Community HEALTH Test QUESTIONS AND ANSWERS| A GRADED

Community Test The nurse working in the community is aware that there are different models for studying the epidemiology of a health condition in a population. One model of investigation of the interrelationships and characteristics of disease is the epidemiologic triangle. This model analyzes what three elements? Correct Answer: Agent, host, and environment When chronic disease became a more important cause of death in developed countries, different epidemiologic models were developed to study the many factors involved in the development of these health conditions. Which of the following is an example of such a model? Correct Answer: Web of causation In the 1850s, a researcher studied a cholera epidemic among people living in different sections of London. The researcher who used epidemiologic methods to study the epidemic and used rates as an epidemiologic tool was: Correct Answer: John Snow. A community health nurse participating in planning programs for the coming year considers incidence rates to better understand the needs of the community. Which statement below is the most accurate explanation of incidence rates? Correct Answer: New cases of a disease or condition in a community over a period of time are included in incidence rates. An epidemic is occurring in a public health nurse's community, and the nurse is working with the epidemiologist and other health professionals seeking to identify the causative agent. What phrase best describes such efforts? Correct Answer: Analytic epidemiology A community nurse is reviewing health statistics to gain a better understanding of a population's health needs. Crude rates are available for several health occurrences. What statement accurately describes crude rates? Correct Answer: In calculating a crude rate, the average population size may be used as denominator. The percentage of deaths resulting from a specific cause provides the nurse with information about areas in which public health programs might make significant contributions in reducing deaths. Select the statistic often used for this purpose. Correct Answer: Proportionate mortality rate The health literature accessed by the community health nurse often addresses the probability of an adverse event. What term refers to the likelihood that healthy people exposed to a specific factor will experience a specific health condition? Correct Answer: Risk Through epidemiologic investigations, effective prevention measures are often identified. When the nurse is engaged in providing prevention for the community before disease has developed, the prevention activities meet the definition for what level of prevention? Correct Answer: Primary The public health nurse is working with a specific population and is preparing to participate in a descriptive epidemiology study. Which of the statements apply to descriptive epidemiology? (Select all that apply.) Correct Answer: Descriptive epidemiology seeks to answer questions about the amount of disease in a given population. Descriptive epidemiology seeks to answer questions about the distribution of disease in a given population. One dimension of a community, which looks at personal characteristics and risks of a group, is called: Correct Answer: aggregate of people. Which of the following groups is an example of a community of solution? A group: Correct Answer: concerned with reducing teenage suicides. Which of the following sources of information about a community's health would give the community health nurse information about births, deaths, and marriages and aid in providing indicators of population growth or reduction? Correct Answer: Vital statistics A community health nurse in the assessment phase of the nursing process conducted research to identify the distribution pattern of breast cancer within a population and the associated risk factors. This is called: Correct Answer: epidemiology. One of the first steps in community assessment may involve the community health nurse driving or walking through an area and making observations about such things as environmental layout and location of agencies, hospitals, industries, and so forth. This is called a(n): Correct Answer: windshield survey. Which of the following methods of gathering data is most effective for remote and vulnerable segments of a community and for those communities with underdeveloped opinions? Correct Answer: Focus groups When writing a community diagnosis, the community health nurse notes that the "among" phrase: Correct Answer: specifies the aggregate that will benefit from the nurse's plan. Identify the etiologic or causal statement component of the following community diagnosis: "There is an increased risk for undetected testicular cancer among young men related to insufficient knowledge about the disease and the methods for preventing and detecting it at an early stage as demonstrated by high rates of late initiation of treatment." Correct Answer: Insufficient knowledge about the disease and methods of prevention Epidemiologic data can be useful in the planning phase of the community assessment process because they: Correct Answer: help construct benchmarks to gauge achievement of program objectives. The steps in the community assessment process for community health nurses are: (Select all that apply.) Correct Answer: writing a community diagnosis. evaluating the outcomes. collecting assessment data planning community interventions. A community health nurse working as a school health nurse conducted a community assessment and determined that the focus of programs and health education for the academic year should address the problem of childhood obesity. In planning, it is important for the nurse to allow time for individual nursing assessment and education for children who are overweight or obese and to plan classroom education programs. The nurse is demonstrating an understanding of which important community health nursing concept? Correct Answer: Community as client What legislation resulted in increased consumer involvement in the U.S. health care system and a review of the allocation of health care resources? Correct Answer: National Health Planning and Resources Development Act A community health nurse is using the health planning model to improve a client's health. The nurse prepares for unexpected problems or complications in the client's care. This attention to unexpected problems takes place during which step? Correct Answer: Intervention Before participating in health care planning, a community health nurse must understand the concept of: Correct Answer: community as client. The community health nurse understands that a client's health can be negatively or positively affected by his or her suprasystem. Which of the following correctly describes a client's suprasystem? The suprasystem includes: Correct Answer: all resources available for use by the client, including health-related and non-health-related resources. Systems theory provides a framework that includes interventions that are possible at the three levels of prevention. The level of prevention that includes early diagnosis is: Correct Answer: secondary prevention. Public service announcements, dissemination of pamphlets, and focus groups are examples of measures that can be used by the community health nurse. These are also known as: Correct Answer: nursing interventions. Which of following factors is NOT necessary to consider when determining priorities for health problem interventions? Correct Answer: The nurse's preferences The rationale behind the Patient Protection and Affordable Care Act is to: Correct Answer: put individuals, families, and small business owners in control of their health care. The Patient Protection and Affordable Care Act of 2010 includes several elements that involve health planning. These elements include: (Select all that apply.) Correct Answer: creation of an innovation center within the Centers for Medicare and Medicaid Services. provisions of monies for funding community health centers, school-based clinics, and the National Health Service Corps to improve access to care. creation of task forces on preventive services and community preventive services to develop, update, and disseminate evidence-based recommendations on health care delivery. establishment of an independent payment advisory board to make proposals to reduce the growth in Medicare spending. Assisting the family of a special needs child through the complex health care system is an example of what type of case management? Correct Answer: Client-centered case management Which of the following was a result of the Patient Protection and Affordable Care Act of 2010? Correct Answer: Value-based purchasing programs for hospitals were established. For an RN to apply for certification for case management through the Case Management Society of America (CMSA), the nurse must perform essential activities of case management. Which of the following is NOT one of the required activities? Correct Answer: Diagnosis In providing care for a client who recently had a liver transplant, a nurse case manager would focus attention on all of the following except: Correct Answer: provision of direct clinical skilled care (e.g., dressing changes, medication administration). In which case management setting is the nurse responsible for providing primary prevention to employees to keep the work force healthy? Correct Answer: Occupational health setting Which model of care was developed to provide collaborative, quality-driven, safe, primary care? Correct Answer: Patient-centered medical home The case manager reviews the chart of a patient to determine appropriateness and timeliness of medical care while the patient is in the hospital. This function of case management is referred to as: Correct Answer: utilization review. Which of the following is a goal of case management? (Select all that apply.) Correct Answer: Providing high-quality care Decreasing fragmentation of health services Containing cost of health care Enhancing quality of life for clients Certification for registered nurses in the field of case management is provided through which professional organization? (Select all that apply.) Correct Answer: American Nurses Credentialing Center Case Management Society of America Which of the following are principles of a patient-centered medical home? (Select all that apply.) Correct Answer: Physician-led, team based care Integration and coordination of care Improved access to care Quality and safety The nurse who was responsible for organizing relief efforts for soldiers during the U.S. Civil War and who was the founder of the American Red Cross was: Correct Answer: Clara Barton. Which act, established in the 1940s, provided grants to states for the purpose of new construction of health care institutions? Correct Answer: The Hill-Burton Act Which of the following is the correct process a bill must take before final approval by the president? Correct Answer: A bill must succeed through the two legislative bodies, the House of Representatives and the Senate, and then be submitted for final approval by the president. Decisions on public policy are made by which part of the federal government? Correct Answer: Legislative, executive, or judicial branches of the government A statement of a decision regarding a goal in health care and a plan for achieving that goal is called: Correct Answer: health policy. Groups such as professional organizations, nonprofit health care organizations, and corporations that sponsor health care are/is called: Correct Answer: the private sector. The Health Resources and Services Administration (HRSA) assists nursing workforce development by: Correct Answer: providing grants to provide for education and recruitment. A person who acts as a representative for another person or organization before the legislature is called a(n): Correct Answer: lobbyist. Political action committees (PAC) are formed by professional organizations, business, or labor groups for the purpose of: Correct Answer: attracting candidates who are sympathetic to particular health care issues Nurses' involvement in policy can be achieved by all of the following: (Select all that apply.) Correct Answer: conducting and supporting health policy research. working with health care professionals to influence change in the quality of health care. writing letters to educate legislators about health care issues. monitoring the quality ratings of health care organizations and suggesting changes that would improve care. How would a community health nurse use Executive Order 12898? Correct Answer: Recognize that it would help achieve environmental justice. Using critical theory when exploring issues of environmental health ultimately allows the nurse to: Correct Answer: alter the precursors of poor health. Which of the following interventions would be the most appropriate to implement for a community that has a high risk for environmental health hazards? Correct Answer: Involve citizens in decision-making processes about proposed activities that could pose an environmental threat. A public health nurse is surveying a population of coal miners. Which of the following questions would elicit information about related risk to a miner's children? Correct Answer: "How close do you live to your workplace?" Approaching health at the aggregate level is the initiative of which agency or document? Correct Answer: Healthy People 2020 When building a collective strategy by framing an environmental problem, the community health nurse should ask which of the following questions? Correct Answer: Who is affected by the problem? A primary role of the community health nurse in facilitating community participation and partnership is: Correct Answer: educating about environmental health hazards. When assisting specific aggregates, which of the following should be included in the community health nurse's outcomes? Correct Answer: Helping people learn from their own experiences and analyzing the world with the intention to change it An emergency department nurse assesses a 25-year-old patient with tachycardia, headache, and nausea. The patient denies drug use, heart problems, and smoking. She works from her house and states that everyone in her house has had the "flu" but that she is the only one who has not been feeling better. The nurse notices that the patient lives in the historic section of the town. What environmental hazard should the nurse be primarily concerned about? Correct Answer: Housing quality A community health nurse would include which of the following in her assessment of environmental health? (Select all that apply.) Correct Answer: Work-related exposures Atmospheric quality Radiation risks Which of the following descriptions does NOT reflect a current definition of family? Correct Answer: Two or more persons living together who share common interests Two unrelated heterosexual adults that share a housing unit with their three children is an example of which of the following? Correct Answer: Cohabitation Family interviewing requires the community health nurse to understand or develop specific skills. All of the following demonstrate appropriate family interviewing skills or techniques except: Correct Answer: establishing the nursing goals based exclusively on the physician's orders. The composition of the family is an example of which of the following? Correct Answer: Internal structure A client is having difficulty performing his activities of daily living. This means he is having difficulty with which of the following? Correct Answer: Instrumental functioning A community health nurse needs to understand that most families in today's society can be described as which of the following? Correct Answer: Defined by its members A client provides information regarding medical and health history. This is an example of which of the following assessment tools? Correct Answer: Family health tree The community health nurse understands that events such as divorce, remarriage, or separation of parents have the potential to affect the family and individuals within the family. This demonstrates the nurse's understanding of which family theory? Correct Answer: Developmental theory The community health nurse assesses the family as a system within the context of their environments using which approach? Correct Answer: Ecological framework Which of the following characteristics is demonstrated by healthy or energized families? (Select all that apply.) Correct Answer: Communication is appropriate and clear. Support and respect are evident and appreciated. Common beliefs and values are shared. Members play and share leisure time appropriately. Katie, a 2-year-old child, is brought to the doctor's office after 2 days of vomiting and diarrhea. Upon completion of the medical history, the mother tells the nurse that several of the other children at the daycare who played with the same toys as Katie have the same symptoms. The mode of transmission for the pathogen more likely was which of the following? Correct Answer: Indirect Four-month-old Lucy is in for immunizations at the local health department. The Vaccine Information Sheet is given to Lucy's mother, and informed consent is obtained. However, the mother then states, "Lucy did have a temperature around 99.1 degrees the night of her last immunizations." After this statement, the nurse should do which of the following? Correct Answer: Give the immunizations. Women have a higher risk of contracting a sexually transmitted disease (STD) than men because: Correct Answer: the anatomical structure of women promotes transmission of STDs. Investigating all contacts of a person infected with a sexually transmitted disease is an example of what? Correct Answer: Secondary prevention Which statement indicates that further teaching is needed for a patient involved in family planning? Correct Answer: "I can't get human papilloma virus (HPV) from my boyfriend because he doesn't have genital warts." Transmission of an infectious disease can be efficiently controlled by: Correct Answer: breaking only one link in the transmission chain. Which of the following is classified as a vector of disease? Correct Answer: Mosquitoes A pathogen lives and multiplies in a __________ and transfers from one host to another by a __________. Correct Answer: reservoir, mode of transmission Seven cases of hepatitis A are diagnosed in a community over a period of 2 weeks. An investigation results in a determination that all of the infected individuals ate at a local restaurant. Which of the following statements explains the possible connection between hepatitis A and a restaurant? Correct Answer: The route of transmission for hepatitis A is fecal-oral. Which of the following factors causes primary vaccine failure? (Select all that apply.) Correct Answer: Inefficient storage An intramuscular vaccine injection given subcutaneously Light-sensitive vaccines exposed to light Seroconversion Which of the following prospective payment methods determined the amount of reimbursement that health care providers would receive for specific illnesses from Medicare? Correct Answer: Diagnostic-related groups Access to health care is determined by the circumstances of the individual that obstruct the means to obtain desired health care. Which of the following is NOT a barrier to access to health care? Correct Answer: Personal avoidance of a health problem In a managed care organization, physicians are responsible for the approval or referral of some services. In this position, they are referred to as: Correct Answer: gatekeepers. Currently, the state with the highest rate of adult smoking is: Correct Answer: Kentucky. During World War II, faced with a decrease in the number of workers, employers added a health insurance plan to employee's benefits. These plans were called: Correct Answer: indemnity plans. A major cause for the rise in health care costs is: Correct Answer: a demand for complex and advanced services. Enacted in 1965 as part of the Social Security Act, __________ was intended to provide health care to the population of U.S. citizens 65 years of age and older. Correct Answer: Medicare One of the first health insurance companies established in the 1930s to provide health care to subscribers was: Correct Answer: Blue Cross and Blue Shield. Cost containment incentives include which of the following? (Select all that apply.) Correct Answer: Capitated reimbursement Fee-for-service billing Health care rationing Provisions of the Patient Protection and Affordable Care act include: (Select all that apply.) Correct Answer: mandating that all citizens obtain health insurance. prohibiting denial of coverage for preexisting conditions. establishing health insurance exchanges. Who is considered the founder of the modern parish nurse movement? Correct Answer: Granger Westberg Which of the following faith community nurse roles includes lobbying for beneficial health policy? Correct Answer: Health advocate In the role of personal health counselor, the faith community nurse would do which of the following? Correct Answer: Teach signs and symptoms of hypertension and stroke to the congregation. In the CIRCLE Model of Spiritual Care, the L represents: Correct Answer: listening. The faith community nurse must recognize which of the following to be correct concerning church law? Correct Answer: Volunteers in a church are held to the same degree of accountability as paid employees. A congregational health nurse is trying to establish a health program that is balanced across all levels of prevention (primary, secondary, and tertiary). An example of a secondary health intervention the nurse might consider would be: Correct Answer: arranging for a mobile mammogr