Public Health Nursing: Population-Centered Health Care in the Community, 9th Edition

One of the primary focuses of improving the health of the American people in the twenty-first century is to address: a. bioterrorism and global health threats. b. delivery of individual care and hygiene. c. the need for increased hospital and acute care. d. chronic disease and disability management. ANS: A There are new concerns, and of the most serious are bioterrorism and globally induced infections, such as the avian flu. These threats will divert health care funds and resources from other health care programs to be spent for public safety. The others are not related to public health or are concerns that have been present for many years. DIF: Cognitive level: Understanding REF: p. 5 TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance 2. A community is concerned about the threat of bioterrorism. Which of the following best describes the basis for this concern? a. Bioterrorism has the potential to dissolve community-based programs. b. This threat could cause the health care system to collapse. c. The threat of bioterrorism may divert funds from other public safety health care programs. d. Fear of bioterrorism will increase the need for shelters. ANS: C Bioterrorism may have an impact on the availability of resources for public safety health care programs. Because funds are diverted it is possible that community-based programs would be eliminated, the health care system could experience changes, and that there would be an increase in the need for shelter. However, all of these things would happen because of the diversion of funds. DIF: Cognitive level: Analyzing REF: p. 5 TOP: Nursing process: Diagnosis MSC: NCLEX: Psychosocial Integrity 3. Which of the following describes the consequence of the successful implementation of the Affordable Care Act? a. Americans will pay closer attention to their health status. b. The majority of the population will be covered by insurance. c. Public health departments will need to increase the number of nursing positions. d. The prevalence of obesity will decrease. ANS: B healthcare One consequence of successful implementation of the Affordable Care Act might actually be that the majority of the population would be covered by insurance and public health agencies will not need to provide direct clinical services in order to assure that those who need them can receive them. The Affordable Care Act will not directly cause Americans to pay closer attention to their health status or decrease the prevalence of obesity. DIF: Cognitive level: Remembering REF: p. 5 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 4. The public health nurse (PHN) must participate in the essential services of public health. Which of the following most accurately describes one of the essential services of public health? a. Monitoring health status by completing a community assessment b. Diagnosing and investigating health problems in the world c. Informing, educating, and empowering people about health issues d. Working in law enforcement to regulate health and ensure safety ANS: C The PHN monitors health status in several ways, completing a community assessment is only one way that health status is monitored. The PHN would not diagnose or solve “world” problems, or work in law enforcement. Rather, the PHN would participate with local regulators to protect communities and empower people to address health issues. DIF: Cognitive level: Understanding REF: p. 8 (How to Box) TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 5. A public health department is using the mission of public health as described by the Institute of Medicine when planning its health programming. Which of the following activities will most likely be implemented? a. Tracking avian flu outbreaks and doing surveillance in the United States b. Providing a flu shot for an elderly person at the health department c. Keeping track of alternative therapies in use in the United States d. Keeping snake antivenom at the Centers for Disease Control and Prevention in Atlanta ANS: A The Institute of Medicine’s stated mission on public health is “to generate organized community and technical knowledge to prevent disease and promote health.” Tracking avian flu outbreaks and doing surveillance applies this concept at a population level. Providing a flu shot for an elderly person only addresses individual care. Keeping track of the use of alternative therapies does nothing to prevent disease or promote health of the population. Keeping snake antivenom is aimed at disease care for an individual, not health promotion or disease prevention. DIF: Cognitive level: Analyzing REF: p. 6 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 6. A public health department makes sure that the essential community-oriented health services are available in the community. Which of the following core public health functions is being implemented? a. Policy development b. Assessment c. Assurance d. Scientific knowledge-based care ANS: C Assurance focuses on the responsibility of public health agencies to ensure certain activities have been appropriately carried out to meet public health goals and plans. Policy development seeks to build constituencies that can help bring about change in public policy. Assessment includes activities that involve collecting, analyzing, and disseminating information on both the health status and the health-related aspects of a community or a specific population. Public health is based on scientific knowledge, but is not a core function. DIF: Cognitive level: Applying REF: p. 14 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 7. The purpose of public health core functions is to: a. clarify the role of the government in fulfilling the mission of public health. b. ensure the safety of populations in receiving quality health care. c. provide community-based individualized care to every person in the United States. d. unite public and private providers of care in a comprehensive approach to providing health care. ANS: A As defined by the Institute of Medicine in its 1988 report The Future of Public Health, assessment, policy development, and assurance are core functions at all levels of government for the purpose of clarifying the government’s role. DIF: Cognitive level: Understanding REF: p. 6 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 8. Which of the following statements about public health is accurate? a. Prevention of early deaths can be more effectively accomplished by medical treatment than by public health approaches. b. Expenditures and resources for public health have increased in recent years. c. Historically, gains in the health of populations have been related largely to changes in safety, sanitation, and personal behavior. d. Reform of the medical insurance system is the single change needed to improve the health of Americans. ANS: C Fielding and Tilson have asserted that most of the increase in life span has been made through improvements in sanitation, clean water supplies, making workplaces safer, improving food and drug safety, immunizing children, and improving nutrition, hygiene, and housing. Medical treatment has not made as significant of an impact on the life span as public health measures. Funding for public health in recent years has been on a gradual decline. Although reform of the medical insurance system may help improve the health of Americans, there are many other factors that will need to be addressed. DIF: Cognitive level: Understanding REF: p. 5 TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 9. A PHN collects data and monitors the health status of the population. Which of the following core public health functions is being implemented? a. Assessment b. Prevention c. Assurance d. Policy development ANS: A Assessment consists of systematic data collection and monitoring health status. Prevention is not a core function, assurance is making sure essential services are available, and policy development is needed to provide leadership in developing policies. DIF: Cognitive level: Applying REF: p. 6 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 10. The PHN compares the rate of teenage pregnancy in various areas of the city. Which of the core functions of public health is being implemented? a. Assurance b. Assessment c. Prevention d. Policy development ANS: B Assessment refers to systematic data collection, which this nurse is doing for teenage pregnancy. Prevention is not a core function, assurance is making sure essential services are available, and policy development is needed to provide leadership in developing policies. DIF: Cognitive level: Applying REF: p. 6 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance