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Advanced Public Health Nursing focuses on the expanded roles and responsibilities of nurses in promoting and protecting the health of populations. This course emphasizes the application of epidemiological principles, evidence-based interventions, and leadership skills in the planning, implementation, and evaluation of community health programs. Students will develop a comprehensive understanding of health policy, interprofessional collaboration, cultural competency, and advanced assessment strategies. The curriculum prepares nurses to address complex health challenges, advocate for vulnerable groups, and lead community-level initiatives aimed at improving health outcomes and reducing disparities.
Recommended Textbook
Foundations for Population Health in Community Public Health Nursing 5th Edition by
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32 Chapters
729 Verified Questions
729 Flashcards
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19 Verified Questions
19 Flashcards
Source URL: https://quizplus.com/quiz/40240
Sample Questions
Q1) Which of the following is responsible for the dramatic increase in life expectancy during the 20th century?
A) Technology increases in the field of medical laboratory research
B) Advances in surgical techniques and procedures
C) Sanitation and other population-based prevention programs
D) Use of antibiotics to fight infections
Answer: C
Q2) Which of the following actions demonstrate effective public health nursing practice in the community?
A) Epidemiologic investigations examine the environment for health hazards.
B) New services are organized where particular vulnerable populations live.
C) Partnerships are established with community coalitions.
D) Staff members at the public health agency continue to increase in number.
Answer: A,B,C
Q3) Which of the following actions best represents public health nursing?
A) Assessing the effectiveness of the high school health clinic
B) Caring for clients in their home following their outpatient surgeries
C) Providing care to children and their families at the school clinic
D) Administering follow-up care for pediatric clients at an outpatient clinic
Answer: A

Page 3
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22 Flashcards
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Sample Questions
Q1) How did Florence Nightingale help bring about community health nursing?
A) She convinced socially prominent wealthy women to volunteer to give care.
B) She focused on all soldiers and their environment.
C) She interacted with each individual person, assessing his or her needs and acting to meet those needs.
D) She kept careful records on what was done and what were the results.
Answer: B,D
Q2) How did health care and its delivery change during the 1980s?
A) Funding to public health increased as funding for acute hospital care decreased.
B) Laws began to be passed that discouraged the use of alcohol, drugs, and tobacco.
C) Nurse practitioners were increasingly used to provide care.
D) Public health programs suffered reduced political support, financing, and effectiveness.
Answer: B,C,D
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16 Flashcards
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Sample Questions
Q1) How does managed care attempt to control costs of care?
A) By encouraging families to use the point of service list of individual practice associates
B) By requiring families to choose a care provider from the MC network and not allowing access to other services without their provider's permission
C) By moving Medicaid-eligible families onto state Medicare enrollment
D) By refusing permission for families to use urgent care or emergency department services
Answer: B
Q2) Which of the following best describes why local,state,and federal governmental agencies have started to cooperate and collaborate more closely in the last few years?
A) Increased administrative pressures to demonstrate outcomes
B) Increased focus on emergency preparedness and response
C) Increased taxpayers' complaints and general unhappiness
D) Increased pressure to decrease overlap in services
Answer: B
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22 Flashcards
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Sample Questions
Q1) A man entered the emergency department bleeding profusely and screaming,"I've got to see a doctor right now! I've got a right to see a doctor! I'm hurt.You have to take care of me!" Which of the following premises would ethically justify such a demand for immediate attention?
A) All hospitals receive federal money and all capable employed adults pay taxes, so all adults have a right to what their tax money has purchased.
B) Saving an individual's life improves society and upholds tradition.
C) Our society believes that all persons should be treated equally and that basic needs, such as not dying if death can be avoided, should be met.
D) The man has a property right to his own body, and the government is responsible to ensure that property rights are protected.
Q2) How are ethics and public policies similar?
A) Both are abstract principles that often differ in actual practice.
B) Both are best achieved by persons in high political office who can effect change.
C) Both strive for the public good.
D) Both use general principles in making decisions.
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Sample Questions
Q1) A health care worker tells a nurse,"It does no good to try to teach those Medicaid clients about nutrition because they will just eat what they want to no matter how much we teach them." Which of the following is being demonstrated by this statement?
A) Cultural imposition
B) Ethnocentrism
C) Racism
D) Stereotyping
Q2) A male nurse had a habit of sitting with the lower part of one leg resting over the knee of his opposite leg when collecting a client's history.He stopped doing this around Muslim clients after being told that Muslims were offended when he exposed the sole of his foot (shoe)to their face.Which of the following was exhibited by the nurse when he changed his behavior?
A) Cultural accommodation
B) Cultural imposition
C) Cultural repatterning
D) Cultural skill
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Q1) Which of the following best describes the purpose of local health departments making unannounced inspections of local restaurants?
A) To enforce local laws and regulations
B) To ensure compliance
C) To provide oversight to potential exposure
D) To monitor employee safety
Q2) The nurse is examining blood lead levels in school-age children 1 year after a community-wide education intervention.Which of the following phases of the nursing process is being implemented?
A) Assessment
B) Diagnosis
C) Intervention
D) Evaluation
Q3) Which of the following are the major sources of air pollution in the United States?
A) Burning of fossil fuels
B) Waste incineration
C) Wood burning fireplaces
D) Motor vehicles
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Sample Questions
Q1) A nurse is advocating for the public health department to increase the number of public health nurses that it employs.Which of the following factors should the nurse emphasize?
A) Providing disease investigation training
B) Providing research opportunities
C) Providing leadership experiences
D) Providing salaries commensurate with responsibilities
Q2) Which of the following describe the significance of the passage of The Public Health Threats and Emergencies Act?
A) It funded ongoing activities of the public health system.
B) It led to improved water quality and food safety guidelines.
C) It included funding for public health activities.
D) It validated that the public health system was prepared for terrorism.
Q3) Which of the following best defines the word politics?
A) The art of influencing others
B) The outcome of governmental policies
C) A provision of power for making decisions
D) The result of legislative action
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Q1) Which of the following must a nurse be knowledgeable about to make decisions regarding the most cost-effective way to allocate health care resources?
A) Insurance resources
B) Health care rationing
C) Health economics
D) Medical technology
Q2) A nurse is providing care to a child whose parents do not receive health insurance as an employee benefit and who do not have the financial resources to pay for health care out of pocket.Which of the following resources should the nurse recommend to the family?
A) A managed care organization
B) An emergency department
C) Medicaid
D) Medicare
Q3) Which of the following is most closely correlated with poor health?
A) Age and gender (i.e., older males)
B) Low socioeconomic status
C) Minority race status
D) High-risk lifestyle behaviors
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34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/40248
Sample Questions
Q1) Persons in an auditorium may have been exposed to a disease.If they are infected,it is crucial that they receive immediate treatment and not take the disease home to their families.Which of the following characteristics would be most important to consider when selecting the screening test to be used?
A) The negative predictive value
B) The positive predictive value
C) The sensitivity of the test
D) The specificity of the test
Q2) A nursing staff has successfully screened for diabetes in the community.Which of the following might best persuade the health board to increase funding for diabetic clinics in this community?
A) An epidemic of diabetes is now recognized and must be addressed.
B) The incidence of diabetes is now higher than previously recognized in the community.
C) The prevalence of diabetes is now higher than previously recognized in the community.
D) The risk for diabetes in the community could decrease if funding is received.
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Q1) Which of the following groups is pressuring clinicians the most to use evidence-based practice (EBP)?
A) Administrators
B) Insurance companies
C) Nurses
D) Physicians
Q2) A nurse manager wants to facilitate incorporation of evidence-based practice (EBP)in the clinical setting.Which of the following would be the best strategy to accomplish this goal?
A) Eliminate all protocols and standards that are not evidence based.
B) Encourage group reflection on the ideals and expectations of nursing care.
C) Refer agency nurses to Internet sources of research findings.
D) Support nurses using practice-oriented research findings in decision making.
Q3) A nurse is familiar with evidence-based practice (EBP)and wants to implement it into the care of clients.Which of the following would present the biggest challenge?
A) Assessing one's current practice and accessing evidence-based resources
B) Convincing administration that EBP is beneficial
C) Distinguishing EBP from practice based on old standards
D) Showing clients that EBP will improve their health outcomes
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20 Flashcards
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Sample Questions
Q1) A nurse is providing an educational program about testicular self-examination (TSE).Which of the following would be the best learning objective for this program?
A) Each participant will state why TSE is important and explain how to do it.
B) Each participant will describe how to do TSE and discuss the dangers of testicular cancer.
C) 90% of the men will correctly demonstrate testicular self-examination.
D) 100% of the men will do a testicular examination correctly on a model.
Q2) A nurse established an ongoing group meeting of teenagers with diabetes.In the early stages,the nurse was very directive in arranging location,providing low-carbohydrate drinks and snacks,steering the discussion,and trying to meet all the teenagers' needs.After the group had been meeting for about 3 months,the nurse noticed that the group members no longer simply accepted everything the nurse suggested.Instead,the teenagers began making decisions themselves,and eventually,the nurse no longer controlled the group.Which of the following most likely happened to cause this shift?
A) The group became cohesive enough to share leadership tasks.
B) Teenagers don't like feeling dependent on adults with power.
C) Teenagers often rebel against adult authority.
D) The nurse was overwhelmed and lost control of task process.
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22 Verified Questions
22 Flashcards
Source URL: https://quizplus.com/quiz/40251
Sample Questions
Q1) A community health nurse is beginning to work with a newly assigned community.Which of the following would be appropriate actions for the nurse to take to help ensure acceptance?
A) Asking those with whom the nurse interacts in the course of daily living their perception of the community (e.g., clerks in grocery stores or pharmacies)
B) Attending community events such as festivals or fairs and interacting with participants
C) Becoming involved in and contributing to volunteer community organizations
D) Completing a comprehensive physical assessment on nearby neighbors
Q2) Which of the following is the best brief definition of community?
A) A geographic area or political division under common leadership
B) A group sharing a common bond such as a profession or occupation
C) A group working together to confront a common problem
D) A social group with common goals within a geographic area
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Sample Questions
Q1) Which of the following public health nurse applicants is the least qualified for a position of case manager in a rural county?
A) A 24-year-old who has a master's degree in public health
B) A 34-year-old who will be moving from a large city
C) A 44-year-old who was born and raised in the community
D) A 54-year-old who, until recently, was a member of the community's school board
Q2) Which of the following best describes the goal or priority of the nurse advocate?
A) To gain organizational and governmental support for the promotion of nursing objectives
B) To improve community service needs identified by research findings
C) To integrate evidence-based practice guidelines in the provision of community nursing service
D) To promote the client's rights and self-determination
Q3) Which of the following are the primary goals of case management?
A) To ensure that care coordination occurs across the continuum
B) To emphasize evidence-based clinical decision making
C) To manage resource use and control expenses
D) To stress the advantages and benefits of community-based care
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) A nurse,after working 2 weeks at the site of the largest natural disaster to hit the United States,returns home.Which of the following behaviors would suggest the nurse needs professional assistance?
A) The nurse becomes angry when family members quit listening to her ongoing stories about the disaster and the problems there.
B) The nurse gives a presentation at the local college about the disaster and describes how health professionals were able to assist the victims who were injured.
C) The nurse is moody and feels family demands are not really as important as the other members of her family think they are.
D) The nurse is very exhausted and asks to have 3 personal days off from employment responsibilities.
Q2) When does disaster management begin?
A) Before the disaster occurs
B) During the disaster
C) Immediately following the disaster
D) During the recovery period
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Sample Questions
Q1) Which of the following describes the purpose of surveillance systems today?
A) To obtain data used to fight for increased budgets from taxpayers
B) To evaluate the effectiveness of public health programs
C) To monitor and reduce the incidence of chronic diseases
D) To note and help prevent occupational exposure and diseases
Q2) A child came to school coughing almost constantly.The next day,six other children in the same school room were coughing.Which of the following types of outbreak would the nurse suspect?
A) Common source
B) Mixed
C) Propagated
D) Intermittent
Q3) Which aspect of a biological agent is probably the most frightening to those exposed?
A) Infectivity
B) Invasiveness
C) Pathogenicity
D) Virulence
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Sample Questions
Q1) A nurse is conducting a needs assessment but has a limited budget.Which of the following data sources would the nurse most likely eliminate?
A) Community forums
B) Examination of community indicators
C) Focus groups
D) Surveys
Q2) A nurse is conducting program evaluation.Which of the following would be the first action the nurse would take?
A) Choose the type of evaluation to be done
B) Determine who will be involved in the evaluation
C) Identify the goal and objectives for the evaluation
D) Obtain answers to specific questions related to the program being evaluated
Q3) Which of the following best describes the ultimate goal of program planning?
A) Avoid unanticipated conflicts in the program development phase.
B) Provide adequate funding to meet the program's resource requirements.
C) Ensure that health care services are acceptable, equal, effective, and efficient.
D) Prevent unnecessary duplication of services.
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Sample Questions
Q1) In which of the following ways does licensing differ from accreditation?
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.
Q2) 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 evidence-based 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.
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Sample Questions
Q1) Which of the following must be firmly established before beginning a family assessment?
A) Why the data are needed
B) How best to interview each individual in the family
C) The most convenient time for you to visit the family
D) The rationale or purpose of the visit
Q2) Which of the following theories views the family as a whole with boundaries that are affected by the environment?
A) Family developmental
B) Exosystems
C) Bioecological systems
D) Family systems
Q3) A nurse is working with a family who is confronting major challenges to their health.Which of the following approaches would be most helpful for the nurse to use?
A) Allowing the family to be noncompliant
B) Building on the family's strengths and resilience
C) Labeling the family as resistant
D) Recognizing that the family is dysfunctional
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Sample Questions
Q1) A nurse is completing an initial home visit with a family.Which of the following actions should be taken first by the nurse?
A) Assess the family and the home setting for both strengths and problems.
B) Determine the family's expectations of a home visit.
C) Establish rapport between the nurse and the family.
D) Engage in extended social interaction as would be expected from any guest.
Q2) Using the Neuman Systems Model,which of the following questions would the nurse ask a client to assess physiological health?
A) "What helps you to cope with situations involving your wife's cancer?"
B) "How has your child's illness affected the behavior of your other children?"
C) "Tell me about any illnesses your other family members have."
D) "Who do you turn to for support outside your immediate family?"
Q3) A nurse is conducting a health risk appraisal.Which of the following activities is the nurse assessing when using this tool?
A) Health promotion activities
B) Illness prevention activities
C) Risk reduction activities
D) Unhealthy activities
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Sample Questions
Q1) 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.
Q2) A nurse wants to establish a program to decrease the death rate among adolescents.Which of the following programs should be developed?
A) Antialcohol program
B) Antismoking program
C) Careful driving program
D) Safe sex program
Q3) 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.
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.
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16 Verified Questions
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Sample Questions
Q1) Which of the following is the primary cause of vulnerability to health problems?
A) Breakdown of family structures
B) Poverty
C) Prejudice
D) Social isolation
Q2) A community health nurse would like to implement an intervention to increase lasting resilience among new immigrants.Which of the following actions should be taken by the nurse?
A) Direct clients to English-as-second-language courses.
B) Give immigrant clients money to help them get settled.
C) Identify areas in the city where housing is less expensive.
D) Solicit donations for food, clothing, and other needs.
Q3) Which of the following terms is used to describe aggregates who are at high risk for having poor health outcomes because of limited resources?
A) Disadvantaged families
B) Multiproblem families
C) Resilient populations
D) Vulnerable populations
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17 Flashcards
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Sample Questions
Q1) A resident in a rural community has been diagnosed with asthma.Which of the following providers will most likely provide care to this client?
A) Advanced nurse practitioner
B) Allergist
C) Pediatrician
D) Pulmonologist
Q2) A nurse is caring for Mexican migrant farmworkers.Which of the following conditions are of greatest importance for the nurse to assess?
A) Cholera
B) Hepatitis
C) High blood level of lead
D) Malaria
Q3) A Mexican immigrant mother tells the nurse she is concerned that people in the community will give her daughter mal de ojo.To which of the following folk illnesses is the nurse referring?
A) Evil eye
B) Fallen fontanel
C) Fright
D) Indigestion
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Sample Questions
Q1) A nurse is trying to decrease the risk for depression among older adults.Which of the following interventions should the nurse implement?
A) Encourage moving to a nursing home where others of the same age reside.
B) Monitor for signs and symptoms of depression.
C) Organize an exercise and health promotion program at the local senior citizen center.
D) Teach older clients to focus on their strengths rather than their weaknesses.
Q2) A nurse is working to improve her self-awareness in order to provide better client-centered care to clients living in poverty.Which of the following questions should the nurse ask herself?
A) What would I do if I lived in poverty?
B) What can be done to get poor people motivated to work?
C) How have the media images of poor persons shaped my image of poverty?
D) How can community resources assist those living in poverty?
Q3) Which of the following is the most rapidly growing group of homeless?
A) Adolescents
B) Families with children
C) Persons in crisis
D) Single men
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Sample Questions
Q1) A home health client has been taking acetaminophen with codeine,a narcotic analgesic,every 4 hours for pain following a hip arthroplasty.Which of the following statements made by a nurse to the client's physician indicates a need for further education on narcotics?
A) "You need to decrease the time interval between doses to every 3 hours so that my client will maintain pain relief."
B) "You need to discontinue that order before my client becomes addicted."
C) "You need to prescribe a different medication so that my client will achieve adequate pain relief."
D) "You need to give my client something in addition to this medication."
Q2) Three women were brought to the emergency department by ambulance after a two-car accident at a busy intersection.Which of the following tests should automatically be done under such circumstances?
A) Alcohol blood level
B) Cardiac workup
C) Pregnancy test
D) STD tests
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Sample Questions
Q1) Which of the following statements is the best explanation as to why some countries are more violent than others?
A) Civilized societies are less violent than primitive societies.
B) Geographical differences are the primary factor.
C) Population differences are the main determinant-for example, having more males than females.
D) Violence is a learned behavior controlled or allowed by social norms.
Q2) Which of the following is the top risk factor for intimate partner homicide?
A) There is a gun in the house.
B) The husband has made threats against wife before.
C) The wife has previously called 911 because of husband's beating her.
D) The woman's young daughter also lives with them.
Q3) Which of the following is a common factor typically found in those who abuse others?
A) Fear and belief that others are "out to get them"
B) Poor self-esteem and unawareness of alternatives
C) Previous observations of violent behaviors to manage conflict
D) Difficulty keeping commitments
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Q1) At a town meeting with public health officials to discuss a communicable disease outbreak,a nurse is asked to explain what is meant by the phrase "a virulent organism." The nurse explains that this means the organism causing the disease is able to do which of the following?
A) Bypass normal immunological response mechanisms
B) Invade major organ systems
C) Produce toxins and poisons that weaken the body
D) Produce very severe physical reactions
Q2) An instructor is reviewing Salmonella infections with her class.Which of the following comments indicates that the student needs further review on how Salmonella is spread?
A) "Certain pets and farm animals may be Salmonella carriers."
B) "It is possible to transmit Salmonella by person-to-person contact."
C) "Salmonella may be spread by spores that form once contaminated blood is exposed to the air."
D) "Salmonella outbreaks are usually due to contaminated meat, poultry, and eggs."
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Q1) The public health nurse comes to the hospital to see a client just diagnosed with hepatitis A.The nurse says,"I'm sorry to bother you when you're not feeling well,but I need to ask you a few questions." Which of the following questions would be most appropriate for the nurse to ask the client?
A) "Do you know how you got this infection?"
B) "Who lives with you?"
C) "Where are you employed?"
D) "Where do you usually eat?"
Q2) A school nurse asks a class about the ways HIV can be transmitted.Which of the following comments by a student indicates a need for additional teaching?
A) "I wouldn't sit next to someone with HIV."
B) "Having unprotected sex with someone who is infected spreads HIV."
C) "Sharing needles when shooting up drugs spreads HIV."
D) "Transfusions of blood products that are contaminated can spread HIV."
Q3) In the United States,which group is most affected by a new HIV diagnosis?
A) Women having heterosexual relationships
B) White IV drug abusers
C) Young Black gay and bisexual men
D) Men who have sex with other men

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Q1) A nurse is working at a local health department.Which of the following would most likely be completed by this agency?
A) Enforcement of laws and regulations related to public health nationwide
B) Filing of a certificate for any birth or death in a community
C) Providing experts in various specialties to answer questions and respond as needed
D) Surveying the state's public health needs
Q2) Which of the following best describes the primary reason life spans have notably lengthened over the past 100 years?
A) Advances in hospital care and procedures
B) Advances in medicine and medical research
C) Advances in nursing practice
D) Advances in public health
Q3) Which of the following is a core competency required of public health nurses?
A) Knowledge in the use of high-technology diagnostics
B) Knowledge of the implementation of electronic medical records
C) Skill in the physical assessment of complex clients
D) Skill in developing policy and planning programs
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Q1) A nurse is considering accepting the parish nursing position within his congregation.Which of the following educational preparation is crucial for the nurse to have received?
A) Baccalaureate education including community health nursing experience
B) Graduate education in community health nursing
C) Passing the national certifying exam for parish health nursing
D) Worship experiences for the process of ministry
Q2) Which of the following statements by a parish nurse exhibits a lack of understanding of the concept of pastoral care?
A) "By working with my clients to help them identify their spiritual strengths, I am drawing on pastoral care aspects of practice."
B) "To incorporate pastoral care, I should involve the pastor in ministering to the members of the congregation."
C) "I use pastoral care when I emphasize the spiritual dimension of nursing when providing care."
D) "When I lend support to my clients during times of joy, as well as during their times of sorrow, this illustrates an important aspect of pastoral care."
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Source URL: https://quizplus.com/quiz/40269
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Q1) Which of the following is the primary focus of hospice care?
A) Curing or controlling the client's chronic disease
B) Decreasing the waste of acute care (hospital) resources
C) Providing palliative care to maintain comfort until death
D) Teaching the client and family how to care for themselves
Q2) A hospital nurse wants to know why home health nurses often take more time with assessment than nurses do in the hospital.Which of the following is the best explanation for this?
A) Home care assessment includes not only the client but the supplies and equipment the family may have available for use.
B) The home environment is less organized and equipped for the nurse's use.
C) Family members must also be assessed for possible problems that could interfere with the primary client's recovery.
D) To be effective, the home health nurse must earn the family's trust and work in partnership with them.
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Source URL: https://quizplus.com/quiz/40270
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Q1) Which of the following activities are expectations for a school health nurse?
A) Ensuring that children with health problems are accepted by their peers
B) Driving children home if parents can't pick them up
C) Giving emergency care in the school or during school events
D) Giving medications as needed if children are ill
Q2) A school nurse is administering medications at the school.Which of the following guidelines should be followed?
A) A current drug reference should be available in case information is needed
B) The nurse should administer medications brought in from home by the child in a plastic bag
C) Medications cannot be administered without a physician order
D) Narcotics and controlled substances should be kept in a locked cabinet
Q3) Which of the following supplies or equipment should a nurse have available in the school health office?
A) Cervical spine collars
B) Complete emergency kit that fulfills American Hospital Association requirements
C) Epinephrine autoinjector kit
D) Material for splints
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Source URL: https://quizplus.com/quiz/40271
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Q1) Which of the following would most likely be one of the first steps taken in employer disaster planning?
A) All employees are invited to attend sessions on disaster planning.
B) Employers stress the importance of disaster drills and encourage active participation.
C) Exhaustive inventory of chemicals and industrial hazards is completed.
D) Written disaster plans are distributed to each employee and each worksite.
Q2) An occupational health nurse sees the various injuries and diseases that persons can acquire from employment.Which of the following recommendations would the nurse most likely provide about safety in the workplace?
A) Find employment in physical labor; at least your body will be in good condition.
B) Professional positions are the safest choice for employment.
C) White collar positions provide the least risk for injury.
D) There is no "safe" occupation or profession.
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