Community/Public Health Nursing:
8th edition Nies Chapter 1 - 34
TEST BANK
,Contents
Chapter 1 Health: A Community View ..................................................................................4
Chapter 2 Historical Factors ................................................................................................14
CHAPTER 03 Thinking Upstream: Nursing Theories and Population-Focused Nursing Practice
..........................................................................................................................................27
CHAPTER 04 Health Promotion and Risk Reduction ............................................................36
CHAPTER 05: EPIDEMIOLOGY .............................................................................................47
CHAPTER 06: COMMUNITY ASSESSMENT ...........................................................................58
CHAPTER 07: COMMUNITY HEALTH PLANNING, IMPLEMENTATION, AND EVALUATION ......65
CHAPTER 08: COMMUNITY HEALTH EDUCATION ................................................................74
CHAPTER 09: CASE MANAGEMENT ....................................................................................84
CHAPTER 10: POLICY, POLITICS, LEGISLATION, AND COMMUNITY HEALTH NURSING ..........90
CHAPTER 11: THE HEALTH CARE SYSTEM ..........................................................................101
CHAPTER 12: ECONOMICS OF HEALTH CARE.....................................................................109
CHAPTER 13: CULTURAL DIVERSITY AND COMMUNITY HEALTH NURSING ........................120
CHAPTER 14: ENVIRONMENTAL HEALTH ...........................................................................130
CHAPTER 15: HEALTH IN THE GLOBAL COMMUNITY .........................................................137
CHAPTER 16: CHILD AND ADOLESCENT HEALTH ...............................................................144
CHAPTER 17: WOMEN’S HEALTH ......................................................................................155
CHAPTER 18: MEN’S HEALTH ............................................................................................167
CHAPTER 19: SENIOR HEALTH...........................................................................................172
,Chapter 20: Family Health ................................................................................................183
CHAPTER 21: Populations Affected by Disabilities .............................................................195
CHAPTER 22: Veterans Health ..........................................................................................203
CHAPTER 24: RURAL AND MIGRANT HEALTH ....................................................................221
CHAPTER 25: POPULATIONS AFFECTED BY MENTAL ILLNESS .............................................230
CHAPTER 26: COMMUNICABLE DISEASE ...........................................................................236
CHAPTER 27: SUBSTANCE ABUSE ......................................................................................245
CHAPTER 28: VIOLENCE ....................................................................................................259
CHAPTER 29: NATURAL AND MAN-MADE DISASTERS .......................................................267
Chapter 30: School Health ................................................................................................272
CHAPTER 31: OCCUPATIONAL HEALTH ..............................................................................283
CHAPTER 32: FORENSIC AND CORRECTIONAL NURSING ...................................................291
Chapter 33: Faith Community Nursing ..............................................................................299
Chapter 34: Home Health and Hospice .............................................................................307
,Chapter 1 Health: A Community View
────────────────────────────────────────────────────────────
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.
Answer: C
Rationale (Nies & McEwen, 8th ed., Chapter 1): Rapidly rising health care costs are an ongoing
concern and a driver of health policy discussions. Americans recognize that health care
expenses, which outpace inflation, are not sustainable long-term and place significant financial
strain on individuals, families, and government budgets.
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 media.
B. Nurses are primarily responsible for managing 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.
Answer: C
Rationale (Nies & McEwen, 8th ed., Chapter 1): Nurses constitute the largest group of health
professionals in the United States and have firsthand experience with health care challenges.
Their input is essential in shaping policy that reflects patient and community needs. The
American Nurses Association (ANA) supports nurse engagement in policy to promote equitable
access to care.
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 relations.
Answer: B
Rationale (Nies & McEwen, 8th ed., Chapter 1): Although managed care organizations do
employ nurses, the important trend is the growing emphasis on community-based and
preventive care. Hospitals may be closing or consolidating, but new outpatient, home health,
and community-based services are emerging to address health needs more proactively and
cost-effectively.
4. Which ethical belief would be most helpful in the current health care crisis?
A. Emphasis should be on individual and corporate 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.
Answer: C
Rationale (Nies & McEwen, 8th ed.,): Public health principles are grounded in collective action
and social justice. Although personal autonomy matters, a focus on community well-being and
ensuring that all have access to basic health services supports broad, equitable solutions to
health care challenges.
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.
Answer: D
Rationale (Nies & McEwen, 8th ed., Chapter 3): Healthy People goals encourage individual
responsibility but can underemphasize the broader social and environmental barriers that
prevent many Americans from accessing healthy options. Effective public health strategies
include both individual and community-level interventions.
,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 to clients.
B. Recognize the need for experienced nurses to mentor new graduates to help increase and
expand the number of professionals available.
C. Support health legislation to improve accessibility and cost of health care.
D. Volunteer to work overtime as needed to ensure maximum quality of care.
Answer: C
Rationale (Nies & McEwen, 8th ed.,): The ANA Code of Ethics calls on nurses to be involved in
social reform, focusing on advocating for policies that expand access to care, improve public
health, and enhance quality. Merely working longer hours or mentoring colleagues does not
fully address systemic equity or accessibility challenges.
7. What is the community health nursing definition of health?
A. Health is a person’s goal-directed purposeful process toward well-being or wholeness.
B. Health is an individual’s physical, mental, and social well-being, not merely the absence of
disease or infirmity.
C. Health is the mutual adaptation between a person and his or her environment in meeting
daily existence.
D. Health is families and aggregates choosing actions to ensure safety and well-being.
Answer: D
Rationale (Nies & McEwen, 8th ed., Chapter 1): Community/public health emphasizes that
health is shaped by collective choices and actions of families, groups, and communities, not
solely by an individual’s personal decisions.
8. How does community health nursing define community?
A. A group of persons living within specific geographic boundaries
B. A group of persons who share a common identity and environment
C. A group of persons who work together to meet common goals
D. A group of persons who resolve a community concern
Answer: B
Rationale (Nies & McEwen, 8th ed., Chapter 1): Communities can be geopolitical (a
geographic region) or phenomenological (shared identity, experience, or culture). Combining
both geography and shared identity is a broader and more inclusive definition for community
health nursing.
,9. Which variable has a major influence on a community’s health?
A. Behavior choices made by persons in the community
B. Number of health care providers and hospitals in the community
C. Quality of the public safety officers (police officers, firefighters, etc.)
D. The number and credentials of public health officials in the community
Answer: A
Rationale (Nies & McEwen, 8th ed., Chapter 1): Individual behaviors such as diet, physical
activity, and smoking collectively account for a large portion of overall health outcomes in a
given population. While access to providers and other factors matters, behavior patterns remain
a dominant determinant.
10. What change could most effectively lead to a longer life span in Americans?
A. Parenting and sexual behavior classes in all public school systems
B. Legislation restricting alcohol and drug use
C. Notably reducing speed limits on all state and federal highways, and changing the age limit
for driving to 21 years of age
D. The belief that smoking is shameful and disgusting, as well as expensive, becoming the
social norm
Answer: D
Rationale (Nies & McEwen, 8th ed., Chapter 4): Smoking is associated with nearly one-fifth of
all deaths in the U.S. Changing the social norm around tobacco use—making it less acceptable—
dramatically decreases smoking rates and contributes to longer average lifespans.
11. What is the health issue causing the most concerns in the United States today?
A. Diabetes epidemic
B. Increase in cardiac disease
C. Increase in obesity
D. Rise in cancer rates
Answer: C
Rationale (Nies & McEwen, 8th ed.,): Obesity has become a major driver of multiple other
health issues, including diabetes and heart disease. Public health strategies often center on
addressing upstream causes of obesity, such as poor nutrition and a sedentary lifestyle.
,12. What factors are most responsible for the increasing length of life of Americans over the
past 100 years?
A. Better nutrition and family planning options
B. Education concerning the need to reduce salt and fat in the diet
C. Improved medical care, including exciting new technologies
D. More efficient cancer screenings and early intervention
Answer: A
Rationale (Nies & McEwen, 8th ed., Chapter 1): Public health improvements and better living
standards—like cleaner water, safer food, better nutrition, and family planning—have
contributed more to life expectancy gains than curative medical interventions alone.
13. Why would a public health nurse want to know about morbidity and mortality statistics on
the local, state, and national level?
A. To be able to share current trends in health problems with the community
B. To be able to observe the community’s statistics over time and compare the community
with other communities
C. To justify local budgets and the need for increased income from citizens
D. To publicize current health issues and suggest appropriate actions to citizens
Answer: B
Rationale (Nies & McEwen, 8th ed.,): Ongoing surveillance and data collection allow a nurse
to track changes in community health indicators and compare them to similar communities or
past data, thus identifying emerging problems or successful interventions.
14. How do public health efforts differ from medical efforts in improving the health of our
citizens?
A. Medical care providers autonomously choose appropriate interventions, whereas public
health care providers must engage in whatever actions legislation requires.
B. Medical care providers are self-employed or agency employed, whereas public health care
providers are employed by and paid through the government.
C. Medical care providers focus only on individuals, whereas public health care providers
focus only on aggregates.
D. Medical care providers focus on disease diagnosis and management, whereas public health
care providers focus on health promotion and disease prevention.
Answer: D
, Rationale (Nies & McEwen, 8th ed., Chapter 1): In public health nursing, the emphasis is on
preventive care, health promotion, and addressing root causes at the population level. Medical
care typically focuses on diagnosis and treatment of existing conditions.
15. Which primary prevention would the school nurse choose to address the school’s number of
unwed pregnancies?
A. Create a class on parenting for both the moms-to-be and the dads-to-be.
B. Convince the school board to allow sex education classes to include birth control measures.
C. Employ the moms-to-be as 1-hour-a-day employees in the school daycare center for
children born to school students.
D. Establish a class where all the unwed moms-to-be can learn infant care.
Answer: B
Rationale (Nies & McEwen, 8th ed.,): Primary prevention focuses on preventing a condition
before it occurs. Offering education related to sexual health and birth control is a key strategy
for preventing unplanned pregnancies in the first place.
16. What would be the proper term for the action of the school health nurse arranging for all
the students in the elementary school to receive H1N1 immunizations?
A. Health education
B. Secondary prevention
C. Specific protection
D. Tertiary prevention
Answer: C
Rationale (Nies & McEwen, 8th ed.,): Immunization is a form of specific protection, which is
part of primary prevention. Primary prevention includes both general health promotion and
specific protection against certain diseases (e.g., vaccines).
17. Which action would probably result in the largest change in health care outcomes for
Americans?
A. Establish large numbers of scholarships for education of nurses, physicians, and other
health care providers.
B. Fund a one-time large stimulus to allow health care providers and agencies to integrate
computer network systems for client records.
C. Increase funding for hospitals and medical centers to expand their neighborhood clinics.
D. Redirect a large portion of federal funding from acute care to health promotion activities.
, Answer: D
Rationale (Nies & McEwen, 8th ed., Chapter 1): Shifting resources from tertiary/acute care to
primary prevention, health promotion, and disease prevention could have a substantial impact
on population health and cost savings over time.
18. Which task will be most helpful in meeting the public health agency’s goals?
A. Complete staff evaluations for planning next year’s individual goals.
B. Actively participate in community agencies’ collaborative action plan to meet the
community’s health goals.
C. Meet with the college of nursing faculty to finalize student objectives and schedules.
D. Teach a free course in healthful living for community residents.
Answer: B
Rationale (Nies & McEwen, 8th ed., Chapter 1): One of the core functions of public health is
building partnerships and coalitions to address community-wide issues. Working directly with
community groups to achieve collective goals helps fulfill the agency’s broader public health
mission.
19. A community health nurse is overwhelmed with all that needs to be done in one day. Which
task could most easily be postponed?
A. Reviewing the most recent hospital patient data collected by the local college of nursing
B. Deciding which of several possible new clinical options would be most effective in better
meeting local community needs
C. Evaluating the results of the most recent community-wide screening program before
planning the next community health program
D. Giving testimony to the state legislature on a new health and safety bill
Answer: A
Rationale (Nies & McEwen, 8th ed., Chapters 1,): Reviewing raw hospital data may not
provide immediate action steps for community-wide prevention efforts. By contrast, advocacy
at the legislative level, planning new clinical initiatives, or evaluating recent screening programs
directly influences public health priorities and resource allocation.
20. A nurse who works on the surgical unit at the local hospital was asked by the home health
unit to make a home visit to a patient who had been discharged the previous day. What kind of
nursing would this nurse be doing?
A. Acute care hospital nursing
B. Community-based nursing
8th edition Nies Chapter 1 - 34
TEST BANK
,Contents
Chapter 1 Health: A Community View ..................................................................................4
Chapter 2 Historical Factors ................................................................................................14
CHAPTER 03 Thinking Upstream: Nursing Theories and Population-Focused Nursing Practice
..........................................................................................................................................27
CHAPTER 04 Health Promotion and Risk Reduction ............................................................36
CHAPTER 05: EPIDEMIOLOGY .............................................................................................47
CHAPTER 06: COMMUNITY ASSESSMENT ...........................................................................58
CHAPTER 07: COMMUNITY HEALTH PLANNING, IMPLEMENTATION, AND EVALUATION ......65
CHAPTER 08: COMMUNITY HEALTH EDUCATION ................................................................74
CHAPTER 09: CASE MANAGEMENT ....................................................................................84
CHAPTER 10: POLICY, POLITICS, LEGISLATION, AND COMMUNITY HEALTH NURSING ..........90
CHAPTER 11: THE HEALTH CARE SYSTEM ..........................................................................101
CHAPTER 12: ECONOMICS OF HEALTH CARE.....................................................................109
CHAPTER 13: CULTURAL DIVERSITY AND COMMUNITY HEALTH NURSING ........................120
CHAPTER 14: ENVIRONMENTAL HEALTH ...........................................................................130
CHAPTER 15: HEALTH IN THE GLOBAL COMMUNITY .........................................................137
CHAPTER 16: CHILD AND ADOLESCENT HEALTH ...............................................................144
CHAPTER 17: WOMEN’S HEALTH ......................................................................................155
CHAPTER 18: MEN’S HEALTH ............................................................................................167
CHAPTER 19: SENIOR HEALTH...........................................................................................172
,Chapter 20: Family Health ................................................................................................183
CHAPTER 21: Populations Affected by Disabilities .............................................................195
CHAPTER 22: Veterans Health ..........................................................................................203
CHAPTER 24: RURAL AND MIGRANT HEALTH ....................................................................221
CHAPTER 25: POPULATIONS AFFECTED BY MENTAL ILLNESS .............................................230
CHAPTER 26: COMMUNICABLE DISEASE ...........................................................................236
CHAPTER 27: SUBSTANCE ABUSE ......................................................................................245
CHAPTER 28: VIOLENCE ....................................................................................................259
CHAPTER 29: NATURAL AND MAN-MADE DISASTERS .......................................................267
Chapter 30: School Health ................................................................................................272
CHAPTER 31: OCCUPATIONAL HEALTH ..............................................................................283
CHAPTER 32: FORENSIC AND CORRECTIONAL NURSING ...................................................291
Chapter 33: Faith Community Nursing ..............................................................................299
Chapter 34: Home Health and Hospice .............................................................................307
,Chapter 1 Health: A Community View
────────────────────────────────────────────────────────────
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.
Answer: C
Rationale (Nies & McEwen, 8th ed., Chapter 1): Rapidly rising health care costs are an ongoing
concern and a driver of health policy discussions. Americans recognize that health care
expenses, which outpace inflation, are not sustainable long-term and place significant financial
strain on individuals, families, and government budgets.
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 media.
B. Nurses are primarily responsible for managing 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.
Answer: C
Rationale (Nies & McEwen, 8th ed., Chapter 1): Nurses constitute the largest group of health
professionals in the United States and have firsthand experience with health care challenges.
Their input is essential in shaping policy that reflects patient and community needs. The
American Nurses Association (ANA) supports nurse engagement in policy to promote equitable
access to care.
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 relations.
Answer: B
Rationale (Nies & McEwen, 8th ed., Chapter 1): Although managed care organizations do
employ nurses, the important trend is the growing emphasis on community-based and
preventive care. Hospitals may be closing or consolidating, but new outpatient, home health,
and community-based services are emerging to address health needs more proactively and
cost-effectively.
4. Which ethical belief would be most helpful in the current health care crisis?
A. Emphasis should be on individual and corporate 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.
Answer: C
Rationale (Nies & McEwen, 8th ed.,): Public health principles are grounded in collective action
and social justice. Although personal autonomy matters, a focus on community well-being and
ensuring that all have access to basic health services supports broad, equitable solutions to
health care challenges.
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.
Answer: D
Rationale (Nies & McEwen, 8th ed., Chapter 3): Healthy People goals encourage individual
responsibility but can underemphasize the broader social and environmental barriers that
prevent many Americans from accessing healthy options. Effective public health strategies
include both individual and community-level interventions.
,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 to clients.
B. Recognize the need for experienced nurses to mentor new graduates to help increase and
expand the number of professionals available.
C. Support health legislation to improve accessibility and cost of health care.
D. Volunteer to work overtime as needed to ensure maximum quality of care.
Answer: C
Rationale (Nies & McEwen, 8th ed.,): The ANA Code of Ethics calls on nurses to be involved in
social reform, focusing on advocating for policies that expand access to care, improve public
health, and enhance quality. Merely working longer hours or mentoring colleagues does not
fully address systemic equity or accessibility challenges.
7. What is the community health nursing definition of health?
A. Health is a person’s goal-directed purposeful process toward well-being or wholeness.
B. Health is an individual’s physical, mental, and social well-being, not merely the absence of
disease or infirmity.
C. Health is the mutual adaptation between a person and his or her environment in meeting
daily existence.
D. Health is families and aggregates choosing actions to ensure safety and well-being.
Answer: D
Rationale (Nies & McEwen, 8th ed., Chapter 1): Community/public health emphasizes that
health is shaped by collective choices and actions of families, groups, and communities, not
solely by an individual’s personal decisions.
8. How does community health nursing define community?
A. A group of persons living within specific geographic boundaries
B. A group of persons who share a common identity and environment
C. A group of persons who work together to meet common goals
D. A group of persons who resolve a community concern
Answer: B
Rationale (Nies & McEwen, 8th ed., Chapter 1): Communities can be geopolitical (a
geographic region) or phenomenological (shared identity, experience, or culture). Combining
both geography and shared identity is a broader and more inclusive definition for community
health nursing.
,9. Which variable has a major influence on a community’s health?
A. Behavior choices made by persons in the community
B. Number of health care providers and hospitals in the community
C. Quality of the public safety officers (police officers, firefighters, etc.)
D. The number and credentials of public health officials in the community
Answer: A
Rationale (Nies & McEwen, 8th ed., Chapter 1): Individual behaviors such as diet, physical
activity, and smoking collectively account for a large portion of overall health outcomes in a
given population. While access to providers and other factors matters, behavior patterns remain
a dominant determinant.
10. What change could most effectively lead to a longer life span in Americans?
A. Parenting and sexual behavior classes in all public school systems
B. Legislation restricting alcohol and drug use
C. Notably reducing speed limits on all state and federal highways, and changing the age limit
for driving to 21 years of age
D. The belief that smoking is shameful and disgusting, as well as expensive, becoming the
social norm
Answer: D
Rationale (Nies & McEwen, 8th ed., Chapter 4): Smoking is associated with nearly one-fifth of
all deaths in the U.S. Changing the social norm around tobacco use—making it less acceptable—
dramatically decreases smoking rates and contributes to longer average lifespans.
11. What is the health issue causing the most concerns in the United States today?
A. Diabetes epidemic
B. Increase in cardiac disease
C. Increase in obesity
D. Rise in cancer rates
Answer: C
Rationale (Nies & McEwen, 8th ed.,): Obesity has become a major driver of multiple other
health issues, including diabetes and heart disease. Public health strategies often center on
addressing upstream causes of obesity, such as poor nutrition and a sedentary lifestyle.
,12. What factors are most responsible for the increasing length of life of Americans over the
past 100 years?
A. Better nutrition and family planning options
B. Education concerning the need to reduce salt and fat in the diet
C. Improved medical care, including exciting new technologies
D. More efficient cancer screenings and early intervention
Answer: A
Rationale (Nies & McEwen, 8th ed., Chapter 1): Public health improvements and better living
standards—like cleaner water, safer food, better nutrition, and family planning—have
contributed more to life expectancy gains than curative medical interventions alone.
13. Why would a public health nurse want to know about morbidity and mortality statistics on
the local, state, and national level?
A. To be able to share current trends in health problems with the community
B. To be able to observe the community’s statistics over time and compare the community
with other communities
C. To justify local budgets and the need for increased income from citizens
D. To publicize current health issues and suggest appropriate actions to citizens
Answer: B
Rationale (Nies & McEwen, 8th ed.,): Ongoing surveillance and data collection allow a nurse
to track changes in community health indicators and compare them to similar communities or
past data, thus identifying emerging problems or successful interventions.
14. How do public health efforts differ from medical efforts in improving the health of our
citizens?
A. Medical care providers autonomously choose appropriate interventions, whereas public
health care providers must engage in whatever actions legislation requires.
B. Medical care providers are self-employed or agency employed, whereas public health care
providers are employed by and paid through the government.
C. Medical care providers focus only on individuals, whereas public health care providers
focus only on aggregates.
D. Medical care providers focus on disease diagnosis and management, whereas public health
care providers focus on health promotion and disease prevention.
Answer: D
, Rationale (Nies & McEwen, 8th ed., Chapter 1): In public health nursing, the emphasis is on
preventive care, health promotion, and addressing root causes at the population level. Medical
care typically focuses on diagnosis and treatment of existing conditions.
15. Which primary prevention would the school nurse choose to address the school’s number of
unwed pregnancies?
A. Create a class on parenting for both the moms-to-be and the dads-to-be.
B. Convince the school board to allow sex education classes to include birth control measures.
C. Employ the moms-to-be as 1-hour-a-day employees in the school daycare center for
children born to school students.
D. Establish a class where all the unwed moms-to-be can learn infant care.
Answer: B
Rationale (Nies & McEwen, 8th ed.,): Primary prevention focuses on preventing a condition
before it occurs. Offering education related to sexual health and birth control is a key strategy
for preventing unplanned pregnancies in the first place.
16. What would be the proper term for the action of the school health nurse arranging for all
the students in the elementary school to receive H1N1 immunizations?
A. Health education
B. Secondary prevention
C. Specific protection
D. Tertiary prevention
Answer: C
Rationale (Nies & McEwen, 8th ed.,): Immunization is a form of specific protection, which is
part of primary prevention. Primary prevention includes both general health promotion and
specific protection against certain diseases (e.g., vaccines).
17. Which action would probably result in the largest change in health care outcomes for
Americans?
A. Establish large numbers of scholarships for education of nurses, physicians, and other
health care providers.
B. Fund a one-time large stimulus to allow health care providers and agencies to integrate
computer network systems for client records.
C. Increase funding for hospitals and medical centers to expand their neighborhood clinics.
D. Redirect a large portion of federal funding from acute care to health promotion activities.
, Answer: D
Rationale (Nies & McEwen, 8th ed., Chapter 1): Shifting resources from tertiary/acute care to
primary prevention, health promotion, and disease prevention could have a substantial impact
on population health and cost savings over time.
18. Which task will be most helpful in meeting the public health agency’s goals?
A. Complete staff evaluations for planning next year’s individual goals.
B. Actively participate in community agencies’ collaborative action plan to meet the
community’s health goals.
C. Meet with the college of nursing faculty to finalize student objectives and schedules.
D. Teach a free course in healthful living for community residents.
Answer: B
Rationale (Nies & McEwen, 8th ed., Chapter 1): One of the core functions of public health is
building partnerships and coalitions to address community-wide issues. Working directly with
community groups to achieve collective goals helps fulfill the agency’s broader public health
mission.
19. A community health nurse is overwhelmed with all that needs to be done in one day. Which
task could most easily be postponed?
A. Reviewing the most recent hospital patient data collected by the local college of nursing
B. Deciding which of several possible new clinical options would be most effective in better
meeting local community needs
C. Evaluating the results of the most recent community-wide screening program before
planning the next community health program
D. Giving testimony to the state legislature on a new health and safety bill
Answer: A
Rationale (Nies & McEwen, 8th ed., Chapters 1,): Reviewing raw hospital data may not
provide immediate action steps for community-wide prevention efforts. By contrast, advocacy
at the legislative level, planning new clinical initiatives, or evaluating recent screening programs
directly influences public health priorities and resource allocation.
20. A nurse who works on the surgical unit at the local hospital was asked by the home health
unit to make a home visit to a patient who had been discharged the previous day. What kind of
nursing would this nurse be doing?
A. Acute care hospital nursing
B. Community-based nursing
