NRS 412 EXAM 1 QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026

NRS 412 EXAM 1 QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026 Public Health History - Answers Middle ages: population density increased (we bPublic Health History - Answers Middle ages: population density increased (we begin to see the development of cities), there is evidence of poor sanitation and increased incidence of communicable diseases. The people during this time period used supernatural explanations for physical and mental illnesses. The average lifespan at this time was about 35 due to high infant and child mortality. 1850: John snow use epidemiological (causality) principles to halt a cholera epidemic in London, earning the title "father of epidemiology". He conducted door to door 'shoe leather epidemiological investigations'. At this time John snow was attempting to improve living conditions and through his efforts and he realized that people were getting sick through the use of dirty water. This was a major turning point in health because it became evident that illness was not caused by dirty air (miasma). During this point in time mental health illness was thought to be caused by demonic expression 1850 to WW2: sanitary methods are developed in order to safeguard water. The pasteurization of milk begins. Immunizations and antibiotics are being more readily used. There is a growing focus on chronic disease, mental health, and substance abuse. AIDS and other emerging infectious diseases become evident. Presence of climate change, violence, poverty, and bioterrorism become increasingly evident. People are living longer. Families become smaller 21st century: public health to social determinants of health as target for population level, not individual health. Policy and environmental interventions are being enacted. Decreased public health focus on trying to change behavior at the individual level Florence Nightingale - Answers Used epidemiological statistics to document outcomes. She found that medical interventions had unclear benefits while nursing care designed to "put patient in the best condition for nature to act upon him" resulted in a dramatic reduction in morbidity/mortality in as hospitals through the use of hygiene, nutrition, infection control, fresh air and light. Used prevention and a systems approach to decrease high mortality rates for infants, children, the poor, and those in the hospital. Recognized that social physics was key to health (jobs, environment, conditions, etc AKA social determinants of health) Clara Barton - Answers In US civil was, she founded the American Red Cross. After the geneva convention (after WW2) this became an international organization dedicated to provision of humanitarian help for people affected by conflict and armed violence, and to promote laws that help the victims of war Lillian Wald - Answers Ran the Henry Street Settlement which advocated for social changes to improve health for immigrant population in tenement slums of NYS, particularly children. Initiated school nursing and school playgrounds. She is thought to be the mother of public health Nursing IOM: Future of Public Health Report - Answers Public health is 'what we, as a society, do collectively to assure the conditions in which people can be healthy' Vision: "healthy people in healthy communities" Mission: "promote physical and mental health and prevent disease, injury, and disability" American Public Health Association - Answers Public Health nurses integrate community involvement and knowledge about the entire population with personal, clinical understandings of the health and illness experiences of individuals and families within the population. Multilevel integrative model of nursing that practices at 3 levels (individual, family, population) Quad Council Tier 1 Competencies - Answers Responsibilities of the tier 1 public health nurse (baccalaureate prepared) may include -working directly with at risk populations -carry out health promotion programs at all levels of prevention -basic data collection and analysis -Field work (doing home visits): in reference the to lead poisoning issue the PH nurse would go out to conduct home visits with an environmental health person -Program planning -Outreach activities (she would want to know who is at risk and target those individuals, you want to know the major risks that you are trying to assist an at risk population with) -Programmatic support -Other organizational tasks American Nurses Association - Answers Public Health nursing is the practice of promoting and protecting the health of populations using knowledge from nursing, social and public health sciences. Public Health nursing practice is population focused, with the goals of promoting health and preventing disease and disability for all people through the creation of conditions in which people can be healthy. Hallmarks of Public Health - Answers -Population/Aggregate focus of care: population indicates a group of people who have something in common, whereas an aggregate is a subgroup of the population -Collaboration among multiple, diverse disciplines with shared scientific base of epidemiology: this is the study of the distribution and determinants of health related states or events in a specified population, and the application of this study to control of health problems -Prevention and health promotion are goals: the ecological model of health considers all factors impacting a populations health status, recognizing that health status and outcomes are shaped by cultural, social, and economic factors. Upstream interventions (often policy changes) are used to impact downstream outcomes for at risk population. -Partnership with the community: Collaboration with a population or community empowers the community for self advocacy and self determination. The goal is ongoing and long term improvement of the community's health status -Primary care+Public health= Population health: public health works with private hospitals and providers in order to improve the health of the population. Primary care providers are able to treat individual symptoms and educate individuals on how to treat and take medicine. Public health has the means of gathering data on local environmental factors that may influence an individual to display symptoms. They also monitor patients at population level to see areas at risk in order to create policies, create educational tools, and raise awareness for community based programs in order to prevent attacks Healthy People 2020 - Answers Provides a comprehensive set of 10 year national goals and objectives for improving the health of all americans. Leading health indicators have been established with this in order to communicate high priority health issues and actions that can be taken. Leading health indicators include access to health services, clinical preventative services, environmental quality, injury and violence, maternal/infant/child health, mental health, nutrition/physical activity/obesity, oral health, reproductive and sexual health, social determinants, substance abuse, tobacc use Public health nurse - Answers -Tier 1 (BSN prepared): case manager, clinic nurse, intake nurse, community liason and educator, environmental investigator and disaster responder -Tier 2 and 3 (MSN/MPH prepared) program manager (includes assessment, grant writing and grant maintenance, program development and education, supervision of professional and para-professional staff), disaster responder and coordinator of public health response team -School nurse: health service coordinator, health educator, environmental health monitor. Participant in individual education plan process for special needs students -Occupational health nurse: practitioner, administrator, educator, researcher, consultant, monitor, and advocate -Faith community nurse (parish nurse): educator, counselor, volunteer coordinator, community liason, referral agent. offers spiritual support Core functions of public health - Answers -Assessment -Policy development -Assurance Assessment (core function of public health) - Answers -Monitor a populations demographics and its frequent causes of morbidity and mortality (overall health status) -Look at current institutional and programmatic resources (as well as the cultural, social, natural, and built environments) YOU ARE ASSESSING THE ENVIRONMENT -This will lead to the identification of resources, risks, barriers, and gaps in service; followed by the diagnosis of problems and risks, prioritization and goal setting -Monitor environmental and health status to identify and solve community environmental health problems -Diagnose and investigate environmental health problems and hazards in the community Policy Development - Answers This is an intervention used to help create the conditions in which people can be healthy. It is intended to empower the community/population, and includes advocacy from funding of programs and services, and for the development of laws and regulation in order to protect the public health -Rules and laws (school board, county board members, congress) -Inform, educate and empower people about environmental health issues -Mobilize community partnerships and actions to identify and solve environmental health problems -Develop policies and plans that support individuals and community health efforts Assurance - Answers The aspect of public health that monitors for compliance with health related regulations and laws, assures a competent workforce, and links vulnerable populations to needed services while also evaluating the effectiveness of various programs and services Anything where you need to make sure of something Do people have access to healthcare? Enforce laws and regulations that protect environmental health and ensure safety Link people to needed environmental health services and assure the provision of these services when otherwise unavailable Evaluate effectiveness, accessibility, and quality of personal and population based environmental health services Research for new insights and innovative solutions to environmental health problems Top 10 essential services of public health - Answers -Monitor health status to identify community health problems (assessment) -Diagnose and investigate health problems and health hazards in the community (assessment) -Inform, educate, and empower people about health issues (policy development) -Mobilize community partnerships to identify and solve health problems (policy development) -Develop policies and plans that support individuals and community health efforts (policy development) -Enforce laws and regulations that protect health and ensure safety (Assurance) -Link people to needed personal health services and assure the provision of health care when otherwise unavailable (assurance) -Assure a competent public health and personal healthcare workforce (assurance) -Evaluate effectiveness, accessibility, and quality of personal and population based health services (assurance) -Research for new insights and innovative solutions to health problems (assurance) ANA code of ethics - Answers Discusses social justice as a core ethical value for professional nursing practice. The profession of nursing, collectively and through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice int nursing and health policy Nursings social responsibility - Answers -What do we owe the society that invests in us the trust to care for them -Purpose of this document is to define the social contract between the profession of nursing and the society This is ecapsulated in the stated definition of nursing -Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals, families, communities, and populaitons Obligations of the health profession - Answers -Principle of respect and autonomy (based on human dignity and respect of individuals, requires that individuals be permitted to choose their own actions) -principle of nonmalificence (requires that we do not harm) -Principle of beneficence (do good, perform actions that benefit others and enhance their dignity) -Principle of distributive justice (similar to the utilitarian principle which seeks the greatest good for the greatest number, in the social sciences this is termed social justice) (think of a traumatic event) (requires agreement on a minimum level of goods and services that are available to all members of society) American Public Health association: public health code of ethics - Answers Humans have a right to resources necessary for health. Everyone has the right to a standard of living adequate for the health and well being of himself and his family Microsystem - Answers This is our immediate environment that supports our development (family, school, church) Mezzosystem - Answers This recognizes the link between two or more microsystem and the individual Macrosystem - Answers Settings or institutions that may not directly come in contact with an individual but still influence development in less direct ways (such as government, values, and media) Nursing process: Assessment - Answers Used to monitor health status, identify trends, identify new threats to health (descriptive epidemiology) It is also used to identify risk factors, patterns, and clusters (analytical) (this looks at why these health problems exist) What is community? A group or collection of individuals interacting in social units and sharing common interests, characteristics, values, and goals Phenomenological community: the place or setting is more abstract. The people share a group perspective or identity based on culture, values, history, interests, and goals. (all graduate of elmhurst college, deaf community) Geopolitical community: formed by natural or manmade boundaries and includes cities, counties, states, and nations. (school districts, census tracts, zip codes, and neighborhoods) (District 87) Assessment tools: primary data is generated by the person who is performing the assessment which can be obtained from -Windshield survey: done by driving or walking through an area and making organized observations. With this the nurse is able to gain an understanding of the environmental layout. You are able to see what differences exist at different times of the day. -Key informant: someone who is not in an elected position, but they are a longtime trusted member of the community and they know details of the community which they are attempting to share with you (school nurse at EC) -Stakeholders: the people who are affected by the issues, these are the individuals whose lives we hope to change for the better with the interventions that we implement -Focus groups: you are not trying to get a representative sample but rather a focused sample. (Alexian brothers asking nursing students what they are looking for in a job) -Surveys Secondary data is previously obtained and analyzed for other purposes -Census data -These are statistics and Nursing process: Analysis - Answers Community diagnosis -Analyze assessment data by identifying problems, strengths, trends -Develop community nursing diagnosis Community planning: -Document the community's resources (the human and material resources that can be built upon to strengthen the community) (what is available in order to support the issue) -The Illinois department of public health requires every county to assess and file a local assessment of needs (LAN) report every 5 years along with 5 year goals and evaluation of previous goal outcomes -What resources could be drawn on to address and lead toxicity community diagnosis above, as primary and secondary levels of prevention? -Identify key players/stakeholders for partnering (this will reflect a shift from the community being a client to them being a partner), prioritization of needs, identify target population, establish goals (both long term and short term expected outcomes with measurable indicators) Long term goal: phrase as an ultimate outcome with time frame and specific measurable behavior Short term goal: set SMART goals to help achieve long term goal -Identify solutions, resources, and strategy Nursing process: Interventions - Answers -Public health core functions: Assurance and policy development -Change theory at the population level (planned change) Unfreezing: need for change is felt (may be as a result of internal or external stimuli). This disequilibrium disrupts the status quo, and change is initiated Moving: old actions are questioned, new actions are tried, and attitudes change causing movement towards acceptance of change (there is increased anxiety/sense of threat and community will need support to cope with change Refreezing: change is established and accepted as permanent, time of stabilization -Community outreach: use of community wide education (television, radio, newspaper, internet) Employ community credible outreach workers Use of community venue for outreach and education Be creative and go where targeted or at risk subgroup is found Be present when and where target group is most available and receptive -Referral: linking the community to services Establish a resource directly by determining the procedure for initiating a referral, eligibility requirement, payment mechanism, contact person, any special considerations. Assess client community receptivity and evaluate the effectiveness of referral Nursing process: evaluation - Answers Turn objectives into outcomes that are measurable, state a time frame and reflect You are not concerned with process, you are more concerned with outcomes: both short term (time bound) and long term Ongoing evaluation: intervention on target? or need to refine strategies? Are short term/ long term objectives met? If not, what are the contributing factors to determine if goal and methods are appropriate and still mutually desired If short term goals/mes are met, then long term should be achieved Branches of government - Answers -Executive: president or governor, cabinet, and regulatory units. Administers and regulates policy -Legislative: senate and house of representatives. Sets policy by making laws. -Judicial: supreme court. Interprets laws and meaning of policies. Federal law/organizations - Answers -The purpose of federal regulating agencies is to advice the executive branch; to determine national funding priorities; to provide direction and consultation for state level counterpart agencies -To provide direction and consultation for state level counterpart agencies -Federal regulatory agencies were created to protect the publics interest and safety through their regulatory function so they have been referred to as "watchdog" agencies -Department of health and human services (DHHS) this is an umbrella organization coordinating the federal agencies listed below: Health resources and services administration (HRSA), agency for healthcare research and quality (AHRQ), OSHA, CDC, EPA, FDA, NIH State level/agencies - Answers The state level regulatory agencies distribute and monitor usage of federal and state tax funds, and coordinate surveillance and reporting of vital statistics and morbidity/mortality trends Illinois department of public health (home agency that responds to the CDC, they are the middle man) Illinois department of financial and professional regulation State level counterparts of federal agencies Local level - Answers Local health departments are usually part of county government, some may be a unit of municipal government Local health departments have a direct responsibility to the population served Local health departments use local taxes and compete for state determined funding Local health departments continuously monitor key populations health data and report data to governing and funding authorities Local health departments provide mandated funded services such as epidemiology, water and air quality testing, resturaunt inspection, local assessment of needs activities, immunization, case management, title X family planning, STD and TB testing What has driven the continuing economic transformation of the US health care system - Answers -Shift from infectious disease as a leading cause of death in 1900, to chronic disease in the 20th century (mortality patterns have shifted from high child mortality and adult death after a brief terminal illness, to a pattern of increased longevity) (this has occurred because of both prevention (vaccines, improved housing and sanitation), and life prolonging treatments (CABG, stent, statin, BP