CHAPTER 23: Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford

Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford Chapter 23: Public Health, Community-Based, and Home Health Care Multiple Choice Questions 1. The student learns that which is the best definition of a public health nurse? A. Works with the public. B. Works in public areas. C. Works with the greater community. D. Works with public funding. Answer: C Explanation: A public health nurse focuses on communities as a whole, addressing specific or vulnerable groups within them. This role prioritizes population health over individual care. Why Other Options Are Wrong: A and B are too vague and do not capture the community centered approach. D incorrectly ties the role to funding rather than health outcomes. 2. A nurse is discharging a patient and is planning on what material to give the patient to take home. What action by the nurse is best? A. Assess the patient's ability to read and understand. B. Determine if the patient wants to take written material home. C. Give the patient the same material as other patients get. D. Ask the patient if he/she has a need for written material. Answer: A Explanation: Health literacy is critical; assessing the patient's ability to comprehend written material ensures effective communication and tailored education. Why Other Options Are Wrong: B assumes the patient knows their needs, which may not align with health literacy gaps. C ignores individualized care. D is passive and less proactive than direct assessment. 3. A nurse is planning primary prevention activities. Which activity would the nurse include in this plan? A. Safer sex education for teens. B. Mammogram screening. C. Medication compliance. D. Annual physical exams. Answer: A Explanation: Primary prevention aims to prevent disease onset, exemplified by education (e.g., safer sex) to reduce risk behaviors. Why Other Options Are Wrong: B and D are secondary prevention (early detection). C is tertiary prevention (managing existing conditions). 4. A nurse wants to volunteer for a community group providing secondary prevention. What activity would the nurse attend? A. Stroke rehabilitation support group. B. Blood pressure screening at the mall. C. Bicycle safety class at the elementary school. D. Drop-by nutrition station at the grocery store. Answer: B Explanation: Secondary prevention focuses on early detection (e.g., blood pressure screening) to intervene before complications arise. Why Other Options Are Wrong: A is tertiary (rehabilitation). C and D are primary prevention (education and wellness). 5. A nurse is orienting to a new job in a home health care agency and is told that most of her patients need tertiary prevention. What activity does the nurse plan to include in the daily routine? A. Household safety checks. B. Well-baby checkups. C. Antibiotic administration. D. Monthly blood pressure assessments. Answer: C Explanation: Tertiary prevention manages existing conditions (e.g., infections) to prevent worsening, such as administering antibiotics. Why Other Options Are Wrong: A and D are secondary prevention (monitoring). B is primary prevention (wellness). 6. A nurse is interested in epidemiology. What work activity would best fit this role? A. Studying census data to determine common causes of death. B. Researching population variables that contribute to disease. C. Developing sanitary measures to prevent foodborne illness. D. Designing research to determine the connection between pollution and cancer. Answer: B Explanation: Epidemiologists analyze population-level factors (e.g., social determinants) to identify disease patterns and prevention strategies. Why Other Options Are Wrong: A is demographic analysis, not epidemiology. C is public health implementation. D is environmental research. 7. The student studying community health nursing learns that vulnerable populations can be best assisted by which activity? A. Researching their genetic risk for health problems. B. Working with the community to decrease health risks. C. Studying vital statistics to determine their causes of death. D. Making sure the population maintains immunizations. Answer: B Explanation: Addressing systemic risks through community collaboration (e.g., education, resources) is most effective for vulnerable groups. Why Other Options Are Wrong: A and C are data-focused but lack direct intervention. D is a single action, not comprehensive risk reduction. 8. A nurse is completing an OASIS assessment on a patient. What data would be most important for the nurse to assess? A. Presence of grocery stores nearby. B. Safety concerns within the home. C. Number and kind of pets. D. Proximity to a health care facility. Answer: B Explanation: OASIS prioritizes home safety (e.g., fall risks) to ensure patient well-being in the care environment. Why Other Options Are Wrong: A, C, and D are irrelevant to OASIS's focus on immediate safety and care needs. 9. A community was devastated by a tornado several months ago. What nursing diagnosis would be most appropriate for the nurse to consider? A. Social isolation. B. Deficient community resources. C. Ineffective community coping. D. Deficient community health. Answer: C Explanation: Post-disaster, communities often struggle with collective coping due to trauma and resource strain, making this diagnosis relevant. Why Other Options Are Wrong: A addresses individuals, not communities. B and D are not standardized nursing diagnoses. 10. When planning interventions for a community, what action by the nurse is best? A. Involve community leaders in planning. B. Create a plan of action addressing priorities. C. Determine what resources are available. D. Attempt to find funding for the plan. Answer: A Explanation: Engaging leaders ensures community buy-in and culturally appropriate solutions, critical for successful interventions. Why Other Options Are Wrong: B, C, and D are steps in planning but secondary to stakeholder involvement. 11. A nurse has referred a patient to a community agency. When talking to the patient later, he states that he did not find the agency helpful. What action by the nurse is best? A. Determine what the patient would find helpful. B. Review the agency's mission and scope. C. Make another appointment with the agency. D. Warn the patient that nonadherence affects payment. Answer: B Explanation: The nurse must verify the agency's fit for the patient's needs before reassessing or re-referring. Why Other Options Are Wrong: A is patient-centered but skips assessing agency alignment. C repeats the error if the agency is unsuitable. D is punitive and untherapeutic. 12. A nurse has assessed a community and has found many areas in which health can be improved. As a result, the nurse has multiple ideas for programming. What action by the nurse is best? A. Determine what the community thinks is most important. B. Use vital statistics to determine which is most important. C. See what other communities are focusing programming on. D. Choose the easiest problem to address first. Answer: A Explanation: Community priorities drive successful interventions; aligning with their perceived needs ensures engagement and sustainability. Why Other Options Are Wrong: B and C ignore community input. D prioritizes convenience over impact. 13. A home health care nurse is working with the family of a patient who has Alzheimer disease and requires 24-hour care. What assessment by the nurse indicates the family is meeting an important goal for caregiver role stress? A. Family eats dinner together every night. B. Family uses respite care one night a week. C. Family investigates research trials for patient. D. Family verbalizes exhaustion from caregiving. Answer: B Explanation: Respite care usage demonstrates proactive management of caregiver stress, a key goal for long-term care sustainability. Why Other Options Are Wrong: A is unrelated to stress management. C focuses on the patient, not caregiver needs. D indicates unmet needs. 14. The nurse has implemented a community-wide immunization program for seasonal influenza. Once the program has ended, what action by the nurse is best? A. Begin planning for next year's program. B. Send mail surveys to participants. C. Determine financial gains or losses. D. Evaluate the program and outcomes. Answer: D Explanation: Evaluation measures program effectiveness (e.g., participation rates, coverage gaps) to guide future improvements. Why Other Options Are Wrong: A is premature without evaluation. B and C are evaluation components but not comprehensive. 15. A nurse is wondering if home health care nursing is a good fit. What characteristic or ability does the experienced home health care nurse suggest is most important? A. Clinical reasoning. B. Organization. C. Assessment skills. D. Time management. Answer: A Explanation: Home health nurses work autonomously, requiring strong clinical reasoning to adapt care without onsite support. Why Other Options Are Wrong: B, C, and D are important but secondary to critical thinking in unpredictable home environments. 16. A nurse is a case manager for a home health care agency. The nurse often orders supplies for patients seen by the agency. What action by the nurse is best? A. Negotiate for cheaper prices from suppliers. B. Investigate what each patient's insurance will cover. C. Refer the patient to the closest supply source. D. Use the same supplier for all patients' needs. Answer: B Explanation: Insurance coverage dictates accessible resources; verifying benefits ensures cost effective, appropriate care. Why Other Options Are Wrong: A may not address coverage limitations. C and D overlook insurance-specific approvals. 17. The public health nurse volunteers for a missionary group caring for Ebola patients in Africa. The nurse is reviewing the data using analytic epidemiology methods. What information does the nurse collect as the priority? A. Cultural norms in burial practices. B. Genetic variables in disease acquisition. C. Statistics related to incidence and prevalence. D. Autopsy data on direct cause of death. Answer: A Explanation: Analytic epidemiology examines cultural practices (e.g., burial rites) to identify disease transmission pathways and prevention strategies. Why Other Options Are Wrong: B and D focus on biological factors, not community behaviors. C is descriptive, not analytic. Multiple Response Questions 1. The student nurse learns the ANA's Scope and Standards of Practice for public health nursing include which components? A. Team membership. B. Developing research. C. Ethical behavior. D. Responsible resource use. E. Advocacy. Answer: C, D, E Explanation: The ANA standards emphasize ethics, resource stewardship, and advocacy as core to public health nursing practice. Why Other Options Are Wrong: A is not a standard. B misrepresents the role (participation in research, not development). 2. A nurse is assessing social determinants of health. Which does the nurse include in the assessment? A. Vaccination compliance. B. Family structure. C. Communication patterns. D. Roles for women. E. Education. Answer: A, B, D, E Explanation: Social determinants include socioeconomic factors (education, gender roles), family dynamics, and health behaviors (vaccination). Why Other Options Are Wrong: C relates to culture but is not a recognized social determinant. 3. A nurse is studying intrinsic factors that influence the development of asthma in a community. What factors does the nurse assess? A. Socioeconomic status. B. Genetics. C. Pollution in the area. D. Water cleanliness. E. Immunization status. Answer: A, E Explanation: Intrinsic factors are individual traits (e.g., SES impacting access to care) or behaviors (immunization), distinct from environmental (extrinsic) factors. Why Other Options Are Wrong: B is genetic but less directly tied to asthma. C and D are extrinsic (environmental). 4. The nurse is conducting a windshield survey. What items does the nurse assess? A. Types of housing available. B. Cars seen in parking lots. C. Recreational facilities. D. Health care facilities. E. Places of worship. Answer: A, C, D, E Explanation: Windshield surveys evaluate community infrastructure (housing, recreation, health care, religion) to identify resources and gaps. Why Other Options Are Wrong: B is irrelevant to health or community assessment. 5. The community health nurse knows that which are standards of professional performance for home care nurses according to the ANA? A. Collegiality. B. Performance appraisal. C. Ethical behavior. D. Outcome identification. E. Resource utilization. Answer: C, E Explanation: The ANA highlights ethics and resource use as key standards, aligning with advocacy and cost-effective care in home health. Why Other Options Are Wrong: A and B are workplace practices, not ANA standards. D is part of the nursing process, not performance. 6. A nurse wants to create a community action plan for health problems related to air pollution from a nearby factory. Which stakeholders does the nurse consult as the priority? A. Factory owners. B. Stock shareholders. C. Community residents. D. Local health care providers. E. Factory employees. Answer: A, C, D Explanation: Priority stakeholders include those directly impacted (residents) or responsible (owners, providers) for pollution and health outcomes. Why Other Options Are Wrong: B lacks direct involvement. E may be secondary unless employment is affected. 7. The nurse explains to the patient that which services will be covered under Medicare? A. Infusion therapy. B. Ostomy management. C. Renal dialysis. D. Chemotherapy. E. Grocery shopping. Answer: A, B, C, D Explanation: Medicare covers skilled care (infusions, dialysis) and chronic condition management (ostomy, chemo) but not non-medical services. Why Other Options Are Wrong: E is a non-covered homemaker service unless tied to skilled care. 8. The home health care nurse educates patients on which goals of hospice care? A. Relieve suffering. B. Support the patient and family. C. Provide grief support. D. Keep patients out of the hospital. E. Lower medical expenses. Answer: A, B, C Explanation: Hospice prioritizes comfort, family-centered care, and bereavement support, not cost or hospitalization avoidance. Why Other Options Are Wrong: D and E are outcomes, not primary goals of hospice philosophy.