1
Chapter 01: Health: A Community View
Nies: Community/Public Health Nursing, 7th Edition
MULTIPLE CHOICE
1. Which best describes the primary reason that Americans are concerned about health care?
a. Politicians are discussing how to improve health care.
b. The media has provided mixed messages about the health care system.
c. Our national health care costs keep increasing.
d. The new health care system offers free services to Americans.
ANS: C
The primary reason for the focus on health care is the constantly increasing costs, which
cannot be sustained. The costs of caring for the sick accounted for the majority of escalating
health care dollars, which increased from 5.7% of the gross domestic product in 1965 to
17.8% in 2015. Politicians and the media both influence Americans’ perceptions about health
care; however, they are not the primary reason why Americans are concerned. The new health
care system will change the health care access and availability, but will not necessarily be
offering any free services to Americans.
DIF: Cognitive Level: Understand (Comprehension)
2. A nurse has begun to lobby with politicians for changes to the health care system. Why is this
involvement important?
a. Nurses, as central characters in several popular TV series, are currently very
visible in American mediN a. R I G B.C M
b. Nurses are primarily responUsibSle foNr mT
anagingOthe various units in our health care
system.
c. Nurses are the largest segment of health care providers.
d. Nurses are the only group that is employed both inside and outside of hospitals.
ANS: C
As the largest segment of health care providers, nurses are informed about the current health
care system and all the problems that result from people not seeking care until they are
desperately ill. Nurses, as the American Nurses Association (ANA) emphasize, usually
believe that health care is a right, not a privilege. Therefore, nurses, whose work is central to
our current health care delivery system, can also be instrumental in working politically to
create a health care delivery system that will meet health needs. While nurses are in several
current TV series and are employed both inside and outside of hospitals, physicians and other
health care providers are as well. Nurses are often managers, but managers often have other
backgrounds, such as business administration.
DIF: Cognitive Level: Understand (Comprehension)
3. What conclusion can be drawn from examining where nurses are employed?
a. There is a trend toward consolidation of health care into large central medical
centers.
b. There is an increased emphasis on community-based health care.
c. There is an obvious need to decrease health care costs by cutting positions.
d. Managed care organizations (MCOs) are employing nurses to improve customer
[AUTHOR] 1
, 2
relations.
ANS: B
MCOs are employing nurses in many capacities. Although hospitals are closing and acute care
is increasingly found in central medical centers, the same trend may be seen in an increase in
neighborhood-based practice centers. While positions are cut in most industries, health care is
recognized as an area where growth in employment is expected. However, nurses are
increasingly employed in community settings as opposed to hospitals. This change reflects the
move toward community-based care rather than hospital-based tertiary care. To help decrease
the continued rise in health care costs, the increased emphasis is on disease prevention rather
than high-cost treatment.
DIF: Cognitive Level: Understand (Comprehension)
4. Which ethical belief would be most helpful in the current health care crisis?
a. Emphasis should be on individual and corporation freedom in the marketplace.
b. Emphasis should be on individual autonomy and freedom of choice.
c. Emphasis should be on social justice and collective responsibility.
d. Emphasis should be on the effectiveness of technology in resolving problems.
ANS: C
Public health recognizes the necessity of collective action in keeping the environment safe and
in egalitarian tradition and vision. An overinvestment in technology and seeking of cures
within the market justice system has stifled the evolution of a health system to protect and
preserve the health of the population. Although individual autonomy and freedom of choice
are important, so is the recognition of collective responsibility in ensuring social justice,
which entitles all people to basic necessities.
DIF: Cognitive Level: Apply (Application)
5. What is the primary problem seen in Healthy People 2020’s emphasis on choosing healthy
lifestyle behaviors, such as daily exercise or healthy food choices?
a. Emphasis on other lifestyle choices, such as not smoking and minimal use of
alcohol or drugs, is also needed.
b. All of us must work together to make unhealthy behaviors socially unacceptable.
c. It costs more to make healthy choices, such as buying and eating fresh fruits and
vegetables as opposed to quick and cheap fast-food choices.
d. Public policy emphasizes personal responsibility but ignores social and
environmental changes needed for well-being.
ANS: D
Although all responses are accurate, the primary problem is the emphasis on personal choices
in the Healthy People 2020 objectives. Emphasis on personal choices ignores the need for
community responsibility and action that addresses environmental or cultural restraints to
health.
DIF: Cognitive Level: Apply (Application)
6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of
the nurse beyond giving excellent care to patients?
a. Accept longer work schedules to ensure that professional care is always available
[AUTHOR] 2
Chapter 01: Health: A Community View
Nies: Community/Public Health Nursing, 7th Edition
MULTIPLE CHOICE
1. Which best describes the primary reason that Americans are concerned about health care?
a. Politicians are discussing how to improve health care.
b. The media has provided mixed messages about the health care system.
c. Our national health care costs keep increasing.
d. The new health care system offers free services to Americans.
ANS: C
The primary reason for the focus on health care is the constantly increasing costs, which
cannot be sustained. The costs of caring for the sick accounted for the majority of escalating
health care dollars, which increased from 5.7% of the gross domestic product in 1965 to
17.8% in 2015. Politicians and the media both influence Americans’ perceptions about health
care; however, they are not the primary reason why Americans are concerned. The new health
care system will change the health care access and availability, but will not necessarily be
offering any free services to Americans.
DIF: Cognitive Level: Understand (Comprehension)
2. A nurse has begun to lobby with politicians for changes to the health care system. Why is this
involvement important?
a. Nurses, as central characters in several popular TV series, are currently very
visible in American mediN a. R I G B.C M
b. Nurses are primarily responUsibSle foNr mT
anagingOthe various units in our health care
system.
c. Nurses are the largest segment of health care providers.
d. Nurses are the only group that is employed both inside and outside of hospitals.
ANS: C
As the largest segment of health care providers, nurses are informed about the current health
care system and all the problems that result from people not seeking care until they are
desperately ill. Nurses, as the American Nurses Association (ANA) emphasize, usually
believe that health care is a right, not a privilege. Therefore, nurses, whose work is central to
our current health care delivery system, can also be instrumental in working politically to
create a health care delivery system that will meet health needs. While nurses are in several
current TV series and are employed both inside and outside of hospitals, physicians and other
health care providers are as well. Nurses are often managers, but managers often have other
backgrounds, such as business administration.
DIF: Cognitive Level: Understand (Comprehension)
3. What conclusion can be drawn from examining where nurses are employed?
a. There is a trend toward consolidation of health care into large central medical
centers.
b. There is an increased emphasis on community-based health care.
c. There is an obvious need to decrease health care costs by cutting positions.
d. Managed care organizations (MCOs) are employing nurses to improve customer
[AUTHOR] 1
, 2
relations.
ANS: B
MCOs are employing nurses in many capacities. Although hospitals are closing and acute care
is increasingly found in central medical centers, the same trend may be seen in an increase in
neighborhood-based practice centers. While positions are cut in most industries, health care is
recognized as an area where growth in employment is expected. However, nurses are
increasingly employed in community settings as opposed to hospitals. This change reflects the
move toward community-based care rather than hospital-based tertiary care. To help decrease
the continued rise in health care costs, the increased emphasis is on disease prevention rather
than high-cost treatment.
DIF: Cognitive Level: Understand (Comprehension)
4. Which ethical belief would be most helpful in the current health care crisis?
a. Emphasis should be on individual and corporation freedom in the marketplace.
b. Emphasis should be on individual autonomy and freedom of choice.
c. Emphasis should be on social justice and collective responsibility.
d. Emphasis should be on the effectiveness of technology in resolving problems.
ANS: C
Public health recognizes the necessity of collective action in keeping the environment safe and
in egalitarian tradition and vision. An overinvestment in technology and seeking of cures
within the market justice system has stifled the evolution of a health system to protect and
preserve the health of the population. Although individual autonomy and freedom of choice
are important, so is the recognition of collective responsibility in ensuring social justice,
which entitles all people to basic necessities.
DIF: Cognitive Level: Apply (Application)
5. What is the primary problem seen in Healthy People 2020’s emphasis on choosing healthy
lifestyle behaviors, such as daily exercise or healthy food choices?
a. Emphasis on other lifestyle choices, such as not smoking and minimal use of
alcohol or drugs, is also needed.
b. All of us must work together to make unhealthy behaviors socially unacceptable.
c. It costs more to make healthy choices, such as buying and eating fresh fruits and
vegetables as opposed to quick and cheap fast-food choices.
d. Public policy emphasizes personal responsibility but ignores social and
environmental changes needed for well-being.
ANS: D
Although all responses are accurate, the primary problem is the emphasis on personal choices
in the Healthy People 2020 objectives. Emphasis on personal choices ignores the need for
community responsibility and action that addresses environmental or cultural restraints to
health.
DIF: Cognitive Level: Apply (Application)
6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of
the nurse beyond giving excellent care to patients?
a. Accept longer work schedules to ensure that professional care is always available
[AUTHOR] 2
