Chapter  1:  Health:  A Community View

1. Which of the following best describes the primary reason that Americans are concerned about health care? 

2. A nurse has begun to lobby with politicians for changes to the health care system. Why is this involvement important? 

3. What conclusion can be drawn from examining where nurses are employed? 

4. Which ethical belief would be most helpful in the current health care crisis? 

5. What is the primary problem seen in Healthy People 2020's emphasis on choosing healthy lifestyle behaviors, such as daily exercise or healthy food choices? 

6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of the nurse beyond giving excellent care to patients? 

7. What is the community health nursing definition of health? 

8. How does community health nursing define community? 

9.  Which variable has a major influence on a community's health? 

10. What change would most effectively lead to a longer life span in Americans? 

11. What is the health issue causing the most concern in the United States today? 

12. What factors are most responsible for the increasing length of life of Americans over the past 100 years? 

13. Why would a public health nurse want to know about morbidity and mortality statistics on the local, state, and national level? 

14. How do public health efforts differ from medical efforts in improving the health of our citizens? 

15.  Which primary prevention would the school nurse choose to address the school's number of unwed pregnancies? 

16. What would be the proper term for the action of the school health nurse arranging for all the students in the elementary school to receive H1N1 immunizations? 

17. Which action would probably result in the largest change in health care outcomes for Americans? 

18. Which task will be most helpful in meeting the public health agency's goals? 

19. A community health nurse is overwhelmed with all that needs to be done in one day. Which task could most easily be postponed? 

20. A nurse who works on the surgical unit at the local hospital was asked by the home health unit to make a home visit to a patient who had been discharged the previous day and to give follow-up care (for overload pay). What kind of nursing would this nurse be doing? 

21. Which task is most crucial for the community health nurse to do well? 

22. A new public health nurse carefully assessed all the local mortality and morbidity data in preparation for making appropriate planning suggestions at a meeting next week. What other action is crucial before the nurse can feel prepared? 

23. Why are high-risk and vulnerable subpopulations identified by public health nurses before deciding on appropriate interventions? 

24. A nurse works hard to develop alliances among various community organizations toward improving health in the community. What are actions such as this called? 

25. After completing a master's degree, a nurse took a course in marketing. Should the agency reimburse the nurse's tuition costs? 

26. Which factor is most responsible for differences in an individual's health? 

27. What are the leading health indicators found in Healthy People 2020? (Select all that apply.) 

1. Financial issues  

28. What historically have been public health nurses' two most important priorities? (Select all that apply.) 

29. As in Healthy People 2010, what are the two primary goals of Healthy People 2020? (Select all that apply.) 

Chapter 2:  Historical Factors

1. Which of the following best describes the time period when communities began to agree on collective action to stay healthy? 

2. Which of the following best describes the first measures used by large communities to ensure community health? 

3. A nurse has determined that there is always a consistent level of people in the population who experience pneumonia. Which of the following best describes the prevalence of this disease? 

4. Which of the following best describes an innovation introduced by the Romans? 

5. Which of the following best describes a modern public health practice that was originally developed as a means of self-protection from the Black Death (bubonic plague)? 

6. Which of the following diseases provided immunity to smallpox? 

7. A scholar during the Sanitary Revolution created medical topography. What was the advantage of these surveys? 

8. How did Edwin Chadwick's ideas help decrease disease in the nineteenth century? 

9. Which of the following best describes how John Snow was able to decrease deaths from cholera? 

10. Which of the following best describes the achievement that Lemuel Shattuck is well known for in the United States? 

11. Which of the following nursing interventions would have most likely been used by Florence Nightingale when treating wounded soldiers? 

12. Which of the following best describes how Nightingale responded to challenges about her suggestions for reform of health care? 

13. When comparing a surgeon today with a surgeon of Nightingale's time, which of the following best describes the primary difference in how they would operate on a patient? 

14. Which of the following scientific beliefs or ideas eventually changed medical practice and decreased morbidity and mortality? 

15. Why did local and state governments start to become more involved in controlling disease? 

16. Which of the following interventions was the first step in controlling the incidence of tuberculosis (TB)? 

17. Which of the following best describes the overall result of Abraham Flexner's report? 

18. Which of the following groups was primarily responsible for the establishment of the first school of public health? 

19. A family living in England in 1860 was part of the community where district nursing was implemented. Who would most likely have seen this family? 

20. Which of the following interventions was most helpful in assisting people become educated on healthy living in nineteenth-century England? 

21. Which of the following best describes the district nursing service created in the United States by Lillian Wald and Mary Brewster? 

22. Which of the following statements best summarizes Wald and Brewster's approach to home nursing? 

23. Which of the following did Lillian Wald help establish? 

24. Which of the following statements best summarizes the view of nurses as seen in novels over the past 100 years? 

25. Which of the following best describes the primary focus of health care efforts in the United States? 

26. Which of the following statements best describes why there is an increased need for advanced practice nurses in primary care? 

27. Which of the following statements best explains the continued incidence of infectious disease in the United States today? 

28. Which of the following best describes the primary concern both historically and today for many people when they become ill? 

29. Which of the following statements best describes the increase in life expectancy among Americans during the twentieth century? 

30. Which of the following is a major challenge for health care provider education today? 

31. Which of the following tool(s) were used by Florence Nightingale to create change? (Select all that apply.) 

32. Which of the following of Nightingale's ideas were forgotten until recently? (Select all that apply.) 

33. Which of the following best describes why folk healers are used by many people? (Select all that apply.) 

34. What current emphases are focusing attention on public health? (Select all that apply.) 

35. Which of the following were the chief factors that led to the creation and growth of Blue Cross hospital insurance? (Select all that apply.) 

Chapter 5:  Epidemiology

1. An epidemiologist has written a summary of a food poisoning outbreak, including its cause and ways to prevent it from occurring in the future. Which of the following best describes what has been done? 

2. Two brothers played with their cousin. One brother later became quite ill, whereas the other did not. Which of the following provides the best explanation for this occurrence? 

3. In which of the following circumstances would it be more helpful to use the wheel model of epidemiology than the epidemiological triangle model? 

4. Which of the following best describes the importance of discovering all of the variables that may be involved in creating a disease state in some persons? 

5. Which of the following best describes the advantage of the web of causation model in comparison with the epidemiological triangle model? 

6. Which of the following has been determined to be a major variable in transmission of sexually transmitted infections? 

7. A community health nurse determined exactly how many cases of a particular disease were currently occurring in the community. Which of the following actions should the nurse take before determining what interventions should be planned? 

8. People were very concerned about another outbreak of swine flu. All care providers were asked to report, without individual names, any new cases to the public health department for tracking. Which of the following would be most helpful for the local media to report to keep citizens informed? 

9. When trying to determine whether the swine flu outbreak was getting worse, which of the following rates should be carefully observed? 

10. A newspaper published an article stating that the athletic banquet at the local high school had approximately 1000 family members in attendance. Exactly 650 persons became ill within 24 hours, complaining of severe diarrhea, vomiting, and cramping. Which of the following best describes the attack

11. In a particular community, the rate of new cases of diabetes and the rate of new cases of flu during the month of January were precisely the same. Which disease would have the higher prevalence rate? 

12. Which of the following statements best describes why the incidence and prevalence of strep throat (streptococcus A) is unknown?  

13. Which of the following groups should be used to determine the community's pregnancy rate? 

14. Which of the following research studies would determine the attributable risk of a sedentary lifestyle in cardiac disease? 

15. A nurse conducted a study of two skin lotions: (1) an inexpensive one and (2) an expensive one. The nurse found that there was a relative risk of 0.7 for skin sores using the inexpensive one and a relative risk of 1.2 using the expensive one. Which skin lotion should the nurse use? 

16. Which of the following best describes a model that demonstrates the progression of disease from prepathogenesis through disease outcome? 

17. A student athlete receives a screening examination before being active in school sports. Which of the following levels of prevention is being used? 

18.  For which of the following would a screening test be most appropriate? 

19. One hundred women received notification that their screening tests suggested that they might have a serious health problem. Which of the following actions should the nurse take to ensure that they will complete follow-up testing? 

20. Which of the following would be the best method to increase the positive predictive value of a screening test? 

21. Which of the following is the most effective way to determine if Healthy People 2020 is improving the health of Americans? 

22. A researcher is examining potential risk factors in comparison with disease at a specific time through collecting data regarding current exercise, sleep patterns, and current health status among 12-year-olds. Which of the following research studies would be most appropriate? 

23. A researcher, interested in the onset of early menses, compared the life experiences and history of 1000 14-year-old girls, half of whom had monthly periods and half of whom did not, to determine what variables might be observed. Which of the following would be the most appropriate categorization of this study? 

24. One famous study followed a cohort of nurses over their lives, collecting data and health histories as they aged. Which of the following would be the most appropriate categorization of this study? 

25. A researcher wanted to engage in the best possible research design to obtain reliable information about the possible cause(s) of a disease. Which of the following designs would the researcher choose? 

26. A researcher has limited time and funds. Which of the following research designs would be most appropriate? 

27. On the basis of findings related to elevated blood levels of cholesterol, a researcher wanted to determine whether a new drug would notably lower the blood levels of cholesterol in otherwise healthy persons. Which of the following studies would the researcher most likely use? 

28. A client has developed pellagra because of a lack of certain B vitamins. Which of the following best describes the classification of the nutritional deficiency? 

29. Which of the following best describes the Tuskegee Syphilis Study? 

30. An epidemiologist is gathering data to determine which factors may lead to disease. Which of the following data will be gathered? (Select all that apply.) 

31. Which of the following information must be analyzed to derive an adequate explanation of disease? (Select all that apply.) 

32. Which of the following best describes the advantage of the ecosocial epidemiology model over both the web of causation model and the epidemiological triangle model? (Select all that apply.) 

33. Which of the following factors are necessary to assume there might be a cause-effect relationship between a particular variable A and a specific illness? (Select all that apply.) 

34. A nurse wanted a screening test that was very sensitive in determining who might have a particular illness. What might be a problem with using such a sensitive test? (Select all that apply.) 

Chapter 6:  Community Assessment

1. Which of the following best describes how care can be appropriately given in a community? 

2. Which of the following provides the most accurate way to explain community health nursing? 

3. Which of the following activities would be most helpful to a person in whom a serious chronic illness has been diagnosed? 

4. Which of the following is a major factor in determining which people or groups are most likely to be helpful to a particular individual? 

5. Which of the following best describes how people typically respond when asked of what community are they a member? 

6. Which of the following best describes what community members receive from each other? 

7. An individual lives in a healthy community. Which of the following characteristics would this community most likely display? 

8. A nurse is helping a community develop its capacity to address future problems. Which of the following activities is the nurse most likely implementing? 

9. Which of the following best describes shoe leather epidemiology? 

10. A community health nurse wants to obtain an overview of the community, but has limited time and resources. Which of the following methods would the nurse most likely use to obtain this information? 

11. Which of the following best describes how the U.S. Census Bureau surveys are helpful to a community health nurse? 

12. A public health nurse wanted statistics on the disability, illness, and other health-related variables for the state. Which of the following would be the best resource for the nurse to obtain the most extensive data? 

13. Which of the following best describes when a community health nurse would try to collect data on a health issue? 

14. All of the needed objective data on a specific health problem are available for the community health nurse. Which of the following best describes why the nurse would also interview community residents about the health problem? 

15. A nurse begins to collect information about a particular health problem from community residents. Which of the following potential problems would most likely arise? 

16. The nurse is interviewing community members as part of a community assessment. Which of the following groups of people would the community health nurse most likely want to interview? 

17. A nurse was debating about which approach to use to both obtain data about community needs and encourage community participation in their resolution. Which of the following approaches would be most effective in meeting both goals? 

18. A community health nurse has completed a community assessment and is now writing a community diagnosis for the problem. Which component of the diagnosis will be used to summarize the assessment data of the problem? 

19. A community health nurse is trying to determine the success of a planned intervention. Which of the following would the community health nurse most likely examine? 

20. A community health nurse found a very small number of families in the community who were desperately in need of basic preventive health services. Which of the following ethical approaches supports expending agency resources on these few, but needy, families? 

21. Which of the following best describes the aspects central to the definition of community? (Select all that apply.) 

22. Which of the following is a central function unique to community health nursing? (Select all that apply.) 

23. Which of the following are considered the most important determinants of a healthy community? (Select all that apply.) 

24. Which of the following from vital statistics records is useful to community health nurses? (Select all that apply.) 

Chapter 7:  Community Health Planning, Implementation, and Evaluation

1. Which of the following best describes how care can be appropriately given in a community? 

2. Which of the following provides the most accurate way to explain community health nursing? 

3. Which of the following activities would be most helpful to a person in whom a serious chronic illness has been diagnosed? 

4. Which of the following is a major factor in determining which people or groups are most likely to be helpful to a particular individual? 

5. Which of the following best describes how people typically respond when asked of what community are they a member? 

6. Which of the following best describes what community members receive from each other? 

7. An individual lives in a healthy community. Which of the following characteristics would this community most likely display? 

8. A nurse is helping a community develop its capacity to address future problems. Which of the following activities is the nurse most likely implementing? 

9. Which of the following best describes shoe leather epidemiology? 

10. A community health nurse wants to obtain an overview of the community, but has limited time and resources. Which of the following methods would the nurse most likely use to obtain this information? 

11. Which of the following best describes how the U.S. Census Bureau surveys are helpful to a community health nurse? 

12.  A public health nurse wanted statistics on the disability, illness, and other health-related variables for the state. Which of the following would be the best resource for the nurse to obtain the most extensive data? 

13. Which of the following best describes when a community health nurse would try to collect data on a health issue? 

14. All of the needed objective data on a specific health problem are available for the community health nurse. Which of the following best describes why the nurse would also interview community residents about the health problem? 

15. A nurse begins to collect information about a particular health problem from community residents. Which of the following potential problems would most likely arise? 

16. The nurse is interviewing community members as part of a community assessment. Which of the following groups of people would the community health nurse most likely want to interview? 

17. A nurse was debating about which approach to use to both obtain data about community needs and encourage community participation in their resolution. Which of the following approaches would be most effective in meeting both goals? 

18. A community health nurse has completed a community assessment and is now writing a community diagnosis for the problem. Which component of the diagnosis will be used to summarize the assessment data of the problem? 

19. A community health nurse is trying to determine the success of a planned intervention. Which of the following would the community health nurse most likely examine? 

20. A community health nurse found a very small number of families in the community who were desperately in need of basic preventive health services. Which of the following ethical approaches supports expending agency resources on these few, but needy, families? 

21. Which of the following best describes the aspects central to the definition of community? (Select all that apply.) 

22. Which of the following is a central function unique to community health nursing? (Select all that apply.) 

23. Which of the following are considered the most important determinants of a healthy community? (Select all that apply.) 

24. Which of the following from vital statistics records is useful to community health nurses? (Select all that apply.) 

Chapter 25:  Communicable Disease

1. Which of the following infections continues to increase in the United States? 

2. Which of the following best describes what is happening with infectious diseases in the United States? 

3. Which of the following is a fairly recent surprise regarding infectious diseases in the United States? 

4. A female client develops a fungal vaginal infection after being treated with antibiotics for strep throat. Which of the following components of the epidemiological triangle is primarily responsible? 

5. Which of the following statements is true concerning tuberculosis (TB) infections in the United States? 

6. One child in a kindergarten room had a slight fever and did not eat lunch. Otherwise, the child seemed OK. Three days later, several children were absent from kindergarten. Which of the following best describes what happened? 

7. A day care center asked the nurse to come because they had several children out as a result of chickenpox. Which of the following statements should the nurse make to the staff? 

8. A city that depended on tourist dollars had feedback that tourists were saying they were never returning because of the constant mosquito bites. Which of the following actions should be taken by the city? 

9. The daily patrons of a local town restaurant became ill with nausea, vomiting, and diarrhea. Without knowing the cause, which of the following actions should be taken immediately to help avoid future problems? 

10. Which of the following best describes why clinical areas are so careful to ensure sanitization of surfaces and equipment between each patient? 

11. Which of the following is the first step in preventing further spread of a particular sexually transmitted disease (STD)? 

12. A case of severe acute respiratory syndrome (SARS) was diagnosed immediately on signs of illness at a tourist site in China. Which of the following actions should be taken to protect the badly needed income from tourist dollars? 

13. A patient walks into a community clinic complaining of severe intestinal cramps and diarrhea. Which of the following actions can be taken to protect the staff at the clinic? 

14. During an outbreak in the hospital, all staff members were given immunoglobulin if they were not already immune to the disease. Which of the following types of immunity will the staff who received the immunoglobulin have? 

15. The nurse could not find a vaccine in the refrigerator. The unopened vaccine vial had been put in a storage cabinet with the other medications. The nurse drew up the appropriate dose in the syringe and then put the vial of vaccine in the refrigerator. Which of the following would be the most likely result? 

16. A school had tried very hard to uphold the requirement for all children to be vaccinated. However, state law allowed parents to exempt their child if they had a religious reason for refusal. Two children have been diagnosed with chickenpox. Which of the following will be the most likely result? 

17. A community health clinic put a tax levy on the ballot. An angry man asks a nurse, "How can you ask me to pay taxes to buy immunizations for parents who do not want to pay for their kids to get their shots?" Which of the following is the most appropriate response by the nurse? 

18. Which of the following statements best explains how infectious diseases are different from any other health problem? 

19. Which of the following would be one of the first steps in attempting to control a disease? 

20. The charge nurse notes that two patients had communicable infectious diseases and were treated appropriately. Which of the following actions should be taken next by the nurse? 

21. Parents have requested that their child be brought up to date on appropriate immunizations. After reviewing the child's medical history, the nurse prepares to give the two immunizations. What additional action should be taken by the nurse before administration of the immunization? 

22. Which of the following groups is especially at risk for sexually transmitted diseases (STDs)? 

23. A young woman is panic-stricken. She had not realized how much she was drinking, and she thinks she had unprotected sex with several men last night. She is petrified and wants an HIV test immediately. Which of the following actions should be taken by the nurse? 

24. Which of the following best explains why the Vaccine Adverse Event Reporting System (VAERS) was originally legislated? (Select all that apply.)