NR-443 – Community Health Nursing Focuses on
public health concepts, community assessments,
health promotion initiatives, prevention
strategies, and population-centered nursing.
1. A community health nurse is applying the core public health function of
"assessment." Which activity best exemplifies this function?
• A) Developing a smoking cessation program for teenagers
• B) Analyzing data on opioid overdoses in the county
• C) Enforcing restaurant sanitation regulations
• D) Providing wound care to a homebound elderly patient
Answer: B
Rationale: The three core public health functions (IOM)
are assessment (systematic data collection and analysis), policy
development (using evidence to develop policies), and assurance (ensuring
services are available). Analyzing overdose data is assessment.
2. A nurse is using the epidemiological triangle to investigate a measles
outbreak. Which component represents the "agent"?
• A) Preschool children without vaccination
• B) Measles virus (rubeola)
• C) Crowded daycare center
• D) Low socioeconomic status
Answer: B
Rationale: Epidemiological triangle: agent (cause – virus, bacteria,
toxin), host (person susceptible), environment (external factors). Measles virus is
the agent. Children are hosts; daycare is environment.
,3. A community health nurse is applying the primary prevention level. Which
intervention is appropriate?
• A) Teaching hand hygiene to prevent influenza
• B) Directly observed therapy for tuberculosis
• C) Stroke rehabilitation support group
• D) Screening for hypertension at a health fair
Answer: A
Rationale: Primary prevention prevents disease before it occurs (health
promotion, specific protection). Teaching hand hygiene prevents infection.
Secondary = screening/early detection. Tertiary = rehabilitation.
4. The nurse uses the "upstream thinking" approach. This means focusing on:
• A) Treating acute illnesses in the emergency department
• B) Addressing root causes of health problems (social, economic,
environmental)
• C) Discharging patients as quickly as possible
• D) Providing bedside nursing care
Answer: B
Rationale: Upstream thinking (McKinlay) addresses fundamental causes of
health disparities (poverty, education, housing, policy) rather than downstream
effects (individual treatment). It is a population-focused perspective.
5. A nurse is conducting a community health needs assessment. Which data
source provides primary data?
• A) Census Bureau reports
• B) Hospital discharge data
• C) A survey distributed to residents
, • D) State vital statistics
Answer: C
Rationale: Primary data are collected directly from the community (surveys,
interviews, focus groups, windshield surveys). Secondary data are existing sources
(census, vital stats, hospital data).
6. A nurse is practicing the ethical principle of "distributive justice." Which
action demonstrates this?
• A) Advocating for equitable allocation of vaccines to underserved
neighborhoods
• B) Keeping a patient's HIV status confidential
• C) Obtaining informed consent for a home visit
• D) Providing compassionate end-of-life care
Answer: A
Rationale: Distributive justice concerns fair distribution of resources and
benefits/burdens across populations. Equitable vaccine allocation addresses health
disparities.
7. The community health nurse uses the "population-focused" approach. The
primary distinction from individual-focused nursing is:
• A) The nurse provides direct care to families
• B) The nurse intervenes at the level of aggregate or community to promote
health and prevent disease
• C) The nurse works only in public health departments
• D) The nurse does not assess individuals
Answer: B
Rationale: Population-focused practice targets aggregates (groups, communities)
with interventions that address common health risks or problems, emphasizing
prevention and health promotion.
, 8. A nurse is using the "Ministry of Health" framework as described by the
Public Health Agency of Canada. The core function of "health protection"
includes:
• A) Immunization campaigns
• B) Outbreak management and sanitation regulations
• C) Chronic disease self-management education
• D) Mental health counseling
Answer: B
Rationale: Health protection includes activities to control infectious diseases,
environmental health, food safety, and emergency preparedness. Outbreak
management and sanitation are health protection.
9. A community health nurse is working with a migrant farmworker
population. Which barrier is most likely to affect access to care?
• A) High income and education
• B) Stable housing and English proficiency
• C) Mobility, language barriers, lack of insurance, and fear of deportation
• D) Overabundance of local clinics
Answer: C
Rationale: Migrant farmworkers face multiple barriers: mobility (seasonal work),
language, low income, limited insurance, immigration concerns, and lack of
transportation.
10. The nurse is applying the "precautionary principle" in environmental
health. This principle states that:
• A) Action to prevent harm should be taken even if scientific certainty is not
yet established
• B) No action should be taken until harm is proven beyond doubt
• C) Economic costs always outweigh health benefits
public health concepts, community assessments,
health promotion initiatives, prevention
strategies, and population-centered nursing.
1. A community health nurse is applying the core public health function of
"assessment." Which activity best exemplifies this function?
• A) Developing a smoking cessation program for teenagers
• B) Analyzing data on opioid overdoses in the county
• C) Enforcing restaurant sanitation regulations
• D) Providing wound care to a homebound elderly patient
Answer: B
Rationale: The three core public health functions (IOM)
are assessment (systematic data collection and analysis), policy
development (using evidence to develop policies), and assurance (ensuring
services are available). Analyzing overdose data is assessment.
2. A nurse is using the epidemiological triangle to investigate a measles
outbreak. Which component represents the "agent"?
• A) Preschool children without vaccination
• B) Measles virus (rubeola)
• C) Crowded daycare center
• D) Low socioeconomic status
Answer: B
Rationale: Epidemiological triangle: agent (cause – virus, bacteria,
toxin), host (person susceptible), environment (external factors). Measles virus is
the agent. Children are hosts; daycare is environment.
,3. A community health nurse is applying the primary prevention level. Which
intervention is appropriate?
• A) Teaching hand hygiene to prevent influenza
• B) Directly observed therapy for tuberculosis
• C) Stroke rehabilitation support group
• D) Screening for hypertension at a health fair
Answer: A
Rationale: Primary prevention prevents disease before it occurs (health
promotion, specific protection). Teaching hand hygiene prevents infection.
Secondary = screening/early detection. Tertiary = rehabilitation.
4. The nurse uses the "upstream thinking" approach. This means focusing on:
• A) Treating acute illnesses in the emergency department
• B) Addressing root causes of health problems (social, economic,
environmental)
• C) Discharging patients as quickly as possible
• D) Providing bedside nursing care
Answer: B
Rationale: Upstream thinking (McKinlay) addresses fundamental causes of
health disparities (poverty, education, housing, policy) rather than downstream
effects (individual treatment). It is a population-focused perspective.
5. A nurse is conducting a community health needs assessment. Which data
source provides primary data?
• A) Census Bureau reports
• B) Hospital discharge data
• C) A survey distributed to residents
, • D) State vital statistics
Answer: C
Rationale: Primary data are collected directly from the community (surveys,
interviews, focus groups, windshield surveys). Secondary data are existing sources
(census, vital stats, hospital data).
6. A nurse is practicing the ethical principle of "distributive justice." Which
action demonstrates this?
• A) Advocating for equitable allocation of vaccines to underserved
neighborhoods
• B) Keeping a patient's HIV status confidential
• C) Obtaining informed consent for a home visit
• D) Providing compassionate end-of-life care
Answer: A
Rationale: Distributive justice concerns fair distribution of resources and
benefits/burdens across populations. Equitable vaccine allocation addresses health
disparities.
7. The community health nurse uses the "population-focused" approach. The
primary distinction from individual-focused nursing is:
• A) The nurse provides direct care to families
• B) The nurse intervenes at the level of aggregate or community to promote
health and prevent disease
• C) The nurse works only in public health departments
• D) The nurse does not assess individuals
Answer: B
Rationale: Population-focused practice targets aggregates (groups, communities)
with interventions that address common health risks or problems, emphasizing
prevention and health promotion.
, 8. A nurse is using the "Ministry of Health" framework as described by the
Public Health Agency of Canada. The core function of "health protection"
includes:
• A) Immunization campaigns
• B) Outbreak management and sanitation regulations
• C) Chronic disease self-management education
• D) Mental health counseling
Answer: B
Rationale: Health protection includes activities to control infectious diseases,
environmental health, food safety, and emergency preparedness. Outbreak
management and sanitation are health protection.
9. A community health nurse is working with a migrant farmworker
population. Which barrier is most likely to affect access to care?
• A) High income and education
• B) Stable housing and English proficiency
• C) Mobility, language barriers, lack of insurance, and fear of deportation
• D) Overabundance of local clinics
Answer: C
Rationale: Migrant farmworkers face multiple barriers: mobility (seasonal work),
language, low income, limited insurance, immigration concerns, and lack of
transportation.
10. The nurse is applying the "precautionary principle" in environmental
health. This principle states that:
• A) Action to prevent harm should be taken even if scientific certainty is not
yet established
• B) No action should be taken until harm is proven beyond doubt
• C) Economic costs always outweigh health benefits
