NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATI, Exams of Nursing

Download NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATI and more Exams Nursing in PDF only on Docsity! NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION Pop EXAM 1 TB Q’s Chapter 1 1. Which of the following best describes community-based nursing? a. A practice in which care is provided for individuals and families b. Providing care with a focus on the group’s needs c.Giving care with a focus on the aggregate’s needs d. A value system in which all clients receive optimal care ANS: A By definition, community-based nursing is a setting-specific practice in which care is provided for “sick” individuals and families where they live, work, and attend school. The emphasis is on acute and chronic care and the provision of comprehensive, coordinated, and continuous care. These nurses may be generalists or specialists in maternal–infant, pediatric, adult, or psychiatric mental health nursing. Community-based nursing emphasizes acute and chronic care to individuals and families, rather than focusing on groups, aggregates, or systems. 2. Which of the following best describes community-oriented nursing? a. Focusing on the provision of care to individuals and families b. Providing care to manage acute or chronic conditions c.Giving direct care to ill individuals within their family setting d. Having the goal of health promotion and disease NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION prevention ANS: D By definition, community-oriented nursing has the goal of preserving, protecting, or maintaining health and preventing disease to promote the quality of life. All nurses may focus on individuals and families, give direct care to ill persons within their family setting, and help manage acute or chronic conditions. These definitions are not specific to community-oriented nursing. 3. Which of the following is the primary focus of public health nursing? a. Families and groups b. Illness-oriented care c.Individuals within the family unit d. Health care of communities and populations ANS: D In public health nursing the primary focus is on the health care of communities and populations rather than on individuals, groups, and families. The goal is to prevent disease and preserve, promote, restore, and protect health for the community and the population within it. Community-based nurses deal primarily with illness-oriented care of individuals and families across the life span. The aim is to manage acute and chronic health conditions in the community, and the focus of practice is on individual or family-centered illness care. 4. 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 NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION needs. 8. Which of the following public health nurses most clearly fulfills the responsibilities of this role? a. The nurse who met with several groups to discuss community recreation issues b. The nurse who spent the day attending meetings of various health agencies c.The nurse who talked to several people about their particular health concerns d. The nurse who watched the city council meeting on local cable television ANS: B Any of these descriptions might represent a nurse communicating, cooperating, or collaborating with community residents or groups about health concerns. However, the nurse who spent the day attending meetings of various health agencies is the most representative, because in public health, concerns are addressed from a broader perspective. In public health, broad concerns of the community should be addressed. Concerns are broader than recreation, individual concerns are not as important as aggregate priorities, and watching television (a one-way form of communication) is less effective than interacting with others. 9. Which of the following best defines aggregate? a. A large group of persons b. A collection of individuals and families c.A collection of people who share one or more characteristics d. Another name for demographic group ANS: C An aggregate is defined a collection of people who share one or more personal or environmental characteristics. Members of a community can be defined in terms of either geography (e.g., a county, a NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION group of counties, or a state) or a special interest (e.g., children attending a particular school). These members make up a population. The term population may be used interchangeably with the term aggregate. A large group of persons, a collection of individuals and families, and another name for demographic group are not accurate definitions of the term aggregate. 10. A registered nurse was just employed as a public health nurse. Which question would be the most relevant for the nurse to ask? a. “Which groups are at the greatest risk for problems?” b. “Which patients should I see first as I begin my day?” c.“With which physicians will I be most closely collaborating?” d. “With which nursing assistants will I partner the most?” ANS: A Asking which groups are at greatest risk reflects a community-oriented perspective. The incorrect responses reflect a focus on individuals rather than a community-oriented perspective. 11. 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 Assurance includes making sure that essential community-oriented health services are available in the community. The definition does not fit the terms assessment, policy development. Scientific knowledge- NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION based care is not a core function of public health. Assessment is systematic data collection on the population, monitoring the population’s health status, and making information available about the health of the community. Policy development refers to efforts to develop policies that support the health of the population, including using a scientific knowledge base to make policy decisions. 12. When talking to a women’s group at the senior citizens’ center, the nurse reminded them that the only way the center would be able to afford to provide transportation services for them would be for them to continue to write letters to their local city council representatives requesting funding for such a service. What was the nurse trying to accomplish through this action? a. Ensure that the women did not expect the nurse to solve their problem. b. Demonstrate that the nurse understood the women’s concerns and needs. c.Express empathy, support, and concern. d. Help the women engage in political action. ANS: D Public health nurses engage themselves and others in policy development and encourage and assist persons to communicate their needs to those with the power to take action. The nurse is demonstrating the role of advocate through this action, it goes beyond merely understanding the women’s concern, and instead mobilizes them to take action. This action does not demonstrate the nurse showing empathy rather the nurse is empowering these women. 13. The public health nurse has a clear vision of what needs to be done and where to begin to improve the health of the community. Why would the nurse spend time meeting with community groups to discuss the most important task to be addressed first? a. To increase the group’s self-esteem NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION that apply.) a. Economic turmoil and demand for high-technology care b. Emergence of new or drug-resistant infectious diseases c.Emphasis on overall health care needs rather than only on acute care treatment d. Threat of bioterrorism ANS: B, C, D As overall health needs become the focus of care in the United States, a stronger commitment to population-focused services is emerging. Threats of bioterrorism, anthrax scares, and the emergence of modern-day epidemics have drawn attention to population-focused safety and services. Economic turmoil and demand for high-technology care have not contributed to a stronger commitment to population-focused services, rather it has occurred as overall health needs have become the focus of care. 2. Which of the following actions demonstrate effective public health nursing practice in the community? (Select all that apply.) 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. ANS: A, B, C Evidence that public health nurses are practicing effectively in the community would include organizing services where people live, work, play, and learn; working in partnerships and with coalitions; and participating in epidemiologic studies. Increasing number of staff does not have a relationship to the NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION effectiveness of public health nursing practice. 3. Why are nurses increasingly providing care in clients’ homes rather than in hospitals? (Select all that apply.) a. Home care is less expensive. b. It is much more efficient to give care in the home. c.Nurses prefer to give home care with individual attention. d. People prefer to receive care in their homes rather than in hospitals. ANS: A, D An increasing number of clients are receiving care in the home because it is less expensive and clients prefer to receive care in familiar and comfortable settings. It is not more efficient nor more convenient, since travel time has to be considered. Nurses differ as to their preferred employment setting. Chapter 2 1. A nurse is considering applying for a position as a public health nurse. Which of the following would be a reason this position would be appealing? a. Its autonomy and independence b. Its focus on acute care and immediately visible outcomes c.Its collaboration with other health care professionals d. Its flexibility and higher wages ANS: A NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION Public health nursing is known for its autonomy and independence. In many instances, there are limited other health care professionals and staff with whom to interact. In-patient acute care nurses focus on acute care with outcomes known fairly quickly. Acute care nurses collaborate frequently with other health care professionals. Depending on the position there may be more flexibility, but typically public health nurses do not receive higher wages. 2. The Elizabethan Poor Law of 1601 is similar to which current law? a. Welfare b. Food stamps c.Medicaid d. Med icare ANS: C The Elizabethan Poor Law guaranteed medical care for poor, blind, and “lame” individuals, similar to Medicaid. Welfare and food stamps do not provide for medical care. Medicare provides medical care to primarily the elderly population. 3. How did the Industrial Revolution result in previous caregiving approaches, such as care by families, friends, and neighbors, becoming inadequate? a. Economic and political wars resulted in frequent death and injuries. b. Incredible plagues consistently and constantly swept the European continent. c.Migration and urbanization resulted in increased demand for care. d. Caregivers could easily find other employment, so they NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION a. Efforts to control alcohol and drug abuse, as well as tobacco use, were initiated. b. Environmental sanitation efforts became an immediate priority. c.Guidelines for modern public health organizations were eventually developed. d. Local and state governments established boards of health after its publication. ANS: C It took 19 years for the first of Shattuck’s recommendations to be implemented, but his report was the first effort to create a modern public health organization. This report called for broad changes to improve the public’s health to take place; however, these changes did not happen immediately after publication. They took 19 years to be implemented in the first state of Massachusetts. The report included establishment of a state health department and local health boards in every town, sanitary surveys, and food, drug, and communicable disease control, but none of these changes happened quickly. 8. Which of the following nurses is famous for creating public health nursing in the United States? a. Florence Nightingale b. Frances Root c.Lillian Wald d. Mrs. Solomon Loeb ANS: C Lillian Wald established the Henry Street Settlement and later emerged as the established leader of public health nursing during its early decades. Mrs. Solomon Loeb was a wealthy layperson who assisted Mary Brewster in the establishment of the Henry Street Nurses Settlement. Francis Root was the first trained nurse in the United States who was salaried as a visiting nurse. Florence Nightingale had many accomplishments, but none of these occurred in the United States. NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION 9. Which of the following would have been the focus of a school nurse in the early 20th century? a. Investigating causes of absenteeism b. Teaching school as well as being a nurse c.Promoting nursing as an autonomous practice d. Providing medical treatment to enable children to return to school ANS: A Early school nursing focused on investigating causes of absenteeism. Providing medical treatment was the responsibility of physicians. School nurses did not teach in the schools nor were they part of an autonomous practice during this time period. 10. A nurse is reviewing the original work of the National Organization for Public Health Nursing. Which of the following accomplishments of today was started within this organization? a. Requiring that public health nurses have a baccalaureate degree in nursing b. Standardizing public health nursing education c.Developing public health nursing competencies d. Opening the Henry Street Settlement ANS: B The National Organization for Public Health Nursing sought to improve the educational and services standards of public health nursing. The Henry Street Settlement was already in existence and was opened by Lillian Wald and Mary Brewster. The baccalaureate degree in nursing was not developed yet. Public health nursing competencies were developed by the Quad Council. 11. Why were nurses so unprepared for public health nursing in the early 20th century? a. Public health nursing had not yet been created as a field. NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION b. No one would teach the nurses how to engage in public health activities. c.Nightingale’s textbook did not include content on public health nursing. d. Nurses were educated in diploma schools, which focused on care of hospitalized clients. ANS: D Nursing school courses taught in diploma schools of nursing emphasized hospital care of patients; thus, nurses were unprepared for home visiting. The specialty of public health nursing practice was developed in the early 1800s. There was not a lack of teachers for this activity, rather the focus of nursing care was in the acute care setting and not in the community. Nightingale did not have a published textbook. 12. A nurse is considering joining the American Public Health Association (APHA). 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 national 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 Nursing Section within APHA provides nurses with a national forum to discuss their concerns and strategies within the larger context of the major public health organization. It also serves as a focus of leadership and policy development for community/public health nursing. The focus of public health concerns of the APHA is broader than only the medical profession. The APHA focuses on concerns of public health nurses, not all nursing specialty practice. The APHA focuses on practical application of public NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION nurses during World War I to establish a public health nursing program for military outposts. The Marine Hospital Service was established well before World War II in 1798. The Frontier Nursing Service was established by Mary Breckinridge in 1925 and provided health care to the rural and often inaccessible populations in the Appalachian region of southeastern Kentucky. 17. 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 2020 documents propose a national strategy to improve significantly the health of Americans by preventing or delaying the onset of major chronic illnesses, injuries, and infectious diseases. The disarray resulting from reduced political support, financing, and effectiveness is described in the The Future of Public Health. The Scope and Standards of Public Health Nursing Practice describes the processes of assessment, analysis, and planning that are carried out by the public health nurse. The Patient Protection and Affordable Care Act improved access to health insurance for Americans. 18. A public health nurse is involved in health care reform. Which of the following best explains why the nurse is involved in these efforts? a. To promote the nursing profession b. To increase funding for public health nursing NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION c.To address the concerns of nurses d. To help improve health care access 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. Health care reform has a larger scope than only the profession of nursing and public health nursing. It addresses the concerns of nurses as well as many other health care professions MULTIPLE RESPONSE 1. How did Florence Nightingale help bring about community health nursing? (Select all that apply.) a. She convinced socially prominent wealthy women to volunteer to give care. b. She focused on all soldiers and their environment. c.She interacted with each individual person, assessing his or her needs and acting to meet those needs. d. She kept careful records on what was done and what were the results. ANS: B, D Nightingale progressively improved the soldiers’ health using a population-based approach that improved both environmental conditions and nursing care. Using simple epidemiology measures, she documented a decreased mortality rate to demonstrate the outcomes. While Nightingale was part of a wealthy family, the role of nurses during this time period was typically fulfilled by poor women. The focus of Nightingale’s care was to identify health care needs and interventions that influenced the health of the entire population, not individuals. 2. A nurse working with Mary Breckinridge would have likely assisted with: (Select all that apply.) NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION 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. ensuring positive outcomes for pregnancies among women in the Appalachian region. ANS: B, D Mary Breckinridge developed health programs geared toward improving the health care of the rural and often inaccessible populations in the Appalachian regions of the Southern Kentucky. Breckinridge introduced the first nurse-midwives into the United States when she deployed FNS nurses trained in nursing, public health, and midwifery. Their efforts led to reduced pregnancy complications and maternal mortality, and to one-third fewer stillbirths and infant deaths in an area of 700 square miles. Lillian Wald established the Henry Street Settlement. Mary Breckinridge developed health programs geared toward improving the health care of the rural and often inaccessible populations in the Appalachian regions of southern Kentucky, not the Rockies. 3. How did nursing education change in the 1950s? (Select all that apply.) a. Baccalaureate nursing programs typically included public health nursing concepts. b. Diploma schools of nursing continued to expand their student numbers. NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION on health care. 3. A nurse is explaining the health care system in the United States to a group of physicians visiting from South America. How would the nurse best describe the current health care system? a. “It is a logical, rational approach to meeting expressed needs while still trying to control costs.” b. “It is a centralized system that provides care in hospitals.” c.“It is divided primarily into two components: private health care and public health care.” d. “It is the best in the world with outstanding research and high-technology care available to all.” ANS: C Health care in the United States consists of a private or personal care system and a public health system, with overlap between the two. The United States health care system is one of the most expensive systems in the world that does not do a good job at controlling costs. Care is provided through an enormous range of facilities and providers, including hospitals, physicians’ and dentists’ offices, nursing homes, mental health facilities, ambulatory care centers, and freestanding clinics. Although there is great research and high-technology care in the United States, the health care outcomes of the country do not reflect this. Health care disparities exist among multiple populations making this system not available to all. 4. Which of the following best describes ideal primary health care? a. Based on a multidisciplinary group of health care providers that work as a team b. Essential care available to all community members, which encourages self-management c.Focused on health promotion and disease prevention for everyone enrolled in the health center d. Local efforts to meet the Declaration of Alma Ata principles ANS: B NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION Primary health care is generally defined as essential care made universally accessible to individuals, families, and the community. Health care is made available to them with their full participation and is provided at a cost that the community and country can afford. Public health is described as organized and multidisciplinary efforts aimed at preventing disease and promoting health, not primary care. Primary care provides for the integration of health promotion, disease prevention, with curative and rehabilitative services. The Declaration of Alma Ata was aimed at a world-wide, not local goal, to attain a level of health that permitted all citizens of the world to live socially and economically productive lives. 5. How does managed care attempt to control costs of care? a. By encouraging families to use the point of service list of individual practice associates b. By requiring families to choose a care provider from the MC network and not allowing access to other services without their 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 ANS: B Managed care is a system in which care is delivered by a specific network of providers. Each provider serves as a gatekeeper who controls access to other providers and services. Cost is reduced because members cannot use specialists or seek hospital or other care without permission from their primary-care providers. Thus, those enrolled in Medicaid managed care have restrictions that help keep costs down for government (and for taxpayers). Managed care provides care through a specific network of providers who agree to comply with the care approaches established through a case management approach, not through a point of service list of individual practice associates. Medicaid and Medicare programs are not interchangeable, NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION these programs serve different populations. Managed care does not refuse permission for certain services such as urgent care or emergency department, rather a case management approach is used to control costs. 6. An 80-year-old woman comes to the community health care facility with a large bag of medications. She tells the nurse she can no longer afford these medications because her only income is Social Security. Which statement is the best response by the nurse? a. “Let’s go through these medications and see which ones we can delete.” b. “You can get these medicines at this clinic for free.” c.“Let’s see if we can get some help from Medicare to help you pay for these medications.” d. “These medications are important. Do your best to pay for them.” ANS: C This elderly patient probably is eligible for benefits through Medicare Part D. Medicare Part D has been added to Medicare to help cover the cost of prescriptions. The role of the nurse would not be to delete medications for the patient or to tell the patient to figure it out on her own. Because of the age of the patient, the nurse should see if options exist under the Medicare system before looking into receiving the medications for free as there may be other barriers which limit the abilities to get these medications at a discounted cost. 7. A nurse is determining which health care services must be offered at a local public health clinic. Which of the following factors is most important for the nurse to consider? a. Data available from the most recent community assessment b. Suggestions from community members about what is needed c.Recommendations from Healthy People 2020 NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION affected area will be expected to collect data and accurately report the situation, to respond appropriately to any type of emergency, and to ensure the safety of the residents of the immediate area, while protecting those just outside the danger zone. This goal—to enable public health agencies to anticipate, prepare for, recognize, and respond to terrorist threats or natural disasters—has required an unprecedented level of interstate and federal-local planning and cooperation among these agencies. Demonstrating outcomes and decreasing overlap of services are both important factors to consider, however, this is not the reason why increased collaboration has occurred. There has not been an increase in taxpayer complaints or unhappiness that has caused these changes to occur. 11. African American females have a higher mortality rate from breast cancer than white females. This is an example of: a. projection. b. disparity. c.racism. d. a sentinel event. ANS: B Disparities are racial or ethnic differences in the quality of health care, not based on access or clinical needs, preferences, or appropriateness of an intervention. Projection is an estimate or forecast of a future situation based on current trends. Racism is a prejudice that exists against someone of a different race based on the belief that ones own race is superior. A sentinel event is an unanticipated event in health care that results in death or serious injury to the patient. NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION MULTIPLE RESPONSE 1. A public health agency is in the process of obtaining accreditation. Which of the following best describes why the agency would want to achieve accreditation? (Select all that apply.) NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION a. To improve health programming and services b. To improve community relationships c.To improve performance and quality d. To improve management ANS: B, C, D The purpose of accreditation for public health departments is to assist and identify quality health department performance and quality, and it develops leadership, improve management, and improve community relationships. The improvement of health care programming and services is not a reason why a public health agency would want to achieve accreditation. 2. What do demographic figures suggest about the ways in which the population of the United States is changing? (Select all that apply.) a. Foreign-born immigrant population is increasing. b. Hispanics are the largest minority group population. c.Leading causes of death are from infectious diseases. d. Mortality for both genders in all age groups declined. ANS: A, B, D The nation’s foreign-born population is growing, and it is projected that from now until 2050 the largest population growth will be due to immigrants and their children. Although African Americans used to be the largest minority group, Hispanics now have that distinction. The population of the United States continues to increase, and mortality for both genders from all age groups has declined. The leading causes of death have changed from infectious diseases to chronic and degenerative diseases. NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION 1. Which of the following is generally considered to be nursing’s first code of ethics? a. Nightingale Pledge b. Code for Professional Nurses c.Code of Ethics for Nurses d. Principles of the Ethical Practice of Public Health ANS: A The Nightingale Pledge is generally considered to be nursing’s first code of ethics. After the Nightingale Pledge, the Code for Professional Nurses was formally adopted by the ANA House of Delegates in 1950. It was amended and revised five more times, until, in 2001 the ANA House of Delegates adopted the Code of Ethics for Nurses with Interpretive Statements. The Principles of the Ethical Practice of Public Health was approved in 2002. 2. A nurse didn’t know what to do when faced with a particular ethical dilemma because an option that would have a good outcome didn’t seem possible. The nurse decided to talk to the agency supervisor and decide what action to take. Which of the following best describes the nurse’s actions? a. Appropriate, because the supervisor is responsible for the nurse’s choices b. Intelligent, because the supervisor has access to resource persons (clergy, physicians, administrators) who might know of options the nurse hadn’t considered c.Justified, because this provides an opportunity to discuss the issue but the nurse maintains responsibility for the decision d. Wise, because the supervisor would be more knowledgeable concerning agency priorities and NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION traditional practices ANS: C Ethically, each nurse is responsible for his or her own decisions and cannot avoid ethical accountability by relying on obedience to a supervisor or any external rule or policy. The supervisor is not responsible for the nurse’s choices, the nurse must maintain responsibility for his/her own decisions. The nurse should have access to the same resources as the supervisor and should have similar knowledge as the supervisor. 3. Which of the following is the first and most crucial step in a generic ethical decision-making process? a. Assess the context or environment in which the decision must be made. b. Consider the various ethical principles or theories. c.Identify the ethical issues and dilemmas. d. Make a decision and act on it. ANS: C The first step in the ethical decision-making framework is to identify the ethical issue or dilemma. After the first step of identifying the ethical concern, the following steps are: (2) place the ethical issue or dilemma within a meaningful context, (3) obtain all relevant facts, (4) reformulate ethical issues or dilemmas, if needed, (5) consider appropriate approaches to action or options, (6) make the decision and take action, and (7) evaluate the decision and action. 4. A nurse is asked to meet with a family who recently immigrated from Botswana (Africa). After the physician tells the husband the wife’s diagnosis of breast cancer, the family thanks the physician and starts to leave. Ethically, which of the following is the nurse’s most important action? a. Emphasizing that the family must set up a surgical appointment for the wife immediately b. Assessing the family’s current living situation, including insurance and other assets NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION c.Educating the family concerning the usual treatment and the prognosis of breast cancer d. Interviewing the family concerning their perspective of the threat to the family’s well-being ANS: D The United States is a multicultural nation with diverse ethnic groups and diverse values. Before any intervention can be made, the health care professionals must understand the family’s cultural, psychological, social, communal, and environmental contexts, because these contexts affect the way issues are formulated and decisions are made. Consequently, it is crucial to interview the family to determine their understanding of the situation before deciding what, if any, intervention must be made. In many cultures the family, rather than the individual, is the unit of primary concern. Setting up a surgical appointment immediately would not be an appropriate action for the nurse to take as this would be a remature action for anyone who has just been told that she has cancer. Assessing the family’s current living situation would not be the first concern of the nurse; the first concern should focus on the family’s well- being. After assessing the family’s well-being, the next action of the nurse may be to educate the family about the treatment and prognosis of breast cancer. 5. The nurse learns that a family has declined an elective medical intervention for a health care problem because paying for the care would drastically reduce the family’s resources and ability to meet the needs of other family members. Ethically, which of the following actions should be taken by the nurse? a. Appreciate that the family has made the decision that it feels is best and take no further action if it is clear the family has made an informed choice. NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION nurse? a. Communitarianism b. Deontology c.Principlism d. Utilitari anism ANS: C NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION The nurse is focusing on ethical principles—in this case, beneficence (do good for the ill family member), nonmaleficence (do no harm, even to the employer), and justice (everyone takes a turn and shares equally). Communitarianism is similar to virtue ethics and looks at the relationship and respoinsibility between the individual and the community. The ethical approach of deontology describes adhering to moral rules or duty rather than to the consequences of the actions. Utilitarianism is a consequentialist ethical theory associated with outcomes or consequences in determining which choice to make. 9. Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, “It’s not up to us; it’s the family’s decision. They know what is best for them.” Which of the following ethical approaches is being used by this nurse? a. Communitarianism b. Deontology c.Principlism d. Utilitari anism ANS: C The nurse is using an ethical principle, namely autonomy, in which each person or group can choose those actions that fulfill its values and goals. Therefore, the nurse is using principlism—that is, basic principles are the basis of the nurse’s actions. Communitarianism is similar to virtue ethics and looks at the relationship and responsibility between the individual and the community. The ethical approach of deontology describes adhering to moral rules or duty rather than to the consequences of the actions. Utilitarianism is a NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION consequentialist ethical theory associated with outcomes or consequences in determining which choice to make. 10. Which of the following is the dominant issue in ethical debate around an issue such as continuing or withdrawing treatment in acute health care? a. Doing what is best for the community b. Doing what is best for the family c.Obeying legal mandates d. Upholding ethical principles ANS: D In acute care settings with a single localized issue, the primary ethical principles are usually applied, with patient autonomy being the dominant or most crucial principle. Upholding ethical principles should be the first consideration before obeying legal mandates or doing what is best for the community or family. 11. The staff cannot reach an agreement on what is the right thing to do in relation to a specific patient. Which of the following approaches should the nurse use in personally deciding what is right? a. Do whatever will not get the nurse in trouble with employer. b. Do whatever is supported by an ethical expert, such as the hospital chaplain. c.Do whatever the nurse would recommend to anyone in a similar situation. d. Do whatever the nurse supervisor would feel comfortable reporting to administration. ANS: C One of the rules in deontological decision making is to determine whether the proposed actions can be generalized so that all persons in similar situations are treated similarly. In the same way, principlism suggests the nurse examine the context and make the decision that can be morally justified within that NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION care provider is paternalistic and unethical on many grounds, the physician may truly be concerned with enabling the injured addict to learn from his experience and possibly develop into a drug-free person. Communitarianism is similar to virtue ethics and looks at the relationship and respoinsibility between the individual and the community. When decisions are based on outcomes or consequences it is known as consequentialism. The ethical approach of deontology describes adhering to moral rules or duty rather than to the consequences of the actions. 15. Which of the following is considered the most important goal in nursing today? a. Adapting to technological advances such as electronic medical records b. Demonstrating caring as the basis of nursing practice c.Distinguishing nursing care from medical care d. Seeking evidence-based outcomes to demonstrate nursing’s contribution to care ANS: B Since the mid-1980s, nurses have written about caring as the essence of nursing and as the ethical and moral ideal of nursing practice. Caring is part of the core values of public health nursing and addresses the importance of the fiduciary relationship between the patient and the care provider. The primary goal of nursing is not to adapt to technological advances, distinguish nursing from medical care, or seek evidence based outcomes; rather, the goal of nursing is to implement caring which has been the moral ideal of nursing for many years. 16. With which of the following ethical approaches are Gilligan and Noddings associated? a. Distributive justice approach NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION b. Feminine ethic c.Principlism approach d. Virtue ethics ANS: B Gilligan and Noddings are associated with the approach known as the feminine ethic, which focuses on the morality of responsibility in relationships that emphasize connection and caring as a moral imperative. Distributive justice (fair distribution of the benefits and burdens of society), principlism (relying on ethical principles for decision making), and virtue ethics (seeking to enable persons to flourish as human beings) were not developed by Gilligan and Noddings. 17. 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. ANS: C An important goal of both policy and ethics is to achieve the public good, and both are involved in good citizenship. Ethics involves the application of specific principles when making decisions. There is nothing that supports that ethics and public policies are better achieved by those in high political office. 18. A new nurse states to a nursing colleague, “But why do I have to be involved in politics? I just want to be the very best clinical nurse I can.” Which of the following would be the best response from the nursing colleague? a. “As long as you pay your membership fee to the American Nurses Association, you have participated NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION in the profession’s political endeavors.” b. “Political action is the way you try to fulfill your ethical responsibilities to clients.” c.“You’re absolutely right; if you are good clinically, you have fulfilled your obligation.” d. “When you’ve completed your clinical orientation, then you’ll have time to be involved in politics.” ANS: B To be a good clinical nurse, the nurse needs resources and supportive policies that can be obtained only through political action to ensure those very resources and policies. Many clients are members of vulnerable groups who have often previously lacked access to quality care at an affordable cost. The American Nurses Association Code of Ethics for Nurses emphasizes political action as the mechanism to effect social justice and reform regarding homelessness, violence, and stigmatization. Nurses need to be involved in the political process in more ways than only being a dues paying member to the American Nurses Association. Clinical practice is not the same as political involvement; political involvement is necessary to achieve the advocacy role of the nurse. Nurses must make a conscious effort to be involved in political action. 19. Which of the following would confirm that the nurse’s advocacy has been truly successful or effective? a. Audiences agree with the nurse who is serving as advocate. b. Legislators discuss appropriate legislation to better allocate resources. c.People verbalize that the disenfranchised should be better treated. d. Systematic social changes are made to improve quality of life. ANS: D Advocacy is the application of information and resources to effect systematic changes that shape the way people in a community live to reduce death and disability and improve quality of life in the community. Only NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION in nursing practice on a regular basis and assist with problem solving. The use of ethics does not allow the nurse to recognize the source of most problems. The used of ethics is more important than political and legal responsibilities in practice. MULTIPLE RESPONSE 1. Three nurses disagree over the appropriate treatment for a woman who is an excellent candidate for hospice care. The first nurse believes that deciding on care rather than cure is the woman’s decision and no one else can decide for her. The second nurse says that it is the responsibility of the health care team to do good for the woman, and if the physician thinks there is still a possibility of cure, then the nurses should do everything they can to implement the treatment plan. The third nurse states that it isn’t fair for the family members to expend all their resources on the woman, who is probably going to die anyway. Which of the following conclusions can be drawn from this dispute? (Select all that apply.) a. Ethical principles can conflict with one another. b. The nurses are each using different ethical approaches. c.The first nurse is correct because autonomy demands that the woman decide for herself. d. There is no single accepted approach for resolving such disagreements. ANS: A, B, D One of the criticisms of using ethical principles is that they can conflict with one another in any given situation. No rule exists for helping resolve such conflicts. Each nurse can apply different ethical principles to reach their own ethical decision. Because there is no one rule to assist with solving an ethical conflict, and ultimately no one right answer, there is not a correct decision that can be made. Chapter 7 NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION 1. 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 ANS: A Politics is the art of influencing others to accept a specific course of action. Political action results in governmental policies and legislation. The result of legislative action typically is done in the form of laws and policies. The provision of power for making decisions is typically assumed by the government. 2. Which of the following activities is completed by the executive branch of the federal government? a. Administration of policy b. Interpretation of policy c.Proposal of policy d. Passage of policy ANS: A The executive branch administers and regulates policy. The legislative branch proposes policy (as bills) and passes policy (as laws). The judicial branch interprets laws. 3. A nurse meets with a senator to lobby for passage of a bill to increase funding for interpreter services. With which of the following branches of the government is the nurse working? a. Constitutional branch of government NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION b. Executive branch of government c.Legislative branch of government d. Judicial branch of government ANS: C The legislative branch of government is composed of the Senate and the House of Representatives. The legislative branch identifies problems and proposes and then debates, passes, and modifies laws to address those problems. There is not a constitutional branch of the government. The executive branch administers and regulates policy. The judicial branch interprets laws. 4. Which of the following statements best describes why the federal government has become involved in health care? a. The states asked the federal level to become involved. b. Because of rising costs to the states, the federal budget needed to be used to pay for necessary services. c.The Constitution gives the federal government the power to promote the general welfare. NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION a. Providing disease investigation training b. Providing research opportunities c.Providing leadership experiences d. Providing salaries commensurate with responsibilities ANS: D Through the input of the Division of Nursing’s National Advisory Council for Nursing Education and Practice (NACNEP), the Division of Nursing sets policy for nursing nationally. A few of the factors indicated by the NACNEP that need to be in place to support the public health nurse role are competitive salaries commensurate with responsibilities, experience in health promotion and prevention, long-term trusting relationships in the community, and a commitment to social justice and eliminating health disparities. The Division of Nursing’s National Advisory Council for Nursing Education and Practice (NACNEP) did not emphasize the importance of providing disease investigation training, research opportunities, or leadership experiences. 8. A nurse is determining whether a hospital has the right to require infected patients to be isolated against their will. To which type of law will the nurse refer? a. Common law b. Constitutional law c.Legislation and regulation d. Judici al law ANS: B Constitutional law provides the right to intervene in a reasonable manner to protect the health, safety, and NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION welfare of the citizenry. State power concerning health care is called police power. This power allows states to act to protect the health, safety, and welfare of their citizens. The state must show that it has a compelling interest in taking actions, especially actions that might infringe on individual rights. The state can isolate an individual to prevent an epidemic, even though this infringes on individual rights. The community’s rights are deemed more important than the individual’s rights when there is a threat to the health of the public. Judicial law, based on court and jury decisions, and the principles of common law (precedent, justice, fairness, respect for an individual’s autonomy, and self-determination) are both used by court’s as the basis to make a decision and do not relate to having the right to isolate a patient. Legislation is law that comes from the legislative branches of the government and regulations are specific statements of law related to defining or implanting individual pieces of legislation. Neither are as important in this case as the constitutional law of the police power of the states in regards to isolation of a patient. 9. Who is responsible for determining the scope of practice for registered nurses? a. American Nurses Association b. Federal legislators c.State legislators d. US Department of Health and Human Services ANS: C Health care practitioners are subject to the laws of the state in which they practice. The state nurse practice acts define the practice of professional nursing, identify the scope of nursing practice, set educational qualifications, and determine legal titles. The nurse practice act is governed by legislators in each state. The American Nurses Association, U.S. Department of Health and Human Services, and federal government do not determine the scope of practice for nurses, this responsibility is the role of state NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION governments. The U.S. Department of Health and Human Services is the agency most heavily involved with the health and welfare of U.S. citizens. 10. Which of the following statements by a client indicates a lack of understanding regarding an appropriate reason to sue for professional negligence? a. “Because the health care workers didn’t turn my mother every 2 hours, she developed bedsores.” b. “I received permanent nerve damage because they would not remove a cast that was too tight.” c.“My daughter wasn’t given a call light, and for a whole shift no one checked on her condition.” d. “They amputated the wrong leg during surgery.” ANS: C Professional negligence, or malpractice, is defined as an act (or failure to act) that leads to injury. All of the choices specify an injury, except for “My daughter wasn’t given a call light, and for a whole shift no one checked on her condition,” in which case the care was substandard, but no injury resulted. The incorrect responses all specify an injury whereas professional negligence, or malpractice, is defined as an act (or failure to act) that leads to injury. 11. Which of the following statements best describes the law in relation to clinical practice by nursing students? a. Students are considered certified until licensure is obtained. b. Students are expected to meet the same standard of care as the professional nurse. c.Students are not legally liable for errors because they practice under the license of their instructor. d. Students have a scope of practice determined by the nurse practice act. ANS: B Nursing students need to be aware that the same laws and rules that govern the professional nurse apply to them as well. Students are expected to meet the same standard of care as that met by any licensed nurse NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION d. Discuss the change in services with the administrators at the hospital. ANS: B Once a bill is passed and becomes law, it is too late to influence congressional members to change their vote; however, it is not too late to influence the outcome of the vote because the nurse can influence how the law is regulated. An agency typically writes the regulations that control how the law is implemented in more specific detail. Often this process can be just as important as lobbying against a bill because it shapes the final implementation of the law. Health care agencies do not have the ability to veto a bill. After a bill has been passed it is too late to contact members of congress. Calling the hospital will not change the implications of the bill. Contact must be made with the regulatory agency in order to influence how the law is regulated. 15. Which of the following agencies has the most influence on the health and welfare of US citizens? a. Agency for Healthcare Research and Quality (AHRQ) b. Centers for Disease Control and Prevention (CDC) c.US Department of Health and Human Services (USDHHS) d. World Health Organization (WHO) ANS: C As the agency to which most health care legislation is delegated, the USDHHS is the agency most heavily involved with the health and welfare of citizens. The AHRQ and CDC are divisions of the USDHHS. WHO’s policy-making body provides policy options and guides but not laws. In the textbook, only the USDHHS is discussed regarding its responsibility for Medicare and Medicaid through the Centers for Medicare and Medicaid Services (CMS). 16. Which of the following laws established programs for provision of health services for women and NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION children and supported community-oriented nursing practice? a. Early Periodic Screening and Developmental Testing (EPSDT) Initiative b. Healthy People 2000 Initiative c.Sheppard-Towner Act d. State Child Health Improvement Act (SCHIP) ANS: C The Sheppard-Towner Act of 1921 played an important role in the development of public health policy, public health nursing, and social welfare policy. Of particular importance was the fact that it established standards for programs to serve women and children and made nurses available to provide these services in the community setting. Within the Sheppard- Towner Act was a provision to start the EPSDT initiative. SCHIP provides insurance for children and families who cannot otherwise afford health insurance. Healthy People 2000 focuses on promoting health and preventing disease for all Americans. MULTIPLE RESPONSE 1. Which of the following describe the significance of the passage of The Public Health Threats and Emergencies Act? (Select all that apply.) 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. ANS: B, C The Public Health Threats and Emergencies Act was the first federal law to comprehensively address the public health NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION system’s preparedness for bioterrorism and other infectious disease outbreaks and signaled the beginning of renewed interest in public health as the protector for entire communities. The focus of this law was to address emerging threats to the public’s health and authorize the Secretary of HHS to take appropriate response actions during a public health emergency, including investigations, treatment, and prevention. It did not support the ongoing activities of public health. It did not validate the public health system was prepared for terrorism. 2. Which of the following best describe the importance of the World Health Organization (WHO) to the United States? (Select all that apply.) a. Provides daily information on disease occurrences. b. Establishes international standards for antibiotics and vaccines. c.Creates international legislation regarding international cooperation. d. Supports national programs to fight disease. ANS: A, B Some WHO services that benefit all countries (including the United States) are providing day-to-day information service on the occurrence of internationally important diseases; publishing the international list of causes of disease, injury, and death; monitoring adverse reactions to drugs; and establishing international standards for antibiotics and vaccines. Individual countries can request assistance with strengthening the delivery of health services, supporting national programs to fight disease, and training health workers—which the United States does not. WHO can suggest but cannot legislate to individual countries. 3. Which of the following activities are the responsibilities of the Centers for Disease Control and Prevention NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION a. Briefly describe personal education, experience, and expertise in the area. b. Discuss how the bill affects more than just nurses. c.Include factual data and, if possible, statistical information in visual form. d. Include the names of famous persons in the media who agree with you. ANS: A, B, C Language must be simple and carefully chosen to convey information to listeners and to avoid professional jargon. The nurse must share a bit of personal education, experience, and expertise to be seen as a credible source. The testimony must go beyond just nursing’s interest and include accurate, credible data. The data must be accurate and credible which may not be the case when getting names from the media. Chapter 8 1. A nurse is discussing how health care rationing occurs in the United States. Which of the following would most likely be discussed as the criterion that is used to ration health care? a. Clinic operating hours b. Ability to pay for services c.Availability of local provider services d. Transportation availability ANS: B Because there are not enough health care services available to provide desired services to everyone, the focus has been on reducing costs by controlling the use of services. All of the factors listed affect health care access and therefore affect health care rationing (either directly or indirectly). The primary NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION determinant, however, is the ability to pay for services. Without this ability, services are denied; therefore, those without insurance that is accepted by a provider or institution or who do not have the money to pay out of pocket are unable to obtain services. 2. Which of the following must a nurse be knowledgeable about to make decisions regarding the most cost-effective way to allocate health care resources? a. Insurance resources b. Health care rationing c.Health economics d. Medical technology ANS: C Economics is the science concerned with the use of resources; health economics is concerned with how scarce resources affect the health care industry. Insurance resources, health care rationing, and medical technology are important components of health economics but by themselves do not provide the broad understanding called for in this question. 3. Which of the following individuals would most likely experience a barrier when accessing health care? a. A 40-year-old female who speaks English b. A 25-year-old female with health insurance c.A 50-year-old male with hypertension d. A 30-year-old male who is unemployed ANS: D Barriers to accessing care include the inability to afford health care, lack of transportation, physical barriers, communication problems, childcare needs, lack of time or information, or refusal of services by NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION providers. The unemployed male is most likely to experience a barrier because of not having a job, which may reduce his access to NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION b. An emergency department c.Medicaid d. Med icare ANS: C Medicaid provides coverage for adults with low income and their children. Medicaid provides coverage for adults with low income and their children. 8. Which of the following best explains how the government unintentionally encourages low-income persons to use emergency departments as their primary-care provider? a. A huge amount of paperwork is required when Medicaid clients go to a physician’s office. b. Government regulations require Medicaid clients to use emergency departments when their primary health care provider is unavailable. c.Legally, emergency departments must see clients even if clients can’t pay. d. Physicians’ limited office hours make them unavailable during evenings and weekends. ANS: C People on Medicaid frequently have no primary-care provider and may not be able to pay for their care. Although physicians can choose clients based on their ability to pay, emergency departments are required by law to evaluate every client regardless of ability to pay. Emergency department copayments are modest and are frequently waived if the client is unable to pay. Thus, low out-of-pocket costs provide incentives for Medicaid clients and the uninsured to use emergency departments for primary-care services. Limited physician office hours over the weekend does make it difficult for low- income persons to access care through a primary care provider; however, this is not influenced by a government decision. The government NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION does not require Medicaid clients to use the emergency department when their primary care provider is unavailable, rather the policies of the emergency department to see all clients regardless of ability to pay may inadvertently encourage them to use this service. The paperwork at a physician’s office that needs to be completed by a Medicaid client is not any different than any other client receiving care at the office. 9. Of the four main factors that affect health, which is the least important? a. Environment b. Human biology c.Lifestyle choices d. Health care system ANS: D The four major factors that affect health are lifestyle, environment, human biology, and the health care system. However, the health care system (medical services) has the least effect on health. Of the four major factors that affect health — personal behavior (or lifestyle), environmental factors (including physical, social, and economic environments), human biology, and the health care system — medical services are said to have the least effect. Behavior (lifestyle) has been shown to have the greatest effect, but environment and biology account for the greatest effect on the development of all illnesses. 10. A nurse is trying to maximize the quality of life of her clients while reducing health care costs. Which of the following actions would most likely be completed by the nurse? a. Assisting in cast application for a client who was injured in a skateboard incident b. Irrigating the eyes of a client splashed with chemicals c.Restoring a normal cardiac rhythm following cardiopulmonary resuscitation of a client with a heart condition NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION d. Teaching a high school boy about sexually transmitted infections and proper condom application ANS: D Education is primary health care prevention. A proactive investment in disease prevention and health promotion targeted at improving health behaviors and lifestyle has the potential to improve health status and reduce health care costs. Assisting in a cast application, irrigating a client’s eyes, and restoring a normal cardiac rhythm are all tertiary prevention methods as a condition has already occurred and the nurse if focusing on restoring health. In order to maximize quality while reducing health care costs, the nurse should focus on primary prevention strategies. 11. Which of the following caused health care providers to begin to focus on individual infections and trauma in the 1900s in the United States? a. Education of health care providers moved into universities. b. People finally had enough money to pay for medical care. c.The improved outcomes of hospital care were recognized. d. Advances were made in sewage disposal, and water and milk quality. ANS: D Environmental conditions influencing health began to improve with major advances in water purity, sanitary sewage disposal, milk quality, and urban housing quality. The health problems of this era were no longer mass epidemics but individual acute infections or traumatic episodes. The education of health care providers did move into universities during this time period; however, this is not the reason why there was an increased focus on infections and trauma. Health care was paid for primarily by individuals during this time period so there was not an increase in the amount of money available to pay for health care. The NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION b. Federal and state government c.Insurance companies and other third-party payers d. Hospitals and health care providers ANS: B Combined state and federal governments paid the most for health care in 2014. Health care financing has evolved from a time when the most money was expended by consumers, then to a system financed by third-party payers such as insurance companies, and finally, to today, when state and federal government payments (primarily through Medicare and Medicaid) pay more than private insurance companies or consumers. From 1960 to 2014, the percentage of third-party public insurance payments increased and the percent of out-of-pocket payments declined. 15. Which of the following services 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. Medicare Part B covers “medically necessary” services, such as health care provider services, outpatient care, home health, and other medical services such as diagnostic services and physiotherapy. 16. A Medicare recipient has elected to pay a monthly premium for Medicare that will cover expenses such as laboratory services and equipment. Which of the following best describes this part of Medicare? a. Part A NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION b. Part B c.Part C d. P art 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. Medicare Part A covers hospital care, home care, and skilled nursing care. Medicare Part C plans are coordinated care plans that include health maintenance organizations, private fee-for-service plans, and medical savings accounts. Medicare Part D provides prescription drug coverage. 17. Which of the following criterion is now used for deciding the amount of the reimbursement before care is provided? a. A proportion of actual cost arbitrarily decided by the Medicare panel b. The federal budget constraints for the current fiscal year c.Hospital and health care provider feedback and political persuasion d. Prospective payment scale based on the medical diagnosis ANS: D As a result of rising health costs, Congress passed a law in 1983 that mandated an end to cost-plus reimbursement and instituted a prospective payment system (PPS) for inpatient hospital services to shift the cost incentives away from the providing of more care and toward more efficient services. The basis for prospective reimbursement is the 468 diagnosis- related groups (DRGs). There is not a Medicare panel that determines the actual cost of services. Payments are determined in advance based on DRGs and are not NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION determined by the budget of the federal government. Hospital and health care provider feedback do not influence the prospective reimbursement, rather, 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. 18. Which of the following payment systems tries to keep clients healthy through education and health promotion, with the goal of reducing the need for professional health care intervention and therefore also lowering cost? a. Managed care plan b. Fee-for-service payment c.Prospective reimbursement d. Retrospective reimbursement ANS: A The concept of managed care is that costly care could be reduced if consumers had access to education and health promotion. Fee-for-service payment encourages more services to be given. Reimbursement, whether prospective or retrospective, is based on the same criteria, but managed care integrates the financing and the delivery of health care. 19. Which of the following terms describes when a nurse practitioner receives a set monthly payment to take care of a group of clients regardless of the services needed and provided? a. Capitation b. Fee for service c.Rationing d. Retrospective reimbursement ANS: A NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION 22. A nurse is implementing a primary prevention strategy focusing on economics within the community. Which of the following interventions is the nurse most likely completing? a. Applying for a grant to establish a daycare center to serve dependent older adult clients living with working families b. Persuading legislators to pass a bill offering health care financial aid to families at risk c.Screening cocaine addicts for financial assistance eligibility for drug treatment d. Referring clients with renal failure to apply for Medicare ANS: B Primary prevention occurs before an illness or condition develops. Of the options provided, only persuading legislators to pass a bill offering health care financial aid to families at risk addresses initiating interventions before an illness occurs. Applying for a grant and referring clients with renal failure both demonstrate the use of tertiary prevention as the illness or condition has already developed. Screening cocaine addicts displays the use of secondary prevention as a screening technique is being used to identify the problem as soon as possible. MULTIPLE RESPONSE 1. In which of the following situations would the federal government provide money through tax relief for private enterprise? (Select all that apply.) a. A business pays for part of health insurance premiums for its employees b. A business purchases gifts for its employees to award them for their service c.An employer provides health screenings and immunizations d. An employer requests reimbursement for employee transportation costs ANS: A, C NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION Businesses can pay for disease prevention and health promotion services for employees (and sometimes their families) in the form of immunizations, health screenings, and counseling. The business can then deduct these costs as a business expense, which reduces the amount the business owes the government in taxes on their profits. Similarly, when businesses subsidize health insurance for their employees—and families—this is also a business expense, which decreases the amount the business would otherwise pay in taxes. Thus, the government indirectly provides the money, but the business, a part of the private sector, decides how it is used. A business purchasing gifts for its employees and an employer requesting reimbursement for employee transportation costs do not result in tax relief for the business. Rather, the business providing health insurance and health promotion/disease prevention services allows the amount of taxes that the business owes to the government to be reduced. 2. Which of the following best explains why clients who have Medicaid have poor health outcomes? (Select all that apply.) a. Clients may have preexisting conditions not covered by insurance. b. Many physicians won’t accept Medicaid clients. c.Medicaid won’t pay for certain medical interventions. d. Medicaid recipients are noncompliant with their health care providers’ recommendations. ANS: A, B, C The primary reasons for delay, difficulty, or failure to access care include inability to afford health care and a variety of insurance-related reasons, including the insurer not approving, covering, or paying for care; the client having preexisting conditions; and physicians refusing to accept the insurance plan. Practical problems such as lack of childcare, transportation, long waiting periods, and communication issues also interfere. Noncompliance is not a primary reason why Medicaid clients have poor outcomes. Rather there NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION are usually other compounding factors that interfere with the client following the regimen or accessing other needed health care services which result in the poor health outcomes. 3. A nurse would like to help members of the community focus on receiving primary preventive health care services. Which of the following interventions should be implemented by the nurse? (Select all that apply.) a. Publicize data on success of health promotion efforts, including cost savings. b. Lobby for decreased reimbursement for secondary and tertiary care services. c.Establish standards for appropriate screenings at specific intervals. d. Encourage members of the military service to engage in appropriate healthy lifestyle behaviors. ANS: A, C Reasons given for the lack of emphasis on prevention in clinical practice and lack of financial investment in prevention include provider uncertainty about which clients should receive services and at what intervals, lack of information about preventive services, negative attitudes about the importance of preventive care, lack of time for delivery of preventive services, delayed or absent feedback regarding success of preventive measures, less reimbursement for these services than for curative services, lack of organization to deliver preventive services, and lack of use of services by the poor and elderly. Considering how health care dollars are spent in the U.S., it would not be reasonable to lobby for decreased funding for secondary and tertiary services, as this would result in less care available for individuals. Requiring people to change their lifestyle would be illegal. 4. Which of the following are some major differences in health care today, as compared with the first half of the 20th century? (Select all that apply.) a. Consumers are influenced by advertising for specific health care agents or procedures. b. The emphasis is on the continued expansion of health care facilities, especially acute care hospitals. NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION c.Laws and policies must reward good healthy behaviors and punish unhealthy behaviors to help individuals recognize the importance of change. d. Society must offer healthy choices, offer support, and practice helpful policies. ANS: D Change for the benefit of the community client often must occur at several levels, ranging from the individual to society as a whole. Lifestyle-induced health problems cannot be solved simply by asking or encouraging individuals to choose health-promoting habits. Society also must provide healthy choices. Most individuals cannot change their habits alone; they require the support of family members, friends, community health care systems, and relevant social policies. Change in society is helpful for addicts to change their behavior. Many times certain aspects of society limit an individuals ability to make change on their own. Laws and policies within society must support individuals to make healthy lifestyle choices. 4. A nurse is focusing on the process dimension of a community’s health. Which of the following interventions will the nurse most likely implement? a. Assessing the health care services available in a community b. Establishing screening programs to diagnosis diseases as early as possible so treatment can begin c.Implementing health promotion activities such as education programs d. Planning for new programs to be developed based on identified needs ANS: C When the emphasis is on the process dimension—usually the level of intervention of the nurse in community health—the best strategy is usually health promotion, such as various primary prevention NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION strategies. The other responses represent the structure dimension of the community. Structure is defined as the services and resources within the community. This includes service use patterns, treatment data from various health agencies, and provider-to-client ratios. 5. A nurse has invited community members to participate as full partners in creating changes to improve the health of the community. Which of the following may be an unexpected consequence of this action? a. A change in the distribution or redistribution of power and influence b. An increase in awareness of the importance of health c.Continued ongoing interest in community health activities d. Improved family functioning and involvement in health activities ANS: A Collaborative practice models involving the community and nurses in joint decision making and specific nursing roles are required. Nurses must remember that collaboration means shared roles and a cooperative effort in which participants want to work together. These participants must see themselves as part of a group effort and share in the process, beginning with planning and including decision making. This means sharing not only the power but also the responsibility for the outcomes of the intervention. By having the community members involved in creating the health change it is likely they will have an increased awareness of the importance of health, an ongoing interest in the health of the community. These things should occur because the community is more educated about its health because of its involvement. Being involved will not necessarily result in improved family functioning so this consequence will most likely not occur. 6. During the assessment phase, the nurse compiles and interprets available data and draws conclusions as to NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION the community’s strengths and concerns. Which of the following best describes why the nurse would also conduct interviews with key informants? a. To ensure that others agree with the nurse’s plans for interventions b. To confirm the nurse’s initial findings and conclusions c.To encourage community partners to feel they “own” the data d. To generate nonstatistical data such as values, beliefs, and perceived needs ANS: D Data generation is the process of developing data that do not already exist, through interaction with community members, individuals, families, or groups. Such information might include the community’s knowledge and beliefs, values and sentiments, and goals and perceived needs. Such data are collected by interviews and observation. Interviews with key informants provide data; the purpose is not to ensure agreement with the nurse’s plan or confirm findings. The key informants are formal or informal leaders within the community and although they may have information to share about the community, it may not be important that they feel that they “own” the data. 7. A nurse just accepted a position in community health and has been assigned to a neighborhood very close to where she lives. Which of the following best describes the rationale for this assignment? a. To allow participant observation by the nurse b. To ensure that the nurse would care about her intervention outcomes c.To maximize convenience and minimize commuting time for the nurse d. To save gasoline in these difficult economic times ANS: A NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION c.To help get a better understanding of the assigned community d. To save time and effort and perhaps have new insights ANS: D The nurse uses previously gathered data because it saves time and effort. Many sources of data are readily available and useful for secondary analysis. Being familiar with the community before the assessment is important, however, being thoroughly oriented is not necessary. The nurse should become familiar with the community, not the goals and priorities of the agency. It is helpful for the nurse to better understand the community, but the main reason is to save time and avoid duplication of data that may already exist. 10. A new nurse is overwhelmed with the needs of the community. Which of the following should be the first priority of the nurse? a. A problem that affects the most disadvantaged residents in the community b. A problem that is very easy and inexpensive to address c.A problem that is of high concern to the community d. A problem in an area in which the nurse has a great deal of expertise ANS: C Choice of priority must depend on the community’s awareness of the problem—and their motivation to improve it. Other bases for choosing include determining which individuals would be most affected, what benefits to the community would result, what might happen if the problem is not resolved, how much it might cost to address the problem, and how much support for or opposition to the problem seem likely based on community values and priorities. Rather than examining the issues from the perspective of the most disadvantaged residents, the nurse should look at the problem which affects the most individuals in the community who may or may not be disadvantaged. The cost of the problem will need to be addressed, NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION but if the problem is not a priority to the community the agency may be wasting money addressing a problem that the community does not care to solve. If the nurse is unfamiliar with interventions to solve the problem, the nurse should collaborate with others to solve the problem. The priority should be the needs of the community, not the needs of the nurse. 11. Which of the following objectives is most appropriate for the development of a community-oriented nursing care plan? a. All monitored patients will receive abortive therapy for lethal dysrhythmias within 3 minutes of dysrhythmia recognition. b. Of mothers receiving nutrition counseling, 80% will identify five sources of calcium by the end of class. c.95% of children will be immunized by 1 year of age. d. There will be a 25% reduction in health disparities by 2015. ANS: B Objectives must be precise, behaviorally stated, and measurable. The response that describes mothers receiving nutrition counseling represents a specific, measurable behavior as an objective. Treatment in an acute care setting is not part of a community-oriented care plan. The objective that 95% of children will be immunized by 1 year does not precisely state which children (in a county? in the country?) and does not state which immunizations. (Some are not appropriate to give to children who are only 1 year old.) A 25% reduction by 2015 is a goal, not an objective. NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION 12. During which of the following activities is the nurse in community health acting as a partner in change? a. Administering vaccinations to preschoolers b. Analyzing community problems to determine the best interventions c.Establishing an elder-care center for older adults living with family members who work d. Teaching anger management skills to a group of teens in a halfway house ANS: D Content-focused roles often are considered change agent roles, whereas process roles are called change partner roles. Change partner roles include those of enabler-catalyst, teacher of problem-solving skills, and activist agent. Teaching anger management skills to a group of teens in a halfway house demonstrates the use of a change partner role of teacher of problem-solving skills. Change agent roles stress gathering and analyzing facts and implementing programs. The nurse establishing an elder-care center is acting as a change agent. The nurses administering vaccinations and analyzing community problems are carrying out other nursing roles. 13. A nurse is assessing a community’s openness to change. Which of the following variables indicate that the community is ready? a. Commitment to current processes and policies b. High socioeconomic status in the community as a whole c.Long history of dependence on the community health agency and its staff d. Minimal level of social participation by community members ANS: B The ability to change is often directly related to higher socioeconomic status; a perceived need for change; NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION 1. A community health nurse encourages members of the community to partner and assist in creating health programs. Which of the following best describes the rationale for this action? (Select all that apply.) a. Partnering results in increased effectiveness b. Involving community members results in contributions of time and money into the program c.Having many partners results in increased publicity for the program d. Participating in planning results in having a vested interest in the outcome ANS: A, D The primary reason community partnership is crucial is that community members and professionals who are active participants in a collaborative decision-making process have a vested interest in the success of efforts to improve the health of their community. The significance and effectiveness of partnership in improving community health are supported by a growing body of literature. Community partners do contribute time and money into programs, and most likely will increase the publicity for the program; however, this should not be the primary reason for including them in the partnership. Through the partnership, it is likely that the program will have increased success and better outcomes which should be the primary objective of the nurse. 2. 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? (Select all that apply.) 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 NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION nearby neighbors ANS: A, B Gaining entry or acceptance into the community is perhaps the biggest challenge in assessment. The nurse is usually an outsider and often represents an established health care system that is neither known nor trusted by community members, who may therefore react with indifference or even active hostility. Entry into the community is critical. Often the nurse can gain entry by taking part in community events, visiting people in formal leadership positions, and clarifying community members’ perceptions of health needs. While an activity such as volunteering is a positive action, it is not the most efficient way to become involved in the wider community. Completing physical assessments on individuals is an individual- based, not community-based intervention and would not be anticipated to be performed by the community health nurse. 3. A nurse is deciding which alternative interventions should be implemented. Which of the following factors must be considered by the nurse when making this decision? (Select all that apply.) a. The expected effect or outcome of each possible intervention b. How interested others are in helping in any particular intervention c.The nurse’s own interest in implementing each intervention d. The likelihood that the intervention will resolve the problem ANS: A, B, D The nurse can list each possible intervention and then consider the resources or barriers to that particular interventio n, the expected effect of each choice, the likelihood that the activity will help meet the objective and resolve the problem, whether others can be educated to implement the intervention, and the change process necessary to complete the objective. The primary interest should be the concern of the community, not the nurse’s personal interests. NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION 4. A nurse wants to determine whether health problems have been improved and interventions have been appropriate and successful over a period of time. Which of the following data should the nurse examine? (Select all that apply.) a. Changes in staffing patterns in the health agency b. Demographic data c.Education and school statistics d. Environmental factors ANS: B, D To see the outcomes of chosen interventions, the nurse would examine changes in demographics, socioeconomic factors, environmental factors, health status, and/or use of health services. Changing in staffing patterns and education and school statistics would not be impacted by a change in the health problems in the community. Epidemiologic data and trends would be the best sources to examine to evaluate the change. 5. Which of the following activities are considered to be part of the core competencies for public health professionals? (Select all that apply.) a. Defining variables relevant to current public health problems b. Obtaining and interpreting information regarding risks and benefits to the community c.Implementing nursing care and subsequent evaluation outcomes d. Maintaining public health departments throughout the United States ANS: A, B Eleven core competencies for the nurse and other health providers working in the community have been defined by the Council on Linkages Between Academia and Public Health Practice. Defining variables NUR 4150 Concepts of Community-Based Nursing Practice EXAM 2022 UPDATE Q&A GUARANTEED SATISFACTION