited by the nurse when he changed his behavior?
a. Cultural accommodation
b. Cultural imposition
c. Cultural repatterning
d. Cultural skill
6. The nurse practitioner (NP) discovered that an immigrant client is not taking the penicillin prescribed because his illness is hot and he believes that penicillin, a hot medicine, will not provide balance. Which of the following terms best describes the action taken by the NP when the clients prescription is changed to a different yet equally effective antibiotic?
a. Cultural awareness
b. Cultural brokering
c. Cultural knowledge
d. Cultural skill
7. Mexican immigrants who take metamizole (Mexican aspirin) for pain may experience life-threatening agranulocytosis. Which of the following actions would be taken by a nurse who employs cultural repatterning?
a. Complete a cultural assessment to identify any other dangerous medications that the client may be taking.
b. Put this into perspective by considering that many drugs used in the United States cause agranulocytosis.
c. Explain the harmful effects of metamizole and recommend an alternative medication for pain.
d. Recognize that taking metamizole is common among persons living in Mexico and accept this as a cultural tradition.
8. A health care worker tells a nurse, It does no good to try to teach those Medicaid clients about nutrition because they will just eat what they want to no matter how much we teach them. Which of the following is being demonstrated by this statement?
a. Cultural imposition
b. Ethnocentrism
c. Racism
d. Stereotyping
9. A nurse says, Im not going to change the way I practice nursing based on where the client is from, because research shows that Western health care technology and research is best. Which of the following is being demonstrated by the nurses statement?
a. Ethnocentrism
b. Prejudice
c. Racism
d. Stereotyping
10. A nurse states, The best way to treat a client from another country is to care for them the same way we would want to be cared for. After all, we are all humans with the same wants and needs. What does this statement reflect in relation to culture?
a. Awareness
b. Blindness
c. Knowledge
d. Preservation

Chapter 06: Environmental Health
1. A nurse wants to have a better understanding of the physiological effects of selected chemicals. Which of the following individuals would provide the most useful information to the nurse?
a. Chemist
b. Epidemiologist
c. Pharmacologist
d. Toxicologist
2. A nurse wants to find information about environmental threats that are present in the community. Which of the following would be the best source of data for the nurse?
b. National Library of Medicine
c. State health department
d. Closest local library
3. A nurse is assessing potential environmental health risks in the community. Which of the following would be the first step that the nurse should take?
a. Conduct health risk assessments of randomly selected individuals
b. Perform a windshield survey
c. Review facility permits and consumer confidence reports
d. Survey community members
4. A community citizen reports to the public health nurse that the city water in one neighborhood has had an unusual taste for the past few months. Which of the following actions should the nurse take first?
a. Check the most recent consumer confidence report.
b. Consult the Centers for Disease Control and Prevention.
c. Notify the Environmental Protection Agency (EPA).
d. Place a call to the poison control center.
5. A nurse who works at the local hospital asks a public health nurse what might be causing her hands to become very sore and sensitive. Which of the following statements would be the most appropriate response by the public health nurse?
a. Ask the staff in employee health if there have been any other complaints.
b. Call the local health department about any recent problems at the hospital.
c. Check the material safety data sheet on any chemicals you have used recently.
d. See the nurses health care provider for a complete work-up.
6. Which of the following statements about children and environmental hazards is correct?
a. The prevalence of autism is directly related to the increase in environmental toxins.
b. Children are more susceptible to environmental toxins because of their smaller size.
c. The prevalence of asthma among children has been decreasing.
d. Children are more susceptible to cancer if they have a family history of the disease.
7. Which of the following actions represents the use of secondary prevention to reduce environmental health risks?
a. Collecting blood specimens from preschool children to check for lead levels
b. Meeting with local government officials to request that the city clean up a hazardous vacant lot
c. Referring a child with toxic lead levels to a neurologist
d. Teaching parents of a 2-year-old about the dangers of lead-based paint in older homes
8. An occupational health nurse at a local factory is using primary prevention strategies to reduce the environmental health risks among the employees. Which of the following activities would the nurse most likely implement?
a. Checking radiation detectors to monitor for unsafe levels of radiation exposure
b. Irrigating the eyes of an employee who has had a chemical splash to the face
c. Teaching new employees who will work outdoors about the signs and symptoms of heat-related illness
d. Using spirometry to rule out obstructive or restrictive lung disease for workers who will be wearing mask respirators
9. A nurse wants to help keep the community environment safe. Which of the following is the most appropriate action for the nurse to take?
a. Conserve water by bathing less often.
b. Downsize to a smaller living space.
c. Reduce, reuse, and recycle.
d. Replace all his appliances with new energy-efficient ones.
10. Which of the following best describes the purpose of local health departments making unannounced inspections of local restaurants?
a. To enforce local laws and regulations
b. To ensure compliance
c. To provide exposure to oversight
d. To monitor employee safety

Chapter 07: Government, the Law, and Policy Activism
1. Which of the following best defines the word politics?
a. A neutral term meaning influence
b. The outcome of governmental policies
c. A provision of power for making decisions
d. The result of legislative action
2. Which of the following activities is completed by the executive branch of the federal government?
a. Administration of policy
b. Interpretation of policy
c. Proposal of policy
d. Passage of policy
3. A nurse meets with a senator to lobby for passage of a bill to increase funding for interpreter services. With which of the following branches of the government is the nurse working?
a. Constitutional branch of government
b. Executive branch of government
c. Legislative branch of government
d. Judicial branch of government
4. Which of the following statements best describes why the federal government has become involved in health care?
a. The states asked the federal level to become involved.
b. Because of rising costs to the states, the federal budget needed to be used to pay for necessary services.
c. The Constitution gives the federal government the power to promote the general welfare.
d. This step was necessary to standardize care on a national level.
5. A client states to the nurse, I have heard the Affordable Care Act is supposed to help improve the health care I receive, but so far I have seen no benefits from this legislation. Which of the following statements would be the best reply by the nurse?
a. Maybe you have not directly seen the changes; however, several things have changed in health care because of this bill.
b. It will take years to see any effects from the act because of the delays in implementation of the changes.
c. This legislation will primarily improve care for the elderly and poor populations, so this is why you may not have seen any benefits.
d. The way health care operates at the federal and state levels has changed, so most individuals will not see any direct impact.
6. What was the significance of the 1979 Surgeon Generals report?
a. It planned the goals and priorities for the entire Veterans Administration medical system.
b. It vastly increased funding for health promotion activities.
c. It identified the use of tobacco as a cause of lung cancer.
d. It created national goals for promoting health and preventing disease.
7. A nurse is advocating for the public health department to increase the number of public health nurses that it employs. Which of the following factors should the nurse emphasize?
a. Providing disease investigation training
b. Providing research opportunities
c. Providing leadership experiences
d. Providing salaries commensurate with responsibilities
8. A nurse is determining whether a hospital has the right to require infected patients to be isolated against their will. To which type of law will the nurse refer?
a. Common law
b. Constitutional law
c. Legislation and regulation
d. Judicial law
9. Who is responsible for determining the scope of practice for registered nurses?
a. American Nurses Association
b. Federal legislators
c. State legislators
d. U.S. Department of Health and Human Services
10. Which of the following statements by a client indicates a lack of understanding regarding an appropriate reason to sue for malpractice?
a. Because the health care workers didnt turn my mother every 2 hours, she developed bedsores.
b. I received permanent nerve damage because they would not remove a cast that was too tight.
c. My daughter wasnt given a call light, and for a whole shift no one checked on her condition.
d. They amputated the wrong leg during surgery.

Chapter 08: Economic Influences
1. A nurse is discussing how health care rationing occurs in the United States. Which of the following would most likely be discussed as the criterion that is used to ration health care?
a. Clinic operating hours
b. Ability to pay for services
c. Availability of local provider services
d. Transportation availability
2. Which of the following must a nurse be knowledgeable about to make decisions regarding the most cost-effective way to allocate health care resources?
a. Insurance resources
b. Health care rationing
c. Health economics
d. Medical technology
3. Which of the following individuals would most likely experience a barrier when accessing health care?
a. A 40-year-old female who speaks English
b. A 25-year-old female with health insurance
c. A 50-year-old male with hypertension
d. A 30-year-old male who is unemployed
4. Which person is most likely to be uninsured?
a. An 82-year-old woman with chronic medical problems
b. A 2-year-old whose mother is on welfare
c. A 50-year-old business man who works for a large corporation
d. A 32-year-old man who works part-time at a small business
5. Which of the following is most closely correlated with poor health?
a. Age and gender (i.e., older males)
b. Low socioeconomic status
c. Minority race status
d. High-risk lifestyle behaviors
6. A pregnant teenager has approached a nurse asking about ways to improve the health outcomes for her and her unborn child. Which of the following statements would be most appropriate for the nurse to make?
a. Dont drop out of school.
b. Sign up for childbirth classes.
c. Sign up for the WIC program.
d. Take your prenatal vitamins daily.
7. A nurse is providing care to a child whose parents do not receive health insurance as an employee benefit and who do not have the financial resources to pay for health care out of pocket. Which of the following resources should the nurse recommend to the family?
a. A managed care organization
b. An emergency department
c. Medicaid
d. Medicare
8. Which of the following best explains how the government inadvertently encourages low-income persons to use emergency departments as their primary care provider?
a. A huge amount of paperwork is required when Medicaid clients go to a physicians office.
b. Government regulations require Medicaid clients to use emergency departments when their primary health care provider is unavailable.
c. Legally, emergency departments must see clients even if clients cant pay.
d. Physicians limited office hours make them unavailable during evenings and weekends.
9. Of the four main factors that affect health, which is the least important?
a. Environment
b. Human biology
c. Lifestyle choices
d. Health care system
10. A nurse is trying to maximize the quality of life of her clients while reducing health care costs. Which of the following actions would most likely be completed by the nurse?
a. Assisting in cast application for a client who was injured in a skateboard incident
b. Irrigating the eyes of a client splashed with chemicals
c. Restoring a normal cardiac rhythm following cardiopulmonary resuscitation of a client with a heart condition
d. Teaching a high school boy about sexually transmitted infections and proper condom application

Chapter 09: Epidemiological Applications
1. A nurse is using analytic epidemiology when conducting a research project. Which of the following projects is the nurse most likely completing?
a. Reviewing communicable disease statistics
b. Determining factors contributing to childhood obesity
c. Analyzing locations where family violence is increasing
d. Documenting population characteristics for healthy older citizens
2. A nurse is employed as a nurse epidemiologist. Which of the following activities would most likely be completed by the nurse?
a. Eliciting the health history of a client presenting with an illness
b. Evaluating the number of clients presenting with similar diseases
c. Performing a physical examination of an ill client
d. Providing treatment and health education to a client with a disease
3. Which of the following actions by Florence Nightingale demonstrates her role as an epidemiologist?
a. She convinced other women to join her in giving nursing care to all the soldiers.
b. She demonstrated that a safer environment resulted in decreased mortality rate.
c. She obtained safe water and better food supplies and fought the lice and rats.
d. She met with each soldier each evening to say goodnight, thereby giving psychological support.
4. Which of the following statements describes how nursing in the community is more challenging than nursing in an acute care setting?
a. There is limited access to information useful to the nurse in giving care in the community.
b. More paperwork and forms are required when giving care in the home.
c. It is more challenging to control the environment in the community.
d. Specialization isnt possible in the community setting.
5. Several small communities have applied for grant funding from the state department of health to help decrease their teenage pregnancy rate. Which of the following communities should the nurse suggest receive funding first?
a. Community Awith 23 single teenage pregnancies in a city of 500
b. Community Bwith 45 single teenage pregnancies in a city of 1000
c. Community Cwith 90 single teenage pregnancies in a city of 2000
d. Community Dwith 90 single teenage pregnancies in a city of 1500
6. Between 2000 and 2005, 1000 of 10,000 young women ages 17 to 20 years at a university tested positive for a sexually transmitted infection (STI). Of the 1000 diagnosed STIs, 300 were gonorrhea and 500 were chlamydia. Which of the following statements best summarizes these findings?
a. The proportion of cases of gonorrhea to all STIs was 300:1300.
b. The proportion of cases of gonorrhea to chlamydia was 300:500.
c. The proportion of cases of gonorrhea to all STIs was 50%.
d. The proportion of STIs to the total population was 100:1000.
7. The nursing staff has attempted to screen the entire African-American population in the community for diabetes. Which of the following would provide immediate verification of the success of the nursing staffs efforts?
a. An epidemic of diabetes will be recognized.
b. The incidence of diabetes will increase in the community.
c. The prevalence of diabetes will decrease in the community.
d. The risk for diabetes in the community will increase.
8. In a particular community, several high school students were diagnosed with diabetes mellitus Type 2 during the annual high school health fair. Over the next few years, the nursing staff developed and implemented educational programs about the risk factors for diabetes mellitus Type 2 and proper nutrition. Which of the following would be most useful for the nurses to use to determine if they are having any impact?
a. The epidemic of diabetes in the high school is gradually ending.
b. The incidence of diabetes is slowly decreasing during screening events.
c. The prevalence of diabetes is slowly decreasing during screening events.
d. The risk for diabetes is slowly increasing over time.
9. This year 600 of 8000 young women ages 17 to 20 years at a university health center tested positive for a sexually transmitted infection (STI). Which of the following terms best describes this data?
a. An epidemic
b. Incidence
c. Prevalence
d. Risk
10. A nursing staff has successfully screened for diabetes in the community. Which of the following might best persuade the health board to increase funding for diabetic clinics in this community?
a. An epidemic of diabetes is now recognized and must be addressed.
b. The incidence of diabetes is now higher than previously recognized in the community.
c. The prevalence of diabetes is now higher than previously recognized in the community.
d. The risk for diabetes in the community could decrease if funding is received.

Chapter 10: Evidence-Based Practice
1. A nurse executive is implementing evidence-based practice at a community nursing center that serves a large Cuban immigrant population. Which of the following actions would be the most helpful for the nurse?
a. Review clinical policies with cultural competency experts from the local university.
b. Conduct weekly staff meetings to discuss which methods work best when helping immigrants.
c. Invite Cuban immigrants from the community to serve on the centers advisory board.
d. Send personnel to conferences and seminars that focus on treating Hispanic immigrants.
2. A community health nurse is determining the best way to address an outbreak of a new infectious disease using evidence-based practice. Which of the following actions would the nurse most likely take?
a. Review policies and procedures
b. Review outcomes of clinical trials
c. Review several nursing textbooks
d. Review reputable sites on the Internet
3. A nursing administrator wants to develop a work environment conducive to the implementation of evidence-based practice (EBP). Which of the following actions would 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
4. 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. Which of the following actions should the nurse take first?
a. Identify students who are obese so that they may be closely monitored for weight control success or failure.
b. Evaluate best practices to determine those that have the highest success rates for weight control in children.
c. Schedule physician appointments for obese children.
d. Develop an obesity management program for children whose body mass index exceeds normal.
5. The nurse has been reading everything she can find on a particular clinical problem, using both the closest medical library and the Internet. Which of the following would be the most helpful source?
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
6. 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 schoolchildren. Which of the following would 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 schoolchildren.
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.
7. After finding several studies related to the clinical problem, a nurse knows the studies must be evaluated. Which of the following characteristics should be present in the literature?
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
8. A nurse is familiar with evidence-based practice (EBP) and wants to implement it into the care of clients. Which of the following would present 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
9. Which of the following groups is pressuring clinicians the most to use evidence-based practice (EBP)?
a. Administrators
b. Insurance companies
c. Nurses
d. Physicians
10. A nurse implements an education program that incorporates computer games to reinforce learning for a group of older adults. Although the research demonstrates evidence of improved retention of this information, the nurse experiences exactly the opposite with this group. Which of the following 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. Lack of skills when evaluating the evidence

Chapter 11: Using Health Education and Groups in the Community
1. A member of a community weight-loss group has maintained a healthy weight for 2 years through healthy eating and daily exercise. Which of the following steps of the affective domain is this participant demonstrating?
a. Analysis
b. Application
c. Evaluation
d. Knowledge
2. A nurse just finished teaching breast self-examination to a large group of women at a professional conference. During the session, she distributed literature and used culturally appropriate visual aids. However, the session was not as effective as it could have been. Which of the following was the most important thing omitted by the nurse?
a. Time for audience members to ask questions and clarify the information
b. Explanation of why culturally appropriate images are more acceptable
c. Opportunity for the women to practice what they learned
d. Use of simple language instead of printed material
3. A nurse is providing an educational program about testicular self-examination (TSE). Which of the following would be the best learning objective for this program?
a. Each participant will state why TSE is important and explain how to do it.
b. Each participant will describe how to do TSE and discuss the dangers of testicular cancer.
c. 90% of the men will correctly demonstrate testicular self-examination.
d. 100% of the men will do a testicular examination correctly on a model.
. A nurse planned a presentation about the latest trends in disaster planning for the senior nursing students at the local college. However, when the nurse began to share the information, the students were talking to one another and essentially ignoring the nurse. Which of the following actions should be taken by the nurse?
a. Ask the students why they are being so rude.
b. Explain why the information is crucial to their current clinical practice.
c. Nothing; let the instructor of the course handle the problem.
d. Tell a joke to get the students attention.
5. A nurse is using the technique of motivational interviewing when working with a client. Which of the following statements by the client indicates the client is ready to make the change?
a. I should change.
b. I am willing to change.
c. Its important to change.
d. I want to change.
6. A nurse uses lecturing as the primary method of educating clients. Which part of the education process is missing?
a. Evaluation
b. Experience
c. Participation
d. Understanding
7. The nurse gives a very informative and engaging presentation and then gives everyone in the audience a handout that outlines the presentation. Later, the nurse discovers that many of the handouts were thrown away before the audience left the building. Which of the following educational principles has the nurse forgotten?
a. Audiences expect PowerPoint or video presentations, not lectures.
b. Many Americans do not have a high reading level.
c. People want photographs and images, not wordy outlines.
d. The nurse gave them too much information too fast for them to want to cope with it all.
8. Which of the following statements regarding the Health Belief Model is accurate?
a. Cues to action are an important component of the model.
b. Multiple methods of education should be used when implementing this model.
c. The first stage experienced in this model is the pre-contemplation stage.
d. To successfully implement this model, ongoing maintenance of the behavior must be considered.
9. A nurse is planning an educational program about cardiovascular disease. Which of the following would be the optimal time for the nurse to elicit feedback from program participants?
a. At the beginning of the program
b. At the program midpoint
c. Immediately following program completion
d. Throughout the program
10. When evaluating an educational program, the nurse discovers that only 25% of community members met the learning objectives. Which of the following parts of the program should be improved?
a. Educator
b. Content
c. Learners
d. Objectives

Chapter 12: Community Assessment and Evaluation
1. Which of the following is the best brief definition of community?
a. A geographic area or political division under common leadership
b. A group sharing a common bond such as a profession or occupation
c. A group working together to confront a common problem
d. A social group with common goals within a geographic area
2. A nurse is practicing in the community but also has the community as the target of practice. Which of the following best describes the activities of this nurse?
a. Providing care to an active caseload of 50 families in the neighborhood
b. Inviting all the parents of asthmatic children in the school to meet together for mutual support
c. Sharing assessment findings and health goals with every community group that will listen
d. Writing articles for the local newspaper highlighting the various programs and services of the local health department
3. Persons often point out that smokers choose to light their cigarettes, alcoholics lift the glass to their mouth, and drug addicts inject or ingest their drugs. Which of the following statements best describes why nurses dont simply focus on helping persons who engage in poor health behaviors to behave appropriately?
a. Addicts dont have the willpower to change their behavior.
b. It is too rewarding to continue the behavior for a person to be able to change.
c. Laws and policies must reward good healthy behaviors and punish unhealthy behaviors to help individuals recognize the importance of change.
d. Society must offer healthy choices, offer support, and practice helpful policies.
4. A nurse is focusing on the process dimension of a communitys health. Which of the following interventions will the nurse most likely implement?
a. Assessing the health care services available in a community
b. Establishing screening programs to diagnosis diseases as early as possible so treatment can begin
c. Implementing health promotion activities such as education programs
d. Planning for new programs to be developed based on identified needs
5. A nurse has invited community members to participate as full partners in creating changes to improve the health of the community. Which of the following may be an unexpected consequence of this action?
a. A change in the distribution or redistribution of power and influence
b. An increase in awareness of the importance of health
c. Continued ongoing interest in community health activities
d. Improved family functioning and involvement in health activities
6. During the assessment phase, the nurse compiles and interprets available data and draws conclusions as to the communitys strengths and concerns. Which of the following best describes why the nurse would also conduct interviews with key informants?
a. To ensure that others agree with the nurses plans for interventions
b. To confirm the nurses initial findings and conclusions
c. To encourage community partners to feel they own the data
d. To generate nonstatistical data such as values, beliefs, and perceived needs
7. A nurse just accepted a position in community health and has been assigned to a neighborhood very close to where she lives. Which of the following best describes the rationale for this assignment?
a. To allow participant observation by the nurse
b. To ensure that the nurse would care about her intervention outcomes
c. To maximize convenience and minimize commuting time for the nurse
d. To save gasoline in these difficult economic times
8. A community health nurse drives through her assigned community before visiting the community groups scheduled for the day. She then drives through the community again that evening before going home. Which of the following best describes the nurses reason for driving through the community twice in the same day?
a. On the second trip, the nurse can carefully confirm the results of the first assessment.
b. Repeating the experience ensures that the nurse absorbed all the relevant details.
c. Driving through twice allows the nurse to see the community when many residents are at work or at school and then again when most are at home.
d. When leaving in the evening, the nurse has more time to write down the results of the earlier assessment.
9. Before beginning to survey the community to assess its health needs and strengths, the nurse reviews various documents, including local statistical data and the minutes of the previous meeting of the health care agency. Which of the following best explains why the nurse would start with this activity?
a. To avoid confronting the community until the nurse is thoroughly oriented
b. To become familiar with previous goals and priorities of the agency
c. To help get a better understanding of the assigned community
d. To save time and effort and perhaps have new insights
10. A new nurse is overwhelmed with the needs of the community. Which of the following should be the first priority of the nurse?
a. A problem that affects the most disadvantaged residents in the community
b. A problem that is very easy and inexpensive to address
c. A problem that is of high concern to the community
d. A problem in an area in which the nurse has a great deal of expertise

Chapter 13: Case Management
1. Which of the following best describes case management?
a. A tool of health maintenance organizations
b. Targeted toward a specific segment of the population
c. Implemented with individual clients
d. Used to monitor the health status, resources, and outcomes for an aggregate
2. Which of the following best describes why planning care for an individual is so challenging in todays health care system?
a. Because todays clients have high expectations of the health care system
b. Because multiple providers, payers, and settings have to be coordinated
c. Because of the new high technology constantly being created and used for client treatment
d. Because so many different health care providers are in the acute care setting today
3. Which of the following best describes the primary problem that can result from health care today being given by many different care providers?
a. Clients are not sure which provider to see first.
b. Health care providers have to make referrals to other providers.
c. Clients sometimes are not sure who their primary provider is.
d. Overuse, underuse, or gaps in care may result.
4. Which of the following public health nurse applicants is the least qualified for a position of case manager in a rural county?
a. A 24-year-old who has a masters degree in public health
b. A 34-year-old who will be moving from a large city
c. A 44-year-old who was born and raised in the community
d. A 54-year-old who, until recently, was a member of the communitys school board
5. Which of the following best explains why every client doesnt receive care from a case manager?
a. Case management time is demanding; thus it is restricted to complex cases.
b. Many health agencies do not employ case managers.
c. Most clients would not benefit from case management.
d. Most nurses do not know how to function as case managers.
6. The nurse suggests use of telehealth to assess how a client is progressing. Which of the following resources must be available for continuing care to be implemented?
a. A physician who is willing to use wireless prescriptions and plans of care
b. Family permission for the nurse to make home visits
c. Long-distance telephone service or a computer with Internet access
d. Willingness of the caregiver to drive the client to the nearest clinic
7. A nurse is using a case management plan to maximize patient care outcomes. Which of the following describes an important consideration that should be made by the nurse?
a. Case management plans should be used only by nurses to manage care.
b. Case management plans should be individualized for each client.
c. Case managements plans provide additional expense to the client and family.
d. Case management plans focus on the natural progression of the disease.
8. A client spends a great deal of his time on the Internet or reading articles related to diabetes and its long-term effects. One day the client asks why the nurse has not suggested a life care plan. Which of the following would be the best response by the nurse?
a. Life care plans are only for young persons who are newly diagnosed.
b. Life care plans are primarily used to determine long-term financial needs for legal reasons.
c. You are receiving appropriate care for your diabetes without serious side effects, so a life care plan isnt really appropriate.
d. I was waiting for you to express interest in having a life care plan.
9. Which of the following Medicaid clients would most likely receive case management?
a. An elderly person
b. A person receiving rehabilitation following an injury
c. A person who has a high-cost chronic disease
d. A person with acute illness
10. Which of the following best describes the goal or priority of the nurse advocate?
a. To gain organizational and governmental support for the promotion of nursing objectives
b. To improve community service needs identified by research findings
c. To integrate evidence-based practice guidelines in the provision of community nursing service
d. To promote the clients rights and self-determination

Chapter 14: Disaster Management
1. Which of the following best defines a disaster?
a. Any event that results in multiple deaths
b. Devastation that cannot be relieved without assistance
c. Devastation that covers a broad geographical area
d. When the event results in multiple injuries and deaths as well as property damage
2. Which of the following best describes countries that bear the greatest burden of disasters?
a. Arid regions that are prone to drought
b. Developing countries with limited resources
c. Industrialized countries with much to lose
d. Water-boundary regions that are prone to floods and hurricanes
3. What is the purpose of the National Response Framework?
a. Create a new branch of government that deals with bioterrorism
b. Establish a way for the Red Cross to carry out its mission
c. Develop a nationwide all-hazards approach to domestic incident management
d. Extend presidential power to act quickly upon weapons of mass destruction
4. When does disaster management begin?
a. Before the disaster occurs
b. During the disaster
c. Immediately following the disaster
d. During the recovery period
5. A nurse is focused on mitigation of disasters at the international level. Which of the following activities would the nurse most likely complete?
a. Provide community educational programs and training on how to prepare for disasters.
b. Request donations be sent to the affected area.
c. Develop a notification procedure to be used by the international disaster relief office.
d. Recruit volunteers to be a part of the disaster team that will travel to the afflicted area.
6. A nurse is employed by the American Red Cross and is frequently assigned to fly to a disaster zone. Which of the following should the nurses family members have readily available?
a. Gloves, mask, and other personal protective equipment
b. A copy of the nurses professional license
c. A 5-day supply of water
d. A disaster/emergency plan
7. A nurse is working with a community during the preparedness stage of disaster management. Which of the following events would the nurse anticipate occurring?
a. Heightened inspection and increased security in the community
b. Incorporation of provision of pets into local disaster plans
c. Purchase of personal protective equipment for all citizens
d. Assembly of disaster kits for the home, workplace, and car
8. A community health nurse has invited several agencies in the community to a meeting to discuss the disaster plan for the community. Which of the following best describes the purpose of this meeting?
a. To increase stability in the community
b. To improve overall community functioning
c. To manage response to disasters in the community
d. To enhance communication among agencies in the community
9. The local hospital, health department, and university together planned and implemented a mock casualty drill, with the universitys theater and nursing students playing the injured victims. After the drill, which of the following would the nursing students most likely complete?
a. Volunteer as leaders in the next casualty drill
b. Evaluate the drill and offer recommendations for more effectiveness in the future
c. Recognize how to respond to a real disaster in the future
d. Write a report on their actions and how they felt during the drill
10. Which of the following organizations would direct nurses response to a county-wide disaster?
a. American Red Cross
b. Centers for Disease Control and Prevention
c. Emergency Management Agency
d. The local public health department

Chapter 15: Surveillance and Outbreak Investigation
1. A nurse considered copying last months surveillance report and changing the date because the number of occurrences per month had not noticeably changed. Which of the following best explains why the nurse should continue to spend time collecting and reporting data that is always nearly the same?
a. Because such data are legally required
b. Because it is still part of the nurses responsibilities, even if it is a waste of time
c. To determine a local baseline rate and immediately notice any change
d. To determine differences among communities in need for state assistance
2. A nurse attends a conference to learn more about public health surveillance. Why is it so important that the nurse be knowledgeable about this topic?
a. Because nurses are employed in public health agencies
b. Because nurses are often the first to recognize and respond to a problem
c. Because nurses are responsible for ensuring that action is taken when necessary
d. Because nurses are typically the ones to interact with the public and the media
3. A rural public health nurse is spending time reviewing death certificates. Which of the following best explains the purpose of this activity?
a. To ensure that local causes of death are consistent with national causes of death
b. To confirm that no local health problems are beginning
c. To evaluate effectiveness of health promotion programs
d. To obtain mortality data for the local area
4. Which of the following types of surveillance is being used when case reports are routinely sent to local health departments by health care providers and laboratories, where the data are then summarized and forwarded to those responsible for monitoring such reports?
a. Active surveillance
b. Passive surveillance
c. Sentinel surveillance
d. Special surveillance
5. In which of the following situations would the nurse most likely use active surveillance?
a. A newspaper wants to know the incidence of asthma in the community.
b. A real-time ongoing communication channel is established to monitor a particular symptom.
c. Several children become ill with GI upset at one local school.
d. The nurse is asked to report the incidence of a specific nonreportable common problem in the community.
6. Several children were hospitalized for severe vomiting and diarrhea. Which of the following best explains why the nurse would continue to pursue the cause of the illness even after the children have been discharged from the hospital?
a. So that the childrens families know the public health department cared about them
b. So that action could be taken to avoid any such future episodes
c. Because the childrens parents need to know whom to sue for their medical expenses
d. To confirm that the symptoms were due to an infectious disease
7. A child came to school coughing almost constantly. The next day, six other children in the same school room were coughing. Which of the following types of outbreak would the nurse suspect?
a. Common source
b. Mixed
c. Propagated
d. Intermittent
8. A nurse noted that of 18 children in a day care center room, 5 became ill. Which of the following best describes a host factor that may be associated with this illness and who became ill?
a. Some of the children were from very low socioeconomic families.
b. Some of the children slept during rest time while others only rested.
c. The bacterial cause of the illness was easily removed by hand washing.
d. The day care center room was much warmer on three sides in comparison to the side with the floor to ceiling windows.
9. In January, a nurse is listening to colleagues talk about the increase in depressed patients asking for help from their physicians recently. The incidence of complaints of depression was higher in the last month than in the previous 3 months. Based on this data, which of the following would be the next step for

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