NR 420/NURSE 420 EXAM 3 LATEST ACTUAL EXAM 50
QUESTIONS AND CORRECT ANSWERS|ALREADY
GRADED A+
Role of public health departments and the public health nurse - ANSWER: Population
assessment
Assurance of a well-coordinated system of health promotion and healthcares
services
Policy development to support the health of the community
Vital statistics, environmental sanitation, health department laboratory services,
maternal/child healthcare and surveillance, public health education (PSAs)
Essential services are provided with interventions at individual, community, and
systems levels of care
Public Health Core Functions: Assurance, Policy, Assessment
Example: Interventions for reducing tobacco use:
- Individual - counseling a pregnant woman in tobacco cessation methods
- Community - group education in tobacco cessation for teens
- Systems - advocating for tobacco tax increases to decrease motivation to use it
PHN roles and responsibilities - ANSWER: Vaccinations
Prenatal care
Medication administration for STIs and TB
Home visits for high-risk community members
Establish relationships with individuals and community groups
Recognize social determinants that affect health
Disease control such as Tuberculosis management, Hepatitis A
TB management:
•Symptoms - night sweats, weight loss, poor appetite, persistent cough.
•Drug-resistant TB has complicated and prolonged the fight to eradicate this disease
(due to non-adherence). Highly contagious, associated with social determinants such
as poverty, crowded living situations (dorms, prisons), alcohol/substance abuse,
arrival from another country with high rates of TB infection.
•Contact those who have been exposed to a positive case. They will need TB testing.
•Treatment requires directly observed therapy for several months to ensure
adherence or medication electronic monitoring system that tracks the openings of
the pill bottle, phone, email or text reminders.
•Public health nurses may contribute to investigations that locate where the TB
cases are concentrated, and organize outreach services to those community
members (testing, information, arrangement of prophylactic treatment as needed)
If there is an outbreak of Hepatitis A in a community what is the most important
information that the public needs to know from you to prevent transmission?
Washing hands - HepA is transmitted fecal-oral route. Contaminated surfaces, food,
and water are touched. Handwashing is the most effective way to prevent
transmission.
,Emerging or re-emerging infections/diseases concerns: Drug resistant variants,
diseases that have started to infect humans, climate change,
globalization/international travel
Case management - ANSWER: Coordination of services across healthcare specialties
and community health services
Improve quality of care, efficiency of services
Cost containment
Must know community resources, be a good communicator
Case management plans: standards of client care, standards of nursing practice,
clinical guidelines using evidence-based practice; adaptation to each client's unique
situation is key
Evaluation: if goals were not met, change the plan
Nursing process and case management - ANSWER: From Stanhope, p. 275
Stanhope p. 281:
Primary prevention: exchange information, increase health literacy, instruct on
accessing healthcare system, engage in health education
Secondary prevention: case finding, using healthcare data to identify health
problems, assessments and interventions that promote health
Tertiary prevention: monitor and adjust the use of prescription medications and
adherence to treatment to reduce the risk of complications
Immunization programs - ANSWER: Essential service
Protects the population from communicable disease
International travel vaccine administration
Post-rabies exposure prophylaxis
Mandated by schools to varying degrees across the country
Immunizations integrated in public health clinical services
If an outbreak occurs, the local health department is responsible for mass
immunizations
Coordination of vaccine supplies, rates of immunizations given regionally, statewide
immunization registries to document, and free immunization clinics
Goal: equitable access
Principles of the ethical practice of public health - ANSWER: PH institutions should
protect the confidentiality of information gathered
PH should achieve community health in a way that respects the rights of individuals
in the community
PH should advocate and work for the empowerment of disenfranchised community
members, aiming to ensure that the basic resources are accessible to all
PH programs should incorporate a variety of approaches that anticipate and respect
diverse values, beliefs, and cultures in the community
PH institutions should engage in collaborations that build the public's trust
Key components of health program planning - ANSWER: Active involvement of the
community as a partner
,Skill and time to do a competent assessment
Shared conclusions with the partners of the needed interventions
Actual program planning, interventions, and evaluation
Social justice: human rights and equity
Mobilizing for acton through planning and partnerships (MAPP) - ANSWER: A
framework for conducting community assessment
Aims to help communities apply strategic thinking to prioritize PH issues and identify
resources to address them
Consists of 4 different assessments
- community themes and strengths assessment
- local public health system assessment
- community health status assessment
- forces of change assessment
Elements of MAPP model include generating shared visions and common values,
developing a framework for long-range planning.
Assess community themes & strengths: Key informant interviews, surveys, focus
groups that assess the strengths & problems within the community - from
community members' perspective.
Community health status: Identify priority community health & quality of life issues -
involves gathering primary and secondary data related to the problem(s)
Local public health system focuses on organizations that contribute to the public's
health in the community
Forces of change: Focuses on identifying forces such as laws, technology, or funding
that affect the context in which the community & its public health system operate.
Examples of PH interventions at the individual and community levels are Women,
Infants & Children (WIC), school health programming, and immunization campaigns.
MAPP example - ANSWER: Problem: infant mortality
Mobilize community partnerships: a MAPP committee was formed
Action: community assessments were done by committees: data collected and
funding sought
Planning/partnership: high infant mortality found to be higher among African
Americans in the community than among others
Programs built to improve access to prenatal care, birth weight, and reduce teen
pregnancy, tobacco use among pregnant women and girls
Rate of infant mortality was increasing in a community.
A MAPP committee was formed including community members, nurses, healthcare
providers, elected officials, pregnant and teen mothers.
Community assessments were done by committees: Data collected from community
members about maternal care, maternal care implementation in the area, vital
statistics, survey data. Funding was sought to build necessary programs for maternal
care
High infant mortality found to be higher among African Americans in the community
than among others. Programs were built to improve access to maternal and infant
care specific to this population found to be at high risk
, Result: The MAPP committee achieved funding to establish a Nurse-Family
Partnership community health program with nurse home visits for low-income, first-
time mothers to address the essential service of linking people to needed PH services
as well as assuring the provision of these healthcare services.
Evidence-based practice: Research supports the nurse-family partnership model as
an effective framework to ensure high-quality programs and services in local
communities.
Logic model - ANSWER: A logic model is a graphic depiction (road map) that presents
the shared relationships among the resources, activities, outputs, outcomes, and
impact for your program
It depicts the relationship between your program's activities and its intended results
A logic model can focus on any. level of a program: the entire organization or one
department or program
The first step in the CDC Framework approach to program evaluation is to engage
the stakeholders. Stakeholders are people or organizations that are invested in the
program, are interested in the results of the evaluation, and/or have a stake in what
will be done with the results of the evaluation. Representing their needs and
interests throughout the process is fundamental to good program evaluation.
Some key terms used in logic models, although not all are employed in any given
model:
Inputs: The resources needed to implement the activities
Activities: What the program and its staff do with those resources
Outputs: Tangible products, capacities, or deliverables that result from the activities
Outcomes: Changes that occur in other people or conditions because of the activities
and outputs
Impacts: long-term outcomes
Moderators: Factors that are out of control of the program but may help or hinder
achievement of the outcomes
Steps to health program management - ANSWER: Assessment, planning,
implementation, evaluation
Assessment includes gathering primary and secondary data. Primary data is how the
community subbjectively perceives the community health need. Sources of primary
data include surveys and focus groups. Secondary data is objective information -
immunization uptake rates, disease rates in a community, birth records, mortality
records.
Primary and secondary data can be collected again after your program or
intervention is complete, to evaluate if goals were met.
Case study: Measles vaccination campaign in New York - ANSWER: Measles is an
airborne virus.
A rash appears within a week of infection, symptoms appear average 14 days.
Cough, sore throat, conjunctivitis.
The sick are contagious from four days before, to four days after the rash starts.
Rash with high fevers that can cause infertility, pneumonia, immune problems in
later years, hearing problems, death.
QUESTIONS AND CORRECT ANSWERS|ALREADY
GRADED A+
Role of public health departments and the public health nurse - ANSWER: Population
assessment
Assurance of a well-coordinated system of health promotion and healthcares
services
Policy development to support the health of the community
Vital statistics, environmental sanitation, health department laboratory services,
maternal/child healthcare and surveillance, public health education (PSAs)
Essential services are provided with interventions at individual, community, and
systems levels of care
Public Health Core Functions: Assurance, Policy, Assessment
Example: Interventions for reducing tobacco use:
- Individual - counseling a pregnant woman in tobacco cessation methods
- Community - group education in tobacco cessation for teens
- Systems - advocating for tobacco tax increases to decrease motivation to use it
PHN roles and responsibilities - ANSWER: Vaccinations
Prenatal care
Medication administration for STIs and TB
Home visits for high-risk community members
Establish relationships with individuals and community groups
Recognize social determinants that affect health
Disease control such as Tuberculosis management, Hepatitis A
TB management:
•Symptoms - night sweats, weight loss, poor appetite, persistent cough.
•Drug-resistant TB has complicated and prolonged the fight to eradicate this disease
(due to non-adherence). Highly contagious, associated with social determinants such
as poverty, crowded living situations (dorms, prisons), alcohol/substance abuse,
arrival from another country with high rates of TB infection.
•Contact those who have been exposed to a positive case. They will need TB testing.
•Treatment requires directly observed therapy for several months to ensure
adherence or medication electronic monitoring system that tracks the openings of
the pill bottle, phone, email or text reminders.
•Public health nurses may contribute to investigations that locate where the TB
cases are concentrated, and organize outreach services to those community
members (testing, information, arrangement of prophylactic treatment as needed)
If there is an outbreak of Hepatitis A in a community what is the most important
information that the public needs to know from you to prevent transmission?
Washing hands - HepA is transmitted fecal-oral route. Contaminated surfaces, food,
and water are touched. Handwashing is the most effective way to prevent
transmission.
,Emerging or re-emerging infections/diseases concerns: Drug resistant variants,
diseases that have started to infect humans, climate change,
globalization/international travel
Case management - ANSWER: Coordination of services across healthcare specialties
and community health services
Improve quality of care, efficiency of services
Cost containment
Must know community resources, be a good communicator
Case management plans: standards of client care, standards of nursing practice,
clinical guidelines using evidence-based practice; adaptation to each client's unique
situation is key
Evaluation: if goals were not met, change the plan
Nursing process and case management - ANSWER: From Stanhope, p. 275
Stanhope p. 281:
Primary prevention: exchange information, increase health literacy, instruct on
accessing healthcare system, engage in health education
Secondary prevention: case finding, using healthcare data to identify health
problems, assessments and interventions that promote health
Tertiary prevention: monitor and adjust the use of prescription medications and
adherence to treatment to reduce the risk of complications
Immunization programs - ANSWER: Essential service
Protects the population from communicable disease
International travel vaccine administration
Post-rabies exposure prophylaxis
Mandated by schools to varying degrees across the country
Immunizations integrated in public health clinical services
If an outbreak occurs, the local health department is responsible for mass
immunizations
Coordination of vaccine supplies, rates of immunizations given regionally, statewide
immunization registries to document, and free immunization clinics
Goal: equitable access
Principles of the ethical practice of public health - ANSWER: PH institutions should
protect the confidentiality of information gathered
PH should achieve community health in a way that respects the rights of individuals
in the community
PH should advocate and work for the empowerment of disenfranchised community
members, aiming to ensure that the basic resources are accessible to all
PH programs should incorporate a variety of approaches that anticipate and respect
diverse values, beliefs, and cultures in the community
PH institutions should engage in collaborations that build the public's trust
Key components of health program planning - ANSWER: Active involvement of the
community as a partner
,Skill and time to do a competent assessment
Shared conclusions with the partners of the needed interventions
Actual program planning, interventions, and evaluation
Social justice: human rights and equity
Mobilizing for acton through planning and partnerships (MAPP) - ANSWER: A
framework for conducting community assessment
Aims to help communities apply strategic thinking to prioritize PH issues and identify
resources to address them
Consists of 4 different assessments
- community themes and strengths assessment
- local public health system assessment
- community health status assessment
- forces of change assessment
Elements of MAPP model include generating shared visions and common values,
developing a framework for long-range planning.
Assess community themes & strengths: Key informant interviews, surveys, focus
groups that assess the strengths & problems within the community - from
community members' perspective.
Community health status: Identify priority community health & quality of life issues -
involves gathering primary and secondary data related to the problem(s)
Local public health system focuses on organizations that contribute to the public's
health in the community
Forces of change: Focuses on identifying forces such as laws, technology, or funding
that affect the context in which the community & its public health system operate.
Examples of PH interventions at the individual and community levels are Women,
Infants & Children (WIC), school health programming, and immunization campaigns.
MAPP example - ANSWER: Problem: infant mortality
Mobilize community partnerships: a MAPP committee was formed
Action: community assessments were done by committees: data collected and
funding sought
Planning/partnership: high infant mortality found to be higher among African
Americans in the community than among others
Programs built to improve access to prenatal care, birth weight, and reduce teen
pregnancy, tobacco use among pregnant women and girls
Rate of infant mortality was increasing in a community.
A MAPP committee was formed including community members, nurses, healthcare
providers, elected officials, pregnant and teen mothers.
Community assessments were done by committees: Data collected from community
members about maternal care, maternal care implementation in the area, vital
statistics, survey data. Funding was sought to build necessary programs for maternal
care
High infant mortality found to be higher among African Americans in the community
than among others. Programs were built to improve access to maternal and infant
care specific to this population found to be at high risk
, Result: The MAPP committee achieved funding to establish a Nurse-Family
Partnership community health program with nurse home visits for low-income, first-
time mothers to address the essential service of linking people to needed PH services
as well as assuring the provision of these healthcare services.
Evidence-based practice: Research supports the nurse-family partnership model as
an effective framework to ensure high-quality programs and services in local
communities.
Logic model - ANSWER: A logic model is a graphic depiction (road map) that presents
the shared relationships among the resources, activities, outputs, outcomes, and
impact for your program
It depicts the relationship between your program's activities and its intended results
A logic model can focus on any. level of a program: the entire organization or one
department or program
The first step in the CDC Framework approach to program evaluation is to engage
the stakeholders. Stakeholders are people or organizations that are invested in the
program, are interested in the results of the evaluation, and/or have a stake in what
will be done with the results of the evaluation. Representing their needs and
interests throughout the process is fundamental to good program evaluation.
Some key terms used in logic models, although not all are employed in any given
model:
Inputs: The resources needed to implement the activities
Activities: What the program and its staff do with those resources
Outputs: Tangible products, capacities, or deliverables that result from the activities
Outcomes: Changes that occur in other people or conditions because of the activities
and outputs
Impacts: long-term outcomes
Moderators: Factors that are out of control of the program but may help or hinder
achievement of the outcomes
Steps to health program management - ANSWER: Assessment, planning,
implementation, evaluation
Assessment includes gathering primary and secondary data. Primary data is how the
community subbjectively perceives the community health need. Sources of primary
data include surveys and focus groups. Secondary data is objective information -
immunization uptake rates, disease rates in a community, birth records, mortality
records.
Primary and secondary data can be collected again after your program or
intervention is complete, to evaluate if goals were met.
Case study: Measles vaccination campaign in New York - ANSWER: Measles is an
airborne virus.
A rash appears within a week of infection, symptoms appear average 14 days.
Cough, sore throat, conjunctivitis.
The sick are contagious from four days before, to four days after the rash starts.
Rash with high fevers that can cause infertility, pneumonia, immune problems in
later years, hearing problems, death.
