Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Population Health: Creating a Culture of Wellness 2nd Edition Nash Fabius Test Bank Chapter 1 Population Health Overview

MULTIPLE CHOICE 1. One of the primary focuses of improving the health of the American people in the twenty-first century is to address: a. Bioterrorism and global health threats b. Delivery of individual care and hygiene c. The need for increased hospital and acute care d. Chronic disease and disability management ANS: A There are new concerns, and one of the most serious is bioterrorism. The others are not related to public health or are concerns that have been present for many years.

DIF: COG: Understanding REF: 4 OBJ: 1 2. The threat of bioterrorism has the potential to: a. Dissolve community-based programs. b. Cause the health care system to collapse. c. Divert funds from other public safety health care programs. d. Increase the need for shelters.

ANS: C Bioterrorism may have an impact on the availability of resources for public safety health care programs.

DIF: COG: Analyzing REF: 4 OBJ: 1 3. Population-based preventive programs launched in the 1970s are responsible for increased: a. Use of tobacco b. Use of automobile safety restraints Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Incidence of hypertension d. Incidence of obesity ANS: B One outcome of preventive programs launched in the 1970s is the increased use of automobile safety restraints. These programs also are responsible for the decreased use of tobacco and improved blood pressure control. None of these programs addressed the incidence of obesity.

DIF: COG: Remembering REF: 5 OBJ: 1 4. The public health nurse must participate in the essential services of public health. These include: a. Monitoring health status by completing a community assessment b. Diagnosing and investigating health problems in the world c. Informing, educating, and empowering people about health issues d. Working in law enforcement to regulate health and ensure safety ANS: C The public health nurse monitors health status in several ways, completing a community assessment is only one way that health status is monitored. The public health nurse would not diagnose or solve world problems, or work in law enforcement. Rather, the public health care nurse would participate with local regulators to protect communities and empower people to address health issues.

DIF: COG: Understanding REF: 5 OBJ: 1 5. Which of the following is an example of the mission of public health according to the Institute of Medicine? a. Tracking avian flu outbreaks and doing surveillance in the United States b. Providing a flu shot for an elderly person at the health department c. Keeping track of alternative therapies in use in the United States d. Keeping snake antivenom at the Centers for Disease Control and Prevention in Atlanta ANS: A The Institute of Medicines stated mission on public health is to generate organized community and technical knowledge to prevent disease and promote health.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: COG: Analyzing REF: 7 OBJ: 1 6. Making sure that essential community-oriented health services are available defines which of the core public health functions? a. Policy development b. Assessment c. Assurance d. Scientific knowledge-based care ANS: C Public health is based on scientific knowledge, but is not a core function. The definition does not fit the terms assessment or policy development.

DIF: COG: Applying REF: 7 OBJ: 1 7. The number and proportion of persons aged 25 or older with less than a high school education is an example of: a. Sociodemographic characteristics b. Health status c. Health risk factors d. Health care resource consumption ANS: A The number and proportion of people is a demographical characteristic.

DIF: COG: Analyzing REF: 8 OBJ: 1 8. The purpose of public health core functions is to: a. Clarify the role of the government in fulfilling the mission of public health. b. Ensure the safety of populations in receiving quality health care. c. Provide community-based individualized care to every person in the United States. d. Unite public and private providers of care in a comprehensive approach to providing health care.

ANS: A As defined by the Institute of Medicine in its 1988 report The Future of Public Health, assessment, policy development, and assurance are core functions at all levels of government for the purpose of clarifying the governments role.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: COG: Understanding REF: 7 OBJ: 1 9. Which of the following statements about public health is accurate? a. Prevention of early deaths can be more effectively accomplished by medical treatment than by public health approaches. b. Expenditures and resources for public health have increased in recent years. c. Historically, gains in the health of populations have been related largely to changes in safety, sanitation, and personal behavior. d. Reform of the medical insurance system is the single change needed to improve the health of Americans.

ANS: C Changes, such as immunizations, tobacco use, blood pressure control, and automobile safety, have helped increase the health of communities.

DIF: COG: Understanding REF: 7 OBJ: 1 10. Collecting data and monitoring the health status of the population defines which of the core public health functions? a. Assessment b. Prevention c. Assurance d. Policy development ANS: A Prevention is not a core function, assurance is making sure essential services are available, and policy development is needed to provide leadership in developing policies. Assessment consists of systematic data collection and monitoring health status.

DIF: COG: Applying REF: 7 OBJ: 1 11. The nurse who compares the rate of teenage pregnancy in various areas of the city is practicing the public health core function of: a. Assurance b. Assessment c. Prevention d. Policy development Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: B Assessment refers to systematic data collection, which this nurse is doing for teenage pregnancy.

DIF: COG: Evaluating REF: 7 OBJ: 1 12. Public health nurses who develop and implement local public health policies through partnerships with agencies, organizations, and consumers within the community are using which core public health function? a. Assessment b. Prevention c. Assurance d. Policy development ANS: D Prevention is not a core function, assurance is making sure essential services are available, and assessment refers to systematic data collection. Policy development deals with developing and implementing health policies.

DIF: COG: Applying REF: 7 OBJ: 1 13. Providing for the availability of essential personal health services for people who would otherwise not receive health care defines which public health core function? a. Assessment b. Prevention c. Assurance d. Policy development ANS: C Assurance deals with the availability of health services. Prevention is not a core function, assessment refers to systematic data collection, and policy development refers to the need to provide leadership in developing health policies.

DIF: COG: Applying REF: 7 OBJ: 1 14. The nurse manager who makes sure that the staff members who work in a local clinic are competent is demonstrating the public health core function of: Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Assurance b. Assessment c. Prevention d. Policy development ANS: A Assurance refers to making sure a competent health care workforce is available.

DIF: COG: Evaluating REF: 7 OBJ: 1 15. The public health nurse analyzes data related to the number and type of United States Environmental Protection agency air quality standards that a community failed to meet.

This data is an example of using which community health profile indicator? a. Sociodemographic characteristics b. Health status c. Health risk factor d. Functional status ANS: C Breathing air of poor quality is a risk to health.

DIF: COG: Evaluating REF: 8 OBJ: 1 16. Which is an example of the primary goal of public health? a. Ensuring that a newly diagnosed 40-year-old hypertensive man takes his medication b. Finding home care for a 70-year-old client recuperating from a hip replacement c. Conducting an infant car seat safety check d. Contacting a local hospice to admit a terminally ill 60-year-old woman ANS: C The correct answer is concerned with the health of many people, while the other answers address individual interventions.

DIF: COG: Evaluating REF: 7 OBJ: 1 17. The public health workforce should demonstrate competency in which of the following competency categories? a. Financial planning and management Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

b. Workforce needs assessment c. Acute care services d. Curriculum development ANS: A Workforce needs assessment, acute care services, and curriculum development are not considered categories of core competencies of public health. Rather there are eight categories of competency, which include: analytic/assessment, policy development/program planning, communication, cultural competence, community dimensions of practice, basic public health sciences, financial planning and management, and leadership and systems thinking.

DIF: COG: Understanding REF: 9 OBJ: 2 18. Public health nursing is a specialty because: a. It has a distinct focus and scope of practice. b. It must be done by a registered nurse with a masters degree. c. It is focused on disadvantaged citizens. d. It performs interventions at the acute care level.

ANS: A Public health nursing has a distinct focus and requires a special knowledge base. The other answers are not characteristics of a specialty.

DIF: COG: Understanding REF: 10 OBJ: 2 19. The necessary basic preparation for public health nursing is a(n)

in nursing.

a. Associates degree b. Baccalaureate degree c. Masters degree d. PhD ANS: B A BSN is the necessary basic preparation to function as a beginning staff public health nurse.

DIF: COG: Remembering REF: 11 OBJ: 2

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

20. Public health practitioners prepared at the graduate level should be able to: a. Teach public and community health nursing b. Assess and intervene successfully at the aggregate level c. Diagnose and treat disease and have prescriptive authority d. Run for political office as experts in public health policy ANS: B According to the Consensus Conference, specialists should have assessment skills that allow them to intervene at the aggregate level. Public health practitioners have a broad range of practice areas within public health and are not limited to only nursing and medicine.

DIF: COG: Applying REF: 11 OBJ: 2 21. A public health nurse provides a clinic for HIV-positive citizens in the community. This is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Policy making ANS: C This clinic is for clients who already have a disease process; therefore, it is tertiary prevention.

DIF: COG: Applying REF: 11 OBJ: 2 22. An example of a community health nursing practice is: a. Administrating a flu shot to a client in a physicians office b. Conducting a flu shot clinic at a community center c. Performing a client assessment in a hospital d. Providing supervision of staff in a rehabilitation center ANS: A Community health nursing practice focuses on providing individual interventions in the community. Administrating a flu shot to an individual is the only example that meets this criterion.

DIF: COG: Applying REF: 16 OBJ: 3 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

23. Which statement about community health nursing practice is correct? a. It focuses on the delivery of personal health services to individuals and families. b. It provides care to protect the health of the community as a whole. c. It emphasizes the setting where care is provided for clients and families. d. It requires a baccalaureate preparation for practice.

ANS: A By definition, the first option is correct. Public health nursing provides care to protect the health of the community as a whole. Community-based nursing practice emphasizes the setting where care is provided for clients and families. It is generally assumed that a graduate of any baccalaureate program has the necessary basic preparation to function as a beginning staff public health nurse; however, this is not a requirement for public health nursing or community health nursing practices.

DIF: COG: Understanding REF: 16 OBJ: 3 24. The term community-based nursing care is applied when implementing which nursing intervention? a. Assessing the health needs of a defined community b. Providing care to families in a community c. Promoting the health of an entire community d. Investigating environmental health problems in a community ANS: B Community-based nursing practice is a setting-specific practice whereby care is provided for families where they live, work, and attend school. The focus is on acute and chronic care and the provision of services. Providing care to families is the only intervention that accurately describes this definition.

DIF: COG: Applying REF: 16 OBJ: 3 25. The nurse who conducts vision screenings on children in the school setting is practicing nursing practice. a. Community-oriented b. Public health c. Community health

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

d. Community-based ANS: D This type of nursing is a setting-specific practice.

DIF: COG: Applying REF: 16 OBJ: 3 26. Which is an example of an aggregate or population? a. Students in a county school system b. Christians around the world c. A patient in the intensive care unit at the local hospital d. People who play cards together once a week at private homes ANS: A A population or aggregate is a collection of individuals who have one or more personal or environmental characteristics in common. They can be defined in terms of geography or a special interest. The clients in the first option share a geographical characteristic.

DIF: COG: Applying REF: 12 OBJ: 4 27. The nurse investigating environmental health problems caused by contaminated ground water is best described as practicing: a. Community-oriented nursing b. Community-based nursing c. Policy development d. Tertiary care ANS: A Community-oriented nursing emphasizes the prevention of disease and disability.

DIF: COG: Analyzing REF: 16 OBJ: 4 28. A population is best defined as a: a. High-risk group b. School or institutional setting c. Collection of individuals who share at least one common characteristic d. Geographical location within a community

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: C The wrong answers are types of populations; they do not define a population.

DIF: COG: Remembering REF: 12 OBJ: 4 29. Population-focused practice focuses on defining the problems or needs of and implementing solutions for: a. Individuals b. Aggregates c. Communities d. Geographical regions ANS: B Aggregates are a defined population made up of individuals in communities of a specific geographical region.

DIF: COG: Understanding REF: 12 OBJ: 4 30. Which of the following statements is true with regard to a population focus in public health nursing? a. Priority is given to the highest risk population. b. Direct caregiving is limited to preventive measures, such as administration of immunizations. c. Attention is given to the population or community as a whole, regardless of whether they do or do not access the health care system. d. Only populations outside institutional settings are considered.

ANS: C Public health nurses are concerned with the health of the entire population.

DIF: COG: Analyzing REF: 12 OBJ: 4 31. A public health staff nurse who has a clear understanding of population-focused practice: a. Is frustrated providing care to individuals b. Would rather perform population-focused interventions c. Is able to improve the effectiveness of care provided Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

d. Is considered a public health nurse specialist ANS: C Public health staff nurses who have a clear understanding of population-focused care improve their effectiveness and efficiency of practice; have professional satisfaction by seeing how individual care contributes to health at the population level; and appreciate the practice of others who are population-focused specialists. Public health nurse specialists are prepared at the masters level and function in an administrative role.

DIF: COG: Analyzing REF: 17 OBJ: 6 32. A key opportunity for public health nurses to improve population-focused care is by: a. Assuming traditional nursing roles b. Influencing public health policy c. Conducting community assessments d. Specializing in community-based nursing practice ANS: B Public health nurses must move into positions in which they can influence policy formation.

They must assume positions that are not traditionally considered nursing. Conducting community assessments is part of public health nursing practice, not necessarily a key opportunity to improve practice. Specializing in community-based nursing practice is setting-specific and does not relate to a key opportunity to improve population-focused care.

DIF: COG: Analyzing REF: 17 OBJ: 6 33. Proposed changes to the health care delivery system in the United States will: a. Provide new opportunities for public health specialists. b. Result in isolated care being provided to individuals. c. Emphasize specialty care. d. Increase the utilization of acute care services.

ANS: A Proposed changes in the health care delivery system will provide new opportunities for public health specialists and result in the creation of new roles within the system. The

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

proposed changes will build an integrated system (not isolated), decrease emphasis on acute care services, and focus on health promotion and disease prevention.

DIF: COG: Analyzing REF: 18 OBJ: 6 34. Implementing quality performance standards in public health is important because: a. They are used to guide improvement in the public health system. b. They rigidly control public health. c. Administrators will not monitor public health at the local level, but instead at the national level. d. They can be used as hiring guidelines for nurses.

ANS: A These standards were developed by the Centers for Disease Control and Prevention in 1998. They set the bar for the level of performance that is necessary to deliver essential public health services.

DIF: COG: Applying REF: 9 OBJ: 7 35. To better address emerging public health issues, a public health nurse enrolls in a course addressing which content area? a. Leadership b. Ethics c. Communication d. Finance ANS: B Public health workers should be educated in eight content areas to be able to address emerging public health issues and advances in science and policy: informatics, genomics, cultural competence, community-based participatory research, policy, law, global health, and ethics.

DIF: COG: Evaluating REF: 9 OBJ: 7 MULTIPLE RESPONSE

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

1. Which of the following are considered barriers to public health nursing? Select all that apply. a. The mindset that the only role for the nurse is at the bedside. b. The structures within which nurses work and the process of role socialization within those structures. c. Few nurses receive graduate-level preparation in the concepts and strategies of the disciplines basic to public health. d. The number of job opportunities in the area has been steadily declining.

ANS: A, B, C All are considered barriers to nurses specializing in public health nursing, except the number of job opportunities, which is not declining.

Chapter 2 The Spectrum of Care

MULTIPLE CHOICE 1. In the past, population-centered nurses have been called: a. District nurses b. Almshouse nurses c. Soldier nurses d. Sisters ANS: A In the past, population-centered nurses have been called public health nurses, district nurses, visiting nurses, school nurses, occupational health nurses, and home health nurses.

DIF: COG: Remembering REF: 23 OBJ: 1 2. Public health practice is an appealing specialty to nurses because of its: a. Interactions with wealthy contributors to secure funding b. Autonomy and independence of practice c. Ability to locate the source of diseases and cure patients d. Opportunities to meet a variety of people ANS: B Community health nurses have a long history of autonomous practice, problem solving, and Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

decision making. Community health care nurses engage in the other activities as well, but overall, they have been best known for autonomy of practice.

DIF: COG: Applying REF: 23 OBJ: 1 3. The Elizabethan Poor Law of 1601 is similar to which current law? a. Welfare b. Food Stamps c. Medicaid d. Medicare ANS: C The Poor Law guaranteed medical care for poor, blind, and lame individuals, similar to Medicaid.

DIF: COG: Evaluating REF: 24-25|36 OBJ: 1 4. Current threats to health in the United States that community health nurses are faced with include: a. Diphtheria, cholera, and hepatitis b. HIV, H1N1 influenza, and bioterrorism c. Avian flu, tuberculosis, and radiation d. Polluted water and air ANS: B The newest threats to health that public health nurses are involved in are HIV, H1N1 influenza, and bioterrorism. Hepatitis is also a current threat, but diphtheria and cholera are not concerns in the United States. Avian flu may be a threat, but radiation and tuberculosis are ongoing. Environmental pollution has been reduced; however, there are pollution issues that do raise concerns.

DIF: COG: Understanding REF: 23 OBJ: 2 5. A colonist working in the public health sector in early colonial North America would likely have focused on: 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 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: C The other choices are events that happened after the colonial period.

DIF: COG: Applying REF: 24 OBJ: 2 6. The original work of the National Organization for Public Health Nursing has influenced nursing practice today by: 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 ANS: B The National Organization for Public Health Nursing sought to standardize public health nursing.

The Henry Street Settlement was already in existence. The baccalaureate degree in nursing was not developed yet.

DIF: COG: Applying REF: 29 OBJ: 2 7. A public health nurse is compiling information about how to promote early detection of breast cancer in women. Which document would most likely provide useful information about this topic? a. The Future of Public Health b. Healthy People 2020 c. Patient Protection and Affordable Care Act d. Scope and Standards of Public Health Nursing Practice ANS: B The Healthy People documents propose national strategies to improve significantly the health of Americans by preventing or delaying the onset of major chronic illnesses, injuries, and infectious diseases.

DIF: COG: Analyzing REF: 38 OBJ: 2 8. A major provision of the Social Security Act of 1935 was the establishment of: a. The Frontier Nursing Service to provide nursing service to rural communities b. State and local community health services and training of personnel c. District nursing to provide home health care to sick people Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

d. Community-based settlement houses ANS: B Title VI of the Social Security Act provided funding for expanded opportunities for health protection and promotion through education and employment of public health nurses. Nurses completed educational programs in public health and funds were provided to assist states, counties, and medical districts in the establishment and maintenance of adequate health services.

DIF: COG: Remembering REF: 32 OBJ: 3 9. Public health nurses are involved in health care reform because reform should: a. Promote the nursing profession. b. Increase funding for public health nursing. c. Address the concerns of nurses. d. Improve health care access and reduce health care costs.

ANS: D Public health nurses have been involved in health care reform for several years. An emphasis of reform is that health promotion and disease prevention appear to yield reduction in costs and illness/injury incidence while increasing years of healthy life.

DIF: COG: Applying REF: 38-39 OBJ: 3 10. A neighborhood health center is researching its origins. Which of the legislative acts most likely provided funds for its development? a. Emergency Maternity and Infant Care Act of 1943 b. Medicaid legislation c. Social Security Act of 1935 d. Economic Opportunity Act ANS: D Funding for neighborhood health centers, Head Start, and other community action programs began in 1964 with the Economic Opportunity Act. DIF: COG: Analyzing REF: 36 OBJ: 3 11. What task would have been a responsibility of a nurse who was employed by the Marine Hospital Service?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

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 ANS: D Providing health care to seamen was an early effort by the federal government to improve public health. The purpose of the Marine Hospital Service was to secure its maritime trade and seacoast cities.

DIF: COG: Analyzing REF: 24 OBJ: 3 12. A 66-year-old woman is retired and no longer has health insurance through her place of employment. Which program would be appropriate for her health insurance needs? a. Medicare b. Medicaid c. Social Security d. Economic Opportunity Act ANS: A The Social Security Act was amended to include health insurance benefits for the elderly, which is addressed through Medicare.

DIF: COG: Analyzing REF: 36 OBJ: 3 13. Florence Nightingales contributions to public health included: a. Caring for the sick, poor, and neglected in institutions and at home b. Using a population-based approach that led to improved environmental conditions c. Writing the Elizabethan Poor Law to guarantee medical care for all d. Founding of the district nursing association to provide health care to needy people ANS: B During the Crimean War, Nightingale progressively improved the soldiers health by adopting a population-based approach that used simple epidemiological measures and greatly decreased mortality.

DIF: COG: Remembering REF: 25 OBJ: 4

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

14. Lillian Walds major contribution to public health nursing was: a. Founding the American Nurses Association b. Developing the New York Training Hospital for Nurses c. Creating the Public Health Service d. Establishing the Henry Street Settlement ANS: D Lillian Wald established the Henry Street Settlement.

DIF: COG: Remembering REF: 27 OBJ: 4 15. Neighborhood centers that provided health care, education, and social welfare programs were called: a. Settlement houses b. Nursing care centers c. Nurse-managed clinics d. Public health services ANS: A Settlement houses were neighborhood centers that provided health care, education, and social welfare programs. Nursing centers, nurse-managed clinics, and public health services are not necessarily in neighborhoods.

DIF: COG: Remembering REF: 27 OBJ: 4 16. Which topic is most likely to have been discussed when Lillian Wald provided public health education? a. Taking and recording blood pressures accurately b. Safe and sanitary baby and child care c. Environmental pollutants and their effects on lung disease d. Time management: balancing factory work and the home ANS: B Lillian Wald provided health care that included educating the community on health care matters.

DIF: COG: Evaluating REF: 26 OBJ: 4

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

17. Nurses who provided care to people in their homes and provided that care to several people at a time were called

nurses.

a. Private duty b. Visiting c. Public health d. Community staff ANS: B The visiting nurse cared for several families in a day and helped to make care of the sick poor at home economical, whereas a private duty nurse may live with a family of clients receiving care and was to be available 24 hours a day.

DIF: COG: Remembering REF: 26 OBJ: 5 18. Which of the trends in health issues in the United States between 1900 and 1955 is accurate? a. There was a rise in chronic disease such as heart disease and cancer. b. There was a rise in communicable disease. c. The crude mortality rate increased dramatically. d. The life span after diagnosis remained the same.

ANS: A Leading causes of death in 1955 were heart disease, cancer, and cerebrovascular disease, whereas in 1900 they were pneumonia, tuberculosis, and diarrhea/enteritis. The mortality rate decreased by 47%. There was a decrease in communicable disease, and the life span after diagnosis increased.

DIF: COG: Understanding REF: 34-35 OBJ: 5 19. Local health departments were formed in urban areas in the late 1800s to: a. Target environmental hazards associated with crowded living conditions. b. Facilitate interdisciplinary efforts and promote practical nursing. c. Provide immunizations and health care services to all citizens. d. Offer public health education to nurses who had finished basic training.

ANS: A Local health departments were formed to handle environmental issues in cities, including problems associated with crowded living conditions and dirty streets, and to regulate public baths, slaughterhouses, and pigsties.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: COG: Understanding REF: 29 OBJ: 5 20. The practice of a school nurse in the early twentieth century would have focused on: 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 ANS: A Early school nursing focused on investigating causes of absenteeism, not providing medical treatment. That was the responsibility of physicians.

DIF: COG: Applying REF: 28 OBJ: 5 21. When comparing the practices of industrial and occupational health nurses, it is noted that: a. Industrial nurses invented new machines to streamline production of medical goods, whereas occupational health nurses provide care to employees. b. Industrial nurses investigated industrial injuries to improve work conditions, whereas occupational health nurses demonstrate proper body mechanics. c. Industrial nurses treated work related-injuries, whereas occupational health nurses care for families in their homes. d. Industrial nurses provided care for workers in their homes, whereas occupational health nurses care for work-related injuries.

ANS: D Early occupational health nursing did not provide care for work-related injuries, but instead focused on the care of employees and their families in the home. Contemporary occupational health nurses provide care for work-related injuries.

DIF: COG: Analyzing REF: 28 OBJ: 5 22. The document, Visiting Nurses in the United States, highlighted the fact that: a. Nurses were trained by Boards of Education. b. Trained nurses adequately covered less densely populated areas. c. Visiting nurse services were concentrated in the northeastern United States. d. Nurses were curing diseases such as tuberculosis and typhoid fever.

ANS: C Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

This report emphasized the fact that visiting nurse services were concentrated in the northeast, which underscored the need for rural health.

DIF: COG: Remembering REF: 28 OBJ: 6 23. Which statement is true about African American nurses in public health? a. Certificate and graduate education were more difficult to obtain. b. Cities were the major areas where they practiced. c. They often belonged to the Frontier Nursing Service. d. They were recruited heavily as military nurses.

ANS: A Due to segregation, certification and graduate education were more difficult to obtain.

DIF: COG: Understanding REF: 30 OBJ: 6 24. An example of the resourcefulness of a nurse during the time when the Rural Nursing Service was operating through the American Red Cross was: a. Using hot bricks, salt, or sandbags to substitute for hot water bottles b. Testing well water for pollutants c. Teaching school and developing curricula for rural nursing programs d. Providing post-surgical care ANS: A In providing medical care, rural nurses were resourceful in finding alternatives when they did not have medical products that were available in urban areas.

DIF: COG: Applying REF: 28 OBJ: 6 25. A nurse working with Mary Breckinridge would have likely assisted with: a. Establishing the Henry Street Settlement b. Developing health programs geared toward improving the health care of the rural populations c. Blazing a nursing trail through the Rockies, providing nursing care to miners and their families d. Teaching birth control measures to large numbers of women in the South ANS: B Mary Breckinridge developed health programs geared toward improving the health care of the rural

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

and often inaccessible populations in the Appalachian regions of southern Kentucky. Lillian Wald established the Henry Street Settlement.

DIF: COG: Applying REF: 30 OBJ: 6 26. Which client would have been most likely to receive care from the Frontier Nursing Service? a. An injured soldier b. A homebound, elderly male c. A woman in labor d. A child with measles ANS: C The Frontier Nursing Service nurses were trained in nursing public health and midwifery and provided care to rural and inaccessible areas, which led to reduced mortality.

DIF: COG: Applying REF: 30 OBJ: 6 27. A nurse is considering joining the American Public Health Association. What information about this organization should be considered when making this decision? a. APHA focuses on the public health concerns of the medical profession. b. APHA represents concerns of nursing specialty practices. c. APHA provides a forum for nurses to discuss their public health concerns. d. APHA focuses on providing health promotion education to the public.

ANS: C APHA was formed to facilitate interprofessional efforts and promote the practical application of public hygiene. The Public Health Section within APHA provides nurses with a forum to discuss their concerns and strategies. It also serves as a focus of leadership and policy development for community/public health nursing.

DIF: COG: Applying REF: 29 OBJ: 6 28. A nursing student during World War II would likely join which group? a. The Public Health Service of New York City b. The Marine Nurse Corps c. The Frontier Nursing Service d. The Cadet Nurse Corps Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: D The Bolton Act of 1943 established the Cadet Nurse Corps during World War II, which increased enrollment in schools of nursing at undergraduate and graduate levels.

DIF: COG: Analyzing REF: 33 OBJ: 6 MULTIPLE RESPONSE 1. The impact of World War I on public health nursing included (select all that apply): a. Many communicable diseases were eradicated. b. The depletion of the ranks of public health nurses to the war. c. The feeling that the greatest patriotic duty was to stay at home. d. Expanding nursing services in the community was limited by lack of funding.

ANS: B, C, D Both World Wars I and II depleted the public health nurse population as nurses went off to war. The feeling of patriotism extended to the idea that patriotic duty could also be served on the home front.

Chapter 3 Policy Implications for Population Health: Health Promotion and Wellness

MULTIPLE CHOICE 1. The first major federal government action relating to health was the: a. Passage of the Social Security Act b. Creation of the National Institutes of Health (NIH) c. Creation of the Public Health Service (PHS) d. Creation of Medicare and Medicaid ANS: C The PHS was created in 1798.

DIF: COG: Remembering REF: 165 OBJ: 1 2. One of the main purposes of the Patient Protection and Affordable Care Act was to: a. Create a government-funded insurance program for all Americans. b. Make health insurance affordable for the middle class and small businesses.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Decrease the rates of chronic disease in the United States. d. Increase the funding for public health agencies.

ANS: C One of the main purposes of this legislation was to make health insurance affordable for middle class families and small businesses with one of the largest tax cuts for health care in history: reducing premiums and out-of-pocket costs. This act does not create a government-funded insurance program nor does it increase funding for public health agencies.

DIF: COG: Understanding REF: 165 OBJ: 1 3. One effect of the use of block grants was a: a. Reduction of federal expenditures b. Decreased ability of states to spend money on programming c. Guaranteed continuation of programs with demonstrated effectiveness d. Shift from hospital-based to community-based nursing care ANS: A Block grants enabled financial responsibility to shift from the federal level to the state level, thereby reducing expenditures.

DIF: COG: Understanding REF: 165 OBJ: 1 4. It is important that nurses are involved in health policy because: a. Government and policy have a large impact on nursing and health. b. Policy affects nursing values as set forth by Florence Nightingale. c. Political science is a course of study that parallels nursing. d. Nurses must interpret laws to fit their practice.

ANS: A Nurses should be advocates for the health of the population. In order to do this, nurse professionals must have a working knowledge of government, health care law, the policy process, and the political forces that are shaping the future of health care.

DIF: COG: Applying REF: 164 OBJ: 1 5. The United States Department of Health and Human Services (DHHS) is part of which branch of the government?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Judicial b. Executive c. Legislative d. Health ANS: B The executive branch includes regulatory departments, one of which is the United States DHHS. DIF: COG: Applying REF: 164 OBJ: 1 6. Which branch of the government interprets the states rights to grant abortions? a. Executive branch b. Legislative branch c. Judicial branch d. Federal branch ANS: C The judicial branch interprets laws and their meaning, as in its ongoing interpretation of states rights to define access to reproductive health services for citizens of the states.

DIF: COG: Applying REF: 165 OBJ: 1 7. Action taken to protect the health, safety, and welfare of citizens, such as requiring immunizations of children before admission to school, is called what kind of power? a. Executive b. Legislative c. Judicial d. Police ANS: D Police power is state power concerning health care. This power allows states to act to protect the health, safety, and welfare of their citizens.

DIF: COG: Applying REF: 165 OBJ: 1 8. When a local health department provides a hypertension screening to all individuals, which general category of health care functions is being used? a. Direct services Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

b. Financing c. Information d. Policy setting ANS: A Direct services are actions that provide health care directly to individuals.

DIF: COG: Applying REF: 166 OBJ: 1 9. The federal government provides for the protection of the publics health by: a. Interpreting decisions related to womens right to privacy b. Setting up immunization clinics for smallpox vaccine c. Regulating nursing at the state level d. Monitoring the influx of disease at the borders ANS: D The United States Constitution gives the federal government the authority to provide for the protection of the publics health. By monitoring the influx of disease at the borders the publics health is being protected.

DIF: COG: Analyzing REF: 167 OBJ: 1 10. A goal of the Division of Nursing is to: a. Enhance nursings competence in providing high-tech skills b. Apply disease prevention, environmental health, and health promotion concepts c. Provide scholarships for advanced nursing education d. Enhance racial and ethnic diversity in the nursing workforce ANS: D One of the Division of Nursings goals is to enhance racial and ethnic diversity and cultural competency in the nursing workforce. The other statements apply to other agencies or are false.

DIF: COG: Understanding REF: 169 OBJ: 2 11. The agency most heavily involved with the health and welfare concerns of United States citizens is the: a. Unites States Department of Health and Human Services (DHHS) b. Public Health Service Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Health Resources and Services Administration d. World Health Organization ANS: A The DHHS is the agency most heavily involved with the health and welfare of United States citizens.

It touches more lives than any other federal agency.

DIF: COG: Understanding REF: 169 OBJ: 2 12. The Office of Homeland Security has a mission to rebuild the crumbling public health infrastructures of each state and provide: a. Vaccines for smallpox, anthrax, and plague b. Regulation of nuclear weapons c. Surveillance of bioterrorism threats d. Regulation of foreign nurses entering the United States ANS: C The DHHS and the new federal agency, the Office of Homeland Security, have provided funds to address serious bioterrorism threats to the people of the United States.

DIF: COG: Understanding REF: 172 OBJ: 2 13. Nurses are available to provide health services for women and children due to the provisions of the: a. Sheppard-Towner Act b. Public Protection of Maternity and Infancy program c. Early Periodic Screening and Developmental Testing (EPSDT) program d. Women, Infants, and Children (WIC) program ANS: A This act also offered well-child and child-development services, provided adequate hospital services and facilities for women and children, and provided grants-in-aid for establishing maternal and child welfare programs.

DIF: COG: Applying REF: 167 OBJ: 2 14. A member of the military receives health care services through which department? a. Defense Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

b. Labor c. Agriculture d. Justice ANS: A The Department of Defense delivers health care to members of the military, including their dependents and survivors, and to retired members and their families.

DIF: COG: Applying REF: 171 OBJ: 2 15. An occupational health nurse maintains a log of injuries from contaminated sharps because of the: a. Bloodborne Pathogen Standard b. Occupational Safety and Health Administration (OSHA) c. Department of Labor (DOL) d. Department of Defense (DOD) ANS: A OSHA is part of the Department of Labor. The Bloodborne Pathogen Standard became effective in 2002.

DIF: COG: Applying REF: 171 OBJ: 2 16. Needle stick legislation clarified the role of employers to: a. Use Universal Precautions when dealing with all patients. b. Select safer needle devices as they became available. c. Provide needle disposal boxes. d. Incinerate all infectious waste including needles.

ANS: B Health care facilities by law have to select safer needle devices and involve employees in identifying and choosing the devices.

DIF: COG: Applying REF: 171 OBJ: 2 17. The practices of physicians, nurses, and other health care providers are differentiated by the: a. Health Resource and Services Administration (HRSA) b. State board of nursing Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Scope of practice d. United States Department of Health and Human Services ANS: C Scope of practice involves defining nursing, setting its credentials, and then distinguishing between the practices of nurses, physicians, and other health care providers.

DIF: COG: Understanding REF: 173 OBJ: 3 18. A nurse is found to be negligent. Because of the doctrine of respondeat superior, the one responsible for that negligence is the: a. Administrator b. Nurses immediate supervisor c. Nurses employer d. Nurse ANS: C The doctrine of respondeat superior says that when a nurse is employed and functioning within the scope of that job, the one responsible for that negligence is the nurses employer.

DIF: COG: Applying REF: 174 OBJ: 3 19. When planning, delivering, and financing responsibility for programs is shifted from the federal level to the state level, it is called: a. Evolution b. Devolution c. Block granting d. State administration ANS: B The process of shifting the responsibility for planning, delivering, and financing programs from the federal level to the states is called devolution. This was a major effort during the Reagan administration.

DIF: COG: Understanding REF: 165 OBJ: 4 20. A nurse discusses with legislators the importance of passing legislation to ban smoking in all public places. This demonstrates the nurses involvement in: Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Policy b. Politics c. Law d. Health policy ANS: A Politics is the art of influencing others to accept a specific course of action. Therefore political activities are used to arrive at a course of action (the policy).

DIF: COG: Applying REF: 164 OBJ: 4 21. When a nurse is sued for malpractice and goes to court, which type of law is being used? a. Constitutional b. Common c. Judicial d. Institutional ANS: C Judicial law is based on court or jury decisions.

DIF: COG: Applying REF: 173 OBJ: 4 22. States have certain continuing education requirements for persons to renew a nursing license.

This type of law is called: a. Constitutional law b. Legislation and regulation c. Judicial and common law d. Police power ANS: B Licensing is regulated by each states nurse practice act as a function of the board of nursing.

DIF: COG: Applying REF: 173 OBJ: 4 23. The state orders a person newly diagnosed with tuberculosis to be quarantined. What type of law allows the state to do this? a. Constitutional b. Common Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Judicial d. State ANS: A Constitutional law provides overall guidance for selected practice situations.

DIF: COG: Applying REF: 173 OBJ: 4 24. When a school nurse reports suspected child abuse, there is a breach of confidentiality. This breach is allowed because of: a. Civil immunity b. Sovereign immunity c. Nurse practice act d. Respondeat superior ANS: A The law mandates that a health professional breach patient confidentiality norms to protect someone who may be in a helpless or vulnerable position.

DIF: COG: Applying REF: 175 OBJ: 5 25. While researching various health care services that are provided in prisons, a nursing student learns that these services: a. Are funded by the Department of Defense b. Focus on health promotion interventions c. Must be provided at an adequate level d. Are available to those diagnosed with a chronic illness ANS: C Health care services for prisoners are required at an adequate level for all incarcerated individuals.

This is administered by the Department of Justice. Prisoners will receive health care services when diagnosed with chronic illnesses as well as acute illnesses.

DIF: COG: Applying REF: 175 OBJ: 5 26. Nurses working in hospice and home care settings need to be knowledgeable of health policy to: a. Provide safe nursing care. b. Prevent elder abuse.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Receive payment for the services provided. d. Influence future legislation.

ANS: C Although nurses should be involved in influencing future legislation by contacting their legislators, the best response is that nurses need to be knowledgeable of the current health policies needed so that payment can be received for services that are providing.

DIF: COG: Evaluating REF: 175 OBJ: 5 27. A nurse would like to propose legislation requiring all schools to employ a registered nurse. The first step taken in the legislative process would be: a. Introducing the bill to the legislature b. Moving the bill to the other house c. Developing the policy option into a bill d. Hearings, testimony, and lobbying ANS: C The first step in the legislative process is developing the policy option into a bill. This is then followed by introducing the bill to the legislature; hearings, testimony, and lobbying; and the bill moving to the other house.

DIF: COG: Applying REF: 176 OBJ: 6 28. A nurse believes additional funding is necessary to support a home-delivered meal program for the elderly. The best way to share these ideas with a legislator is to: a. Send an e-mail. b. Write a formal letter. c. Attend a town hall meeting. d. Schedule a face-to-face visit.

ANS: D Face-to-face visits with legislators are viewed as the most effective means of communication.

DIF: COG: Evaluating REF: 178 OBJ: 6 29. A nurse is interested in census data. Which federal departments website would be a good place to start?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Department of Labor b. United States Immunization Survey c. Commerce Department d. World Health Organization ANS: C The Commerce Department handles the United States Census and population estimates and projections.

DIF: COG: Applying REF: 167 OBJ: 7 30. If a nurse researcher wants to get information on the occurrence of an internationally important disease, where would be a good place to seek this information? a. The United Nations website b. The World Health Organization (WHO) website c. The World Bank website d. The World Health Assembly website ANS: B The WHO publishes day-to-day information about international occurrence of disease, injury, and death.

DIF: COG: Applying REF: 168 OBJ: 7 31. A doctoral prepared nurse (PhD) at a university wants to submit a grant to study the impact of a nursing activity on patient outcomes. From which federal agency could this nurse potentially seek funding? a. Centers for Disease Control and Prevention (CDC) b. National Institute of Nursing Research (NINR) c. Department of Health and Human Services (DHHS) d. World Health Organization (WHO) ANS: B NINR funds the development of the knowledge base of nursing and promotion of nursing services in health care.

DIF: COG: Analyzing REF: 170 OBJ: 7

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

MULTIPLE RESPONSE 1. Congresss legal base for actions in health care include (select all that apply): a. Providing for the general welfare b. Raising funds to support research c. Regulating commerce among the states d. Providing spending power ANS: A, B, C, D The legal base for actions in health care includes providing for the general welfare, regulating commerce among the states, providing spending power, and raising funds to support the military.

DIF: COG: Understanding REF: 165 OBJ: 2 2. The Centers for Disease Control and Prevention accomplishes its mission by (select all that apply): a. Implementing prevention strategies b. Detecting and investigating health problems c. Dictating world health policy d. Fostering safe and healthful environments ANS: A, B, D The Centers for Disease Control and Prevention implements prevention strategies, detects and investigates health problems, and fosters safe and healthful environments.

DIF: COG: Understanding REF: 169 OBJ: 2 3. When writing to a legislator to advocate for funds to support advanced practice nursing education, a nurse should remember to (select all that apply): a. Limit the letter to one page in length. b. Identify oneself as a nurse. c. Provide only factual information. d. Share personal knowledge about the issue.

ANS: B, D When writing to a legislator, the letter should be a maximum of two pages in length and opinions should be expressed. Additionally, the nurse should identify oneself as a nurse and share knowledge about the issue.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Chapter 4 Population Health: Education

MULTIPLE CHOICE 1. The cognitive domain includes: a. Changes in attitudes and the development of values b. The performance of skills c. Memory, recognition, understanding, reasoning, and problem solving d. Memorization of one set of skills before moving on to the next ANS: C The cognitive domain includes memory, recognition, understanding, reasoning, and problem solving.

DIF: COG: Understanding REF: 354 OBJ: 1 2. What is the purpose of providing education across the three levels of prevention? Education: a. Enables clients to attain optimal health b. Identifies and treats health problems early to eliminate disability c. Enables populations to break into individuals d. Teaches people about Healthy People 2010 ANS: A Health education enables clients to attain optimal health, prevent health problems, and identify and treat health problems early to minimize disability. Elimination of a disability may not be possible.

DIF: COG: Understanding REF: 352 OBJ: 1 3. A nurse is teaching a client about how to complete a dressing change of a wound. The nurse knows that what conditions must be met before learning will occur? a. Must be able to memorize the instructions, relay this information to a partner, and demonstrate the dressing change b. Must master the dressing change at the time it is taught, repeat the demonstration for the nurse, and teach another person c. Must be able to speak the language of the nurse, have time to practice the dressing change, and

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

master the dressing change in a short time d. Must have the necessary ability, a sensory image of how to carry out the dressing change, and an opportunity to practice the dressing change ANS: D Before psychomotor learning occurs, the learner must have the necessary ability, a sensory image of how to carry out the skill, and an opportunity to practice the skill.

DIF: COG: Applying REF: 354 OBJ: 1 4. A health educator trying to change a clients attitudes about smoking would be using which of the following domains? a. Cognitive b. Affective c. Psychomotor d. Developmental ANS: B The affective domain is used to attempt to influence what individuals, families, communities, and populations feel, think, and value.

DIF: COG: Applying REF: 354 OBJ: 1 5. Which of the following domains would be used to teach a new diabetic how to give an insulin injection? a. Developmental b. Cognitive c. Affective d. Psychomotor ANS: D The psychomotor domain includes the performance of tasks that require some degree of neuromuscular coordination and emphasizes motor skills.

DIF: COG: Applying REF: 354 OBJ: 1 6. Which format would be most appropriate for teaching a group of nursing students who are learning to give injections?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Demonstration b. Health fair c. Lecture d. Nonnative language session ANS: A Demonstration also includes return demonstration. Giving injections can best be learned by seeing the behavior being done.

DIF: COG: Analyzing REF: 356 OBJ: 1 7. Which statement about education is true? a. It emphasizes the provider of knowledge and skills. b. It emphasizes the recipient of knowledge and skills. c. It is a process of gaining knowledge and expertise. d. It results in behavioral change.

ANS: A Education is the establishment and arrangement of events to facilitate learning.

DIF: COG: Understanding REF: 353 OBJ: 2 8. Which core competency of communication is used by nurses engaged in group work? a. Soliciting input from individuals and organizations b. Using simple language when presenting information c. Asking the group to develop the program of interest d. Presenting material to lay audiences only ANS: A Soliciting input from individuals and organizations is a communication competency.

DIF: COG: Understanding REF: 369 OBJ: 2 9. When implementing a community health education program, which educational principle will the nurse use as a guide? a. Refer to trustworthy sources b. Use an active voice c. Create the best learning environment Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

d. Accentuate the positive ANS: C The environment must be conducive to learning for educational programs to be effective.

DIF: COG: Applying REF: 357 OBJ: 2 10. Nurses who use Healthy People 2020 as a guide for education: a. Focus on avoiding cigarette smoking and using alcohol in moderation b. Educate clients using primary and secondary levels of prevention c. Use Blooms taxonomy when planning educational objectives d. Design health fairs aimed at individuals ANS: B Healthy People 2020 focuses on primary and secondary prevention. Understanding the three learning domains is crucial in providing effective health care.

DIF: COG: Applying REF: 353|356 OBJ: 2 11. A nurse is implementing an educational program about the importance of being physically active. Which step would the nurse complete first? a. Provide learning guidance b. Present the stimulus c. Gain the learners attention d. Ask learners to recall prior learning ANS: C Gaining the learners attention must happen first before learning can take place.

DIF: COG: Applying REF: 356 OBJ: 2 12. A potential barrier that a nurse may experience when in the educator role is: a. Working with clients with a low literacy level b. Memorizing the information that is to be taught c. Having a limited vocabulary d. Lacking knowledge about how to gain participation ANS: D Educators may lack knowledge about how to gain participation. Participation can be fostered by Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

asking open-ended questions, inviting participation, and planning small-group activities whereby a person responds based on the group rather than presenting his own information.

DIF: COG: Applying REF: 359 OBJ: 2 13. After evaluating learning needs, what is the next step the nurse should take in developing an educational program? a. Consider any potential barriers to learning. b. Establish goals and objectives for the program. c. Select appropriate materials for the program. d. Assess the dynamics of the group.

ANS: B Instructional objectives need to be evaluated before a teaching program is designed.

DIF: COG: Applying REF: 355 OBJ: 2 14. Which behavior would the nurse anticipate when working with an individual with low literacy? a. Asking for additional clarification of materials b. Requesting to read the information later c. Having a high level of motivation d. Being overly dependent on others ANS: B Individuals with a limited literacy may have a limited vocabulary and general knowledge and do not ask for clarification. They may focus on details and deal in literal or concrete concepts versus abstract concepts. They may select responses on a survey without necessarily understanding them and may be unable to understand math. They may have a low motivation to engage in learning or may drop subtle clues that they cannot read by stating they will look at information later or take it home.

DIF: COG: Applying REF: 359-360 OBJ: 2 15. A nurse prepares for a presentation to a group of adults using strategies appropriate for adult learning. This concept is called: a. Authoritarianism b. Learning style Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Pedagogy d. Andragogy ANS: D Andragogy is a term and model developed by Malcolm Knowles to describe learning strategies for adult learners.

DIF: COG: Applying REF: 358 OBJ: 2 16. A nurse is teaching a postpartum mother how to breastfeed her infant. The nurse notes that the mother is alert and agrees that breastfeeding is important to her and beneficial to her baby. The nurse outlines the expectations of breastfeeding for the mother and the baby. Considering the events of instruction, what should the nurse do next? a. Ask the mother about her previous experience with breastfeeding. b. Demonstrate how to position the baby for breastfeeding. c. Show the mother a video about breastfeeding. d. Have the mother demonstrate breastfeeding.

ANS: A Asking the mother about her previous experience with breastfeeding identifies her educational needs. Using the TEACH mnemonic, the first thing the nurse should do is Tune in: listen before starting to teach; the clients needs should direct the content.

DIF: COG: Applying REF: 355 OBJ: 2 17. A diabetic client reports to the nurse that she has been learning more about controlling her blood sugars by reading information found on the Internet. Which statement by the nurse would be most appropriate? a. Looking at the date the content was posted on the website is important. b. The Internet is an unreliable source of information and should not be used. c. The best sources of information are found on pharmaceutical websites. d. Your physician will provide you better information than the Internet.

ANS: A One of the ways to assess the reliability and validity of Internet sources is to look at its currency, including the dates when the content was posted and updated.

DIF: COG: Evaluating REF: 362 OBJ: 2 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

18. Which of the following is an example of a goal? a. Mr. Williams will look at his stoma without disgust each time his ostomy bag comes off. b. Mr. Williams will be able to independently take care of his ostomy bag within three months. c. Mr. Williams will gather all ostomy supplies correctly each time his ostomy bag needs to be changed. d. Mr. Williams will successfully describe to the nurse how to care for his ostomy when he is asked.

ANS: B Goals are broad, long-term expected outcomes. The correct answer describes something that will happen over a long period of time. The other choices describe objectives.

DIF: COG: Evaluating REF: 355 OBJ: 2 19. A correctly written objective would be: a. Each member of the Jones family will give an insulin injection to Billy with accurate dosage 100% of the time for 10 consecutive trials. b. Ms. Smith will perform a blood sugar test on herself with an accurate blood sugar reading. c. The community will take their children to receive immunizations within 1 month of the immunization due date. d. Fifty percent of the eligible women seen in the clinic will return for their scheduled mammogram appointment.

ANS: A Objectives are specific, short-term criteria that need to be met as steps toward achieving the longterm goal. They are written as statements of an intended outcome or expected change in behaviors and should be defined in measurable terms.

DIF: COG: Evaluating REF: 355 OBJ: 2 20. Which group would be likely to demonstrate the most cohesion? a. A group with several leaders b. A group with diverse attitudes and values c. A group with a common goal d. A group with efficient members ANS: C Cohesion is the attraction between individual members and between each member and the group.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Group effectiveness improves as members work together toward group goals while still satisfying the needs of individual members.

DIF: COG: Applying REF: 364 OBJ: 3 21. It is important for a nurse to recognize group norms because they: a. Allow for creativity and variety among group members b. Influence members perception of community c. Are helpful in evaluating the effectiveness of the group d. Maintain the group through various supports to members ANS: D Group norms serve to maintain the group through various supports to members.

DIF: COG: Applying REF: 365 OBJ: 3 22. A nurse demonstrates the leadership behavior of reflecting when: a. Providing feedback on how behavior appears to others b. Introducing new topics to the group c. Verifying information through questions and restatement d. Highlighting important points from the discussion ANS: A Reflecting involves giving feedback on how behavior appears to others. Advising introduces new topics. Clarifying verifies new information. Summarizing highlights the important points.

DIF: COG: Applying REF: 367 OBJ: 3 23. A leader controls members through rewards and often keeps members in the dark about the goals and rationale behind prescribed actions. What type of leadership does this describe? a. Democratic b. Patriarchal c. Socialist d. Communication structure ANS: B Patriarchal or paternal style is authoritative, winning respect and dependence through parent-like devotion.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: COG: Applying REF: 367 OBJ: 3 24. A group member who has taken on the role of the gatekeeper will: a. Seek and accept the authority or direction of others. b. Guide and direct the group activity. c. Control outsiders access to the group. d. Focus the movement toward the main work of the group.

ANS: C The gatekeeper controls outsiders access to the group.

DIF: COG: Applying REF: 366 OBJ: 4 25. An established group requests a teaching and learning session on hypertension. What can the nurse expect with this type of group? a. The group membership will change from week to week. b. The members all have the same interests. c. They prefer lectures rather than demonstrations. d. The group already has operating methods that have been successful.

ANS: D Nurses working with established groups should know that this type of group has membership ties and an existing structure that has proven to be successful.

DIF: COG: Applying REF: 367 OBJ: 4 26. Which intervention can be implemented by a nurse when working with a group focused on improving the health of the community? a. Make decisions for the group to move the process along. b. Invite wealthy individuals to participate in the group process. c. Maintain members through recognition and encouragement. d. Teach topics that are of national importance.

ANS: C Maintaining members is an important intervention to facilitate group process.

DIF: COG: Applying REF: 367 OBJ: 4

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

27. A nurse is working with a group of clients with diabetes and is teaching a class about avoiding the long-term effects of diabetes. The nurse begins the class by reviewing the basic physiology of diabetes, which was taught the week before. This nurse is providing effective education by: a. Stimulating recall of prior learning b. Gaining attention c. Presenting the material d. Providing learning guidance ANS: A The educator should have the learners recall previous knowledge related to the topic of interest.

DIF: COG: Analyzing REF: 357 OBJ: 5 28. During a class on newborn care given at a local health department, a nursing student asks the participants to practice with baby dolls. Which step of promoting effective education is the student using? a. Eliciting performance b. Assessing performance c. Enhancing retention and transfer of knowledge d. Gaining attention ANS: A The step of eliciting performance includes encouraging the learners to demonstrate what they have learned.

DIF: COG: Analyzing REF: 357 OBJ: 5 29. The educational process of selecting appropriate educational methods is similar to which of the following steps of the nursing process? a. Assessment b. Evaluation c. Implementation d. Planning ANS: D Assessment would be identifying educational needs, evaluation would be evaluating educational

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

process, and implementation would be implementing the educational plan. Planning is similar to selecting appropriate educational methods.

DIF: COG: Evaluating REF: 355 OBJ: 5 30. When a nurse is evaluating the components of an educational program, the nurse is completing a(n): a. Education evaluation b. Educational product c. Process evaluation d. Ongoing evaluation ANS: C Process evaluation means looking at the components of an educational program.

DIF: COG: Applying REF: 362 OBJ: 6 31. Evaluation of individual and group progress toward health goals is important. Which component should be included in the evaluative process? a. Type of teaching strategy used b. Recognition of accomplishments in the group c. Conflict that occurred in the group d. The type of leadership in the group ANS: B Recognition of accomplishments in the group and of the group is built into the evaluative process.

DIF: COG: Applying REF: 370 OBJ: 6 MULTIPLE RESPONSE 1. When conducting an effective educational program, a nurse would use which basic principle?

Select all that apply. a. Use a clear, succinct style. b. Use an active voice. c. Refer to Internet sources. d. Use aids to highlight key points.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: A, B, D Reliable sources must be used, and information found on the Internet is not always reliable.

Chapter 5 The Political Landscape in Relation to the Health and Wellness of Nations

MULTIPLE CHOICE 1. The biomedical model defines health as the: a. Avoidance of illness b. Absence of disease c. Promotion of healthy behaviors d. Protection from illness and disease states ANS: B The biomedical model defines health as the absence of disease. It does not explain why populations remain healthy or how health is enhanced.

DIF: COG: Remembering REF: 375 OBJ: 1 2. According to Leavell and Clark, primary prevention consists of: a. Health promotion and rehabilitation b. Health promotion and specific protection c. Early diagnosis and prompt treatment d. Health maintenance and early diagnosis ANS: B Leavell and Clark stated that primary prevention includes health promotion and specific protection from disease.

DIF: COG: Understanding REF: 380 OBJ: 1 3. According to Laffrey, Loveland-Cherry, and Winkler, the health perspective views: a. Health as the absence of disease b. Human lifestyle based on ones prescribed regime c. Humans as complex and interconnected with the environment d. Community education as the role of the registered nurse ANS: C The health paradigm includes the view that humans are complex and interconnected with the environment.

DIF: COG: Understanding REF: 375 OBJ: 1 4. Screening school-age children for hearing deficits is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion ANS: B

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

DIF: COG: Applying REF: 380 OBJ: 1 5. Examples of modifiable behaviors include: a. Smoking, poor diet, and alcohol consumption b. Cancer, emphysema, and cardiovascular disease c. Walking, running, and aerobic exercise d. Genetic abnormalities ANS: A The leading causes of death in 2000 were tobacco use, poor diet, physical inactivity, and alcohol consumption. These are modifiable behaviors.

DIF: COG: Applying REF: 374 OBJ: 1 6. A nurse utilizing a disease-oriented approach would: a. Promote a greater level of positive health. b. Teach about common disease processes. c. Provide acute care management of chronic disease. d. Direct care toward disease prevention.

ANS: D Disease prevention, risk appraisal, and disease management are all elements of the diseaseoriented approach.

DIF: COG: Applying REF: 375 OBJ: 1 7. A client eats a nutritious, balanced diet on a daily basis to keep the current state of health. This is described as behavior. a. Illness prevention b. Health promotion c. Health maintenance d. Health protective ANS: C Health maintenance behavior is directed toward keeping a current state of health.

DIF: COG: Applying REF: 381 OBJ: 1 8. A 5-feet, 6-inch, 25-year-old female who weighs 120 pounds walks 5 miles a day because she has a long family history of early death from heart attacks and is refraining from a sedentary lifestyle. Which term best describes this example? a. Health promotion b. Illness prevention c. Health maintenance d. Health protection ANS: B The woman is exercising to prevent an illness that runs in her family. Illness prevention is a behavior directed toward reducing the threat of illness.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: COG: Applying REF: 381 OBJ: 1 9. A 5-feet, 6-inch, 25-year-old woman who weighs 120 pounds runs 5 miles a day because it improves her mood and energy level. Which term best describes this example? a. Health promotion b. Illness prevention c. Health maintenance d. Health protection ANS: A The woman is exercising to improve and promote her health. Health promotion is directed toward achieving a greater level of health.

DIF: COG: Applying REF: 381 OBJ: 1 10. A woman has attended a weight reduction program for a year and lost 75 pounds. She now attends weekly meetings to keep the weight off. Which term best describes this example? a. Health promotion b. Illness prevention c. Health maintenance d. Health protection ANS: C The womans weight is being maintained through attending the weight reduction program.

Health maintenance focuses on keeping a current state of health.

DIF: COG: Applying REF: 381 OBJ: 1 11. The Guide to Clinical Preventive Services provides: a. The most recent recommendations for preventive interventions b. Assistance in interpreting Healthy People 2020 c. A basis for public health nursing practice d. Health risk appraisal instruments ANS: A The Guide to Clinical Preventive Services provides recommendations for preventive interventions including screening tests, counseling, immunizations, and chemoprophylaxis.

DIF: COG: Understanding REF: 382 OBJ: 2 12. One advantage of health-risk appraisal instruments is that they: a. Are suitable for all age-groups b. Accurately reflect an individuals ability to initiate changes in lifestyle c. Provide support to nurses in counseling individuals about self-care behaviors d. Emphasize environmental factors ANS: C Health-risk appraisal instruments provide support to nurses in counseling and educating individuals in self-care behaviors.

DIF: COG: Understanding REF: 382 OBJ: 2 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

13. Which statement best describes health risk appraisals? a. Data about health practices are collected from families. b. Primary prevention strategies are implemented by using the collected data. c. Identified risks can be easily modified. d. Individual health practices are compared with data from epidemiologic studies.

ANS: D During a health risk appraisal, individuals supply information about their health practices, demographic characteristics, and personal and family medical history for comparison with data from epidemiologic studies. These comparisons are used to predict individuals risk of morbidity and mortality and to suggest areas in which disease risks may be reduced.

Health risks appraisals use secondary prevention by screening to prevent or detect disease in its earliest stages.

DIF: COG: Understanding REF: 381 OBJ: 2 14. When using the integrative model for community health promotion, the nurse would apply the dimension of client system by: a. Concentrating on individual health behaviors b. Studying client-centered initiatives c. Providing multidimensional nursing care among various levels of clients d. Focusing on health promotion, illness prevention, and illness care ANS: C Nursing care is targeted toward several levels of clients in the client system.

DIF: COG: Applying REF: 376-377 OBJ: 2 15. When would a nurse use The Guide to Clinical Preventive Services? a. Conducting group risk appraisal and risk reduction b. Providing recommendations for preventive interventions c. Completing a community wellness inventory d. Improving environmental living conditions and sanitation ANS: B These include screening tests, counseling, immunizations, and chemoprophylaxis regimens for more than 80 conditions.

DIF: COG: Applying REF: 382 OBJ: 2 16. The Framingham Heart Study was successful in: a. Providing information on the effectiveness of risk-reduction interventions b. Documenting the relationship between social variables and heart disease c. Identifying factors contributing to the development of coronary heart disease d. Demonstrating the effects of mass media in modifying high-risk behavior ANS: C The Framingham Heart Study identified factors contributing to the development of coronary heart disease and high blood pressure.

DIF: COG: Understanding REF: 385 OBJ: 3

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

17. Which community-based risk-reduction intervention resulted in equally favorable health risk changes for both control and treatment groups? a. Framingham Heart Study b. Stanford Heart Disease Prevention Program c. North Karelia Study d. Minnesota Heart Health Program ANS: D The Minnesota Heart Health Program resulted in equally favorable health risk changes for both control and treatment groups.

DIF: COG: Understanding REF: 386 OBJ: 3 18. A public health nurse collaborates with local community leaders to develop a local campaign educating about the importance of wearing a seat belt. What client system of the integrative model does this describe? a. Community b. Aggregate c. Family d. Individual ANS: A Interventions to initiate or maintain healthy lifestyles must be multifocal. At the broadest level of care (community), nurses work with community leaders, other community residents, and health professionals to plan programs to promote optimal health for the community and its people.

DIF: COG: Applying REF: 377 OBJ: 3 19. When applying the integrative model for community health promotion, a nurse assesses a neighborhood for accessibility and adequacy of care to provide treatment for medical conditions. What client system does this describe? a. Individual b. Family c. Aggregate d. Community ANS: D The community focus includes the nurse assessing the community for accessibility and adequacy of care to provide treatment for medical conditions.

DIF: COG: Applying REF: 377|389-390 OBJ: 3 20. When using Anderson and McFarlanes model to complete a community health assessment, a nurse would collect information about the the community. a. Resources available to promote health in b. Interactions among subsystems in c. Physical environment of d. Demographics of ANS: B

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

A community health assessment must include information about the subsystems and interactions of the total community with the systems external to it.

DIF: COG: Analyzing REF: 384 OBJ: 3 21. A nurse provides counseling to an obese client about the importance of good nutrition and regular exercise with the intention of helping the client avoid future chronic diseases associated with obesity. What client system and focus of care are being applied in this situation? a. Family level health promotion b. Individual level illness prevention c. Aggregate level illness prevention d. Individual level health promotion ANS: B The simplest level of the client system is the individual. The focus of care is illness prevention, directed at disease or disability prevention.

DIF: COG: Applying REF: 377|384 OBJ: 4 22. A public health nurse collaborates with a physicians clinic to increase the number of infants and toddlers who receive lead screening. According to the integrative model, what client system and focus of care are being addressed? a. Aggregate level health promotion b. Aggregate level illness prevention c. Family level illness care d. Individual level health promotion ANS: A Each succeeding level of the client system is more complex. In this situation, the public health nurse is working with an aggregate of infants and toddlers. The focus of care being addressed is health promotion, focusing on positive measures such as education for healthy living and promotion of favorable environmental conditions as well as periodic examinations, including well-child developmental assessment and health education.

DIF: COG: Applying REF: 377|381 OBJ: 4 MULTIPLE RESPONSE 1. Which intervention is being performed on the individual level? Select all that apply. a. Teaching well-balanced nutrition to a mother with a malnourished child b. Providing a parent age-specific information for immunizations c. Assessing the community for other cases of malnutrition d. Assessing other families on the same street for similar problems ANS: A, B Teaching well-balanced nutrition and age-specific information about immunizations are the only interventions that focus on individuals. The other examples relate to families and the community.

Chapter 6 Behavior Change Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

MULTIPLE CHOICE 1. The blueprint or code that is used to construct other components of cells is called the: a. DNA b. Gene c. Chromosome d. Base ANS: A The DNA is the chemical inside the nucleus of the cell that has the genetic instructions for making living organisms. This can be compared to a blueprint or code that is used to construct other components of cells.

DIF: COG: Remembering REF: 244 OBJ: 1 2. Which statement regarding mutations is true? a. Mutations in the DNA sequence occur on a regular basis. b. Mutagens are a result of a mutation. c. Environmental factors can be linked to many mutations. d. Spontaneous mutations occur because of environmental exposure.

ANS: C A large number of agents are known to cause mutations. These mutations are attributed to known environmental causes. DNA replication is very accurate, thus, mutations do not occur on a regular basis. Mutagens are the factors that cause mutations. Spontaneous mutations occur naturally during DNA replication.

DIF: COG: Understanding REF: 244 OBJ: 1 3. When a nurse learns more about the Human Genome Project to better counsel families about the process of genetic testing, the nurse is learning about: a. Genetics b. Genomics c. Genes d. Genetic susceptibility ANS: B Genomics refers to the study of individual genes to understand the structure of the genome, including the mapping of genes and sequencing the DNA. DIF: COG: Applying REF: 242|245 OBJ: 1 4. An example of a multifactorial disorder is: a. Measles b. Hepatitis B c. Eczema d. Type I diabetes ANS: D Disorders that are influenced by multiple factors including genetics/genomics, environment, lifestyle, and other factors are considered to be multifactorial.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: COG: Applying REF: 246 OBJ: 1 5. The increasing knowledge about genetics and genomics will influence nursing practice by changing how: a. Nurses collect and use health histories b. Nursing students complete clinical experiences c. Referrals to other disciplines are made d. Ethical dilemmas are solved ANS: A Genetics and genomics will change future practice in several areas including: how students are educated, how nurses collect and use health histories, how nurses learn and apply innovative biotechnology, how prevention and health education is provided, administration of new therapies, and public health debates.

DIF: COG: Understanding REF: 242 OBJ: 2 6. The father of genetics is: a. Charles Darwin b. Gregor Mendel c. James Watson d. Francis Galton ANS: B Gregor Mendel is considered to be the father of genetics. Charles Darwin expounded on theories of evolution. Francis Galton performed family studies using twins to understand the influence of heredity on various human characteristics. James Watson was the codiscoverer of DNA. DIF: COG: Remembering REF: 242 OBJ: 2 7. One of the main goals of the Human Genome Project was: a. Providing physicians with a national database for information related to genetic disorders b. Developing new medications that can be used in genetics research c. Addressing ethical, legal, and social issues related to this research d. Improving the ability to accurately test for genetic disorders ANS: C The goals of the Human Genome Project were to determine the sequences of the base pairs in human DNA; improve tools for data analysis; transfer related technologies to the private sector; and address the ethical, legal, and social issues that may arise.

DIF: COG: Understanding REF: 243 OBJ: 2 8. While collecting a medical history, a client reports having a family history positive for Huntingtons disease. However, the client states he does not want to have genetic testing performed. The nurse recognizes that one reason a client may refuse genetic testing is because of the: a. Impact it may have on obtaining health insurance in the future b. Legal consequences that may result Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Inaccuracy of the results that are obtained d. Decreased quality of life that may occur if the results are positive ANS: D Barriers to genetic testing are: some individuals do not have an insurance carrier that reimburses for genetic testing, a high-deductible insurance policy, and feelings that testing may decrease the quality of life and increase anxiety for the future if the results were positive. Others may also feel guilty about passing along a disease to children and grandchildren.

DIF: COG: Applying REF: 245 OBJ: 2 9. A nurse working in the 1970s would have applied genetic concepts by: a. Providing genetic counseling to those with genetic disorders b. Educating clients about using genetic testing for risk identification c. Explaining the purposes of the Human Genome Project to clients d. Facilitating referrals for specialized genetic services for clients ANS: A In the 1970s, nurses working in genetics provided genetic counseling to persons with genetic diseases or risk factors for such disorders. The other activities performed by the nurse did not occur until the 1990s.

DIF: COG: Applying REF: 248 OBJ: 2 10. Which question would be the most appropriate for the nurse to ask when eliciting information about a clients genetic history? a. Have any of your family members ever completed genetic testing? b. Do any of your family members have a genetic disorder? c. What medical problems have your parents and grandparents experienced? d. What environmental exposures have you had?

ANS: C A clients family medical history is important to obtain in order to consider the clients potential risk for genetic diseases and disorders. The best way to obtain this information is to ask an open-ended question about past medical history of parents and grandparents.

DIF: COG: Analyzing REF: 246 OBJ: 3 11. The best response from a nurse when counseling a client who is considering purchasing a genetic testing kit from a vendor advertised on the Internet would be: a. It is illegal to purchase genetic testing kits from Internet vendors. b. It will be important to follow up with a health care provider after receiving your results. c. Many times online vendors experience inaccuracies with their results. d. Internet vendors use the latest technology to perform these tests.

ANS: B The most important aspect of genetic testing is the counseling that occurs with the testing.

Purchasing genetic testing kits on the Internet makes it easy for the public to access, but leaves a health care professional out of the testing process. Meeting with a health care professional is important to counsel a client about the implications and indications for such testing.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: COG: Analyzing REF: 246 OBJ: 3 12. A nurse implements the principles of the Personalized Health Care Initiative in practice by: a. Educating clients that multiple factors influence the development of disease b. Counseling clients about the results of genetic testing c. Lobbying for legislation to support genetic research d. Protecting clients from discrimination based on the results of genetic testing ANS: D The goals of the Personal Health Care Initiative are to link clinical and genomic information to support personalized health care, protect individuals from discrimination-based or unauthorized use of genetic information, ensure the accuracy and clinical validity of genetic tests performed for medical application purposes, and develop common policies for access to genomic databases for federally-sponsored programs.

DIF: COG: Analyzing REF: 247 OBJ: 3 13. A nurse uses the Codes of Ethics developed by the International Council of Nurses and the American Nurses Association when: a. Providing confidential genetic testing for a client b. Advocating for the inclusion of genetic content in a nursing curriculum c. Considering the pros and cons of an ethical dilemma d. Becoming competent in genomics ANS: A The Codes of Ethics include in this mandate the right that people have to seek and receive genomic heath care that is nondiscriminatory, confidential, private, and that enables those served to make informed decisions.

DIF: COG: Analyzing REF: 249 OBJ: 3 14. A nurse is counseling a client who is considering having genetic testing completed to determine whether she is a carrier of the gene linked to Huntingtons disease. What is the first step the nurse would take when assessing this client? a. Assess vital signs. b. Assess family history of this disorder. c. Assess clients past medical history. d. Assess current medications.

ANS: B Taking a family history is a useful place to begin when considering a genetic connection and prior to the onset of testing.

DIF: COG: Analyzing REF: 244 OBJ: 3 15. Which role of the nurse will be most important in the future practice of providing genomic nursing care? a. Direct caregiver b. Educator c. Advocate Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

d. Referral agent ANS: C Although the nurse will use all of these roles when providing genomic nursing care, the most important role will be that of advocate. Nurses will increasingly provide guidance on policy discussions and ethical issues that relate to confidentiality, privacy, and commercialization. This is the nursing role of advocate.

DIF: COG: Evaluating REF: 250-251 OBJ: 3 16. A public health nurse is demonstrating one of the minimum competencies set forth by the National Coalition of Health Professional Education in Genetics (NCHPEG) when: a. Organizing a meeting to discuss the care of cystic fibrosis clients b. Making a referral to a genetics specialist c. Advocating for legislation to support stem cell research d. Educating a client about the results of genetic testing ANS: B The minimum competencies for health care professionals set forth by NCHPEG are: be able to examine competence of practice, understand the social and psychological implications of health-related genetic information, and know how and when to make referrals to a genetics professional. Making a referral is the only example that is described in these competencies.

DIF: COG: Analyzing REF: 248 OBJ: 4 17. A nurse applies genetic and genomic knowledge when completing a client assessment by: a. Constructing a pedigree from a collected family history b. Identifying a client who may benefit from genetic counseling c. Referring a client to specialized genetic services d. Incorporating knowledge of genomic risk factors ANS: A Constructing a pedigree from a collected family history demonstrates assessment in the nursing process. Identification is demonstrated by identifying a client who may benefit from genetic counseling. Referral is demonstrated by referring a client to specialized genetic services. Provision of education, care, and support is demonstrated by incorporating knowledge of genomic risk factors.

DIF: COG: Applying REF: 249 OBJ: 4 18. When a nurse considers that clients may not want to have genetic testing done because of the impact that it may have on future life decisions, the nurse is incorporating genetics/genomics into practice using: a. Assessment b. Identification c. Referral d. Provision of education, care, and support ANS: B One of the ways that a nurse uses identification is by identifying ethical, cultural, and societal issues related to genetic and genomic information and technologies. Assessment is Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

not being performed here because the nurse is not assessing a particular clients needs or history. Referral is not taking place, nor is education, care, or support of a patient.

DIF: COG: Applying REF: 249 OBJ: 4 19. When a nurse understands the significant impact that genetic testing can have on an individual and family, the nurse is meeting a competency identified by the: a. National Coalition of Health Professional Education in Genetics (NCHPEG) b. Centers for Disease Control and Prevention c. American Nurses Association d. International Council of Nurses ANS: A The NCHPEG identifies one competency of health care professionals as being able to understand that health-related genetic information can have social and psychological implications for individuals and families.

DIF: COG: Applying REF: 248 OBJ: 4 20. Which statement would be most appropriate for the nurse to make when assisting a family in compiling a family health history? a. When you have completed this history, it will not need to be updated. b. Looking back at two generations of biological relatives will be sufficient. c. The purpose of completing a family history is to decrease genetic susceptibility. d. A family history is a useful tool when considering your future health risks.

ANS: D A family history is a useful tool to help families know about their health risks and prevent disease in themselves and their close relatives. It is recommended that families develop a three generation history and update it on a regular basis. Completion of a family history will not decrease genetic susceptibility; rather it will make families more aware of what that susceptibility may be.

DIF: COG: Evaluating REF: 249 OBJ: 4 21. The Genetic Information Nondiscrimination Act (GINA): a. Protects individuals from discrimination based on their genetic information b. Allows health insurance companies to deny coverage for pre-existing conditions c. States employers may collect genetic information from employees as needed d. Requires employees to report genetic disorders to their employer ANS: A GINA was designed to prohibit the improper use of genetic information in health insurance and employment. It protects individuals from discrimination based on their genetic information, prevents denial of coverage based solely on genetic predisposition to disease, and limits disclosure of genetic information.

DIF: COG: Understanding REF: 247 OBJ: 5 22. A nurse is counseling a client whose genetic test results show a genetic susceptibility for breast cancer. The most appropriate statement by the nurse would be: Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. You should discuss hormone replacement therapy with your physician. b. You are at an increased risk to develop breast cancer. c. You should have a bilateral mastectomy as soon as possible. d. You should tell all of your siblings and children to get tested.

ANS: B Persons with a genetic susceptibility are at increased risk for developing the disease.

Although the client may choose to have a bilateral mastectomy and recommend genetic testing to other family members, the most important thing to relay to the client is that having a genetic susceptibility does not mean that one will automatically have the disease.

DIF: COG: Analyzing REF: 249 OBJ: 5 MULTIPLE RESPONSE 1. According to the CDCs Genomic competencies for the public health workforce, all public health workers should be able to (select all that apply): a. Demonstrate basic knowledge of the role that genomics play in disorders. b. Make appropriate referrals to those with more genomic experience. c. Counsel individuals about their genetic susceptibility for particular disorders. d. Recommend appropriate genetic screening tests for clients.

ANS: A, B The CDCs Genomic competencies for the public health workforce apply to all public health professionals. All public health workers should demonstrate basic knowledge and be able to make appropriate referrals. The other statements would not be true of competencies of all public health workers.

DIF: COG: Understanding REF: 247 OBJ: 4 2. When delivering safe and effective nursing care, the nurse must consider the significance of which factor(s) in the development of disease? Select all that apply. a. Genetics b. Lifestyle c. Environment d. Technology ANS: A, B, C The knowledge of human genetics can improve the safety, quality, and effectiveness of care for clients. It is important for nurses to understand the predisposition to disease as well as the impact of behavior and social conditions on overall community health and well-being.

Many genetic disorders have an environmental link.

DIF: COG: Applying REF: 244|248 OBJ: 3 3. A nurse is counseling a client who has just learned that she is a carrier of the BRCA-2 gene. What are potential reactions by this client? a. Feelings of guilt b. Fear of loss of insurance coverage c. Feelings of anxiety d. Fear for children Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: A, C, D Feelings of guilt, anxiety, and fear for future susceptibility for children are all potential reactions this client may have. The Genetic Information Nondiscrimination Act (GINA) protects clients from losing insurance benefits based upon genetic information.

Chapter 7 Patient Engagement: Engaging Patients in the Care Process

MULTIPLE CHOICE 1. Change for the community as client must often occur at several levels because: a. Health problems caused by lifestyle are multidimensional. b. Most individuals can change their habits alone. c. Aggregates are responsible for social change. d. Geographic areas often have health risks that the nurse must identify.

ANS: A Because health problems caused by lifestyle cannot be solved simply by asking individuals to choose healthy habits, change for the community client must often take place at several levels.

DIF: COG: Understanding REF: 399-400 OBJ: 1 2. A nurse cares for the community as the client when focusing on: a. Providing care for aggregates living in the community b. The collective good of the population c. The provision of care for families in the home setting d. Providing health education in the community ANS: B The community is considered the client when the nursing focus is on the collective good of the population. Providing education is one way the nurse can care for the community as the client; however, the focus of nursing care is larger in scope than only education.

DIF: COG: Applying REF: 398 OBJ: 1 3. A collection of individuals who have in common one or more personal or environmental characteristics is the definition of a(n): a. Community b. Group Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Family d. Aggregate ANS: D An aggregate is a collection of individuals who have one or more personal or environmental characteristics in common.

DIF: COG: Remembering REF: 398 OBJ: 2 4. What are the critical attributes in the definition of community? a. Families, groups, and health organizations b. Health needs, geographical boundaries, and target population c. People, place, and functions d. Populations and health resources ANS: C The people are community members or residents; place refers to geographic and time dimensions; and function refers to the aims and activities of the community.

DIF: COG: Understanding REF: 397 OBJ: 2 5. A group of nursing students forms a student nursing association to provide support while they are enrolled in a nursing program. This is known as a community of: a. Place b. Special interest c. Problem ecology d. Function ANS: B A community of special interest brings members together with common concerns and interests.

DIF: COG: Applying REF: 397 OBJ: 2 6. A public health nurse is collecting data about the biological aspects of community health. What data will the nurse collect? a. Race/ethnicity b. Traditional morbidity and mortality rates c. Policy making and social change Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

d. Homicide rates ANS: B Biological community health is often measured by traditional morbidity and mortality rates, which can be found in The Morbidity and Mortality Weekly Report.

DIF: COG: Applying REF: 400 OBJ: 2 7. A community that has residents who are very involved in its activities and encourage activities that promote the health of the community displays which condition of community competence? a. Commitment b. Participation c. Articulateness d. Effective communication ANS: B Participation is an essential condition of community competence defined by active, communityoriented involvement.

DIF: COG: Applying REF: 401-402 OBJ: 2 8. Which data source provides information about the function of the community? a. Maps b. Census data c. State departments, business and labor, local library d. Civic groups ANS: C Function relates to production, distribution, and consumption of goods and services.

DIF: COG: Applying REF: 399 OBJ: 2 9. Which characteristic is an indicator of community health process? a. Participation and community action b. Live birth rate c. Racial distribution d. Socioeconomic levels

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: A Participation and community action are indicators of community health process.

DIF: COG: Applying REF: 401 OBJ: 2 10. A community that demonstrates commitment would most likely support the development of a: a. Community club to facilitate community involvement b. Childrens recreation program c. Curb-side recycling program and community-based education about recycling d. Cooperative agreement with a neighboring city to share needed services ANS: C The commitment condition of community competence defined by Cottrell refers to the affective and cognitive attachment to a community, that is worthy of substantial effort to sustain and enhance. Creating a recycling program as well as associated education enhances both the cognitive and affective domains of the community.

DIF: COG: Evaluating REF: 402 OBJ: 2 11. The main characteristics of partnership are: a. Awareness, flexibility, and distribution of power b. Rights, responsibilities, and consensus c. Commitment, participation, and articulation d. Collaboration, advocacy, and utility ANS: A The main characteristics of partnership are being informed, flexibility, and negotiated distribution of power.

DIF: COG: Understanding REF: 403 OBJ: 3 12. When completing a community assessment, the nurse will: a. Identify community needs and clarify problems. b. Determine the weaknesses of a community. c. Perform the core functions of public health nursing. d. Assess individual needs within a community.

ANS: A Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

In a community assessment, one of the core functions is a logical, systematic approach to identifying community needs, clarifying problems, and identifying community strengths and resources.

DIF: COG: Applying REF: 407 OBJ: 3 13. When a nurse focuses intervention strategies on the structural dimension of community health, they are directed toward: a. Health services b. Primary prevention c. Health promotion d. Secondary prevention ANS: A Intervention strategies include service use patterns, treatment data from various health agencies, and provider/client ratios.

DIF: COG: Applying REF: 400-401|406 OBJ: 3 14. Which characteristic is an indicator of community health structure? a. Infant mortality rate b. Effective communication c. Crime rate d. Emergency room utilization ANS: D The structure of the community is defined in terms of services and resources.

DIF: COG: Applying REF: 400-401 OBJ: 3 15. After identifying the boundaries of a community, what is the next step the nurse should take in completing a community assessment? a. Gather relevant existing data and generating missing data. b. Plan interventions that benefit the entire community. c. Formulate nursing diagnoses. d. Evaluate the interventions that were used.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: A Community assessment includes gathering relevant existing data and generating missing data.

DIF: COG: Applying REF: 406-407 OBJ: 3 16. What intervention would be the most appropriate for the nurse to use when trying to develop community partnerships? a. Involve only the community residents. b. Use nurses as the source of information and leadership. c. Rely on the power of local officials. d. Include a variety of disciplines.

ANS: D Community partnerships occur when community residents and health workers come from a variety of disciplines.

DIF: COG: Analyzing REF: 402 OBJ: 3 17. When writing a community-level diagnosis, Among refers to the: a. Specific problem or health risk faced by the community b. Characteristics of the community c. Community client experiencing the risk or problem d. Likelihood that the problem will be solved ANS: C Among identifies the specific community client with whom the nurse will be working to address the identified problem.

DIF: COG: Understanding REF: 413 OBJ: 4 18. Which nursing diagnosis is written at the community-level? a. Risk of hypertension related to poor diet and sedentary lifestyle b. Risk of obesity among school-age children related to lack of opportunities to engage in physical activity c. Risk of ineffective health maintenance among individuals who do not have access to a primary care provider d. Ineffective coping related to multiple stressors as evidenced by client crying and stating she has Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

no support system ANS: B There are three parts: risk of, among, and related to. The risk of identifies a specific problem or health risk faced by the community. Among identifies the specific community client with whom the nurse will be working in relation to the identified problem or risk. Related to describes characteristics of the community.

DIF: COG: Evaluating REF: 413 OBJ: 4 19. A nurse surveys the school nurses in a community to determine their roles in the schools because this data is not available. The nurse is engaging in the process of data: a. Collection b. Gathering c. Generation d. Interpretation ANS: C Data generation is the process of developing data that do not already exist by interacting with community members or groups. This data includes information about a communitys knowledge and beliefs, values and sentiments, goals and perceived needs, norms, problem-solving processes, power, leadership, and influence structures.

DIF: COG: Applying REF: 409 OBJ: 5 20. A nurse schedules an appointment with a physician who has a practice in the community to learn more about the communitys beliefs regarding childhood immunizations. This is known as: a. Informant interview b. Participant observation c. Secondary analysis d. Windshield survey ANS: A An informant interview is a method of community data collection that involves directed conversation with selected community members.

DIF: COG: Applying REF: 409 OBJ: 5

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

21. When conducting informant interviews in a small community, the nurse would most likely contact: a. The state department of health for death records b. A local priest for congregation information c. Surrounding communities for crime comparison d. The Centers for Disease Control and Prevention (CDC) for illnesses in the area ANS: B Informant interviews are methods of directly collecting data. County health department nurses and church officials are often good key informants.

DIF: COG: Applying REF: 409 OBJ: 5 22. A nurse collects data about seat belt usage by interviewing key informants and observing behaviors in the community. What type of data is being collected? a. Quantitative b. Qualitative c. Focus-groups d. Survey ANS: B Qualitative data is collected through interviews and observation.

DIF: COG: Applying REF: 409 OBJ: 5 23. A nurse who reads the local community newspaper is using which method to gather data about the community? a. Informant interview b. Survey c. Participant observation d. Windshield survey ANS: C The nurse is deliberately sharing in the life of the community.

DIF: COG: Applying REF: 409 OBJ: 5

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

24. Which method of data collection is being used as a nurse gathers information about the condition of homes, size of lots, neighborhood hangouts, road conditions, and modes of transportation? a. Participant observation b. Windshield survey c. Survey d. Informant interviews ANS: B Windshield surveys are the motorized equivalent of simple observation.

DIF: COG: Applying REF: 409-410 OBJ: 5 25. A nurse who uses such data as minutes from a community meeting is using: a. Secondary analysis b. Informant interviews c. A survey d. A windshield survey ANS: A The data is secondary because it is collected by someone else.

DIF: COG: Applying REF: 410 OBJ: 5 26. A nurse plans on implementing a community-wide influenza immunization program. Which factor should the nurse consider when implementing this program? a. The number of community members who have already received the immunization b. The existence of formal groups in the community c. Public policy that mandates influenza immunization for certain populations d. The communitys readiness to participate in the program ANS: D The factors that influence implementation in the community are the nurses chosen roles, the type of health problem selected as the focus for intervention, the communitys readiness to take part in problem solving, and characteristics of the social change process.

DIF: COG: Analyzing REF: 416 OBJ: 5

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

27. To effectively complete the evaluation phase, the nurse must have: a. Demonstrated the ability to improve the health of the participants b. Developed measureable objectives and goals before implementation c. Encouraged full participation by community members d. Improved the health of the population through the program ANS: B Evaluation begins in the planning phase, when goals and measurable objectives are established and goal-attaining activities are identified. After implementing the intervention, only the meeting of objectives and effects of the intervening activities have to be assessed.

DIF: COG: Analyzing REF: 418 OBJ: 5 28. To analyze the problem of increased adolescent alcohol use in the community, a nurse brings together several groups of people to address the issue. These groups come together at the same time to work on identifying potential causes of the problem, but do not interact during the process.

Which model is the nurse applying? a. Delphi technique b. Program planning model c. Community-as-partner model d. Community empowerment model ANS: B The program planning model is known as the nominal group process. It makes the most of the contributions by various groups with diverse interests, skills, and knowledge. These groups work in the presence of one another but do not interact.

DIF: COG: Analyzing REF: 411-412 OBJ: 5 29. A nurse is trying to increase participation in a free colorectal screening program for middle-aged adults who lack health insurance. Which implementation mechanism would be most effective? a. Small interacting groups b. Health policy c. Lay advisors d. Mass media ANS: D

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

The mass media (newspapers, television, and radio) represent an impersonal and formal type of communication and are useful in providing information quickly to a large number of people.

DIF: COG: Evaluating REF: 418 OBJ: 5 MULTIPLE RESPONSE 1. A nurse may define a community as a(n) (select all that apply): a. Social group determined by geographic boundaries b. Group of people who share common values and interests c. Group of people defined by their interactions d. Individual with a specific health concern ANS: A, B, C Community can be defined as many things, including a social group determined by geographical boundaries, a group of people who share common values and interests, and a group of people defined by their interactions.

DIF: COG: Applying REF: 397 OBJ: 1 2. Which data would be useful for a nurse to collect when assessing safety in a community? Select all that apply. a. Number of billboards in the area b. Interviews with health care providers who are familiar with the community c. Observation of community members d. Nurses own observations ANS: B, C, D Other nurses, social workers, and health care providers, community members, and the nurses own observations are reliable sources of information about the safety of an area.

Chapter 8 Behavioral Economics: How BE Influences and Changes Health

MULTIPLE CHOICE 1. The allocation of scarce resources within the health care sector and the focus on resource allocation issues related to producing and distributing health care is called: Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Economics b. Health economics c. Economic evaluation of health care d. Microeconomic theory ANS: B Health economics is the allocation of scarce resources within the health care sector and the focus on resource allocation issues related to producing and distributing health care.

DIF: COG: Remembering REF: 100 OBJ: 1 2. Public health economics focuses on the: a. Use of resources b. Availability and usage of goods and services related to public health c. Scarcity of resources in the health care industry d. Management and use of monies to improve the health of populations ANS: B Public health economics focuses on producing, distributing, and consuming goods and services related to public health.

DIF: COG: Understanding REF: 100 OBJ: 1 3. Which statement regarding poverty and health insurance is true? a. Millions of people in the United States are without health insurance. b. The poor in the United States are as healthy as persons with higher incomes. c. Persons with money or health insurance are less likely to seek health care. d. The poor are more likely to receive health care through private agencies.

ANS: A In the United States, 49.4 million people are without health insurance. The poor in the United States are generally not as healthy as persons with middle or higher incomes. Persons with money and/or health insurance are more likely to seek health care. The poor are less likely to receive health care through private agencies.

DIF: COG: Understanding REF: 99 OBJ: 1

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

4. Implementation of a teen pregnancy prevention program in a high school is shown to decrease the rate of teen pregnancy. This is an example of: a. Effectiveness b. Efficiency c. Microeconomics d. Production ANS: A Effectiveness refers to the extent to which a health care service meets a stated goal or objective, or how well a program or service achieves what is intended.

DIF: COG: Applying REF: 102 OBJ: 1 5. Which is an example of a service offered at the federal government level? a. Family planning b. Counseling c. Policy making d. Prevention of communicable diseases ANS: C Policy making is offered at the federal level. Family planning, counseling, and preventing communicable and infectious disease are offered at the state and local levels.

DIF: COG: Applying REF: 100 OBJ: 1 6. Conducting a class at a public health clinic on breast self-examination to a group of 50 women is an example of: a. Supply and demand b. Market c. Efficiency d. Effectiveness ANS: C Efficiency refers to producing maximum output, such as a good or service, or using a given set of resources or inputs, such as labor, time, and available money. Teaching one topic to many people is an example of this.

DIF: COG: Applying REF: 102 OBJ: 1 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

7. Nurses can promote efficiency by: a. Evaluating how well a program of service achieves what was intended b. Trying new products provided by sales representatives c. Using time wisely by delegating non-nursing tasks to unlicensed care providers d. Setting up a clinic to look aesthetically pleasing to clients ANS: C Efficiency relates to producing maximal output given a set of resources. Using time wisely through delegation is the best example of using efficiency.

DIF: COG: Analyzing REF: 102 OBJ: 1 8. When a business offers wellness incentives to its employees and then notices a decrease in the frequency of physician visits among employees, this is an example of: a. Macroeconomic theory b. Efficiency c. Supply and demand d. Microeconomic theory ANS: D Microeconomic theory is examining the behaviors of individuals and organizations that result from trade-offs in utility and budget constraints of health care.

DIF: COG: Applying REF: 101 OBJ: 2 9. Nurses should be cognizant of microeconomics because: a. Nurses are often the ones to allocate resources to solve a problem. b. Nurses are often involved in federal policy making. c. Nurses should know about microeconomics in order to deliver quality patient care. d. Health care supplies can be very costly and nurses must use them wisely.

ANS: A Nurses often allocate resources, design, plan, coordinate, and evaluate community-based health services.

DIF: COG: Analyzing REF: 103 OBJ: 2

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

10. Evaluating a smoking cessation program, the gained or increased financial income, the improvements in the community attributable to the program, or costs that would result if the program was not given are examples of: a. Cost-effectiveness analysis b. Cost-benefit analysis c. Supply and demand d. Microeconomic theory ANS: B Cost-benefit analysis involves the listing of all costs and benefits that are expected to occur from an intervention during a prescribed time.

DIF: COG: Analyzing REF: 103 OBJ: 2 11. Supply and demand is illustrated when: a. The demand for nurses in public health is low, but the supply is high b. Few goods or services are available, the price tends to rise c. Supplies are low, nurses must find alternate resources d. Lesser-developed countries receive supplies from other countries ANS: B Supply and demand is in force when few goods or services are available, and then the price tends to rise.

DIF: COG: Analyzing REF: 101-102 OBJ: 2 12. An example of a macroeconomics issue faced by nurses is: a. The evaluation of client access to services b. A health policy that makes the development of a new program possible c. Informing clients and others of the cost of service d. The referral of clients to available services ANS: B Macroeconomics focuses on the big picture, such as a program, whereas microeconomics focuses on the individual or organization.

DIF: COG: Analyzing REF: 102 OBJ: 2

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

13. Nurses working with aggregates would apply the macroeconomic theory because they are concerned with the: a. Factors that determine prices and affect resource allocation b. Positive effect of competitiveness on health care costs c. Supply, demand, and costs of services available to their clients d. Policies to support programs to improve the health of the community ANS: D Macroeconomics focuses on the big picture, which is policy, whereas microeconomics focuses on the individual or organization.

DIF: COG: Evaluating REF: 102 OBJ: 2 14. Which characteristic has the greatest effect on health? a. Obesity b. Marital status c. Health insurance d. Age ANS: A Personal behavior/lifestyle (obesity) has the greatest effect on health. Environmental factors (marital status) and human biology (age) are next followed by the health care system (health insurance).

DIF: COG: Applying REF: 105 OBJ: 3 15. Which individual 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 ANS: D Barriers to accessing care include the inability to afford health care, lack of transportation, physical barriers, communication problems, child care needs, lack of time or information, or refusal of services by providers. The unemployed male is most likely to experience a barrier because of not having a job, which may reduce his access to health insurance and limit his income.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: COG: Analyzing REF: 105 OBJ: 3 16. 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 businessman who works for a large corporation d. A 32-year-old man who works part-time at a small business ANS: D The typical uninsured person is one who works at a low-paying job, part-time or temporary, or at a small business. The elderly person would be eligible for Medicare, and the 2-year-old is probably eligible for Medicaid. The man who works at the large corporation probably has health insurance, since most large businesses provide it.

DIF: COG: Analyzing REF: 104 OBJ: 3 17. Which was considered the first national health insurance plan in the United States? a. HMO Act b. Marine Hospital Service c. Medicare d. Medicaid ANS: B The Marine Hospital Service was created in 1798 by the federal government to provide medical service for sick and disabled sailors and to protect the nations borders against the importing of disease through seaports.

DIF: COG: Remembering REF: 114 OBJ: 4 18. The first phase of development of the health care system was characterized by: a. The rise in technology b. Epidemics of infectious disease, such as typhoid, influenza, and malaria c. Physicians and nurses who attained their skills in scientifically-based programs d. An expansion of hospital clinics and long-term care facilities ANS: B Phase one was concerned with epidemics and infectious disease control. Technology is characteristic of phase four, and physicians and nurses attained skills in scientifically based Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

programs in phase two. Phase three included the expansion of hospital clinics and long-term care facilities.

DIF: COG: Understanding REF: 107 OBJ: 4 19. A characterization of the fourth developmental stage of the health services delivery framework is: a. Nurses in the United States being predominantly women b. The expansion of the number and type of health care facilities c. Dependence on technology for patient care d. The discovery and development of pharmacological advances ANS: C Nurses have become dependent on technologies to monitor client progress, make decisions about care, and deliver care in innovative ways.

DIF: COG: Understanding REF: 109 OBJ: 4 20. Which statement about the Medicare program is accurate? a. Part A provides coverage for hospitalization. b. Part A requires payment of a monthly premium for coverage. c. Part B provides payment for home health services and extended care facilities. d. Part B is available without cost to all elderly people who have paid social security taxes.

ANS: A Medicare Part A covers hospital care, home care, and skilled nursing care. Medicare Part B is a supplemental program available to all Medicare-eligible persons for a monthly premium.

DIF: COG: Understanding REF: 115 OBJ: 4 21. Medicare and Medicaid are: a. Available to any citizen who wishes to enroll b. Two federal programs that provide insurance to special groups c. Private insurance providers d. Funded by the state government ANS: B Medicare provides insurance for persons over 65, and Medicaid is for low-income and needy Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

children, aged, blind, and/or disabled. Medicare is financed by the federal government. Medicaid is jointly financed by states and the federal government. They are not private insurance providers by definition.

DIF: COG: Understanding REF: 115 OBJ: 4 22. A Medicare recipient has elected to pay a monthly premium for Medicare that will cover expenses, such as laboratory services and equipment. This part of Medicare is called Medicare Part: a. A b. B c. C d. D ANS: B Medicare Part B is a supplemental (voluntary) program; it provides coverage for services that are not covered by Part A, such as laboratory services, ambulance transportation, prostheses, equipment, and some supplies.

DIF: COG: Applying REF: 115 OBJ: 4 23. A person with end-stage kidney failure who is on dialysis is eligible for: a. Medicaid b. Blue Cross c. Medicare d. HMO ANS: C Medicare is available to anyone on dialysis regardless of age.

DIF: COG: Applying REF: 115 OBJ: 4 24. Which individual would most likely receive Medicaid services? a. An 85-year-old female who has hypertension b. A 25-year-old female who is pregnant c. A 50-year-old male who is blind d. A 70-year-old male who is hearing impaired ANS: C Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Medicaid provides financial assistance to states and counties to pay for medical services for the aged poor, the blind, the disabled, and families with dependent children who are below state poverty income levels.

DIF: COG: Analyzing REF: 116 OBJ: 4 25. Which service would be covered under Medicare Part A? a. Blood draw to assess PT/INR b. Physical therapy visit c. Stay in skilled nursing facility d. Transportation by an ambulance ANS: C Medicare Part A covers hospital care, home care, and skilled nursing care.

DIF: COG: Analyzing REF: 115 OBJ: 4 26. When a health care organizations fees for delivery of services are not decided until after they are provided, it is called: a. Retrospective reimbursement b. Prospective reimbursement c. Fee-for-service d. Capitation ANS: A Retrospective reimbursement is the method whereby fees for the delivery of health care services in an organization are set after services are delivered.

DIF: COG: Understanding REF: 120 OBJ: 5 27. When a third-party payer establishes the amount of money that will be paid for the delivery of a particular service before offering the service to the client, it is called: a. Retrospective reimbursement b. Prospective reimbursement c. Fee-for-service d. Capitation ANS: B Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Prospective reimbursement is the method of paying an organization whereby the third-party payer establishes the amount of money that will be paid for the delivery of a particular service before offering the services to the client.

DIF: COG: Understanding REF: 120-121 OBJ: 5 28. Which statement about the reimbursement of health services for nurses is accurate? a. Reimbursement for health care services can be directed only to physicians. b. Nurse practitioners and clinical nurse specialists are reimbursed for Medicare Part B services. c. Nursing care is a separate budget item in determining hospital service costs. d. Nursing care is reimbursed separately from medical care in outpatient settings.

ANS: B This became effective January 1, 1998, under Public Law 105-33.

DIF: COG: Understanding REF: 122 OBJ: 5 29. A physician receives a set amount of money to provide care to a given group of clients for a set period of time. This is an example of: a. Retrospective reimbursement b. Prospective reimbursement c. Fee-for-service d. Capitation ANS: D Capitation describes the practice of paying physicians and other practitioners a set amount to provide care to a given client or group of clients for a set period of time and amount of money. This is similar to prospective reimbursement for health care organizations.

DIF: COG: Applying REF: 121 OBJ: 5 30. An employee is able to receive health insurance from a former employer after changing jobs because of the: a. Health Insurance Portability and Accountability Act (HIPAA) b. Omnibus Budget Reconciliation Act c. Balanced Budget Act of 1997 d. Social Security Act Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: A HIPAA is a federal intervention to protect health insurance coverage for workers and families following a job change or loss.

DIF: COG: Applying REF: 114|119 OBJ: 5 31. An example of managed care is: a. Medicare b. Medicaid c. Medical savings accounts d. Health maintenance organizations ANS: D Health maintenance organizations and preferred provider organizations are types of managed care.

DIF: COG: Applying REF: 120 OBJ: 6 32. A public health nurse is counseling a client who is trying to determine if a health maintenance organization (HMO) or preferred provider organization (PPO) will provide the better health care coverage. One main difference between these two types of managed care arrangements is: a. HMOs provide comprehensive care to its members for a fixed fee. b. PPOs designate providers that members can choose. c. PPOs employ physicians as PPO employees. d. HMOs provide financial incentives to encourage members to select HMO providers.

ANS: A The HMO is a provider arrangement whereby comprehensive care is provided to members for a fixed per member per month fee. A PPO uses predetermined rates for services to be delivered to members. HMOs have multiple models of delivery including the staff model, where physicians are HMO employees. PPOs provide financial incentives to encourage members to select PPO providers.

DIF: COG: Analyzing REF: 120 OBJ: 6 33. An example of primary prevention is: a. A smoking cessation program b. Radiation therapy for lung cancer c. Care at a long-term care facility Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

d. Hospice care ANS: A Primary preventions aim is preventing disease. Radiation therapy, a long-term care facility, and hospice are secondary or tertiary care examples.

DIF: COG: Applying REF: 105 OBJ: 7 MULTIPLE RESPONSE 1. Factors that influence health care costs include (select all that apply): a. Technology and intensity b. Demographicsthe aging population c. Chronic illness d. Use of the health care system ANS: A, B, C All but the last option influence health care costs. The fact that individuals have, over time, consumed more health care is not an adequate explanation.

Chapter 9 Health System Navigation: The Role of Health Advocacy and Assistance Programs

MULTIPLE CHOICE 1. The process of program management is similar to: a. The nursing process b. The medical model of care delivery c. The requirements for licensure as a registered nurse d. Summative and formative evaluation ANS: A The nursing process has the same basic steps but addresses the needs of a specific population.

DIF: COG: Understanding REF: 549 OBJ: 1 2. Which is a benefit of systematic planning? a. Allowing nurses to be in charge of materials presented b. Ensuring that resources are used to address the needs of the community Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Linking local politicians with the community d. Educating student nurses about public health nursing ANS: B The focus should be on what the organization and health provider are attempting to do for clients.

DIF: COG: Understanding REF: 552 OBJ: 1 3. Which phase of the program planning process is being used when the provider and client consider the possibilities of solving a problem using one of the solutions identified? a. Conceptualization b. Detailing c. Implementation d. Evaluation ANS: B The provider details the costs, resources, and program activities needed to choose one of the solutions from the conceptualizing phase.

DIF: COG: Understanding REF: 556 OBJ: 2 4. To increase the immunization rates among children in the community, a nurse manager considering holding immunization clinics on Saturdays one month before school begins. This is an example of: a. Assessing b. Planning c. Organizing d. Evaluating ANS: B Planning is selecting and carrying out a series of actions to achieve stated goals.

DIF: COG: Applying REF: 550 OBJ: 2 5. When a nurse matches client needs, provider strengths and competence, and agency resources, which type of planning is being used? a. Strategic planning b. Program planning Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Management planning d. Process planning ANS: A Matching client needs, provider strengths and competence, and agency resources is considered strategic planning.

DIF: COG: Applying REF: 552 OBJ: 2 6. A nurse completes a program evaluation to identify if the objectives of the program were met.

This is an example of: a. Assessment b. Goal evaluation c. Formative or process evaluation d. Summative or impact evaluation ANS: C Formative or process evaluation is used to assess whether objectives are met or planned activities are completed.

DIF: COG: Applying REF: 550 OBJ: 2 7. A nurse surveys program participants after completion of a wellness program to determine if the participants have increased their involvement in daily exercise. This is an example of: a. Assessment b. Goal evaluation c. Formative or process evaluation d. Summative or impact evaluation ANS: D Summative or impact evaluation is used to assess program outcomes or as a follow-up to the results of the program activities.

DIF: COG: Applying REF: 550 OBJ: 2 8. For the purpose of obtaining information about services needed to meet community needs, business leaders within a community were interviewed. This method of obtaining needs assessment data is called a(n): Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Community forum b. Key informant interview c. Survey of existing agencies d. Indicator approach ANS: B Interviewing business leaders within a community is an example of key informant interviews.

DIF: COG: Applying REF: 554 OBJ: 2 9. Focus groups are used to determine the method of cleanup for contaminated groundwater in a neighborhood. What is a disadvantage of this needs assessment tool? a. Technically demanding b. Expensive c. Bias of leaders d. Time consuming ANS: D Using focus groups to determine the method of cleanup for contaminated groundwater in a neighborhood would be very time consuming.

DIF: COG: Applying REF: 554 OBJ: 2 10. What is the most critical action a nurse should take when planning a health program? a. Assessing need of the community b. Considering alternative solutions or options c. Detailing the costs and resources needed d. Weighing each alternative ANS: A Assessing need provides the reasons and rationale for the program plan.

DIF: COG: Analyzing REF: 554 OBJ: 2 11. What action should a nurse take to have a clear understanding of the overall health status of a community and to identify populations at risk? a. Complete a community assessment. b. Perform a population needs assessment.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Evaluate past programs in the community. d. Develop program resources for the community.

ANS: A Community assessment is a community-oriented approach that views the entire community as the client.

DIF: COG: Analyzing REF: 552 OBJ: 2 12. A nurse uses a key informant interview as part of completing a needs assessment. What is the primary advantage of using this tool? a. Low cost b. Provides a picture of services needed c. Identifies the perspectives of large number of persons d. Indicates the extent of services offered by existing programs ANS: B The main advantage of using a key informant as a needs assessment tool is that it would provide a picture of the services needed.

DIF: COG: Analyzing REF: 554 OBJ: 2 13. What is the purpose of developing objectives for a program? a. Give the speaker specific topics to cover. b. Provide direction for conducting the program. c. Provide an enriching experience for participants. d. Formulate a mission statement.

ANS: B Objectives provide direction and provide the mechanism for evaluating specific activities in light of the total program.

DIF: COG: Understanding REF: 557 OBJ: 3 14. Which is an example of a population needs assessment? a. A health status report indicates many people are not using the health department because of long waits. b. The WHO encourages all travelers to be up to date on the immunizations when traveling abroad.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. A nurse assesses the health status of older adults with diabetes prior to initiation of a health education program. d. An agency uses a television advertisement to encourage healthy eating by the citizens in the community.

ANS: C A nurse assessing the health status of older adults with diabetes is an example of a population needs assessment.

DIF: COG: Applying REF: 553 OBJ: 3 15. A community identifies cardiovascular disease as a priority need because its mortality rate is four times higher than the rate identified in Healthy People 2020. The approach to identifying this need was: a. Proactive b. Reactive c. Inactive d. Interactive ANS: C The inactive approach defines the problem based on the existing health state of the population to be served.

DIF: COG: Applying REF: 554 OBJ: 3 16. It is projected that the incidence of diabetes will increase in the future and therefore create a need for more diabetic health educators. Which approach was used to identify this need? a. Preactive b. Reactive c. Inactive d. Interactive ANS: A Identifying the need for more diabetes health educators based on the projected incidence of diabetes is an example of the preactive approach.

DIF: COG: Applying REF: 554 OBJ: 3

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

17. When a nurse implements basic program planning, what would most likely occur during the formulating stage? a. The client and provider analyze available solutions. b. The best plan for funding is presented to administrators. c. The provider group identifies solutions. d. The client identifies problems.

ANS: D The first step in the planning process involves the identification of problems.

DIF: COG: Analyzing REF: 554 OBJ: 3 18. Which program planning stage defines the problem based on the existing health status of the population to be served? a. Preactive b. Reactive c. Inactive d. Interactive ANS: C The inactive stage defines the problem based on the existing health status of the population to be served.

DIF: COG: Understanding REF: 554 OBJ: 4 19. What question should be answered through a program evaluation? a. Did the audience enjoy the program? b. Is a process evaluation also necessary? c. Are the problems it was designed to solve being solved? d. Was enough information given to change policy?

ANS: C Program evaluation is a means of documenting accountability. The question Are the problems it was designed to solve being solved? addresses the aspect of accountability.

DIF: COG: Understanding REF: 559 OBJ: 4

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

20. According to the CDCs format for evaluation, what would occur during the making activities operational step? a. Identifying goal-attaining activities b. Determining goal measurement c. The actual administration of the program at a health department d. Evaluating the program ANS: C The actual administration of the program at a health department involves doing an activity.

DIF: COG: Understanding REF: 561 OBJ: 4 21. The monitoring of program activities, such as hours of service, number of providers used, number of referrals made, and amount of money spent to meet program objectives, is an example of which aspect of program evaluation? a. Relevance b. Progress c. Efficiency d. Effectiveness ANS: B The monitoring of program activities is an example of the progress aspect of program evaluation.

DIF: COG: Applying REF: 559 OBJ: 4 22. An example of a program objective would be: a. To decrease the incidence of early childhood disease in Center County by providing immunization clinics in all schools between August and December of 2007 b. To provide condoms to sexually active teenagers in the local high school c. To increase by 25% the number of school-age children wearing seat belts d. To provide free diabetic screening every other month for two years ANS: A A program objective needs a strong, action-oriented verb, a statement of a single purpose, a statement of a single result, and a time frame for achieving the expected result.

DIF: COG: Applying REF: 558 OBJ: 4

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

23. In the objective to decrease the incidence of early childhood disease in Center County by 10% to 25% by providing immunization clinics in all schools before August and December 2007, the operational indicator is: a. Decrease b. Promoting immunization clinics c. 10% to 25% d. Before August and December 2007 ANS: C The operational indicator is 10% to 25%; decrease is the action verb; promoting immunization clinics is the purpose; and before August and December 2007 is the time frame.

DIF: COG: Applying REF: 558 OBJ: 4 24. With the involvement of the local government and health department, a community-wide program is planned to make all public businesses smoke free, thus eliminating exposure to secondhand smoke. This program is an example of applying which level of prevention to program planning and evaluation? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment ANS: A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

DIF: COG: Applying REF: 563 OBJ: 4 25. Which critique of the program objective to decrease the incidence of early childhood disease in Center County by providing immunization clinics in all schools between August and December of 2005 is accurate? a. It is accurate as written. b. The results are ambiguous. c. The action verb is not action-oriented. d. The purpose is not stated.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: A A program objective needs a strong, action-oriented verb, a statement of a single purpose, a statement of a single result, and a time frame for achieving the expected result.

DIF: COG: Evaluating REF: 558 OBJ: 4 26. What is the purpose of performing a cost accounting study? a. To detect what percentage of clients recover b. To measure how long it takes for clients to see a caregiver c. To note how many cases are associated with other major risk factors d. To find the actual cost of a program ANS: D Cost accounting studies are performed to find the actual cost of a program.

DIF: COG: Understanding REF: 569 OBJ: 5 27. A nurse needs to collect baseline data before implementing which type of a study? a. Cost-accounting study b. Cost-benefit study c. Cost-effectiveness study d. Cost-efficiency study ANS: C A study designed to measure the quality of a program as it relates to cost is a cost-effectiveness study.

DIF: COG: Understanding REF: 569 OBJ: 5 28. A nurse collects data about productivity of staff members in order to evaluate a program. Which type of study is the nurse completing? a. Cost-accounting study b. Cost-benefit study c. Cost-effectiveness study d. Cost-efficiency study ANS: D

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

A cost-efficiency study is designed to examine the actual cost of performing program services and to focus on productivity versus cost.

DIF: COG: Applying REF: 570 OBJ: 5 29. Which is an example of a philanthropic contribution? a. Contract b. Gift c. Grant d. Loan ANS: B Gifts are philanthropic contributions.

DIF: COG: Applying REF: 570 OBJ: 5 30. A nurse completes a cost accounting study on a program which targets obese adults, helping them to adopt healthier lifestyle choices. The nurse would like to compare the cost of the program to the cost-savings in the health care system by preventing the occurrence of chronic illnesses.

Which type of study would be most appropriate to use in this situation? a. Cost-accounting study b. Cost-benefit study c. Cost-effectiveness study d. Cost-efficiency study ANS: B A study used to assess the desirability of a program by examining costs and benefits is a cost benefit study.

DIF: COG: Analyzing REF: 569 OBJ: 5 MULTIPLE RESPONSE 1. After a need and client demand for a program have been determined through the needs assessment process, the next step in the development of the program is to choose a procedural method that will assist the nurse in planning the program to be offered. Which are possible planning methods? Select all that apply.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Program planning method (PPM) b. Multiattribute utility technique (MAUT) c. Sustainability method d. Effectiveness method ANS: A, B PPM and MAUT are types of planning methods. The sustainability and effectiveness methods are parts of the PPM. Chapter 10 Transitions of Care

MULTIPLE CHOICE 1. A school nurse wants to decrease the rate of obesity among children. Which of the

following actions in the community would be most effective? 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 knowledge of the child is insignificant.

DIF: Cognitive Level: Analyze (Analysis) REF: pp. 349, 355 2. A nurse wants to establish a program to decrease the death rate among children.

Which of the following health problems should be the target of this program?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

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: Apply (Application) REF: p. 350 3. A nurse wants to establish a program to decrease the death rate among adolescents.

Which of the following programs should be developed? 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: Apply (Application) REF: p. 351 4. Which of the following is of the greatest concern for the nurse who works with high

school students? a. Alcohol use b. Motor vehicle accidents

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Sports-related injuries d. Unprotected sex ANS: B

Motor vehiclerelated injuries and violence are the leading causes of morbidity and mortality for adolescents. Thus, this would be the greatest concern for the nurse working with high school students.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 351 5. A mother says, My son wants me to let him buy a car. I must admit, I certainly get

tired of driving him around to all his sports and other activities. Do you think I should let him have a car? Which of the following statements would be the best response by the nurse? a. Absolutely, it will help him recognize the cost of gas and maintenance. b. Certainly. Most young men want their own car, and peer pressure can be

painful. c. It depends on whether you trust your son to drive safely. d. No, adolescent males cannot be trusted with an automobile.

ANS: C

Motor vehiclerelated injuries and violence are the leading causes of morbidity and mortality for adolescents. Males are more likely to take risks, and injury death rates for boys are twice as high as those for girls. Thus, the response by the nurse should take these factors into consideration in response and encourage the mother to individualize her decision for her son.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 351 6. Which of the following children is most at risk for being abused?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. A 1-year-old b. A 6-year-old c. A 9-year-old d. A teenager ANS: A

Children under the age of 4 years and children with special needs are at highest risk for abuse.

DIF: Cognitive Level: Apply (Application) REF: p. 353 7. If underlying causes were listed on autopsy reports, which of the following 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: Understand (Comprehension) REF: p. 355 8. A client has designated someone else to make health care decisions when he or she

is unable to do so. Which of the following methods is the client using to make health care decisions? a. An advance directive b. A living will

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. A durable medical power of attorney d. The Patient Self-Determination Act ANS: C

Durable medical power of attorney is the legal way for a client to designate someone else to make health care decisions when he or she is unable to do so.

DIF: Cognitive Level: Apply (Application) REF: p. 357 9. A woman needs to take some time off from work to care for her invalid mother.

Which of the following health policies allows her to take an extended leave from work to care for a family member? a. Personal Responsibility and Work Opportunity Reconciliation Act b. Womens Health Equity Act (WHEA) c. Temporary Assistance for Needy Families (TANF) d. Family and Medical Leave Act (FMLA) ANS: D

The FMLA provides job protection and continuous health benefits where applicable for eligible employees who need extended leave for their own illness or to care for a family member.

DIF: Cognitive Level: Apply (Application) REF: p. 357 10. Which of the following situations would most likely indicate elder abuse? a. A daughter refuses to visit her mother due to work commitments. b. A child runs around a grandparents house breaking items. c. A young man repeatedly steals money from his grandmother. d. An elderly person demands that the family come for dinner.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: C

Theft or mismanagement of money or resources is an element of abuse.

DIF: Cognitive Level: Apply (Application) REF: p. 358 11. A nurse would like to learn more about the overall health of a population. Which

of the following indicators would the nurse most likely use? a. Life expectancy b. Mortality rate c. Morbidity rate d. Health status ANS: A

Life expectancy is a measure that is often used to gauge the overall health of a population.

DIF: Cognitive Level: Apply (Application) REF: p. 358 12. A nurse is new to the community but wants to begin planning immediately for

health promotion programs. Even though the nurse does not yet know the community, which of the following programs would be good to plan first? a. Alcohol and tobacco cessation programs b. Cancer screening programs c. Cardiac health education programs d. Exercise for life programs ANS: C

Heart disease is one of the most significant public health problems in the United States, responsible for premature mortality and disability. Cardiovascular disease is Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

the leading cause of death in the United States. Good nutrition and exercise programs, while both good health promotion programs, are too narrow in focus to represent the greatest need in the community. Cancer is the second leading cause of death so may be the nurses second focus.

DIF: Cognitive Level: Apply (Application) REF: p. 359 13. A nurse is performing a health assessment on a young adult female. Which of the

following comments by the client would cause the nurse to be concerned? a. I cant believe I didnt get that promotion. I thought I was the best

candidate. b. I cant believe they didnt admit me to that graduate program with my

good undergraduate grades! c. I cant believe how lonely it is around the house since my spouse died. d. I cant believe how little I care about anything anymore since that

diagnosis.

ANS: D

A number of factors contribute to depression, including being female, having a family history of depression, unemployment, and chronic disease. All the options represent a loss, either potential or actual, but the statement about not caring about anything represents an actual symptom of depression.

DIF: Cognitive Level: Apply (Application) REF: p. 360 14. A community health nurse is planning to implement an intervention to reduce the

prevalence of sexually transmitted diseases in the community. Which of the following actions would most likely be taken by the nurse? a. Establish immunization clinics to prevent STDs. b. Educate people with HIV about the mode of transmission.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Explain to women that HIV is transmitted to women usually by IV drug

abuse. d. Develop a STD clinic to increase community access to services.

ANS: A

The goal of Healthy People 2020 is to promote responsible sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases and their complications. Nursing activities should align with these goals.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 361 15. Which statement about eating disorders is correct? a. Individuals with anorexia frequently complain about weight loss. b. Purging is associated with anorexia. c. Most women with bulimia are concerned with the shape and weight of

their body. d. Bulimia is considered to have more medical complications than

anorexia.

ANS: C

Those with bulimia are usually concerned with the shape and weight of their body.

Those with anorexia view themselves as normal or overweight, purging is associated with bulimia, and anorexia is considered to have more complications than bulimia.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 361 16. A nurse is providing contraceptive counseling to a female client. Which of the

following is the most appropriate outcome of this counseling? a. Encourage the individual to choose abstinence.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

b. Ensure the individual is educated to make an informed choice about

reproduction. c. Advocate for increased funding for reproductive services. d. Reduce the health risks of the individual.

ANS: B

The goal of contraceptive counseling is to ensure that women have appropriate instruction to make informed choices about reproduction. The nurse should provide a nonjudgmental approach during counseling and allow the woman to choose the appropriate contraceptive method. Nurses do advocate for reproductive services for women, but that is not a goal of contraceptive counseling. Reduction in the health risks of the individual is a goal of pre-conceptual counseling.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 362 17. A nurse is providing pre-conceptual counseling to a young woman. Which of the

following supplements would the nurse most likely recommend? a. Iron b. Calcium c. Folic acid d. Vitamin C ANS: C

Research has shown that intake of folic acid can significantly reduce the occurrence of serious and often fatal neural tube defects by 50% to 70%. A recommendation was made that women capable of or planning a pregnancy take 0.4 to 0.8 mg of folic acid daily (USPSTF, 2009).

DIF: Cognitive Level: Apply (Application) REF: p. 362

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

18. Which of the following best describes the current research findings related to the

use of hormone replacement therapy (HRT)? a. HRT does not prevent heart disease. b. Use of HRT is recommended to prevent osteoporosis. c. When used with complementary therapies, HRT is most effective. d. HRT is a contributing cause of breast cancer.

ANS: A

HRT does not prevent heart disease. To prevent heart disease women should avoid smoking, reduce fat and cholesterol intake, limit salt and alcohol, maintain a healthy weight, and be physically active.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 362 19. Which of the following best describes where health care dollars in the United

States be focused to improve breast cancer cure rates? a. Education for 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 detection typically ensures a poor prognosis. The differences in the outcomes between women of color and white women point to issues associated with early detection, access to health care, and follow-up by a regular care provider.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 362

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

20. Which of the following behaviors 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. Men do not participate in health care at the same level as women, apparently because of the traditional masculine gender role learned through socialization (Bonhomme, 2007).

Only 57% of U.S. men see a doctor, nurse practitioner, or physician assistant compared with 74% of women (AHRQ, 2010).

DIF: Cognitive Level: Understand (Comprehension) REF: p. 363 21. Which of the following characteristics indicates a man is at a higher risk for

developing prostate cancer? a. Being of Caucasian descent b. Has not had a PSA test c. Has a father or brother who has had prostate cancer d. Has benign prostatic hypertrophy (BPH) ANS: C

Having a father or brother who has had prostate cancer places a man at higher risk for developing prostate cancer.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 364

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

22. Which of the following factors has the largest impact on health disparities among

all populations? a. Ethnicity b. Education level c. Lifestyle choices d. Poverty ANS: D

Poverty is a strong and underlying current factor that affects all special groups.

DIF: Cognitive Level: Understand (Comprehension) REF: pp. 364-365 23. A nurse is working with incarcerated adults who are being released from prison.

Which of the following nursing interventions would be most appropriate for the nurse to implement? a. Connect offenders with community-based mental health programs. b. Provide community supervision for mentally ill offenders. c. Advocate for increased prison time to decrease recidivism rates. d. Educate about available state resources.

ANS: A

Connecting offenders with community-based mental health programs at the time of release from prison can decrease recidivism rates, because many incarcerated adults experience major psychiatric disorders. It would be impossible for the nurse to supervise all mentally ill offenders in the community. Increased prison time is not shown to decrease recidivism rates and education about available state resources is not the most important nursing intervention to provide for this population.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 365

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

24. Which of the following will provide the highest benefit to an older adults well-

being? a. Eligibility for Medicare and Social Security b. Higher socioeconomic status, income, and education c. Senior citizen privileges such as senior citizen centers and senior citizen

discounts d. Social networks that give support and meaning to life ANS: D

Medicare, Social Security, senior privileges, and high socioeconomic status, income, and education are all extremely helpful to older adults. However, social networks that give support and meaning to life are a major factor that can contribute to ongoing health and vitality. One of the biggest dangers is social isolation.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 367 25. A nurse is implementing Wagners Chronic Care Model. Which of the following

actions would the nurse most likely take? a. Educate a community group about hypertension control. b. Create a budget for chronic disease management. c. Administer immunizations to community members. d. Conduct depression screenings in the community.

ANS: A

Use of electronic health records, provider reminders for key evidence-based care components, interprofessional teams communicating regularly and community health classes to educate people with chronic diseases are various ways the CCM is being implemented. Creating a budget is not a way to use CCM. Administration of immunizations and conducting depression screenings do not address the management

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

of the most common and costly chronic diseases: heart disease, diabetes, stroke, cancer, and arthritis.

DIF: Cognitive Level: Apply (Application) REF: p. 367 26. Toward whom is the TLC model targeted? a. Caregivers of older persons with health problems b. Community organizations that offer services for the elderly c. Elderly clients with health problems d. Nurses who care for older clients ANS: A

The TLC model is focused toward caregivers (primarily families) in an effort to relieve caregiver burden. Components are T = training in care techniques, safe medication use, recognition of abnormalities, available resources; L = leaving the care situation periodically to obtain respite and relaxation and maintain their normal living needs; and C = care for themselves (the caregiver) through adequate sleep, rest, exercise, nutrition, socialization, solitude, support, financial aid, and health management.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 367 27. A client explains to the nurse that it is just impossible for her and her husband to

continue to have his mother in the home alone during the day while they work because the woman becomes confused and has fallen twice. Which of the following community resources should the nurse recommend? a. Adult day health b. Home health c. Long-term care d. Senior center

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: A

Adult day health is for individuals whose mental and/or physical function requires additional health care and supervision. It serves as more of a medical model than the senior center, and individuals typically return home to their caregivers at night. Longterm care would take the client out of the home. Home health would leave the patient for periods of unsupervised time in which the patient could have problems and help would not be available.

DIF: Cognitive Level: Apply (Application) REF: p. 368 28. An elderly person is in the last stages of dying. Which type of care would be the

best for him? a. Home health b. Assisted living c. Nursing home d. Hospice ANS: D

Hospice would be the best form of care for a person in the last stages of dying.

DIF: Cognitive Level: Apply (Application) REF: pp. 349, 368 29. Which of the following is the best way to ensure good nutrition in infants? a. Breastfeeding only b. Feed them only brand-name baby foods c. Feed them only brand-name cereals d. Feed them only brand-name formulas ANS: A

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

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. Breastfeeding is associated with a lower risk in developing childhood obesity.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 349 30. A nurse is implementing a tertiary prevention program to promote health among

middle-aged women with diabetes. Which of the following best describes the intervention being implemented by the nurse? a. Developing lifestyle improvement programs for women at risk for

diabetes b. Presenting lifestyle management presentations at womens conferences c. Monitoring blood glucose levels closely and modifying diet accordingly d. Screening glucose levels of women at risk for development of diabetes ANS: C

Tertiary prevention includes activities that are aimed to reduce the complications of the disease process. Only monitoring blood glucose levels is directed toward preventing problems in women who already are diagnosed with diabetes.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 360 31. A nurse advises a client who has HIV not to donate blood, plasma, or organs.

Which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion ANS: C Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Tertiary prevention includes those interventions aimed at disability limitations and rehabilitation from disease, injury, or disability.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 360 32. A nurse wants to promote improved health for obese children in the community.

Which of the following best describes a tertiary prevention measure that the nurse would implement? 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. 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: Analyze (Analysis) REF: p. 360 MULTIPLE RESPONSE 1. Which of the following adolescent(s) would receive care from the advanced

practice nurse without parental consent? (Select all that apply.) a. A 16-year-old who is living on his own (not with his parents) b. A pregnant adolescent c. An adolescent in an emergency situation

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

d. An adolescent whose diagnosis has a serious prognosis ANS: A, B, C

Most states have enacted laws allowing health care providers to treat adolescents in certain situations without parental consent. These situations include emergency care, substance abuse, pregnancy, and birth control. All 50 states recognize the mature minors doctrine. This allows youths 15 years of age and older to give informed medical consent if it is apparent that they are capable of understanding the risks and benefits and if the procedure is medically indicated.

DIF: Cognitive Level: Apply (Application) REF: pp. 351-352 2. Which of the following interventions would the nurse most likely implement when

addressing the problem of asthma among school-aged children? (Select all that apply.) a. Assess schools and day care centers for environmental friendliness. b. Share nutritional information with all students in the school. c. Develop home and environmental assessment guides. d. Teach all school personnel how to use rescue inhalers.

ANS: A, C

Population-focused strategies for asthma management include education programs for families of children and adolescents who have asthma, development of home and environmental assessment guides to identify triggers, education and outreach efforts in high-risk populations to aid in case finding (e.g., in areas with low income, high unemployment, and substandard housing, where there is exposure to secondhand smoke), development of community clean air policies (e.g., no burning of leaves, use of smoke-free zones), improved access to care for asthmatic patients (e.g., developing clinic services with consistent health care providers to decrease emergency department use), and assessment of schools and day-care centers for lack of asthma triggers.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: Cognitive Level: Apply (Application) REF: p. 354 3. A health care provider is working with elderly clients who have ongoing chronic

disease. Which of the following strategies can best assist them with healing? (Select all that apply.) a. Advocating for increased support for elderly persons b. Eliminating signs and symptoms of disease c. Managing any chronic diseases to prevent complications and delay

deterioration d. Maximizing self-care capacity ANS: C, D

With chronic illness, the focus is on healing (a unique process resulting in a shift in the body/mind/spirit system) rather than curing (elimination of the signs and symptoms of disease). Appropriate goals include maximizing self-care capacity, managing chronic diseases effectively, preventing complications, delaying deterioration and decline, and achieving the highest possible quality of life before dying with comfort, peace, and dignity.

DIF: Cognitive Level: Analyze (Analysis) REF: pp. 357-358 4. After seeing a public education program on the need for screening colonoscopy and

the dangers of colorectal cancer, an older friend asks the nurse, Im really scared of getting cancer. What can I do to avoid that kind of cancer? Which of the following recommendations should be made by the nurse? (Select all that apply.) a. Avoid smoking or much alcohol. b. Choose poultry or fish rather than red or processed meat. c. Eat lots of fruits, vegetables, and fiber each day. d. Try to get at least 8 hours of sleep a night.

ANS: A, B, C Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Obesity, physical inactivity, smoking, heavy alcohol consumption, a diet high in red or processed meats, and insufficient intake of fruits and vegetables are risk factors for colorectal cancer.

DIF: Cognitive Level: Apply (Application) REF: p. 361 5. A nurses mother leans forward and says, My best friend fell the other day and now

shes in the hospital. Im really worried about getting osteoporosis. What do you think I should do? What should the nurse recommend? (Select all that apply.) a. Ask your doctor for hormone replacement therapy. b. Continue to abstain from alcohol and not use tobacco. c. Eat foods high in calcium such as fortified skim milk. d. Eat lots of green leafy vegetables.

ANS: B, C

It is estimated that one of every two American women older than 50 years will experience an osteoporosis-related fracture in her lifetime. Primary prevention activities include a diet rich in calcium and vitamin D; exposure to sunlight for 20 minutes a day; exercise, especially weight-bearing activities such as walking, running, stair climbing, and weight lifting, to improve bone density; limiting alcohol consumption; and avoiding smoking.

Chapter 11 Quality and Safety across the Care Continuum

MULTIPLE CHOICE 1. Which of the following best describes one of the main problems in ensuring quality

for health care in the United States? a. Consumers believe American health care is high-quality and the best in

the world.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

b. Every hospital and health care agency has its own approach to data

collection and documentation. c. Finances are the basis of clinical decisions, not quality of care. d. We all agree on what quality is but not on how best to measure it.

ANS: B

Very little is known about quality of care in this country because a variety of definitions of quality are used and it is difficult to get comparable data from health care providers and agencies. Based on international comparisons, health care in the United States does not have the best statistics related to outcomes.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 289 2. A wealthy factory owner says, I dont care about the poor. I just want the best care

available for me and my family. Why should I care whether other people get health care or not? Which of the following would be the most appropriate response by the nurse? a. If your employees are ill, who will do the work in your factory? b. You might catch a contagious disease from one of your employees. c. You have a moral obligation to help those less fortunate. d. Your personal insurance and tax costs will go up if your employees have

to use community resources when theyre ill.

ANS: D

Because the speakers primary concern is apparently money, an appropriate response must show that the factory owner will lose money if he doesnt support the health of others in the community.

DIF: Cognitive Level: Apply (Application) REF: p. 289

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

3. Which of the following information can be gathered by reviewing a community

health report card? a. Utilization of health care services in the community b. Demographic information of the community c. Leading causes of morbidity in a community d. Frequency of malpractice claims within a community ANS: C

The term community health report card refers to different types of reports, community health profiles, needs assessments, scorecards, quality of life indicators, health status reports, and progress reports. Community health report cards can be a useful tool in efforts to help identify areas where change is needed, to set priorities for action, and to track changes in population health over time. The report card may be used to track leading causes of morbidity and mortality in a community, looking at trends over time to see if public health interventions have improved health care outcomes.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 289 4. Which of the following led to the development of the National Health Quality

Improvement Act? a. A very famous movie and television star died as the result of a medical

error. b. The number of malpractice claims had increased. c. Media such as films highlighted the reality of current medical care. d. Publicity about a few unfortunate cases caused consumers to become

concerned.

ANS: B

In response to a growing number of malpractice claims in the United States, the National Health Quality Improvement Act of 1986 was established, which encouraged Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

consumers to become informed about their practitioners practice record and created a national clearinghouse of information on provider malpractice records.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 290 5. Which of the following describes the principal problem with early efforts at

ensuring quality of care? a. No one knows how to measure quality care. b. Professionals resisted and sabotaged such efforts. c. Standards emphasized structure, not process. d. There were no standards as to what represented quality care.

ANS: C

Early efforts such as the National Health Quality Improvement Act of 1986 emphasized structure rather than process or outcome of care; hence, they did not really address the root issues of quality.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 290 6. An agency has not created a continuous quality improvement program. Which of

the following actions should the agency take to help ensure quality care within the institution? a. Ensure appropriate policies and procedures are followed. b. Employ highly recommended and credentialed professionals to give

care. c. Use administrative action to ensure that quality care is given to clients. d. Write quality care plans for the most typical problems of clients.

ANS: A

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Quality assurance/quality improvement (QA/QI) programs remain the enforcers of standards of care for many agencies that have not elected to engage in a program of CQI. These activities are called assurance activities because they make certain that those policies and procedures are followed so that appropriate quality services are delivered.

DIF: Cognitive Level: Analyze (Analysis) REF: pp. 290-291 7. A home care nurse is encouraging the administration of the agency to increase their

quality assurance efforts. Which of the following best describes a negative outcome from this activity? a. An agency deficiency may become visible. b. An individual may be found at fault and then become fearful of being

involved. c. Some agency processes may be questioned. d. Employees at the agency will have to commit extra time to complete this

process.

ANS: B

Total quality management/continuous quality improvement are concepts that give direction for managing a system of care, whereas quality assurance focuses on the care a client receives within the system. QA is concerned with the accountability of the provider. A major problem with quality assurance efforts, done by the quality assurance team, is that individuals may be found to be at fault and hence may be fearful of reporting problems or errors. Continuous quality improvement focuses on processes and possible deficiencies of the organization as a whole so that everyone is involved.

DIF: Cognitive Level: Apply (Application) REF: pp. 291-292 8. How does continuous quality improvement (CQI) differ from quality assurance?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Quality assurance focuses on client care, whereas CQI focuses on

system issues. b. Quality assurance focuses on system issues, whereas CQI focuses on

individual client care. c. Quality assurance measures care at one point in time, whereas CQI is an

ongoing issue. d. Quality assurance focuses on families, whereas CQI focuses on agency

issues.

ANS: A

Total quality management and continuous quality improvement are concepts that give direction for managing a system of care, whereas quality assurance focuses on the care a client receives within the system.

DIF: Cognitive Level: Understand (Comprehension) REF: pp. 292, 301 9. Which of the following is accomplished through the use of traditional quality

assurance? a. Implementation of new techniques to improve outcomes b. Implementation of appropriate interventions for diagnosed problems c. Implementation of change when measured performance does not meet

standards d. Implementation of research findings to ensure appropriate clinical

treatment ANS: C

Traditional approaches to quality assurance are to focus on assessing or measuring performance, to ensure that performance conforms to standards, and to take action to bring about change when care does not meet standards.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 292

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

10. What is the primary goal of total quality management? a. To confirm the high standards desired in patient care b. To discover and correct errors in task completion c. To eliminate problems before negative outcomes occur d. To enable organizations to publicize their quality approach to patient

care ANS: C

The goal of TQM and CQI is to eliminate errors in the work process before negative outcomes occur rather than waiting until after the fact to correct individual performance; the focus is on problem prevention and continuous improvement.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 303 11. An agency is beginning to implement a general approach for quality improvement.

Which of the following activities would the agency most likely implement? a. Customer satisfaction is assessed through the use of surveys provided to

the client after each appointment. b. The health maintenance organization (HMO) provides incentives to

personnel who complete in-house programs on customer service. c. The institution has received accreditation through The Joint

Commission. d. The total quality improvement (TQI) team meets to examine how to

make the registration process more efficient.

ANS: C

General approaches to quality improvement seek to protect the public by ensuring a level of competency among health care professionals. Examples are credentialing, licensure, accreditation, certification, charter, recognition, and academic degrees.

DIF: Cognitive Level: Apply (Application) REF: p. 292 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

12. The pharmacist sent up the wrong medication for the patient. The nurse filled out

an incident report when the error was discovered. Which of the following best describes the likely outcome when the quality improvement team reviews the incident report? a. The nurse will receive a commendation for recognition of the error. b. The pharmacist will be disciplined. c. The pharmacist will be reported to the state pharmacy board. d. The CQI team will try to determine how the error occurred.

ANS: D

It is important for ongoing quality improvement not to blame or discipline those involved or to commend those who recognize a problem, but rather focus on what led to the error occurring. In quality improvement, people are asked to help identify problems and seek ways to improve system performance.

DIF: Cognitive Level: Apply (Application) REF: p. 294 13. A home health care agency has major problems but does not want consumers to

know about these problems while the agency decides what should be done to improve them. Employees are not told to lie, but they are advised not to share information.

Which of the following is the most likely outcome of this situation? a. As long as employees do not share what they know, the community will

be uninformed. b. By law, comparative information will be available to the public via the

Internet. c. Only a few informed persons will know about the problems. d. Secrecy will prevail unless the local newspaper does an investigative

report.

ANS: B

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

In 2003 the Home Health Care Quality Initiative (HHQI) was developed by the USDHHS to provide consumers with data on the quality of home health services.

Home Health Compare, posted on the Medicare website, is a home health report card available to consumers nationwide.

DIF: Cognitive Level: Apply (Application) REF: p. 295 14. The nurse admits uncertainty over how to address the needs of a group of clients.

The long-term nurse in the area suggests that the nurse review published evidencebased clinical guidelines. How can the nurse know these guidelines are reliable? a. Because the agency supports their use b. Because the guidelines have been published c. Because the long-term nurse trusts them d. Because they are based on research and expert opinion ANS: D

Evidence-based practice guidelines are protocols or statements of recommended practice developed by professional organizations and based on scientific clinical data and research as well as expert opinion from extensive clinical experience. Such guidelines help a clinician in decision making.

DIF: Cognitive Level: Apply (Application) REF: p. 295 15. The quality improvement team reviews the records of clients on a monthly basis to

determine whether protocols for pain assessment were followed. Which of the following best describes this activity? a. Accreditation review b. Concurrent audit c. Retrospective audit d. Utilization review

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: C

The retrospective audit, or outcome audit, evaluates quality of care through appraisal of the nursing process after the clients discharge from the health care system.

DIF: Cognitive Level: Apply (Application) REF: p. 296 16. The quality improvement team reviews the records of clients on a monthly basis to

determine whether protocols for pain assessment were followed. Which of the following best describes the major drawback to the teams approach? a. The client is no longer under the agencys care. b. It is difficult to compare documentation of care to standards of care. c. Records can be inaccurate or incomplete. d. Team members may disagree on whether the standards of care were met.

ANS: A

With this approach, problems are identified only after clients have been discharged.

Although the hope is that better care will be given to future clients, nothing can be done about the clients who received less than optimal care.

DIF: Cognitive Level: Apply (Application) REF: p. 296 17. A nurse is invited to join the utilization review team to help the agency avoid

giving unnecessary care. Which of the following difficulties would the nurse most likely confront as client records are reviewed? a. Alternative care options rather than agency care are often encouraged. b. Not all clients fit the pattern and need more care than guidelines suggest. c. The nurse suggests the agency provide guidelines to professionals giving

care. d. The agency is now accountable to its clients and their families.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: B

The major disadvantage of utilization review is that not all clients fit the classic picture presented by the criteria used to determine approval or denial of care.

DIF: Cognitive Level: Apply (Application) REF: pp. 296-297 18. The staff was informed that a PRO (Professional Review Organization) would be

making an unannounced visit in a few hours. Which of the following would the hospital nurse expect the PRO team to examine? a. Records of hospital admissions and scheduled procedures b. Nursing care plans of patients with unexpected problems (infections,

falls) c. Discharge paperwork of patients discharged in the past 30 days d. Documentation of adherence to nursing standards of care ANS: A

PROs are directed by the federal government to reduce hospital admissions for procedures that can be performed safely and effectively in an ambulatory surgical setting on an outpatient basis and to reduce inappropriate or unnecessary admissions or invasive procedures by specific practitioners or hospitals. Therefore, the PRO team would examine records to see whether the hospital admissions and all procedures performed were medically necessary.

DIF: Cognitive Level: Apply (Application) REF: p. 297 19. Which of the components of the PDCA model and Donabedians framework is the

most crucial? a. Standard b. Outcome c. Process

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

d. Structure ANS: B

The PDCA model and Donabedians framework for evaluating health care programs, using the components of structure, process, and outcome, are useful in developing a quality assurance program. Outcome is the most important ingredient of a program, because it is the key to evaluation of providers and agencies by accrediting bodies, insurance companies, and Medicare and Medicaid through PROs, report cards, and other accrediting agencies.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 298 20. Stakeholders developing a new community-oriented clinic plan want to include a

quality assurance (QA) program. Which of the following would be the first step in measuring the structure component? a. Criteria that will be used to measure quality b. Philosophy and objectives of the organization c. Requirements of accrediting agencies d. Standards the QA program wishes to achieve ANS: B

The philosophy and objectives of an agency define the structural standards of the agency. Identification of standards and criteria for quality assurance begins with writing the philosophy and objectives of the organization.

DIF: Cognitive Level: Apply (Application) REF: p. 298 21. Which of the following best explains why evaluation of client outcomes resulting

from nursing intervention is so difficult? a. Client records may not include appropriate data.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

b. Few tools exist to measure client outcomes. c. Many other factors can also affect client outcomes. d. Measuring client outcomes is extremely time consuming.

ANS: C

The major problem with outcome evaluation is determining which nursing care activities are primarily responsible for causing changes in client status. In nursing, many uncontrolled factors in the field, such as environment and family relationships, have an effect on client status.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 300 22. The management team of the Central County Community Health Agency wants to

analyze the cost of homebound client services. Which of the following records are most likely to provide useful data? a. Clinical records b. Financial records c. Morbidity and mortality records d. Provider service records ANS: D

The provider service records include information about the numbers of clinic clients seen daily, home visits made daily, transportation and mileage, the providers time spent with the client, and the amount and kinds of supplies used. The provider service record is completed on a daily basis by each provider and is summarized monthly and annually to indicate trends in health care activities and costs relative to personnel time, transportation, maintenance, and supplies. A clinical record is the client health record. This would contain health information for a single client, would not generally include clinic costs, and would be an inefficient source because it identifies service to only one individual. Financial records include extraneous items for the clinic as a Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

whole. Extracting specific data will not be as easy, because they will be from the provider service record. Morbidity and mortality records would not be suitable in this instance.

DIF: Cognitive Level: Apply (Application) REF: p. 302 23. A nurse has identified a need to increase the quality assurance efforts within the

home care agency. Which of the following has most likely occurred? a. Increased number of client complaints and injuries b. Increased costs of providing care c. Reduced number of incident reports d. Reduced government reimbursement (Medicare and Medicaid) ANS: A

The types of problems that may lead to increased quality assurance efforts include client complaints, injury, or death, poor documentation of care, with subsequent denials of reimbursement by third-party payers, lack of or inefficient service, and concerns about client or staff safety.

DIF: Cognitive Level: Apply (Application) REF: p. 300 24. A nurse is implementing tertiary prevention strategies as part of the quality

management process. Which of the following best describes a strategy the nurse would have used? a. All new employees complete a program on fire safety that details what

to do in the event of a fire. b. At the yearly employee picnic, teams compete in putting out trash can

fires and in racing while carrying mock victims, using safe evacuation techniques. c. After evaluation of response to an actual fire, new procedures

implemented in the fire response protocol are distributed to employees.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

d. Mock fire drills are carried out twice a year to assess response and

readiness in the event of a real fire.

ANS: C

Tertiary prevention involves activities that are carried out when evaluation indicates needed improvement. A program on fire safety is an example of primary prevention.

The employee picnic activity and mock fire drills provide for evaluation of competency (screening) and are thus secondary prevention.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 301 MULTIPLE RESPONSE 1. In which of the following ways does licensing differ from accreditation? (Select all

that apply.) a. Licensing applies to the individual, whereas accreditation applies to a

program. b. Licensing is required to practice, whereas accreditation is by choice. c. Licensing is required by state law, whereas accreditation is required by

federal law. d. Licensing is required for all professions, whereas accreditation is only

available for some.

ANS: A, B

Licensure controls entrance into a profession or occupation and is mandatory to practice. Accreditation is a voluntary or at least a quasi-voluntary approach used by institutions or programs. Licensure is based on state law, whereas accreditation is dependent upon professional standards. Although there are cost differences between licensure and accreditation, individuals pay for licensure, whereas agencies pay for accreditation.

DIF: Cognitive Level: Understand (Comprehension) REF: pp. 292-293 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

2. A nursing committee is responsible for evaluating the process of health care agency

in their quality assurance efforts. Which of the following techniques would most likely be used by the committee members? (Select all that apply.) a. Client satisfaction survey data b. Confirmation of credentials of all health care providers employed c. Patient discharge data over the past one year d. Peer review committee audit ANS: A, D

The primary approaches used for process evaluation are the peer review committee and the client satisfaction survey. The techniques used for process evaluation are direct observation, questionnaire, interview, written audit, and videotape of client and provider encounters. Once data are collected to evaluate nursing process standards, the peer review committee reviews the data to identify strengths and weaknesses in the quality of care delivered.

Chapter 12 Information Technology

Multiple Choice 1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on the incidence of nosocomial (hospital-acquired) infections in acute care settings. An article presented findings at a level of significance of <0.01. This indicates that A) the control group and the experimental group were more than 99% similar.

B) the findings of the study have less than 1% chance of being attributable to chance.

C) the effects of the intervention were nearly zero.

D) the clinical significance of the findings was less than 1:100.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Ans: B Client Needs: A-1 Cognitive Level: Evaluation Difficulty: Moderate Integrated Process: Nursing Process Objective: 1 mcs: 568, Analysis of Quantitative Research Feedback: The level of significance is the level at which the researcher believes that the study results most likely represent a nonchance event. A level of significance of <0.01 indicates that there is less than 1% probability that the result is due to chance.

2. A nurse has read a qualitative research study in order to understand the lived experience of parents who have a neonatal loss. Which of the following questions should the nurse prioritize when appraising the results of this study?

A) How well did the authors capture the personal experiences of these parents?

B) How well did the authors control for confounding variables that may have affected the findings?

C) Did the authors use statistical measures that were appropriate to the phenomenon in question?

D) Were the instruments that the researchers used statistically valid and reliable?

Ans: A Client Needs: A-1 Cognitive Level: Application Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Difficulty: Moderate Integrated Process: Nursing Process Objective: 1 mcs: 568, Analysis of Quantitative Research Feedback: Qualitative studies are judged on the basis of how well they capture and convey the subjective experiences of individuals. Statistical measures and variables are not dimensions of a qualitative methodology.

3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming that nursing research has little relevance to practice. How can the nurses colleague best defend the importance of nursing research?

A) The existence of nursing research means that nurses are now able to access federal grant money, something that didnt use to be the case.

B) Nursing research has allowed the development of masters and doctoral programs and has greatly increased the credibility of the profession.

C) The growth of nursing research has caused nursing to be viewed as a true profession, rather than simply as a trade or a skill.

D) The application of nursing research has the potential to improve nursing practice and patient outcomes.

Ans: D Client Needs: A-1 Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/Learning Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Objective: 2 mcs: 564, The Development of Nursing Research Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimately, to improve patient outcomes. This supersedes the contributions of nursing research to education programs, grant funding, or the public view of the profession.

4. Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of a busy urban hospital. She has noticed that many new mothers abandon breastfeeding their babies when they experience early challenges and wonders what could be done to encourage more women to continue breast-feeding. What role is Tracy most likely to play in a research project that tests an intervention aimed at promoting breast-feeding?

A) Applying for grant funding for the research project B) Posing the clinical problem to one or more nursing researchers C) Planning the methodology of the research project D) Carrying out the intervention and submitting the results for publication Ans: B Client Needs: A-1 Cognitive Level: Application Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 3 mcs: 569, A Staff Nurses Role in the Research Process Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Feedback: A major role for staff nurses is to identify questions or problems for research. Grant applications, methodological planning, and publication submission are normally carried out by nurses who have advanced degrees in nursing.

5. A patient signed the informed consent form for a drug trial that was explained to patient by a research assistant. Later, the patient admitted to his nurse that he did not understand the research assistants explanation or his own role in the study. How should this patients nurse respond to this revelation?

A) Explain the research process to the patient in greater detail.

B) Describe the details of a randomized controlled trial for the patient.

C) Inform the research assistant that the patients consent is likely invalid.

D) Explain to the patient that his written consent is now legally binding.

Ans: C Client Needs: C Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 3 mcs: 569, A Staff Nurses Role in the Research Process Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsible for research consent. If patients who have agreed to participate exhibit ambivalence or uncertainty about participating, do not try to convince them to participate. Ask the person from the research team who is managing consents to speak with concerned patients about the study, even after a patient has signed the consent forms.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Multiple Selection 6. A nurse leader is attempting to increase the awareness of evidence-based practice (EBP) among the nurses on a unit. A nurse who is implementing EBP integrates which of the following? (Select all that apply.)

A) Interdisciplinary consensus B) Nursing tradition C) Research studies D) Patient preferences and values E) Clinical expertise Ans: C, D, E Client Needs: A-1 Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing Process Objective: 4 mcs: 571, Establishing a Definition of Evidence-Based Nursing Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-solving approach to the delivery of healthcare that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values.

Multiple Choice

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

7. Mrs. Mayes is a 73-year-old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now poses a threat of osteomyelitis. The wound care nurse who has been working with Mrs. Mayes applies evidence-based practice (EBP) whenever possible and has proposed the use of maggot therapy to debride necrotic tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this treatment despite the sizable body of evidence supporting it. How should the nurse reconcile Mrs. Mayes views with the principles of EBP? A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.

B) The nurse should explain the evidence to the patient in greater detail.

C) The nurse should integrate the patients preferences into the plan of care.

D) The nurse should involve the patients family members in the decision-making process.

Ans: C Client Needs: A-1 Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 4 mcs: 571, Establishing a Definition of Evidence-Based Nursing Feedback: Patient preferences should be integrated into EBP and considered alongside research evidence and the nurses clinical expertise; evidence does not trump the patients preferences. The family should be involved, but this is not an explicit dimension of EBP. Similarly, explaining the evidence in more detail is not a demonstration of EBP. Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

8. The administrators of a long-term care facility are considered the use of specialized, pressure-reducing mattresses in order to reduce the incidence of pressure ulcers among residents. They have sought input from the nurses on the unit, all of whom are aware of the need to implement the principles of evidence-based practice (EBP) in this decision. Which of the following evidence sources should the nurses prioritize?

A) A qualitative study that explores the experience of living with a pressure ulcer B) A case study that describes the measures that nurses on a geriatric unit took to reduce pressure ulcers among patients C) Testimonials from experienced clinicians about the effectiveness of the mattress in question D) A randomized controlled trial that compared the pressure-reducing mattress with standard mattresses Ans: D Client Needs: A-1 Cognitive Level: Evaluation Difficulty: Moderate Integrated Process: Nursing Process Objective: 5 mcs: 572, Determining Adequate Evidence Feedback: The most reliable evidence is considered RCTs. Qualitative studies, case studies, and expert opinion are low on the hierarchy of evidence.

9. Hospital administrators are applying the principles of evidence-based practice (EBP) in their attempt to ascertain the most efficient and effective way to communicate between nurses who are on different units, a project that will consider Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

many types of evidence. Which of the following information sources should the administrators prioritize?

A) A systematic review about communication in nursing contexts B) Nurses ideas about communication methods C) The results of a chart review D) The hospitals accreditation status Ans: A Client Needs: A-1 Cognitive Level: Evaluation Difficulty: Moderate Integrated Process: Nursing Process Objective: 5 mcs: 572, Display 16.2 Feedback: Systematic reviews are assigned a high value in EBP. Reviews would be prioritized over nurses ideas or a chart review, though both are potential considerations. The hospitals accreditation status is not a relevant consideration.

10. A nurse has resolved to apply the evidence-based practice (EBP) process to the way that admission assessments are conducted and documented on a unit. How should the nurse begin the process of establishing EBP? A) Gather evidence showing the shortcomings of current practices B) Formulate a clear and concise question to be addressed C) Elicit support from the nurses who are most often responsible for admissions Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

D) Search the literature for evidence that is potentially relevant to the practice need Ans: B Client Needs: A-1 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing Process Objective: 6 mcs: 575, Asking Appropriate Questions Feedback: The first step in applying EBP is to ask a clear, focused question. This should precede a search of the literature or the recruitment of participants. An assessment of the shortcomings of the current system is not an explicit component of the EBP process.

11. Which of the following questions best exemplifies the PICOT format for asking evidence-based questions?

A) What affect does parents alcohol use have on the alcohol use of their teenage children?

B) Among postsurgical patients, what role does meditation rather than benzodiazepines have on anxiety levels during the 48 hours following surgery?

C) Among high school students, what is the effectiveness of a sexual health campaign undertaken during the first 4 weeks of the fall semester as measured by incidence of new sexually transmitted infections?

D) In children aged 68, is the effectiveness of a descriptive pain scale superior to a numeric rating scale in the emergency room context?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Ans: B Client Needs: A-1 Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 6 mcs: 575, Asking Appropriate Questions Feedback: The correct answer includes a population (postsurgical patients), intervention (meditation), comparison (benzodiazepines), outcome (anxiety levels), and a time frame (48 hours). No other option contains each of the five elements of a PICOT question.

12. A nurse has made plans to implement the University of North Carolina (UNC) model of 5 As during the process of applying evidence-based practice (EBP) to a practice problem. What is the final step that the nurse will take in applying this model?

A) Analyze the results of the EBP process B) Advocate for others to embrace the identified change C) Adopt the changes identified in the review process D) Assess the outcomes of the new practice Ans: D Client Needs: A-1 Cognitive Level: Application Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Difficulty: Moderate Integrated Process: Nursing Process Objective: 6 mcs: 577, Assessing Outcomes of New Practices Feedback: The final step in the UNC rubric is to Assess the change using the quality improvement process in place in the institution.

13. A nurse has been asked to make a presentation to a group of high school students on the subject of sexual health. However, the nurse does not have a background in this practice area and requires rapid access to evidence-based guidelines. Which of the following strategies is most likely to provide the nurse with valid and reliable evidence in a time-efficient manner?

A) Search the Cochrane Library of Systematic Reviews B) Google search terms such as sexual health teens and sexual education C) Search Medline using PubMed and order relevant articles D) Scan the most recent issues of nursing journals that address this area of practice Ans: A Client Needs: A-1 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing Process Objective: 6 mcs: 583, Evaluating Information Retrieved Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Feedback: For some problems, a systematic review may be available from a source such as the Cochrane Library. Often this review is done by an expert panel providing excellent information on which to base decisions. This approach is more likely to produce valid and reliable results than a Google search and is more efficient than searching journal manually or ordering articles through PubMed. 14. The nurses at a university hospital have been informed that a computerized record system will be implemented over the next 12 months. The nurses should be aware that such as system presents particular challenges in the area of A) vulnerability to errors in charting and the inability to make changes.

B) patient privacy and confidentiality of records.

C) enforcing compliance with the system on the part of nurses.

D) ensuring compatibility with different computer operating systems.

Ans: B Client Needs: A-1 Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 7 mcs: 587, Patient Privacy and Computerized Records Feedback: Concerns about privacy become magnified when information is available to many people in many sites far removed from where the patient is located, a situation that exists when computerized records are used. This is usually considered a more important concern than issues of compliance, compatibility, or vulnerability to errors.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

15. A nurse is nervous about the impeding introduction of computerized nursing care records at the hospital because he does not consider himself to be technologically adept. How should this nurse best respond to this situation?

A) Take courses in advanced practice nursing to build his knowledge.

B) Explore employment opportunities in settings that use written documentation systems.

C) Advocate for a delay in the introduction of the proposed system.

D) Seek out opportunities to learn the relevant knowledge and practice the necessary skills.

Ans: D Client Needs: A-1 Cognitive Level: Application Difficulty: Easy Integrated Process: Communication and Documentation Objective: 8 mcs: 585, Technology in Healthcare Feedback: A nurse who lacks technological knowledge or skills should seek out opportunities to expand these. This is preferable to finding a job elsewhere, studying advanced practice nursing, or attempting to delay the change.

Chapter 13 Decision Support

Multiple Choice

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

1. A goal of community nursing is to provide primary prevention from disease. Which of the following nursing actions reflect this goal?

A) A nurse creates a pamphlet discussing heart-healthy foods and distributes it in the neighborhood community center.

B) A nurse starts an intravenous line on a dehydrated baby who has been brought to the emergency department.

C) A nurse performs range-of-motion exercises for a patient in traction.

D) A nurse repositions an elderly patient confined to a wheelchair to avoid the formation of pressure ulcers.

Ans: A Client Needs: B Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Nursing Process Objective: 4 mcs: 400, Primary Prevention Feedback: Primary prevention involves the efforts to prevent disease from ever occurring. Primary prevention can be aimed at stopping the cause of disease.

Generalized efforts to educate people regarding healthy diets are aimed at this type of primary prevention. Tertiary prevention focuses on preventing long-term disability and restoring functional capacity, as exemplified by repositioning an immobile patient, rehydrating a patient, or assisting with exercises.

2. A nurse decides to pursue a career in community-based nursing. Which of the following statements represents the environment in which the nurse will be working?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

A) Community-based nursing is limited to work in public clinics, schools, and industry.

B) The key to community-based settings is that the nurse is in charge.

C) The nurse serves as an educator, guide, and resource person and determines the action taken by the client.

D) Care in the community is cost-effective.

Ans: D Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Nursing Process Objective: 2 mcs: 398, Understanding Community-Based Nursing Feedback: Care in the community is cost-effective and often more acceptable to the client because it causes less disruption in life. It takes place in a wide variety of settings and involves the nurse entering into a collaborative relationship with clients.

3. The movement of a client from acute care to a long-term nursing care facility involves planning to provide continuity of care. What is the term for this type of planning?

A) Discharge planning B) Comprehensive planning C) Ongoing planning Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

D) Transition planning Ans: D Client Needs: A-1 Cognitive Level: Comprehension Difficulty: Easy Integrated Process: Nursing Process Objective: 2 mcs: 405, Transition Planning Feedback: Transitions are the movement of the patient from one care environment to another. Transition planning refers to the planning process that takes place to assure that the patients well-being is maintained throughout the time of transition.

Organizing this transition from one care setting to another is not termed discharge planning, comprehensive planning, or ongoing planning.

4. A nurse is called into work to perform triage in the aftermath of an earthquake.

Which of the following are the expected responsibilities of this nurse?

A) Set up and monitor IV lines.

B) Prepare the emergency room for multiple victims.

C) Screen victims to prioritize treatment.

D) Check available blood products and assist with transfusions.

Ans: C Client Needs: A-1 Cognitive Level: Application Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Difficulty: Moderate Integrated Process: Nursing Process Objective: 7 mcs: 410, Institution and Agency Disaster Response Feedback: Triage involves the initial screening of victims for the purpose of prioritizing treatment and making the most effective and efficient use of both human and material resources. The other noted tasks are within the scope of disaster nursing but are not triage activities.

5. A client asks a nurse for help in obtaining an alternative healthcare provider. Which of the following is an accurate fact regarding alternative care that the nurse should share with this client?

A) Most alternative healthcare practitioners do not have education-based credentials to practice their medicine.

B) Alternative providers are not usually included in the federal HIPAA legislation that mandates confidentiality in conventional healthcare settings.

C) The cost of alternative therapy is never covered by insurance carriers or healthcare plans.

D) It is easy to find accurate safety and efficacy data for alternative medicine on the Internet.

Ans: B Client Needs: A-1 Cognitive Level: Application Difficulty: Moderate

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Integrated Process: Teaching/Learning; Teaching/learning Objective: 9 mcs: 421, Investigate Service Delivery Feedback: Alternative providers are not normally included in the federal Health Insurance Portability and Accountability Act of 1996 legislation that mandates confidentiality in conventional healthcare settings. Alternative practitioners do not necessarily lack credentials. Accurate online information can be difficult to find and costs for treatment may be covered by some insurance plans.

6. There is an increasing trend for nursing care to move from the hospital setting into the community. Nurses who are to provide excellent care in a community setting should prioritize which of the following?

A) Integrating culture and family into the planning and delivery of care B) Becoming more assertive in client education and the planning of client care C) Encouraging clients to limit their interactions with physicians D) Teaching clients to replace biomedical interventions with complementary therapies Ans: A Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Nursing Process Objective: 1 mcs: 398, Understanding Community-Based Nursing Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Feedback: The move to community care heightens the importance of family-centered, culturally-competent nursing. Community nursing does not necessarily require that a nurse become more assertive with client. It would be simplistic, and in most cases inappropriate, to guide clients to replace biomedical interventions or avoid doctors.

7. In spite of the important role that hospitals play in American healthcare, there is growing importance of community-based healthcare and community-based nursing.

Which of the following statements best conveys a central aspect of the philosophy of community care?

A) The client is in charge of his or her health and healthcare in the community.

B) Nurses maximize their scope of practice in noninstitutional settings.

C) Community settings allow for the greatest number and variety of treatment options.

D) The nurse becomes the key member of the healthcare team in a community setting.

Ans: A Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Nursing Process Objective: 2 mcs: 398, Understanding Community-Based Nursing Feedback: A central premise of community healthcare is the fact that patients/clients are in charge. The move toward community care is not motivated by an increased role for nurses. There are a greater number of treatment options in hospitals than in the community, but this fact does not negate the importance of community care.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

8. Mr. Hammond is a 70-year-old man with a diagnosis of type 1 diabetes who developed a diabetic foot ulcer earlier this year. He has recently been discharged from the hospital and now requires regular wound care. Karen is a community health nurse who provides wound care for Mr. Hammond twice weekly. Which of Karens actions is most likely to empower Mr. Hammond?

A) Encourage Mr. Hammond to acknowledge his contribution to the development of his wound.

B) Provide information to Mr. Hammond that matches his expressed needs.

C) Encourage Mr. Hammond to involve members of his family in his care.

D) Delegate wound care to Mr. Hammond and reduce the frequency of her visits.

Ans: B Client Needs: C Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 3 mcs: 399, Client Empowerment Feedback: Client empowerment is often fostered by assessing and meeting a clients need for information. Encouraging an acknowledgement of the clients contribution to his or her current health state is beneficial in many circumstances, but it less likely to make the client feel empowered. Similarly, family involvement can be beneficial but does not directly foster empowerment. Empowerment does not necessarily mean that the nurse does less and the client performs his or her own care; delegation may not be appropriate.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

9. An elderly female client who resides in the community tends to defer decisions regarding her care to her eldest son. How should the community health nurse respond to the clients reluctance to make independent decisions?

A) Discuss this observation with the client and her son in an open manner and explore alternatives.

B) Organize care so that it takes place at times when the son is not present in the home.

C) Accommodate this aspect of the clients family dynamics when planning and carrying out care.

D) Teach the client assertiveness skills that she can apply in her interactions with her son.

Ans: C Client Needs: C Cognitive Level: Application Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 3 mcs: 399, Client Empowerment Feedback: The nurse should respect the clients desire to organize her care in the way that she prefers. It is not the responsibility of the nurse to reorganize or overcome this familys dynamics.

10. A client with a long-standing diagnosis of chronic obstructive pulmonary disease (COPD) has been enrolled in a disease management program. Which of the following activities will be prioritized in this program?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

A) Providing comprehensive and evidence-based care of the clients COPD B) Creating collaborative relationships between the client and the care team C) Ensuring that the client qualifies for Medicare and Medicaid D) Liaising between the client and his health maintenance organization (HMO) Ans: A Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Nursing Process Objective: 5 mcs: 401, Disease Management Feedback: Disease management focuses on providing the best evidence-based care for an individual with a specific chronic illness. This does not necessitate enrollment in an HMO, Medicare, or Medicaid. Collaborative relationships facilitate effective disease management but this is a means to the end of positive health outcomes rather than an end in itself.

11. One of the expressed goals of Healthy People 2020 is to achieve health equity and eliminate disparities. What health indicator can most accurately gauge whether this goal is being achieved?

A) Environmental quality B) Injury and violence C) Mental health Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

D) Access to healthcare services Ans: D Client Needs: B Cognitive Level: Analysis Difficulty: Easy Integrated Process: Nursing Process Objective: 6 mcs: 403, Display 11.1 Feedback: Health equity is achieved when all Americans have equitable access to health services and there a fewer disparities in health access and health outcomes.

Environmental quality, mental health and injury, and violence are important health indicators but these are less directly indicative of health equity and the elimination of disparities.

12. Nurses have the potential to positively impact the health of communities. Which of the following actions is most likely to improve the health of a community?

A) Publicizing the consequences of unhealthy lifestyles B) Advocating politically for laws and policies that foster community health C) Ensuring that nurses are practicing to the full extent of their scope of practice D) Providing nursing care to individuals who are not patients or clients Ans: B Client Needs: B Cognitive Level: Application Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 6 mcs: 404, Nurses Roles in Supporting Healthy Communities Feedback: One important role of nurses in the promotion of healthy communities is as a supporter and advocate for political measures that would improve the health of the community. Publicizing negative health outcomes is appropriate in some contexts but this is likely less effective than promoting broad change politically. It is not normally appropriate to provide nursing care for individuals who are not patients or clients.

Practicing to the full extent of ones scope of practice is not likely to impact community health in a direct way.

13. A nurse who provides care in an acute medical unit is aware of the importance of thorough discharge planning. The discharge planning process should begin A) once the patient has stabilized and is assured of positive outcomes.

B) as soon as possible after the patient is admitted.

C) once the patient has received a discharge order from his or her primary care provider.

D) 48 to 72 hours before the projected date of discharge.

Ans: B Client Needs: A-1 Cognitive Level: Application Difficulty: Easy Integrated Process: Nursing Process Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Objective: 1 mcs: 406, Discharge Planning Feedback: If possible, discharge planning should begin immediately upon admission.

14. A hospital patient has discussed with the nurse her use of visualization, biofeedback, and relaxation exercises in managing the chronic pain that results from her fibromyalgia. The nurse should recognize this patients use of what category of complementary/alternative medicine (CAM)?

A) Biologically-based practices B) Manipulative practices C) Traditional indigenous medicine D) Mind-body medicine Ans: D Client Needs: B Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing Process Objective: 8 mcs: 413, Tables 11.1 and 11.2 Feedback: Examples of mind-body medicine include relaxation exercises, hypnosis, meditation, dance, prayer, visualization, and biofeedback. Biologically-based practices focus on food and dietary supplements while indigenous medicine applies

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

the collective health knowledge of a particular culture. Manipulative practices involve the systematic application of touch.

15. A hospital patient who suffered a spinal cord injury has expressed an interest in exploring complementary/alternative therapies. The nurse should encourage the patient to begin this process by doing which of the following activities?

A) Asking practitioners of different therapies to provide lists of satisfied clients B) Asking the patients primary care provider for permission to explore nonbiomedical treatments C) Finding reliable evidence regarding the safety and effectiveness of therapies D) Determining whether the patients health insurance would cover the cost of alternative/complementary therapies Ans: C Client Needs: A-1 Cognitive Level: Application Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 10 mcs: 420, Assess Safety and Effectiveness Feedback: The first step for an individual interested in complementary/alternative therapies is to assess the safety and effectiveness of the therapy in relationship to his or her own condition. This must precede the identification of specific practitioners or making financial arrangements. Communication with the care team is important, but the patient does not need to seek permission before exploring treatment alternatives.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Chapter 14 Population Health in Action: Successful Models

MULTIPLE CHOICE 1. Which type of nursing center actively integrates service, education, and research in its model? a. Special care b. Freestanding organization c. Fee-for-service d. Academic ANS: D Academic nursing centers actively integrate service, education, and research in their model.

DIF: COG: Understanding REF: 463|465 OBJ: 1 2. Which type of nursing center operates under a service model? a. Free-standing center b. Affiliated center c. Comprehensive primary care center d. Community center ANS: C The service model includes comprehensive primary care centers, wellness centers, and special care centers.

DIF: COG: Understanding REF: 464 OBJ: 1 3. What is the focus of a special care nursing center? a. A particular demographical group or those with special care needs b. An affiliation with a school of nursing c. Providing services while maintaining a not-for-profit status d. Providing fee-for-service care with designated HMO providers ANS: A Special care centers focus on a particular demographical group or those with special needs.

Examples are those that focus on persons with HIV/AIDS, adolescent mothers, and the frail elderly.

DIF: COG: Understanding REF: 464 OBJ: 1 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

4. Which characteristic is common among all nursing centers? a. Provision of community-based culturally competent care b. Services provided by physicians and health care providers c. Focus on the biological factors contributing to the development of disease d. Fee-for-service reimbursement model ANS: A One characteristic that is common among all nursing centers is the provision of community-based culturally competent care that is accessible, acceptable, and responsive to the populations being served.

DIF: COG: Understanding REF: 463 OBJ: 1 5. What type of services will a client receive when visiting a nursing center? a. Illness-oriented care b. Direct access to nursing services c. Free services d. Physician diagnosis of health problems ANS: B A nursing center deemphasizes illness-oriented care, is reimbursed for services, and uses nurses to diagnose and treat.

DIF: COG: Applying REF: 463 OBJ: 1 6. A client would like to enroll in a smoking cessation program. Which type of nursing center would be most likely to provide this type of programming? a. Academic Nursing b. Wellness c. Comprehensive Primary Care d. Special Care ANS: B Wellness centers focus on health promotion, disease prevention, and management programs.

DIF: COG: Applying REF: 464|477 OBJ: 1

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

7. A nurse executive reports that the nursing center receives reimbursement through contracted rates. What type of reimbursement mechanism is being used? a. Fee-for-service b. Federally Qualified Health Center (FQHC) c. HMO provider d. Third-party reimbursement ANS: C HMO providers pay at contracted rates.

DIF: COG: Applying REF: 464 OBJ: 1 8. Which health promotion topic would most likely be discussed in a class held at a nursing center? a. Advanced care of the chronically ill elderly at home b. Smoking cessation and weight management techniques c. How to provide primary services d. Providing financial support for nursing students ANS: B Smoking cessation and weight management techniques focus on health promotion.

DIF: COG: Analyzing REF: 463-464 OBJ: 1 9. Individuals, families, groups, organizations, policy makers, and staff who are involved in community collaboration are known as: a. Nursing Center workers b. Policy makers c. Stakeholders d. Diversity ANS: C Stakeholders offer diversity in perspective in community collaborative efforts.

DIF: COG: Remembering REF: 467 OBJ: 2 10. How can a nursing center best be responsive to the needs of the community? a. Having staff examine the needs of the community b. Determining the services to be established by the center Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Involving the community in assessing its own needs d. Addressing the problems in the community ANS: C Nurses work in close partnership with the communities. As the community and center work together, a multilevel approach is needed. For comprehensive community health improvement, strategies are needed at organizational, community, and sociopolitical levels. Thus, it is important to involve the community in the planning of a nursing center.

DIF: COG: Applying REF: 468|472 OBJ: 2 11. A nursing center is going to be placed in a rural community. Who has the most power and influence on model development and team composition? a. The rural community b. The mayor c. The nursing executive d. The centers staff ANS: A The fundamental premise of any nursing center is that the community has the most power and influence.

DIF: COG: Applying REF: 470 OBJ: 2 12. Which factor is the most important for the nurse to consider when facilitating successful collaboration? a. Focus of the group b. Planned change that will occur c. Decisions made by executive director d. Open and frequent communication ANS: D Although the focus of the group and its planned change are important, they are not the most important factor for the nurse to consider. To accomplish anything with the group open and frequent communication is necessary.

DIF: COG: Evaluating REF: 467-468 OBJ: 2

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

13. What was the overarching concept upon which Healthy People 2020 was built? a. Establish nursing centers for the purpose of health promotion. b. Create partnerships among individuals, communities, and systems. c. Eliminate disease in lesser-developed countries. d. Further the agenda of the World Health Organization.

ANS: B Healthy People 2020 builds upon shared responsibility to improve the nations health. Powerful, productive partnerships among diverse people and groups and long-term commitments to community collaboration are needed to achieve these goals.

DIF: COG: Understanding REF: 467 OBJ: 3 14. Which level of prevention is being used when a community conducts blood lead screenings on a regular basis for children under 6 years old? a. Tertiary prevention b. Primary prevention c. Secondary prevention d. Health education ANS: C Secondary prevention often involves screening. Primary prevention involves education.

DIF: COG: Applying REF: 469 OBJ: 3 15. Which term addresses the multiple levels of intervention required for bringing about and sustaining change? a. Community collaboration b. Community assessment c. Strategic planning d. Partnership ANS: C Strategic planning addresses the multiple levels of intervention required for bringing about and sustaining change.

DIF: COG: Remembering REF: 468 OBJ: 4

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

16. A nurse develops a plan to describe the development and direction of the nursing center and identifies how the center will meet its goals. This plan is called a(n): a. Feasibility study b. Business plan c. Strategic plan d. Organizational strategies ANS: B A business plan describes the development and direction of the nursing center and how goals will be met.

DIF: COG: Applying REF: 472 OBJ: 4 17. When making a final decision about establishing a nursing center, which factor is the most important for the nurse to consider? a. Legal and regulatory considerations b. Community involvement c. Nursing interest d. Potential grant funding ANS: A Several essential areas must be explored before a final decision is made about establishing a nursing center, including legal and regulatory considerations.

DIF: COG: Applying REF: 471-472 OBJ: 4 18. When examining the strengths, limitations, and capacity of an organization and the community to support the establishment and viability of a nursing center, a nurse is completing a: a. Data collection b. Feasibility study c. Focus groups d. Community forums ANS: B A feasibility study reveals the strengths, limitations, and capacity of an organization and community to support the establishment and viability of a nursing center.

DIF: COG: Applying REF: 472 OBJ: 4 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

19. Which essential step of program evaluation is completed when a nurse executive publishes information about the effectiveness of a prenatal program? a. Focusing on design b. Engaging stakeholders c. Ensuring use and sharing lessons learned d. Gathering credible evidence ANS: D A nurse executive providing materials on the effectiveness of a prenatal program is an example of gathering credible evidence.

DIF: COG: Applying REF: 477 OBJ: 4 20. A nurse executive would like to hire a neighborhood resident who is trained in community outreach to work at the nursing center. What would be the title of this position? a. Community health worker b. Support staff member c. Clinical specialist d. Specialty care provider ANS: A Community health workers are typically neighborhood residents who are trained in community outreach, family case management, or on-site services.

DIF: COG: Applying REF: 470-471 OBJ: 4 21. In which situation would a nurse be using the Health Insurance Portability and Accountability Act (HIPAA)? a. When counseling an employee that his insurance will remain the same after changing jobs b. When supervising staff to ensure that all work has been completed c. When adhering to client confidentiality when providing care d. When an employee takes additional time off of work to care for a sick family member ANS: C HIPAA also states that staff must monitor and keep client records secure, and have mechanisms to transfer client information securely and appropriately.

DIF: COG: Analyzing REF: 474 OBJ: 4 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

22. A nurse has recently completed a research study in a nursing center. Based on the historical pattern of research in nursing centers, what would likely have been the focus of this research? a. The development and characteristics of nursing centers b. The effects of nursing models of care in nursing centers c. Client outcomes d. Managed competition in nursing centers ANS: A Typically, descriptive data has been collected about clients, types of services, the financial supports, and community relationships over the past three decades.

DIF: COG: Applying REF: 476-477 OBJ: 5 23. A nurse executive is managing a nursing center. What would be an expected responsibility of a nurse in this role? a. Managing the business operations b. Managing the data systems c. Providing patient care and referral d. Overseeing contracts and grants ANS: D The nurse executive has many leadership roles and responsibilities including responsibility for overseeing contracts and grants, annual reports, development of the advisory board, and hiring and retention of highly qualified staff.

DIF: COG: Applying REF: 470 OBJ: 5 24. What is an appropriate role for a nursing student to engage in while working in a nursing center? a. Leader b. Follower c. Advocate d. Researcher ANS: C Students most often play the role of advocate in a nursing center. Students have the opportunity to promote social justice while engaging in community service learning activities with underserved,

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

vulnerable populations. A student needs to be a leader, but with supervision. A student can collect data, but is not yet a researcher.

DIF: COG: Evaluating REF: 471 OBJ: 5 25. A nurse is presenting information to community members about the potential development of a retail care clinic in the neighborhood. What information would the nurse include in this presentation? a. These clinics are typically staffed by physicians. b. These clinics are usually located in community centers. c. These clinics focus on providing information related to health promotion. d. These clinics are many times owned by for-profit organizations.

ANS: D Retail care clinics are typically staffed by nurse practitioners, located in a high volume retail business, and provide a limited scope of care including immunizations, routine school physicals, and care for common acute problems. The majority of retail clinics are owned by for-profit organizations and its management does not consider the clinics as nurse-managed health centers.

DIF: COG: Applying REF: 477 OBJ: 6 26. A nursing faculty member is discussing the importance of joining a professional organization as a registered nurse with a group of undergraduate students. Which statement would be most appropriate for the faculty member to include in this discussion? a. All nurses should be members of the American Nurses Association. b. Membership in a professional organization helps nurses organize around critical health issues. c. Dues for professional organizations are expensive, so it is important to set aside money to pay these dues. d. Membership in a professional organization will foster change in legislation.

ANS: B Membership in a professional organization helps nurses to organize around one or more critical health threats and strategize about what interventions work locally, regionally, and nationally.

Membership in organizations should be based on interest, clinical and academic preparation, and employment. Dues for professional organizations vary, but most are not extremely expensive. One

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

of the benefits of membership in a professional organization is that legislation can be influenced, however this in only one of the benefits of belonging to a professional organization.

DIF: COG: Analyzing REF: 478 OBJ: 6 MULTIPLE RESPONSE 1. Which would be an appropriate source for a nurse to look for financial support when developing a nursing center? Select all that apply. a. Grant funding b. Charitable organizations c. Private pledges d. Foundations ANS: A, B, C, D Support for nursing centers can come from grants, charitable organizations, private pledges, and foundations.

DIF: COG: Applying REF: 473 OBJ: 1 2. A nurse is performing the role of researcher in a nurse center. Which type of data would most likely be collected by a nurse in this setting? Select all that apply. a. Client use of services b. Trends in community characteristics c. Staff compliance with HIPAA d. Client satisfaction ANS: A, B, D Trends in health care services, client responses, and changes in community characteristics must be documented and summarized periodically. Outcome measurements such as client use of on-site services, childhood and adult immunization patterns, pregnancy outcomes, emergency department and hospital use, and other health indexes including client satisfaction and quality-of-life measures should also be collected. Staff compliance with HIPAA is a legal responsibility of staff .

Chapter 15 The Legal Implications of Reform

MULTIPLE CHOICE Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

1. Which statement about Florence Nightingales ideas about ethics is correct? a. Nursing is a call to service, and the moral character of persons entering nursing is important. b. Ethical principles are based on the values of the individual nurse. c. Society will dictate the ethical principles to which nurses must adhere. d. Ethics are very important in times of war, such as in the Crimean War, when she set up public health centers.

ANS: A Florence Nightingale saw nursing as a call to service and viewed the moral character of persons entering nursing as important.

DIF: COG: Understanding REF: 126 OBJ: 1 2. When nurses apply the knowledge and processes of ethics to the examination of ethical problems in health care, they are using: a. Values b. Morality c. Ethics d. Bioethics ANS: D Bioethics applies the knowledge and processes of ethics to the examination of ethical problems in health care.

DIF: COG: Applying REF: 127 OBJ: 1 3. A nurse in the 1960s would have referred to which code of ethics to guide ethical decision making? a. Nightingale Pledge b. Code for Professional Nurses c. Code of Ethics for Nurses with Interpretive Statements d. International Council of Nurses (ICN) Code of Ethics for Nurses ANS: B Florence Nightingale lived in the 1800s. The Code for Professional Nurses was adopted in 1950, the Code of Ethics for Nurses with Interpretive Statements was adopted in 2001, and the International Council of Nurses (ICN) Code of Ethics for Nurses was adopted in 2000.

DIF: COG: Applying REF: 127 OBJ: 1 4. An orderly process that considers ethical principles, client values, and professional obligations is: a. Accountability b. Ethical decision making c. Moral principles d. Code for Nursing Practice ANS: B Ethical decision making is defined as an orderly process that considers ethical principles, client values, and professional obligations.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: COG: Understanding REF: 127 OBJ: 2 5. The growing multiculturalism of American society can contribute to ethnicity conflicts when: a. Cultural standards are congruent with professional standards. b. Cultural traditions within an ethnic group align with those of the community. c. Ethnic groups overburden the health care system. d. The greater communitys values are jeopardized by specific ethnic values.

ANS: D Callahan offered perspectives on judging diversity and suggests a thoughtful tolerance and some degree of moral persuasion (not coercion) for ethnic groups to alter values so that they are more in keeping with what is normative in American culture.

DIF: COG: Understanding REF: 128 OBJ: 2 6. There are two medically indigent clients in the clinic who have come to get their monthly supply of free insulin. There is only enough for one client. Which action does the nurse take first? a. Identify all options. b. Make a decision. c. Gather additional information. d. Act and assess decisions made.

ANS: C One must have all information before looking at options and making a decision.

DIF: COG: Applying REF: 128 OBJ: 2 7. An example of an ethical dilemma is: a. Whether or not to set up a community health center in a rural area b. Allocating resources in a natural disaster c. Deciding to withdraw care on a hospice patient d. Applying the principles of Florence Nightingale in Bangladesh ANS: B When resources are scarce, a dilemma may exist as to how to allocate them.

DIF: COG: Applying REF: 127 OBJ: 2 8. The steps of the ethical decision making process are similar to the steps of: a. Healthy People 2010 b. Deontology c. The nursing process d. Advocacy ANS: C The nursing process involves the same basic steps: assessment, diagnosis, planning, implementation, and evaluation.

DIF: COG: Evaluating REF: 128 OBJ: 2

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

9. Which ethical principle requires doing no harm? a. Respect for autonomy b. Non-maleficence c. Beneficence d. Distributive justice ANS: B Non-maleficence refers to doing no harm.

DIF: COG: Remembering REF: 129 OBJ: 3 10. Which statement fits the Liberal Democratic Theory of John Rawls? a. Rejection of any idea that societies, states, or collectives of any form can be the bearers of rights or can owe duties. b. Inequalities result from birth, natural endowment, and historic circumstances. c. Everyone has a right to private property. d. Government should be limited.

ANS: B Rawls acknowledges that inequities are inevitable in society, but he tries to justify them by establishing a system in which everyone benefits, especially the least advantaged. This is an attempt to address the inequalities that result from birth, natural endowments, and historic circumstances. The other choices relate to libertarianism.

DIF: COG: Understanding REF: 130-131 OBJ: 3 11. According to Leininger and Watson, the moral ideal of nursing is: a. Caring b. Advocacy c. Responsibility d. Accountability ANS: A This conceptualization occurred as a response to the technological advances in health care science and the desire of nurses to differentiate nursing practice from medical practice.

DIF: COG: Understanding REF: 131 OBJ: 3 12. Which statement about feminist ethics is correct? a. Feminists include only women in their worldview. b. Persons who ascribe to feminist ethics are passive and wish to pursue their ideals through the legislative process. c. Feminists believe that men should not be nurses. d. Womens thinking and moral experiences are important and should be taken into account.

ANS: D Feminist theory ascribes to the idea that womens thinking and moral experiences are important and should be considered.

DIF: COG: Understanding REF: 132 OBJ: 3

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

13. Examples of the benefits of distributive justice are: a. Basic needs, material and social goods, liberties, rights, and entitlements b. Taxes, military service, location of incinerators or power plants c. Entitlement to equal rights and equal treatment d. The right to private property and personal assets ANS: A Justice requires that the distribution of benefits and burdens on a society be fair or equal. the third option refers to egalitarianism, and the last option refers to libertarianism. Taxes, military service, and location of incinerators or power plants are not benefits associated with justice.

DIF: COG: Applying REF: 130 OBJ: 3 14. A nurse believes everyone is entitled to equal rights and equal treatment in society when applying: a. Distributive or social justice b. Egalitarianism c. Libertarian view of justice d. Communitarianism ANS: B Egalitarianism is defined as the view that everyone is entitled to equal rights and equal treatment in society.

DIF: COG: Applying REF: 130 OBJ: 3 15. When using the principles of virtue ethics in decision making, a nurse would: a. Provide efficient and effective nursing care. b. Identify the meaningful facts in the situation. c. Seek ethical community support to enhance character development. d. Plan ways to restructure the social practices that oppress women.

ANS: C According to Aristotle, virtues are acquired and include interest in the concept of the good, including benevolence, compassion, trustworthiness, and integrity. One part of the process is seeking ethical community support to enhance character development.

DIF: COG: Analyzing REF: 131 OBJ: 3 16. A nurse applies the ethical principle of non-maleficence when: a. Administering medications using the five rights b. Allowing clients to be active participants in their care c. Providing patient privacy when delivering care d. Referring a client to a physical therapist ANS: A Non-maleficence requires that one do no harm. It requires that health care professionals act according to the standards of due care, always seeking to produce the least amount of harm possible.

DIF: COG: Analyzing REF: 129|131 OBJ: 3 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

17. A nurse providing care using the idea of servicing citizens, not customers is applying the: a. Ethical tenets of policy development b. Basic concepts of the feminist theory c. Underlying premise of virtue ethics d. Components of distributive justice ANS: A There are three tenets of both policy and ethics. The approach is based on the voice of the community as the foundation on which policy is developed.

DIF: COG: Applying REF: 133 OBJ: 4 18. Public health administrators in a community provide a health department to serve an indigent population of immigrants providing translators on certain days of the week. This is an example of: a. Policy b. Quality c. Assurance d. Libertarian philosophy ANS: C Assurance refers to the role of public health in making sure that essential communityoriented health services are available, which may include providing essential personal health services for those who would otherwise not receive them.

DIF: COG: Applying REF: 133-134 OBJ: 4 19. Which core function supports the belief that all Americans should receive basic health care services? a. Assessment b. Assurance c. Policy development d. Advocacy ANS: B Assurance purports that all persons should receive essential personal health services.

DIF: COG: Applying REF: 133-134 OBJ: 4 20. Which statement is discussed in the Code of Ethics for Nurses with Interpretive Statements? a. The profession of nursing is responsible for making political statements and supporting nurse-friendly candidates for office. b. The nurses primary focus is on acute bedside nursing, followed by community health care to promote seamless care. c. The nurse owes duty primarily to the physician to strive to protect health, safety, and the rights of the patient. d. The profession of nursing is responsible for articulating nursing values, for maintaining the integrity of the profession, and for shaping social policy.

ANS: D Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Provision 9 of the Code of Ethics for Nurses with Interpretive Statements discusses the need for the nursing profession to address national and global health concerns as well as be involved with shaping policies through political action.

DIF: COG: Understanding REF: 134 OBJ: 5 21. Why would a nurse refer to the Code of Ethics for Nurses or the Public Health Code of Ethics? a. To provide answers for ethical dilemmas b. To guide professional practice related to ethics c. To increase moral leadership in ethics d. To find a framework for ethical decision making ANS: B These codes provide general ethical principles and guide personnel in thinking about the underlying ethics of the profession.

DIF: COG: Applying REF: 135 OBJ: 5 22. Which nursing action demonstrates advocacy? a. Offering a smoking cessation program b. Screening for hypertension c. Lobbying for health care reform d. Conducting home visits ANS: C Nurses should participate in implementing new directions for health care and help envision these new directions. Nurses can be an important voice in advocating for access to consistent, effective, efficient health care for all.

DIF: COG: Applying REF: 137-138 OBJ: 6 23. The community leaders in a lesser-developed country decide not to tell the citizens of a small village about a chemical spill at a major industrial facility that could produce harmful effects. Which principle are they violating? a. Policy b. Advocacy c. Caring d. Virtue ANS: B Advocacy requires that the community be properly informed, and this was violated in the above scenario.

DIF: COG: Evaluating REF: 137 OBJ: 6 MULTIPLE RESPONSE 1. The ethical tenets that underlie the core function of assessment are (select all that apply): a. Competency: the persons assigned to develop community knowledge are prepared to collect data on groups and populations Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

b. Moral character: the persons selected to develop, assess, and disseminate community knowledge possess integrity c. Service to others over self: a necessary condition of what is good or right policy d. Do no harm: disseminating appropriate information about groups and populations is morally necessary and sufficient ANS: A, B, D Service to others over self is an ethical tenet of policy development. Competency, moral character, and do no harm are the ethical tenets of assessment.

DIF: COG: Understanding REF: 133 OBJ: 4 2. How can a community health nurse apply the Ethical Principles for Effective Advocacy?

Select all that apply. a. Act in the health care providers best interest. b. Keep the client (group, community) properly informed. c. Maintain client confidentiality. d. Carry out instructions with diligence and competence.

ANS: B Keep the client (group, community) properly informed, maintain client confidentiality, and carry out instructions with diligence and competence are ethical principles for effective advocacy.

Chapter 16 Making the Case for Population Health Management: The Business Value of a Healthy Workforce

Multiple Choice 1. What is the basic tenet of shared governance?

A) It allows nursing staff and management to be involved in decision-making.

B) It establishes the control of the institution over the actions of the nursing staff.

C) It allows the administrative decision area to be controlled by management.

D) It supports the traditional role of the supervisor as one who hires, evaluates, promotes, and fires.

Ans: A Client Needs: A-1

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing Process Objective: 3 mcs: 166, Shared Governance Model Feedback: Shared governance may be viewed as a system in which nurses have organizational autonomy as reflected in control over their practice, and have input into decision relating to patient care. It is a professional practice model in which both the nursing staff and the nursing management are involved in decision-making, as opposed to the administrative decision area being controlled by management. In this way, it is an alternative to traditional supervision models and hierarchies.

2. A nurse is assigned for the care of each patient from the time the patient is admitted to the hospital until that patients discharge. What system of care delivery is most likely in place?

A) Functional care B) Primary care C) Modular care D) Team care Ans: B Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Integrated Process: Nursing Process Objective: 5 mcs: 171, Primary Care Nursing Feedback: In a pattern of primary care, one nurse was assigned the responsibility for the care of each patient from patient admission until that patients discharge. The primary nurse was responsible for initiating and updating the nursing care plan, patient teaching, and discharge planning. An associate nurse worked with this same patient on other shifts and on the primary nurses day off, carrying out the plan of care developed by the primary nurse.

3. Nurses working in a hospital initiate a negotiating session in which they offer to take a pay cut to allow management to provide job security and to hire more nurses to alleviate understaffing. What is the term for this type of session?

A) Interest-based bargaining B) Collective action bargaining C) Concession bargaining D) Good faith bargaining Ans: C Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 6

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

mcs: 177, Bargaining and Negotiating Feedback: Concession bargaining is a process in which there is an explicit exchange of reduced labor costs for improvements in job security. This specific tradeoff is not a characteristic of interest-based bargaining, collective action bargaining, or good faith bargaining.

4. Nurses decide to go on strike to try to force improvement in the quality of patient care in their facility. Once the strike is resolved, what are their options for being rehired by the facility under the reinstatement privilege that is in effect in their contract?

A) They will be rehired after the strike whether or not it is decided that the strike was lawful.

B) They will be rehired after the strike as positions become available provided they have not engaged in unfair labor practices.

C) They will be rehired to replace nurses hired during the strike who were hired to replace them.

D) They will be rehired at their former job as soon as the strike is resolved.

Ans: B Client Needs: A-1 Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 7 mcs: 181, Reinstatement Privilege

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Feedback: A reinstatement privilege is a guarantee offered to striking employees that they will be rehired after the strike as positions become available, provided that they have not engaged in any unfair labor practices during the strike, and provided that the strike itself is lawful.

5. Which of the following statements accurately reflects the general use of the grievance process by nurses?

A) Grievances usually are related to interpretations of a contract or to policies and procedures.

B) Although either the management or an employee can file grievances, in most instances it is management that initiates the case.

C) A grievance involves informal talk between the management and the employee until the issue is resolved.

D) Employees may have grievances about the contract negotiation process itself.

Ans: A Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 9 mcs: 173, Grievance Process Feedback: A grievance is a circumstance or action believed to be in violation of a contract (or of policies of an institution if a contract is not in place). Grievances usually are related to interpretations of a contract or policies and procedures and they

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

are usually initiated by employees. Although resolution may begin with an informal talk, this proceeds to a formal process if resolution is not achieved.

6. As part of the development of a new inner-city clinic, a group of nurses and members of other health disciplines have drafted a mission statement for the clinic.

This statement will most likely specify A) the priorities for the health of the identified population.

B) the main goals and functions that the organizers envision for the clinic.

C) the philosophies and beliefs that underlie the existence and functioning of the clinic.

D) the health outcomes that the organizers see as currently lacking in the community.

Ans: B Client Needs: A-1 Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 1 mcs: 156, Mission Statement and Philosophy Feedback: The purpose of an organization is often expressed in the form of a mission statement, which outlines what the organization plans to accomplish, including its goals and function. This may or may not identify the philosophy of the organization, specific health outcomes, or priorities for the health of residents.

7. Which of the following conditions must be met in order to ensure the efficient and effective operation of a healthcare organization?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

A) Span of control must be kept as narrow as possible.

B) The chain of command must be explicitly and clearly delineated.

C) The formal organizational structure must closely mimic the informal relationships that exist (the grapevine).

D) Registered nurses must occupy positions in employee, middle management, and executive roles.

Ans: B Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 2 mcs: 162, Chain of Command Feedback: The effective operation of a healthcare organization requires a detailed and clear chain of command. A narrow span of control is not always preferable to broader spans of control and formal structure does not necessarily have to replicate informal structures, though each should be acknowledged and recognized. It is certainly possible, and potentially beneficial, for nurses to occupy a variety of roles in the organizational hierarchy but this is not a precondition for successful organization.

8. A nurse has concerns about some of the practices on the hospital unit and met with the unit manager to explain these concerns. After the meeting, the nurse felt misunderstood and rebuffed by the manager. How should the nurse determine who in the organization to meet with next?

A) Consult with the hospital bureaucracy Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

B) Enlist the help of a union representative C) Ask colleagues about who is most influential in the organization D) Refer to the hospitals chain of command Ans: D Client Needs: A-1 Cognitive Level: Application Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 2 mcs: 162, Chain of Command Feedback: The chain of command represents the path of authority and accountability from individuals at the top of the organization to those at the base of the organization.

The nurse should most likely meet with the person who is above the manager in the chain of command. The hospital bureaucracy, the union, and the persons who are informally influential are less likely to help the nurse identify the appropriate person with whom to meet.

9. There is general agreement on a postsurgical unit that the admission assessment template that is used is lengthy, unwieldy, and includes many parameters that are not relevant to the care of the patient population on the unit. Which of following aspects of amending the assessment template best exemplifies the concept of shared governance?

A) Managers and nurses cooperatively make a change and share accountability for the outcomes.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

B) The unit manager consults with nurses and members of other disciplines prior to changing the document.

C) The decision-making process reflects the chain of command that exists at the hospital.

D) Nurses collectively present the change in practice to the manager, who is then accountable for the outcomes of the change.

Ans: A Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 3 mcs: 166, Shared Governance Model Feedback: Shared governance encompasses a collaborative model of decision-making and shared accountability for the outcomes of these decisions. It does not involve nurses announcing an independent change to management or management being solely accountable for the decisions of others. Shared governance is not necessarily linked to the chain of command in an organization.

10. The staff, the administrators, and the executives of a large, urban hospital are currently celebrating the fact that the hospital has recently been granted Magnet Recognition by the American Nurses Credentialing Center (ANCC). This designation suggests that the hospital A) pays nurses higher wages than the national median.

B) has lower staff turnover than most hospitals.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

C) integrates the principles of evidence-based practice into care.

D) has a committed and responsive bureaucracy.

Ans: B Client Needs: A-1 Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 4 mcs: 168, Magnet Hospitals Feedback: While all of the given options may underlie or contribute to a hospitals Magnet designation, low staff turnover is one of the key attributes of such a hospital.

Magnet Recognition is not explicitly based on high wages, effective bureaucracy, or evidence-based practice.

11. A nurse who has a baccalaureate degree in nursing has begun working at a hospital in which the principles of primary care nursing are used to organize care. Which of the following actions should the nurse anticipate?

A) Performing the most complex nursing tasks on the unit for all of the patients B) Taking action to ensure that neither too much nor too little care is provided for each patient C) Directing a team of practical (vocational) nurses and unlicensed care providers D) Being responsible for specific patients from the time of their admission to the time of discharge

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Ans: D Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Nursing Process Objective: 5 mcs: 171, Primary Care Nursing Feedback: In a pattern of primary care, one nurse is assigned the responsibility for the care of each patient from patient admission until that patients discharge. Patient care is not fragmented according to complexity, as in functional nursing. Collaboration of a group of RNs, PNs. and UAPs is characteristic of team nursing. Tight control of the amount of care a patient receives is a key characteristic of case management.

12. Collective bargaining has a long history in nursing. Which of the following milestones in the history of collective bargaining resulted from the 1974 amendment of the Taft-Hartley Act (Labor Management Relations Act)?

A) Nurses were granted the right to form unions and engage in collective bargaining.

B) The maximum length of a work week and the minimum nursing wage were established.

C) Nursing was formally recognized as a professional occupation.

D) Nonprofit hospitals were obliged to bargain with nurses around wages and working conditions.

Ans: D Client Needs: A-1 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Cognitive Level: Knowledge Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 8 mcs: 176, Table 5.1 Feedback: Under the 1974 amendment of the Taft-Hartley Act, nonprofit hospitals were required to bargain with nurses for better salaries and working conditions. The formation of unions and the recognition of nursing as a profession predated this act.

The 1974 amendment did not specify wages and hours of work.

13. Contracts are essential to the maintenance of high quality care in healthcare institutions. As well, they are necessary to protect the interests of nurses who provide this care. Which of the following issues is most likely to be addressed in a contract for nurses?

A) The process that should be followed when distributing overtime work B) The obligation of nurses to participate in nursing research C) The details of the organizational structure of a hospital D) The relationships among nurses, physicians and members of other health disciplines Ans: A Client Needs: A-1 Cognitive Level: Analysis Difficulty: Moderate

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Integrated Process: Communication and Documentation Objective: 9 mcs: 182, Issues Negotiated in Contracts Feedback: Contracts commonly address such issues as overtime work. Relationships between care providers, participation in research, and organizational structure of a hospital are issues that are normally outside the purview of a nursing contract.

14. Despite the long history of collective bargaining in the nursing profession, many nurses have concerns regarding membership in a collective bargaining unit. Which of the following statements by nurses best conveys one of the primary concerns that are prevalent among nurses?

A) I think that physicians recognize our value and sufficiently advocate for our best interests.

B) I think that a collaborative model results in higher wages than a confrontational model such as collective bargaining.

C) Im not sure that joining a union is congruent with the philosophy of the nursing profession.

D) In the end, I think that the costs of being in bargaining unit outweigh the potential benefits.

Ans: C Client Needs: A-1 Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Communication and Documentation

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Objective: 10 mcs: 184, Issues Related to Collective Bargaining and Nursing Feedback: Among the major issues of collective bargaining that affect the nursing profession is the fact that some nurses see collective bargaining as unprofessional.

The other most common concerns involve the matter of which bargaining group will represent nursing when nurses participate in collective bargaining, the question of whether to join a union when one exists, and the issue of the role of the supervisor.

15. Nurses, as well as individuals outside the profession, have sometimes expressed concern around the involvement of state nurses associations in collective bargaining.

What factor most often underlies such concerns?

A) State nurses associations lack the legal authority to engage in bargaining though this has been their traditional role.

B) State nurses associations tend to be unaware of many of the issues that nurses face when providing care.

C) It can be difficult to reconcile the professional obligations of nurses associations with their role in bargaining.

D) Few practicing nurses participate in the activities of state nurses associations.

Ans: C Client Needs: A-1 Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 11

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

mcs: 185, Activity of the ANA Feedback: Some individuals contend that it is not realistic for state nurses associations to work with the professionalism aspect of nursing as well as with the issues of wages, benefits, and working conditions. State nurses associations do not lack the legal right to bargain and participation of nurses in the operations of state nurses associations does not directly affect their right or ability to bargain.

Chapter 17 Marketing and Communication

MULTIPLE CHOICE 1. Which of the following best describes Peplaus theory on therapeutic use of self? a. Putting patients needs ahead of your own b. Providing excellent clinical skills to improve patients health status c. Using excellent interpersonal skills to help patients improve their health

status d. Self-protection through avoidance of a relationship with the patient ANS: C Feedback A Putting patients needs ahead of your own is not the best answer because

although it is true that the patients needs, not the nurses, are met during the therapeutic relationship, nurses should not necessarily put all patient needs ahead of their own.

B The theory focuses on therapeutic communication, not clinical skills.

C Peplaus theory described using ones personality and communication

skills to help patients improve their health status as therapeutic use of self.

D The focus is the patient, not the nurse.

DIF: Cognitive Level: Comprehension REF: p. 170 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

2. Therapeutic use of self involves a. forming a relationship based on the nurses knowledge, attitudes, and

skills to communicate effectively. b. providing a safe environment based on the use of environmental

manipulation and verbal limit setting. c. evaluation of nurse-patient interactions and the creation of social

alliances. d. determining whether it is necessary to listen to the patient and provide

feedback.

ANS: A Feedback A Therapeutic use of self as defined by Peplau included using

communication skills to help patients.

B Therapeutic use of self does not involve the manipulation of the

environment.

C Therapeutic use of self does not involve the creation of social alliances.

D Therapeutic use of self involves listening and providing feedback to the

patient.

DIF: Cognitive Level: Comprehension REF: p. 170 3. What is the most important information the nurse should share with the patient

during the orientation phase? a. Name, credentials, extent of responsibility b. Plan for the day, times the nurse will be unavailable, how to contact the

nurse c. Nurses name, physicians name, possible discharge date d. Plan for discharge, teaching needs, goals for the day ANS: A Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Feedback A During the orientation phase the nurse shares his or her name,

credentials, and extent of responsibilities.

B Sharing information about the plan for the day, times the nurse will be

unavailable and how to contact the nurse is not primary during the orientation phase.

C Determining a discharge date would be the responsibility of the entire

treatment team.

D The nurse does not share the plan for discharge and teaching needs

during the orientation phase.

DIF: Cognitive Level: Knowledge REF: p. 170 4. One of the most important outcomes of the orientation phase of the nurse-patient

relationship is the development of mutual a. communication. b. understanding. c. acceptance. d. trust.

ANS: D Feedback A The entire relationship requires excellent communication, not just the

orientation phase.

B All phases of the therapeutic relationship require understanding.

C All phases require nonjudgmental acceptance.

D The purpose of the orientation phase is to establish trust.

DIF: Cognitive Level: Comprehension REF: p. 170 5. Which behaviors help patients develop trust in the nurse?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Answering questions with authority b. Sharing personal information to indicate openness c. Conveying acceptance of the patient and a nonjudgmental attitude d. Meeting with the patient spontaneously because that indicates caring ANS: C Feedback A Although answering questions as fully as possible and admitting the

limits of knowledge facilitates trust, answering questions with authority implying that this is the entire answer does not help develop trust.

B The sharing of personal information does not help develop trust.

C Accepting the patients thoughts and feelings without judgment helps

develop trust in the nurse.

D Meeting at designated times helps the patient develop trust that the

nurse will follow through with what is promised.

DIF: Cognitive Level: Comprehension REF: p. 170 6. The nurse says to a newly diagnosed diabetic patient, I will be working with you

during your 3-day stay to help you practice insulin injections and to review your new diet. Im wondering if we could find a time of day to begin the teaching sessions that is good for us. This conversation would occur in which phase of the nurse-patient relationship? a. Acquaintance phase b. Orientation phase c. Working phase d. Termination phase ANS: B Feedback Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

A The phases of the nurse-patient relationship do not include an

acquaintance phase.

B During the orientation phase the time frame of the relationship is

established, the problems to be worked on are identified, and a time to meet is established.

C The working phase is when the nurse and patient address the problems.

D The termination phase is when the relationship is ending.

DIF: Cognitive Level: Application REF: p. 170 7. Which of the following suggests that a successful contract has been established

between the nurse and patient in the orientation phase of the nurse-patient relationship? a. Patient has agreed to learn to change his colostomy bag. b. Patient ambulates in the hall without assistance. c. Patient allows the nurse to inject his daily insulin. d. Patient asks the charge nurse to verify that the staff nurses teaching is

correct.

ANS: A Feedback A The successful completion of a planned intervention signifies the

successful establishment of the therapeutic relationship.

B The patient is acting independently of the nurses instructions.

C The patient is not moving toward goals of independence.

D Trust has not been established.

DIF: Cognitive Level: Application REF: p. 171 8. A newly diagnosed diabetic patient states I have very definite likes and dislikes

when it comes to food. Am I going to have to eat only certain foods, or will I have Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

some choice? The nurse responds, Why dont you give me a list of your likes and dislikes? I will consult with the dietitian about how to include your preferences and still come up with a good diet for you. What phase of the nurse-patient relationship is this? a. Relationship phase b. Orientation phase c. Working phase d. Termination phase ANS: C Feedback A The phases of the nurse-patient relationship do not include a

relationship phase.

B The orientation phase is when the relationship is established, the

problems to be worked on are identified, and a time to meet is established.

C The working phase is when the nurse and patient address the problems

that have been identified.

D The termination phase is when the relationship is ending.

DIF: Cognitive Level: Comprehension REF: p. 171 9. A patient demonstrates obvious regression in ability to perform self-care during the

working phase. Which response by the nurse is most appropriate? a. Frustration because the patient does not appear to be motivated to

achieve goals b. Persistence in demonstrating the importance of achieving goals c. Patience and understanding because regression is a defense mechanism d. Ignoring it because the nurse realizes the patient is exhibiting childlike

behavior Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: C Feedback A The nurse needs to show patience and maturity, not frustration.

B Regression may be a necessary defense mechanism against stress, and

the nurse needs patience during this time.

C Patience and understanding are necessary because the patients progress

toward goal achievement may not be smooth. Regression is a defense mechanism that may precede positive outcomes.

D Understanding of regression is needed during this time.

DIF: Cognitive Level: Analysis REF: p. 171 10. When should the preparation for the termination phase of the nurse-patient

relationship begin? a. In the orientation phase b. During the working phase c. As part of the termination phase d. Right before termination ANS: A Feedback A During the orientation phase, the nurse gives the patient an estimated

time frame for their relationship. This begins the preparation for termination.

B Preparation for termination of the nurse-patient relationship begins in

the orientation phase.

C Preparation for termination of the nurse-patient relationship begins in

the orientation phase.

D Preparation for termination of the nurse-patient relationship begins in

the orientation phase.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: Cognitive Level: Knowledge REF: p. 171 11. The nurse and patient may experience sadness during the termination phase. How

can the nurse help the patient be successful in the termination phase of the nursepatient relationship? a. Providing personal contact information so the patient can contact the

nurse if needed b. Visiting the patient at home during off-duty time to help the transition to

self-care c. Emphasizing the achievements the patient has made, including the

ability for self-care d. Exchanging goodbye gifts as a sign that the relationship is terminated ANS: C Feedback A Nurses should not maintain personal communication with patients after

discharge.

B The nurse respects professional boundaries.

C Emphasizing the patients achievement of goals and the reasons he or

she does not need the nurse anymore is effective in the termination process.

D Nurses should not exchange gifts with patients but should instead

respect professional boundaries.

DIF: Cognitive Level: Comprehension REF: p. 171 12. A patient is being discharged from the hospital. Which statement by the nurse is

appropriate for the termination phase of the nurse-patient relationship? a. You must be happy to be going home. Here are the written diet and

medication instructions.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

b. It has been wonderful getting to know you. The best of luck when you

get home. c. During the past 3 days, you have learned how to inject insulin and how

to make appropriate food choices. Remember that you have the unit telephone number if you have any questions. d. You have done well learning a lot of new material and should be able to

do well at home.

ANS: C Feedback A This response does not summarize what has occurred, which is an

important part of the termination phase.

B This response does not include a summary of the progress the patient

has made, which is an important part of the termination phase.

C Summarizing the gains the patient has made is important during the

termination phase.

D This response gives false reassurance about success at home.

DIF: Cognitive Level: Application REF: p. 171 13. Which of the following is an effective way to maintain safe professional

boundaries? a. Never accepting small gifts from patients b. Finding ways to satisfy your needs through personal relationships

outside of nursing c. Avoiding caring for patients who ask personal questions about you d. Sharing your personal stories so that patients will feel understood and

trusting ANS: B Feedback Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

A There are many other possibilities for violating professional boundaries;

gifts are only one small way and, on occasions when the gift is not valuable and can be shared with the entire staff, may be accepted.

B Respecting professional boundaries means that the nurse recognizes the

vulnerability of the patient and the power that comes from the nurses personal knowledge about the patient. Finding ways to satisfy personal needs outside of the professional relationship will prevent the nurse from becoming inappropriately involved with the patient.

C Avoidance is not a helpful response to any nurse-patient problem.

D The nurse should stay focused on the patient.

DIF: Cognitive Level: Comprehension REF: p. 172 14. Which of the following is most important in order for a new staff nurse to

communicate therapeutically with patients? a. Focusing interactions on educating patients about their treatments b. Becoming aware of own feelings about illness and death c. Sharing information about the intimate details of ones own life d. Presenting himself or herself as a knowledgeable and experienced

clinician ANS: B Feedback A Although education is important for patients, this does not help the

nurse understand his or her feeling and responses.

B Reflection will allow the nurse to develop self-awareness, which will

help him or her become a better advocate for the patients.

C Sharing intimate personal information is not therapeutic.

D As a new nurse, knowledge and experience may be limited; portraying

more knowledge and experience than one has is deceitful.

DIF: Cognitive Level: Application REF: p. 175 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

15. During report, a nurse complains about a 3-year-old boy, saying He sure knows

when to pour on the tears. Theres nothing wrong until he sees you; then the tears start, but they stop as soon as you leave or his mother comes. Hes just spoiled because they have a nanny at home who waits on him hand and foot. This is an example of a. lack of understanding of child development. b. frustration that the mother is not present. c. assessment of the childs behavior. d. stereotyping because the child has a nanny.

ANS: D Feedback A The response does not reflect lack of knowledge about child

development, assessment of the behavior, or a response to the mothers not being present.

B The response does not reflect lack of knowledge about child

development, assessment of the behavior, or a response to the mothers not being present.

C The response does not reflect lack of knowledge about child

development, assessment of the behavior, or a response to the mothers not being present.

D Stereotypes are simplistic and illogical images used to describe groups

of people.

DIF: Cognitive Level: Analysis REF: p. 174 16. A nurse comments in private about a patient: That lady with six kids is pregnant

again! It makes me sick to see these people on welfare taking away from our tax dollars. I dont know how she can continue to do this. The best response by a nurse peer is to a. ignore the biased statements. b. accept the comments as self-disclosure.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. offer neutral responses. d. convey acceptance of the patient.

ANS: D Feedback A To ignore the statements will not help this nurse become aware of

stereotypes.

B These statements do not qualify as self-disclosure.

C Offering neutral responses will not help the nurse become aware of

stereotyping.

D Acceptance conveys neither approval nor disapproval of personal

beliefs. Nonjudgmental acceptance means that the nurse acknowledges that all people have rights to be different and to express their differences. Nurses should convey acceptance of people as they are even if they disagree with specific beliefs and/or practices.

DIF: Cognitive Level: Application REF: p. 175 17. Which of the following best illustrates nonjudgmental acceptance by the nurse? a. Using professional influence to change a patients morality to be more in

keeping with societal norms b. Changing your assignment if you discover that you have negative

feelings toward your patients lifestyle c. Demonstrating caring behavior in spite of negative feelings d. Avoiding all negative feelings about the patient ANS: C Feedback A The nurse should not attempt to change a patients belief system or

morality.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

B We cannot control our feelings but need to be able to control our

behaviors.

C Acceptance indicates neither approval nor disapproval of patients

beliefs, behaviors, or lifestyles.

D Prejudices are strong, and we may be unaware of them. It is impossible

to control all negative feelings, but it is professional to acknowledge them and continue to provide safe and effective care.

DIF: Cognitive Level: Analysis REF: p. 175 18. Using Hagerty and Patuskys theory of human relatedness (2003), the nurse-patient

relationship has been reconceptualized by approaching a. each patient contact as one step in a lengthy relationship-building

process. b. patients with a sense of the patients autonomy, choice, and participation. c. the relationship as one in which the nurse has the power. d. the nurse-patient contact as an opportunity to streamline caregiving.

ANS: B Feedback A Each contact should be approached as an opportunity for connection and

goal achievement and not a lengthy process.

B The relationship between the nurse and the patient is on a more

equitable basis than the traditional nurse-patient relationship.

C The relationship should be equitable.

D The reconceptualization does not streamline caregiving.

DIF: Cognitive Level: Comprehension REF: p. 175 19. Which is true of verbal and nonverbal communication? a. Verbal messages are more important than nonverbal cues.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

b. Individuals can exercise more control over nonverbal communication. c. Verbal and nonverbal communication always match. d. The nonverbal communication may be a more reliable message.

ANS: D Feedback A The nonverbal message may tell much more than the verbal one.

B Individuals can exercise more control over verbal communication than

nonverbal communication.

C Verbal and nonverbal communication are not always congruent.

D Nonverbal communication includes gestures, posture, facial

expressions, eye contact, and actions, among other things. Although the verbal message using words may be short, the nonverbal message can tell much more about the persons feelings.

DIF: Cognitive Level: Comprehension REF: p. 176 20. Which of the following could be considered congruent communication? a. The nurse manager states, Come by my office anytime. Then she keeps

her door closed and does not answer phone calls. b. As a co-worker hurries down the hall, he asks, Is there anything you

need help with? c. As she drops a stack of charts loudly on the desk, a co-worker states,

This is going to be a wonderful day. d. The nurse manager sits with you in the nurses lounge and asks, Is there

anything you would like to talk about?

ANS: D Feedback A The verbal message is that she is available, but the closed door indicates

otherwise.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

B The verbal message is willingness to help; the nonverbal message is, I

hope you do not ask.

C The dropping of the charts loudly indicates frustration and is

incongruent with the message This is going to be a wonderful day.

Sarcasm is incongruent communication.

D The nurse managers verbal message matches the nonverbal message.

This is the definition of congruent communication.

DIF: Cognitive Level: Application REF: p. 176 21. A nurse is irrigating pressure ulcers on a patients coccyx. When the patient asks

how they are healing, the nurse grimaces and says, Oh, theyre doing just fine. This is a. incongruence between verbal and nonverbal messages. b. a confirming statement. c. objectivity in responding to the question. d. the therapeutic use of humor.

ANS: A Feedback A The words say, Its OK, but the facial grimaces say it is not.

B The verbal and nonverbal messages do not match.

C Objectivity is not found in the statement.

D There is no use of humor.

DIF: Cognitive Level: Application REF: p. 176 22. Context is one of the five major elements of communication identified by Ruesch.

Which of the following is part of the context of communication? a. Information about the sender b. Attitude of the receiver Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Response of the receiver d. Content of the message ANS: B Feedback A Information about the sender is not part of the context of the

communication.

B Context refers to the environment in which the interaction occurs. This

includes the mood and the relationship between the sender and receiver.

C The response of the receiver is not part of the context of

communication.

D The content of the message is not part of the context of communication.

DIF: Cognitive Level: Comprehension REF: p. 177 23. A new mother says to the nurse, It really hurts me to breastfeed. I think I should

wean my baby. The most appropriate response by the nurse is, a. It is good to wean the baby early because it is easier on you. b. If I understand you, it hurts when you breastfeed. Tell me how and when

it hurts. c. It is your decision to make whether you breastfeed. d. You should continue to breastfeed because it is much better for the baby.

ANS: B Feedback A Saying It is good to wean the baby early because it is easier on you

gives a response before the situation is clarified and closes off continued communication.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

B The nurse is gaining feedback that helps the nurse understand more

about the situation from the patients perspective and keeps communication open.

C Saying It is your decision to make whether you breastfeed gives a

response before the situation is clarified and closes off continued communication.

D Saying You should continue to breastfeed because it is much better for

the baby gives a response before the situation is clarified and closes off continued communication.

DIF: Cognitive Level: Application REF: p. 178 24. A new mother says to the nurse, It really hurts me to breastfeed. I think I should

wean my baby. The nurse responds, If I understand you, it hurts when you breastfeed.

Tell me how and when it hurts. This response best represents which criterion of successful communication? a. Appropriateness b. Efficiency c. Feedback d. Flexibility ANS: C Feedback A Appropriateness relates to whether the reply fits the circumstances and

matches the message.

B Efficiency means using simple, clear words that are timed at a pace

suitable to the patient.

C The nurse seeks to clarify the hurt before intervening further.

D Flexibility means the message is based on the immediate situation and

not preconceived expectations.

DIF: Cognitive Level: Application REF: p. 178 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

25. When a co-worker tells the nurse, I am not sure I will be able to give the right

answers in the job interview, the nurse replies, I know what you mean. Interviews have always been a problem for me, too. This response can be evaluated as lacking a. appropriateness. b. efficiency. c. feedback. d. flexibility.

ANS: A Feedback A Appropriateness relates to whether the reply fits the circumstances and

matches the message. The nurses response related to his own issue does not deal with the co-workers issue, which should be the focus of the interaction.

B Efficiency means using simple, clear words that are timed at a pace

suitable to the patient.

C Feedback means the nurse seeks to clarify what the patient has said and

gain understanding.

D Flexibility means the message is based on the immediate situation and

not preconceived expectations.

DIF: Cognitive Level: Application REF: p. 178 26. A new mother says, My baby is being kept in the nursery. Im really worried about

him. Im also worried that the separation will interfere with breastfeeding. The most appropriate response by the nurse is, a. Well, thats not my territory. Youll have to deal with the nursery staff

about breastfeeding. b. As a nurse on this unit, I can assure you that we will do all we can to

help you.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. I can see youre upset about this, but to be honest with you, Im a new

nurse here, and Im not sure how I can help you. d. I can see this is a problem for you. I will go to the nursery and see if I

can get some answers for you.

ANS: D Feedback A Telling the mother that she will need to deal with the nursery staff does

not address the concern of the mother.

B Saying that the staff of the hospital will do all they can to help does not

address the concern of the mother.

C The nurse telling the mother that he is new and does not know how to

help does not address the concern of the mother.

D The nurses response fits the circumstances and matches the mothers

message of being concerned about the separation and breastfeeding.

DIF: Cognitive Level: Application REF: p. 178 27. Using simple, clear words to explain the details of a colonoscopy procedure shows

sensitivity to which successful communication criterion? a. Appropriateness b. Efficiency c. Feedback d. Flexibility ANS: B Feedback A Appropriateness relates to whether the reply fits the circumstances and

matches the message.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

B Efficiency means using simple, clear words that are timed at a pace

suitable to the patient.

C Feedback means the nurse seeks to clarify what the patient has said and

gain understanding.

D Flexibility means the message is based on the immediate situation and

not preconceived expectations.

DIF: Cognitive Level: Application REF: p. 179 28. A 4-year-old child is going to have an abdominal x-ray examination. The child

asks, Why do they have to do this? Will it hurt? Which of the following is the most appropriate response by the nurse? a. The doctor needs you to have the x-ray so she knows what is wrong with

you. b. You will go to the x-ray department so they can take pictures of your

tummy to find out why you have a tummy ache. The bed you lie on may be cool, but you will have a blanket to keep you warm. The test will not hurt. c. You will go downstairs on a stretcher. You will need to lie very still on a

hard table while the x-ray machine goes over you. It will not take very long. d. X-rays do not hurt. The machine takes a picture but will not touch you.

ANS: B Feedback A Telling the child that he will need an x-ray to determine what is wrong

with him does not provide a clear explanation that addresses the childs concerns.

B The nurses response explains the procedure in clear and simple words

that are suitable to a 4-year-old child.

C Explaining the x-ray procedure in terms that may not be easy to

understand for a 4-year-old does not provide a clear explanation that addresses the childs concerns.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

D Telling the child that x-rays do not hurt and that they take pictures does

not provide a clear explanation that addresses the childs concerns.

DIF: Cognitive Level: Application REF: p. 179 29. Which of the following examples illustrates the nurses failure to use flexibility

effectively in professional communication? a. Asking on the admission assessment, You dont smoke, do you? b. When updating a family member on a patients condition stating, Your

wifes ABG report indicates significant hypoxia. c. Continuing to follow the agenda in a staff meeting when people are

obviously upset by a recent death on the unit d. Requiring nurses to read back phone orders to physicians ANS: C Feedback A You dont smoke, do you? is an example of value judgment.

B This is an example of poor communication, because the message is not

geared to the receivers level of understanding.

C Continuing to follow an established agenda when the emotional state of

the group needs to be addressed indicates inflexibility on the part of the leader.

D Requiring nurses to read back phone orders to physicians is an example

of feedback.

DIF: Cognitive Level: Analysis REF: p. 179 30. The nurse plans to teach a patient about the care of her mastectomy site. The nurse

finds the patient crying. The best response by the nurse is, a. It is time to discuss how to care for the surgical site.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

b. You seem upset. You should start looking forward to going home and

being a wife and mother again. c. I see you are upset. Is there something on your mind youd like to talk

about? d. Dr. Abrams said you can go home tomorrow, and we need to talk about

the care of your surgical site.

ANS: C Feedback A This statement follows the established agenda and does not respond to

the emotional state of the patient.

B This statement follows the established agenda and does not respond to

the emotional state of the patient.

C The nurses response demonstrates flexibility. The response identifies

the emotional state of the patient and requires deviation from the established agenda.

D This statement follows the established agenda and does not respond to

the emotional state of the patient.

DIF: Cognitive Level: Application REF: p. 179 31. The patient says to the nurse, The staff treats me like Im a child. Everyone tells me

what to do. No one ever asks my opinion. After all, it is my body. Which response by the nurse indicates active listening? a. Well, youre sick. Dont you think you should let us take care of you? b. I dont think I can help you with this. This is a personal matter between

you and the rest of the staff. c. It makes you angry not to be included in your health care decisions. Lets

talk about how you can vent your anger appropriately. d. Let me see if I understand. It bothers you not to be recognized for your

abilities to handle your life. I can discuss this with the staff if you wish so that everyone involves you in planning your care.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: D Feedback A This statement indicates a lack of interest in what the patient was saying

and is paternalistic.

B This statement indicates a lack of interest in what the patient was saying

and an unwillingness to help the patient.

C This statement shows an assumption by the nurse that should be

verified.

D The nurses response recognizes the patients feelings and concerns. The

nurse verifies the patients feelings and suggests an action which gives the patient the desired control.

DIF: Cognitive Level: Application REF: p. 175 32. In which of the following examples is the nurse demonstrating empathy for the

postoperative mastectomy patient? a. With todays advanced reconstruction techniques, youll quickly forget

you ever had surgery. b. Youll be back to your busy routine sooner than you think. c. This must be a very difficult time for you. d. I know how you feel; I also had breast cancer.

ANS: C Feedback A Saying With todays advanced reconstruction techniques, youll quickly

forget you ever had surgery discounts the patients feelings and is false reassurance.

B The nurse is making an assumption that the patient wants to return to a

busy routine. This is false reassurance based on a faulty assumption about the patient.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

C The nurse acknowledges the patients feelings and uses an open-ended

statement to encourage the patient to verbalize further.

D The nurse should never assume to know how the patient feels. The

focus should be on the patient, not the nurse. The nurses experience is not germane to the nurse-patient relationship.

DIF: Cognitive Level: Application REF: p. 181 33. Which of the following demonstrates giving information versus opinion? a. Mrs. Khan, lets practice together the breathing techniques you learned in

Lamaze classes. That will help us to work together more effectively later when your labor is stronger. b. You learned breathing techniques in Lamaze classes. I really believe the

breathing techniques make labor easier. c. Mrs. Khan, have you been practicing the breathing techniques you

learned? It is very important to practice if you wish to use them effectively in labor. d. Using breathing techniques in labor is really to your benefit because you

feel in control.

ANS: A Feedback A Saying Mrs. Khan, lets practice together the breathing techniques you

learned in Lamaze classes. That will help us to work together more effectively later when your labor is stronger does not offer an opinion.

B Saying You learned breathing techniques in Lamaze classes. I really

believe the breathing techniques make labor easier offers the nurses opinion regarding the breathing techniques.

C Saying Mrs. Khan, have you been practicing the breathing techniques

you learned? It is very important to practice if you wish to use them effectively in labor offers the nurses opinion regarding the breathing techniques.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

D Saying Using breathing techniques in labor is really to your benefit

because you feel in control offers the nurses opinion regarding the breathing techniques.

DIF: Cognitive Level: Application REF: p. 181 34. How would a nurses use of the technique of reflection help a person? a. Showing an awareness of the persons feelings b. Causing the person to answer more fully than yes or no c. Showing knowledge the person is not expected to know d. Encouraging the person to think through problems for himself or herself ANS: D Feedback A Reflection may involve the person becoming aware of his or her

feelings but does not require the nurses awareness.

B Reflection is not related to the answers provided by the patient.

C Reflection is related to the insight the person gains, not information

provided to him or her.

D Reflection implies respect for the patient and his or her ability to solve

his or her problems.

DIF: Cognitive Level: Comprehension REF: p. 181 35. Within nurse-patient communication, the use of silence can a. block further therapeutic communication. b. allow the patient to not feel pressured to provide information. c. demonstrate trust. d. provide the nurse with an opportunity to complete the patients care.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: B Feedback A Using silence actually encourages communication because it allows the

patient to organize his or her thoughts.

B Using silence means allowing periods of quiet thought during the nurse-

patient interaction when the patient does not feel pressure to provide conversation.

C Using silence does not relate to trust.

D Using silence is not a requirement for completing patient care.

DIF: Cognitive Level: Comprehension REF: p. 182 36. A patient states, The harder I try to get along with my son, the more I feel he just

wants to be left alone, and the nurse responds, I guess parents have to expect these problems as children get older. The nurses response is an example of a communication breakdown known as a. failing to see the uniqueness of the individual. b. failing to recognize levels of meaning. c. using value statements d. failing to clarify unclear messages.

ANS: A Feedback A The nurses response has put the patient into a group, parents, and

therefore does not respond to the patient as a unique individual.

B There is no meaning under the surface content in the patients remark.

C There are no value statements in the nurses response.

D The patients remark was not unclear.

DIF: Cognitive Level: Application REF: p. 184 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

37. A patient states, The thing that scares me the most about surgery is the spinal

anesthesia. Im afraid itll leave me paralyzed, and the nurse responds, Everything will be fine. The anesthesiologists are very skilled in administering spinal anesthesia. The nurses response is an example of a communication breakdown known as a. failing to see the uniqueness of the individual. b. failing to recognize levels of meaning. c. using value statements. d. using false assurance.

ANS: D Feedback A The nurse does not fail to respond to the patient as a unique individual.

B The nurse does not fail to take into account the meaning under the

surface content.

C The nurse does not use value statements.

D The nurse offers false assurance.

DIF: Cognitive Level: Application REF: p. 185 38. Collaboration in health care settings involves a. professionals respected for their unique knowledge and abilities. b. professionals educated in a collaborative model of education. c. recognition of individual professional accomplishments. d. a multitiered system hierarchy.

ANS: A Feedback

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

A Collaboration implies working jointly with other professionals, all of

whom are respected for their unique knowledge and skills in the situation.

B Currently most professionals are not educated in a collaborative model

of education, although they are expected to work in collaboration.

C In collaboration the accomplishments of the total group are recognized,

not individuals.

D Collaboration implies that everyone on the interdisciplinary team can

make valuable contributions.

DIF: Cognitive Level: Comprehension REF: p. 190 39. Collaboration among health care professionals most importantly results in a. the development of esprit de corps. b. benefits to the organization alone. c. positive patient outcomes. d. maintenance of employee satisfaction.

ANS: C Feedback A Although esprit de corps develops, the ultimate result is for positive

patient outcomes.

B Collaboration benefits the individuals involved, as well as the

organization.

C Making the most of collaborative opportunities enhances positive

patient outcomes.

D Employee satisfaction is greater with more collaboration, but the

ultimate value of collaboration is positive patient outcomes.

DIF: Cognitive Level: Comprehension REF: p. 190 MULTIPLE RESPONSE Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

1. Which behaviors foster active listening? (Select all that apply.) a. Encouraging the speaker by saying, Tell me more b. Limiting verbal ventilation because it is not focused c. Sitting in an open posture such as leaning forward d. Engagement in a task e. Good eye contact at eye level and nodding of the head ANS: A, C, E Feedback Correct

Active listening is a method of communicating interest and attention. Encouraging the speaker, using an open posture, eye contact, and nodding the head all communicate interest and attention.

Incorrect Limiting verbal expression is likely to decrease the sharing of

information by the patient. A task may serve as a distraction for the nurse and patient and may limit active listening.

DIF: Cognitive Level: Comprehension REF: p. 180 2. Which of the following are examples of open-ended questions? (Select all that

apply.) a. Ms. Goode, did you have a productive therapy session? b. How are you? c. How do you feel about staying with your daughter? d. What would you like to discuss today while we take a walk? e. Are you having that problem with arthritis in your hand again?

ANS: B, C, D Feedback Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Correct

The questions How are you? How do you feel about staying with your daughter? and What would you like to discuss today while we take a walk? require the patient to answer by providing data and not just a yes or no answer.

Incorrect The statements Ms. Goode, did you have a productive therapy

session?and Are you having that problem with arthritis in your hand again? do not require more than yes or no answers.

Chapter 18 Research and Development in Population Health

MULTIPLE CHOICE 1. Evidence-based public health is: a. An integration of the best available nursing expertise b. Derived from community principles to fit the area where it is practiced c. A health endeavor that makes informed use of evidence d. Comprised of only public health records ANS: C Evidence-based public health is a health endeavor that makes informed use of evidence.

DIF: COG: Understanding REF: 339 OBJ: 1 2. A nurse makes clinical judgments based upon trial and error and past clinical experiences. What problem can result from using these data sources in clinical decision making? a. Not all sources of information are reliable. b. Authority always leads to faulty decision making. c. Ethical knowledge is not taken into account. d. Trial and error has lead to poor outcomes.

ANS: A Using the sources of knowledge listed in the other options does not consistently produce desired outcomes.

DIF: COG: Applying REF: 341 OBJ: 1 3. A nurse uses clinical experience and client preference to guide clinical decision making when using: a. Evidence-based practice b. Internal evidence c. Research utilization d. External evidence ANS: B Internal evidence refers to the use of the nurses clinical experiences and the clients preferences.

DIF: COG: Applying REF: 339 OBJ: 1 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

4. The term evidence-based was first used in: a. Canada b. Great Britain c. The United States d. Australia ANS: A The term evidence-based was first attributed to Gordon Gyatt, a Canadian physician at McMaster University in 1992.

DIF: COG: Remembering REF: 339 OBJ: 2 5. A nurse providing care in the 1970s would have used which process as the guide for making clinical decisions? a. Evidence-based nursing practice b. The science of medicine c. Evidenced-based medicine d. Research utilization ANS: D Research utilization projects in the 1970s provided a guide to clinical practice.

DIF: COG: Analyzing REF: 340 OBJ: 2 6. A summary of the research evidence that relates to a specific question and to the effects of an intervention is: a. Evidence-based practice b. Action research c. Systematic review d. Best practices ANS: C A systematic review is a summary of the research evidence that relates to a specific question and to the effects of an intervention.

DIF: COG: Remembering REF: 343 OBJ: 3 7. Which type of research is defined as the gold standard of evidence in evidence-based practice? a. Clinical expertise b. Randomized controlled trials c. Case studies d. Systematic review ANS: B The double blind randomized controlled trial generally provides the highest level of evidence followed by other randomized controlled trials.

DIF: COG: Understanding REF: 341 OBJ: 3 8. A nurse is grading the strength of evidence when critiquing a research study. Which domains will the nurse need to consider?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Randomness, sample size, and blinding b. Selection, variables, and description c. Nursing, medicine, and physiology d. Quality, quantity, and consistency ANS: D Quality, quantity, and consistency are the three domains for evaluating systems.

DIF: COG: Applying REF: 344 OBJ: 3 9. It would be important for a nurse researcher to use blinding when: a. The sample size is small b. The outcomes must be accurately measured c. Using a control group d. Studying the attrition rate ANS: C Blinding refers to a procedure where the researcher or evaluator does not know which participants are in the experimental or control group.

DIF: COG: Applying REF: 345-346 OBJ: 3 10. What information will a nurse find when reading a systematic review? a. Results of randomized controlled trials b. A description of the methods used to search for evidence c. Data compiled on a particular question d. An in-depth review of the literature completed by one person ANS: B A systematic review is usually done by more than one person and describes the methods used to search for the evidence. It is a method of identifying, appraising, and synthesizing research evidence to evaluate and interpret all available research relevant to a particular research question.

DIF: COG: Analyzing REF: 343 OBJ: 3 11. A nurse working in a community setting should apply evidence-based practice methods that are described by: a. Randomized clinical trials b. Qualitative studies c. Quantitative studies d. Multiple research methods ANS: D Evidence from multiple research methods has the potential to enrich the application of evidence and improve nursing practice.

DIF: COG: Applying REF: 347 OBJ: 4 12. A public health nurse would like to incorporate evidence-based practice into the clinical practice at the health department. According to Melnyk and Fineout-Overholt et al., the first step in this process is: Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

a. Integrating the evidence with clinical expertise b. Cultivating a spirit of inquiry c. Asking clinical questions d. Searching for the best evidence ANS: B According to Melnyk and Fineout-Overholt et al., the first step is step 0: cultivating a spirit of inquiry.

DIF: COG: Applying REF: 342 OBJ: 4 13. When looking at evidence-based practice to support the methods used to facilitate smoking cessation, which type of evidence would be the best for the nurse to examine? a. Scientific literature found in systematic reviews b. Double-blind randomized controlled trial c. Quasi-experimental studies d. Expert opinion ANS: A Because it is difficult to find or perform randomized controlled trials in the community, other types of evidence have been highlighted as the best evidence in public health literature upon which to base evidence-based public health (EBPH) practice; scientific literature found in systematic reviews is one type that is recommended. Although randomized controlled trials are the highest level of evidence, it would not be possible to implement this type of study when studying smoking cessation.

DIF: COG: Applying REF: 341 OBJ: 4 14. A public health nurse uses a published systematic review to determine which exercises should be incorporated into a newly developed older adult exercise program. Which resource would most likely contain this information? a. Evidence-Based Practice for Public Health Project b. PubMed c. Cochrane Public Health Group (PHRG) d. Task Force on Community Preventive Services ANS: C The PHRG works with contributors to produce and publish Cochrane reviews of the effects of population-level public health interventions. The PHRG undertakes systematic reviews of the effects of public health interventions to improve health and other outcomes at the population level, not those targeted at individuals.

DIF: COG: Applying REF: 344 OBJ: 6 MULTIPLE RESPONSE 1. Which are barriers to implementation of evidence-based practice? Select all that apply. a. Lack of available time b. Inferior quality of available research c. Unwillingness of organizations to fund research d. Inability to understand the evidence Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

ANS: A, B, C, D All of these are barriers to evidence-based practice.

Chapter 19 The Role of Comparative Effectiveness

Multiple Choice 1. Which of the following statements accurately reflects the nurses responsibility for patient outcomes in todays workplace?

A) Tasks can be delegated, but accountability cannot be delegated.

B) In todays environment, authority is more often given to management.

C) Most nurses who are accountable have the authority to affect the situation or effect change.

D) Nurses are protected against legal action being taken in cases of malpractice in the hospital setting.

Ans: A Client Needs: A-1 Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing Process Objective: 1, 2 mcs: 428, Differentiating Between Accountability and Authority Feedback: Tasks can be delegated, but accountability cannot; nurses who delegate tasks to assistive personnel continue to be accountable for that care. Many nurses experience frustration because they must be accountable for activities without the authority to affect the situation or create change. Authority is often shared in Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

contemporary care settings. Nurses are legally responsible for the care they provide and are vulnerable to malpractice suits.

2. Which of the following statements accurately describes a basic guideline for using communication skillfully?

A) Managers should communicate how to perform a task even if it is something the subordinate has already learned.

B) Managers should not be afraid of making judgmental statements when dealing with a subordinate who has broken policy rules.

C) Managers should attempt to formulate a response to an individual who is still speaking to avoid awkward pauses in the conversation.

D) Managers should present direction as briefly as possible while still providing adequate data.

Ans: D Client Needs: C Cognitive Level: Application Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 9 mcs: 445, Using Communication Skills in the Leadership Role Feedback: Effective managers state the necessary information as briefly as possible while still providing enough data to be clear. Interruptions, judgmental statements, and repeated explanations are characteristics of ineffective communication.

3. What is the primary objective of a performance appraisal?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

A) Establish written documentation of incompetent behavior to facilitate dismissal B) Maintain and develop employee performance C) Establish criteria for accreditation standards D) Determine who receives pay raises Ans: B Client Needs: A-1 Cognitive Level: Comprehension Difficulty: Easy Integrated Process: Communication and Documentation Objective: 11 mcs: 447, Performance Appraisal Feedback: The primary objectives of performance appraisal are to maintain or improve employee performance and to enhance the development of employees. They are not intended to be punitive measures or criteria for accreditation. Performance appraisals may have an influence on a nurses pay but this is not their primary objective.

4. Which of the following is a characteristic of an effective performance evaluation system?

A) The appraisal system operates outside of the scope of administration.

B) Employees do not know in advance who will be evaluating them.

C) The final disposition of the appraisal is shared with the employee.

D) Evaluation concentrates on the personality of the employee.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Ans: C Client Needs: A-1 Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 11 mcs: 448, Display 12.4 Feedback: A sound performance appraisal is shared with the employee who is the subject of the appraisal. The appraisal system should be strongly supported by administration and employees should be made aware of who will appraise them. An employees personality should not be the focus for appraisal.

5. A nursing student finds that she has difficulty with procrastination. Which of the following is a recommended guideline to help this student manage her time?

A) Start working on a project for 10 minutes, and quit if tired or bored.

B) Schedule 2 or 3 days a week in which to concentrate her tasks.

C) Avoid spending the time it takes to make to-do lists.

D) Schedule down-time first and work second.

Ans: A Client Needs: A-1 Cognitive Level: Application Difficulty: Moderate

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Integrated Process: Communication and Documentation Objective: 12 mcs: 455, Dealing with Procrastination and Time Wasters Feedback: Kanarek (1996) provides five suggestions for dealing with procrastination.

First, she suggests that you start working on a project for 10 minutes and quit if tired or bored. Work times should be prioritized carefully and spread out over time. The creation of lists is a useful tool.

6. A nursing leader has expressed a desire to foster the characteristics and behaviors associated with transformational leadership. Which of the following actions best demonstrates transformational leadership?

A) The leader makes it clear to employees that positive work performance will be rewarded and that sub-standard performance will bring consequences.

B) The leader ensures that decisions are based on the consensus of every employee.

C) The leader prioritizes the needs of each individual employee over the interests of the larger organization.

D) The leader takes action to build trust and relationships between him or her and the employees.

Ans: D Client Needs: C Cognitive Level: Application Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 3 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

mcs: 430, Table 12.1 Feedback: Leader activities associated with transformational leadership include creating a vision, building relationships, developing trust, and building self-esteem.

An emphasis on rewards and punishment is associated with transactional leadership.

Consensus is not appropriate for every decision, and the interests of individual employees cannot always supersede the interests of the organization.

7. The manager of a hospital unit has unilaterally decided on a change in the way that overtime is distributed among the nursing staff and has followed up this decision with an e-mail to all employees. What leadership style is exemplified by this manager?

A) Participative leadership B) Permissive leadership C) Laissez-faire leadership D) Autocratic leadership Ans: D Client Needs: C Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 4 mcs: 431, Leadership/Management Styles Feedback: In autocratic or authoritarian leadership, the leader/manager makes the majority of the decisions without direct consultation with employees. Laissez-faire or

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

permissive leadership occurs when little or no direction or guidance is provided.

Participative leadership involves extensive input from employees.

8. Experts have identified a close relationship between the practice of transformational leadership and the empowerment of employees. What action should a nursing leader take to foster employee empowerment?

A) Have the performance of each employee appraised by his or her peers rather than by a manager or leader.

B) Share information as openly as possible in order to make employees aware of problems.

C) Adopt a hands-off approach in order to allow leadership to organically emerge from within the group of employees.

D) Eliminate the practice of conducting performance appraisals of employees.

Ans: B Client Needs: C Cognitive Level: Application Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 5, 6 mcs: 436, Empowerment Feedback: Transformational leaders foster empowerment by openly sharing information with workers so that everyone is aware of problems and the need for action. Performance appraisals are not necessarily contrary to the philosophy or practice of transformational leadership, and these should not be conducted by an

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

employees peers. Transformational leadership is characterized by constructive engagement, not a hands-off approach.

9. Jennifer is a registered nurse who works in a busy emergency department. As one of her goals for the current year, Jennifer has resolved to develop her emotional intelligence. How should Jennifer best meet her goal?

A) Try to remove emotion from her clinical decision-making whenever possible.

B) Become more assertive when responding to the emotional responses of patients, families, and coworkers.

C) Become more aware of the way that her emotions function and how they influence her actions.

D) Try to limit her expressions of emotion to times when she is not interacting with others.

Ans: C Client Needs: C Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 7 mcs: 439, Enhancing Your Emotional Intelligence Feedback: Self-awareness is one of the central aspects of emotional intelligence.

Emotional intelligence does not necessarily involve removing emotion from decisionmaking or removing emotion from interpersonal interactions. Awareness of others emotions is a dimension of emotional intelligence, but the appropriate response to this is not normally increased assertiveness.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

10. A recent nursing graduate has asked an expert nurse how best to foster her leadership abilities, since she wishes to explore leadership opportunities later in her career. How should the expert nurse best respond?

A) Even if you dont trust a decision that you have to make, act like you chose the best option.

B) Become as specialized as possible in your nursing experience.

C) Develop your interpersonal skills by having a wide variety of interactions.

D) Become as assertive as you can and take every opportunity to guide the behavior of others.

Ans: C Client Needs: C Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 8 mcs: 443, Developing Your Leadership Style Feedback: The development of sophisticated interpersonal skills is important to building leadership abilities. Effective leadership does not depend on feigned confidence, though self-confidence is a trait that can be fostered. In most cases, variety and depth of experience are superior to narrow specialization. Effective leadership is more nuanced and complex than simply directing the behavior of others or demonstrating assertiveness.

11. A nurse has responded to a patients call light for the fourth time in the past hour only to be berated by the patient for taking so long to come to the bedside. Rather than Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

responding in a confrontational tone the nurse has paused to think of the best response to the patients statements. In doing so, the nurse has exhibited A) self-regulation.

B) sympathy.

C) manipulation.

D) self-strategy.

Ans: A Client Needs: C Cognitive Level: Analysis Difficulty: Easy Integrated Process: Communication and Documentation Objective: 7 mcs: 440, Self-Regulation Feedback: Self-regulation refers to the ability to control inappropriate impulses and to think before acting or speaking. Research on mindfulness training indicates it is a positive strategy for managing emotionally charged situations. The nurse has not acted in a manipulative way. Sympathy involves feeling sorrow for another persons pain, a dynamic that is not evident in this interaction.

12. A patient is receiving a transfusion of packed red blood cells and consequently requires frequent vital signs. A set of vital signs was just due during the nurses scheduled lunch break and so a colleague took the patients vital signs. After returning from lunch, the nurse confirmed with the colleague that the scheduled vital signs were taken, to which the colleague replied, Yes, it seems like Im covering you a whole lot lately. How should the nurse best respond to the colleagues statement?

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

A) I dont think thats a fair thing to say because I cant help when a set of vitals are due.

B) If youre implying that I dont pull my weight I think that youre badly mistaken.

C) Well, what goes around comes around, right?

D) Could you explain what you mean by that?

Ans: D Client Needs: C Cognitive Level: Application Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 10 mcs: 444, Communicating Effectively Feedback: An important principle of communication is to ensure that meanings are clearly understood by both parties. This is especially true in the case of a statement that may be accusatory. Responding confrontationally or sarcastically is rarely appropriate.

13. The nurse manager of a busy medical unit prioritizes effective communication with the employees of the unit. In recent years, an increasing amount of this communication has involved e-mails and text messages. When using these communication media, the nurse should A) take action to ensure that patient confidentiality is maintained.

B) cc upper management and human resources with all e-mails.

C) avoid using a smartphone on the unit whenever possible.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

D) follow up e-mails with a paper copy of important messages.

Ans: A Client Needs: C Cognitive Level: Application Difficulty: Moderate Integrated Process: Communication and Documentation Objective: 10 mcs: 444, Communicating Effectively Feedback: Patient privacy can be difficult to ensure when communicating electronically. As a result, nurse leaders must take measures to protect confidentiality.

Electronic messages do not always need be followed up with paper copies and it is unnecessary to cc superiors on all communications. Smartphones are an effective communication tool, provided they are used in an appropriate manner.

14. It has been a frantic morning on the hospital unit and the nurse is unsure whether she will be able to complete her required tasks on time before her scheduled lunch break. Which of the following is the nurses most appropriate response to this problem?

A) Skip lunch or trade her lunch break with a colleague who is scheduled for a later break.

B) Determine if more of her tasks could be delegated to another member of the care team.

C) Ask the unit manager for advice.

D) Explain to a colleague that she will likely be unable to complete her required work.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Ans: B Client Needs: A-1 Cognitive Level: Application Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 12 mcs: 454, Principles of Time Management Feedback: Delegation is an appropriate and useful strategy for effective time management. This would be a preferred approach over changing the lunch schedule.

The nurse should attempt to delegate before approaching her manager for a solution or resigning herself to the fact that she will not complete her work.

Multiple Selection 15. All performance evaluations, whether formal or informal, should be based on appropriate standards of performance. In the context of a performance appraisal, which of the following are appropriate performance criteria? (Select all that apply.)

A) The managers experience base B) The nurses written job description C) The institutions policies and procedures D) Nursing standards of practice E) The nurses career goals Ans: B, C, D Client Needs: A-1 Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Communication and Documentation Objective: 11 mcs: 448, Criteria for Evaluation Feedback: Standards of performance include job descriptions, policies and procedures, and professional standards of practice. A leaders personal experience base and the nurses goals may be relevant but neither is an objective measure for appraising the nurses performance.

Chapter 20 The Future of Population Health

MULTIPLE CHOICE 1. What is the goal of local public health departments? a. To monitor communicable diseases b. To improve the health status of communities c. To offer services for the uninsured d. To enforce environmental codes and laws ANS: B The goal of local public health departments is to safeguard the publics health and improve the health status of communities.

DIF: COG: Understanding REF: 992 OBJ: 1 2. Which agency delegates the authority of the local health department? a. The federal government b. The state c. Local authorities d. Regional governing boards ANS: B The authority of the local health department is delegated by the state.

DIF: COG: Understanding REF: 992 OBJ: 1 3. A nurse working in public health focuses on: a. Home visiting and hospice care b. Care communicable diseases Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Health maintenance and health promotion d. Illness prevention ANS: C Public health nurses employed in local, state, and federal agencies work together to identify, develop, and implement interventions that will improve and maintain the nations health.

DIF: COG: Applying REF: 990 OBJ: 1 4. Which event has the potential to weaken existing public health programs? a. The shift in funding to support bioterrorism response efforts b. The outbreaks of H1N1 influenza c. The number of citizens with human immunodeficiency virus d. The lack of public health nurses ANS: A The events of the twenty-first century have shifted funding to bioterrorism programs. This shift of funding has the potential to weaken existing important public health programs.

DIF: COG: Understanding REF: 993 OBJ: 2 5. When a public health nurse discusses with a client which services are appropriate to meet her needs, the public health nurse is functioning as a(n): a. Case manager b. Advocate c. Counselor d. Role model ANS: B A public health nurse discusses with a client which services are appropriate to meet her needs. In this case, the nurses the public health function is that of an advocate.

DIF: COG: Applying REF: 999 OBJ: 3 6. Which role of the nurse is being used when a public health nurse assists a client in identifying the services needed the most at the least cost? a. Role model b. Primary caregiver c. Outreach worker d. Case manager ANS: D The public health function of a nurse who assists a client in identifying the services needed the most at the least cost is a case manager.

DIF: COG: Applying REF: 1000 OBJ: 3 7. The public health nurse who aims to change behaviors such as poor hand washing skills and unsafe sex practices is acting in the role of a(n): a. Case manager b. Advocate Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

c. Educator d. Role model ANS: C The public health nurse who aims to change behaviors, such as poor hand washing skills and unsafe sex practices, is acting in the role of educator.

DIF: COG: Applying REF: 1000 OBJ: 3 8. A nurse providing services for uninsured women is performing the function of: a. Role model b. Primary caregiver c. Outreach worker d. Case manager ANS: B A nurse providing services for uninsured women is acting in the role of primary caregiver.

DIF: COG: Applying REF: 1000 OBJ: 3 9. Providing information about safe-sex practices is an example of which level of prevention? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment ANS: A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

DIF: COG: Applying REF: 1002 OBJ: 3 10. An example of secondary prevention is: a. Screening children for lead poisoning b. Working with communities on emergency preparedness plans c. Developing social networking interventions to modify community norms d. Educating patients with strokes at rehab centers to help optimize their functioning ANS: A Screenings are secondary prevention activities.

DIF: COG: Analyzing REF: 1002 OBJ: 3 11. Which activity demonstrates the use of a tertiary prevention strategy? a. Providing immunizations b. Conducting lead screening activities for children c. Providing case management services for clients with chronic illness d. Identifying and treating clients in a TB clinic ANS: C Providing immunizations is a primary prevention, and conducting lead screening activities and identifying and treating clients in a TB clinic are at the secondary level of prevention.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Tertiary prevention refers to activities aimed at rehabilitation of the disease process and return to the highest possible functioning.

DIF: COG: Analyzing REF: 1003 OBJ: 3 12. Which action is the most appropriate for the public health nurse to take when working with uninsured individuals? a. Providing direct care for this population in times of acute illness b. Advocating for federal policy changes for this population c. Assisting this population to access necessary health care services d. Encouraging lifestyle changes for this population ANS: C Public health nurses serve vulnerable populations by acting as a bridge between these populations and the resource needs for this at-risk group by approaching health care providers on behalf of individuals seeking medical/health services and keeping the needs of this population on the political agenda.

DIF: COG: Evaluating REF: 996 OBJ: 3 13. After reviewing the objectives of Healthy People 2020, the public health nurse determines that programming for communicable diseases in the community should focus on: a. Encouraging community members to engage in healthy behaviors b. Identifying high-risk sexual behaviors among community members c. Monitoring the sexual activity of adolescents d. Providing information about the hazards of multiple sexual partners ANS: D Healthy People 2020 lists communicable disease as an area of focus including levels of human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), and sexually transmitted infections. One method to reduce the risk of acquiring a communicable disease is by the public health nurse providing information on the hazards of multiple sexual partners and street drug use.

DIF: COG: Analyzing REF: 999 OBJ: 4 14. Which is a principle of good practice for community partnerships? a. Partnerships are easily formed among those working in public health. b. Partnerships use their own roles to accomplish tasks. c. Partnerships are built on identified strengths and assets. d. Partnerships are loose associations among people.

ANS: C Partnerships are built up on identified strengths and assets including areas that need improvement. This is one of the principles of good practice.

DIF: COG: Understanding REF: 990 OBJ: 6 15. A nurse considering working as a public health nurse should recognize that the American Public Health Association Public Health Nursing Section has recommended which Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

level of educational preparation? a. Associate degree b. Baccalaureate degree c. Masters degree d. Certification ANS: B This is because all public health nurses should have a background in the social and behavioral sciences, epidemiology, environmental health, current treatment modalities, and health care delivery options in order to fully understand health policy, research, and treatment choices and to translate this knowledge into the promotion of healthy populations.

DIF: COG: Applying REF: 999 OBJ: 7 16. Why is it important that the public health nurse be included in disaster planning? a. To be most effective as a disaster responder b. To anticipate the potential disasters that may occur c. To educate the public about their responsibilities if a disaster occurs d. To demonstrate the importance of community partnerships ANS: A To be most effective as a disaster responder, the public health nurse needs to be part of the team before an emergency occurs.

DIF: COG: Applying REF: 1001 OBJ: 8 MULTIPLE RESPONSE 1. Which is an example of a federal agency? Select all that apply. a. The U.S. Department of Health and Human Services b. The Centers for Disease Control and Prevention (CDC) c. The Health Resources and Services Administration d. The Pentagon ANS: A, B, C The United States Department of Health and Human Services, the CDC, and the Health Resources and Services Administration are all federal agencies.

DIF: COG: Applying REF: 991 OBJ: 1 2. Which principles are included in the Scope and Standards of Public Health Nursing Practice? Select all that apply. a. The client or unit of care is the population. b. Primary prevention is given priority. c. All processes must include partnering with representatives of the people. d. Government agencies mandate requirements for public health.

ANS: B, C The eight tenets of public health nursing distinguish public health nursing from other nursing specialties. Primary prevention is given priority and all processes must include partnering with representatives of the people are part of these established principles.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius

DIF: COG: Understanding REF: 994 OBJ: 3 3. A public health nurse collaborates with agencies to address the problem of obesity in the community. Who would be the most appropriate people to include in this collaborative partnership? Select all that apply. a. Local health department staff members b. Restaurant owners c. Parks and recreation department staff members d. Church representatives ANS: A, B, C, D Public health nurses practice in partnership with each other at the local, state, and federal levels and with other public health staff, other governmental agencies and the community to safeguard the publics health and to improve the communitys health status. All of these people would provide valuable insight into the problem of obesity in the community.

Test Bank for Population Health Creating a Culture of Wellness 2nd Edition Nash Fabius