Stanhope: Community Health Nursing in Canada, Second Canadian Edition

Chapter 01: COMMUNITY HEALTH NURSING

Test Bank

MULTIPLE CHOICE

	1.	Which of the following best describes community health nursing?
a.	Focusing on the health care of individual clients in the community	
b.	Giving care with a focus on the group’s needs	
c.	Giving care with a focus on the aggregate’s needs	
d.	Working with an approach of unique client care	

ANS:	A
By definition, community health nursing is the health care of individual clients in the community.

DIF:	Cognitive Level: Knowledge	REF:	p. 2	OBJ:	1
TOP:	CRNE Competency: Changes in Health	

	2.	Which of the following best describes primary health care?
a.	A comprehensive way to address issues of social justice	
b.	Giving care to manage acute or chronic conditions	
c.	Giving direct care to ill individuals within their family setting	
d.	Having the goal of health promotion and disease prevention	

ANS:	A
By definition, primary health care is comprehensive and addresses issues of social justice and equity. Social justice in the context of health refers to ensuring fairness and equality in health services so that vulnerable individuals in society have easy access to health care.

DIF:	Cognitive Level: Knowledge	REF:	p. 20	OBJ:	1
TOP:	CRNE Competency: Health and Wellness	

	3.	The health of which of the following is the primary focus of public health nurses (PHNs)?
a.	Families	
b.	Groups	
c.	Individuals	
d.	Populations	

ANS:	D
PHNs use knowledge of nursing, social sciences, and public health sciences for the promotion and protection of health and for the prevention of disease among populations.

DIF:	Cognitive Level: Knowledge	REF:	p. 4, Table 1-1; p. 24	
OBJ:	7	TOP:	CRNE Competency: Health and Wellness	

	4.	Which of the following is the primary explanation for life expectancy increasing so notably during the twentieth century?
a.	An increase in findings from medical laboratory research	
b.	Incredible advances in surgical techniques and procedures	
c.	Improved sanitation and other public health activities	
d.	Increased use of antibiotics to fight infections	

ANS:	C
Improvement in control of infectious diseases through immunizations, sanitation, and other public health activities led to the increase in life expectancy from less than 50 years in 1900 to more than 77 years in 2002.

DIF:	Cognitive Level: Knowledge	REF:	p. 24	OBJ:	5
TOP:	CRNE Competency: Health and Wellness	

	5.	Which community health nursing practice area receives funding from the private sector?
a.	Telenurses	
b.	Corrections nurses	
c.	Nurse entrepreneurs	
d.	Street or outreach nurses	

ANS:	C
The nurse entrepreneur receives private funding, whereas all of the other community health nurse (CHN) roles are with provincially or federally funded positions.

DIF:	Cognitive Level: Knowledge	REF:	p. 6, Table 1-1 Examples
OBJ:	7	TOP:	CRNE Competency: Professional Practice	

	6.	Which of the following definitions reflects “client as society”?
a.	Groups within a population working together on a defined activity	
b.	Systems that incorporate the social, political, economic, and cultural infrastructure to address issues of concern	
c.	People and the relationships that emerge among them as they develop and share environments	
d.	A large group of people who have at least one characteristic in common and who reside in close proximity	

ANS:	B
Systems that incorporate the social, political, economic, and cultural infrastructure to address issues of concern is the definition of client as society.

DIF:	Cognitive Level: Knowledge	REF:	p. 7, Table 1-2		
OBJ:	1	TOP:	CRNE Competency: Nurse–Client Partnership

	7.	A PHN strives to prevent disease and disability, often in partnership with other community groups. Which one of the following is an appropriate summary of the PHN’s role?
a.	The PHN asks the political leaders what interventions should be chosen.	
b.	The PHN assesses the community and decides on appropriate interventions.	
c.	The PHN uses data from the main health care institutions in the community to determine needed health services.	
d.	The PHN works with community members to carry out public health functions.	

ANS:	D
It is crucial that the PHN work with members of the community to carry out core public health functions.

DIF:	Cognitive Level: Application	REF:	p. 25, How To box	
OBJ:	7	TOP:	CRNE Competency: Health and Wellness	

	8.	Which of the following is used as a measurement of population health?
a.	Health status indicators	
b.	Awareness of levels of prevention	
c.	The number of memberships at the local fitness centre	
d.	Reported provincial alcohol and tobacco sales in any given month	

ANS:	A
The focus of community health nursing practice is disease prevention, which is broken down into three levels of prevention: primary, secondary, and tertiary.

DIF:	Cognitive Level: Knowledge	REF:	p. 8	OBJ:	2
TOP:	CRNE Competency: Changes in Health	

	9.	Ms. LeBlanc, BSc, registered nurse (RN), has just been employed as a CHN. Which of the following questions might be very relevant to her practice as she begins her position?
a.	“Which community groups are at greatest risk for problems?”	
b.	“Which patients should I see first as I begin my day?”	
c.	“With which physicians will I be collaborating most closely?”	
d.	“Who is the nursing assistant to whom I can refer patients?”	

ANS:	A
CHNs apply the nursing process to the entire community; asking which groups are at greatest risk reflects a community-oriented perspective. The other possible responses focus on particular individuals.

DIF:	Cognitive Level: Application	REF:	p. 20	OBJ:	8
TOP:	CRNE Competency: Health and Wellness	

	10.	Whenever Ms. LeBlanc, BSc, RN, talks to the women at the senior citizens’ centre, she reminds them that the only way the centre will be able to afford a driver and a van service for those who cannot drive themselves is to continue to write letters to their local city council representatives, requesting funding for such a service. What is Ms. LeBlanc doing?
a.	Ensuring that the women do not expect Ms. LeBlanc herself to do anything about their problem	
b.	Demonstrating that she understands the women’s concerns and needs	
c.	Expressing empathy, support, and concern	
d.	Helping the women engage in political action locally	

ANS:	D
PHNs have an imperative to work with the members of the community to carry out public health functions.

DIF:	Cognitive Level: Application	REF:	p. 25, How To box	
OBJ:	7, 8	TOP:	CRNE Competency: Nurse–Client Partnership

	11.	Which one of the following is an example of the “advocate” role of the CHN?
a.	Organizing home care support for a newly discharged older adult client	
b.	Acting as a member of a community action group for provision of accessible transit choices	
c.	Doing prenatal assessments	
d.	Facilitating a self-help group for smoking cessation	

ANS:	B
An advocate provides a voice to client concerns when acting as a member of a community action group for provision of accessible transit choices.

DIF:	Cognitive Level: Application	REF:	p. 28, Table 1-6	
OBJ:	7	TOP:	CRNE Competency: Health and Wellness	

	12.	In which of the following scenarios is the PHN most probably fulfilling required employment responsibilities?
a.	The PHN meets with several groups about community recreation issues.	
b.	The PHN spends the day attending meetings at various health agencies.	
c.	The PHN talks to several people about their particular health concerns.	
d.	The PHN watches television, including a telecast of a city council meeting on the local cable station.	

ANS:	B
Any of these might represent a PHN communicating, cooperating, or collaborating with community residents or groups about health concerns. However, the PHN who spends the day attending meetings at various health agencies is most probably fulfilling requirements effectively, since health is broader than recreation, individual concerns are not as important as aggregate priorities, and watching television is only one-way communication.

DIF:	Cognitive Level: Synthesis	REF:	pp. 4–6, Table 1-1	
OBJ:	8	TOP:	CRNE Competency: Health and Wellness	

	13.	A CHN often has to make resource allocation decisions. In such cases, which of the following approaches will help the CHN to arrive at the decision?
a.	Choosing a moral or ethical principle	
b.	Choosing the cheapest, most economical approach	
c.	Choosing the most rational outcome	
d.	Choosing the needs of the aggregate, rather than the needs of a few individuals	

ANS:	D
Although all of the answers represent components of the CHN’s decision-making process, the predominant needs of the population outweigh the expressed needs of one person or a few people.

DIF:	Cognitive Level: Application	REF:	pp. 2, 7	OBJ:	7, 8
TOP:	CRNE Competency: Nurse–Client Partnership

	14.	Which one of the following situations represents public health nursing?
a.	Assessing the services and effectiveness of the school health clinic	
b.	Caring for patients after their outpatient surgeries	
c.	Giving care to schoolchildren at the school clinic and to the children’s families	
d.	Treating paediatric patients at an outpatient clinic	

ANS:	A
A public health or population-focused approach would consider the entire group of children receiving care, to see if services are effective in achieving the goal of improving the health of the school population.

DIF:	Cognitive Level: Application	REF:	p. 25, How To box	
OBJ:	7	TOP:	CRNE Competency: Health and Wellness	

	15.	Which one of the following public health services represents primary prevention?
a.	Developing a health education program about the dangers of smoking	
b.	Providing a diabetes clinic for adults in low-income neighbourhoods	
c.	Providing an influenza vaccination program in a community retirement village	
d.	Teaching school-aged children about the positive effects of exercise	

ANS:	C
Although all the services listed are appropriate and valuable, providing influenza vaccines to healthy adults represents the primary level of health prevention.

DIF:	Cognitive Level: Application	REF:	p. 8	OBJ:	2
TOP:	CRNE Competency: Health and Wellness	

	16.	What term is used interchangeably with the term subpopulations?
a.	Groups	
b.	Aggregates	
c.	Clients	
d.	Communities	

ANS:	B
Generally, subpopulations are referred to as aggregates within the larger community population.

DIF:	Cognitive Level: Knowledge	REF:	p. 8	OBJ:	1
TOP:	CRNE Competency: Nurse–Client Partnership

	17.	Which one of the following public health services represents secondary prevention?
a.	Administering the influenza vaccine to a community of seniors	
b.	Initiating an infant car seat safety screening program for parents in low-income housing	
c.	Starting a rehabilitation clinic for middle-aged adults residing in low-income housing	
d.	Setting up a support group for teenage mothers of infants with Down syndrome	

ANS:	B
Secondary prevention seeks to detect disease early in its progression—for example, through mass screening programs.

DIF:	Cognitive Level: Application	REF:	p. 8	OBJ:	1
TOP:	CRNE Competency: Health and Wellness	

	18.	Which type of thinking is most reflective of looking at a macroscopic, big-picture population focus?
a.	Collaborative thinking	
b.	Upstream thinking	
c.	Holistic thinking	
d.	Downstream thinking	

ANS:	B
Upstream thinking uses a macroscopic, big-picture population focus, whereas downstream thinking is a microscopic, individual curative focus.

DIF:	Cognitive Level: Knowledge	REF:	p. 9	OBJ:	1
TOP:	CRNE Competency: Health and Wellness	

	19.	What were the first determinants of health as identified by the Lalonde Report in 1974?
a.	Biology, lifestyle, health care, environment	
b.	Resources, social justice, stable ecosystem, equity	
c.	Biology, genetics, education, social supports	
d.	Income, social status, education, health services	

ANS:	A
The Lalonde Report first identified four determinants of health: biology, lifestyle, health care organization, and environment.

DIF:	Cognitive Level: Knowledge	REF:	p. 15	OBJ:	3
TOP:	CRNE Competency: Health and Wellness	

	20.	Which of the following ethical principles indicates that the CHN is ethically bound to do good within the limitations of time, place, and talent?
a.	Justice	
b.	Beneficence	
c.	Nonmaleficence	
d.	Distributive justice	

ANS:	B
Beneficence is the ethical principle that states that CHNs are ethically bound to do good within the limitations of time, place, and talent.

DIF:	Cognitive Level: Knowledge	REF:	p. 20	OBJ:	5
TOP:	CRNE Competency: Professional Practice	

	21.	Which of the following is a requirement for reaching the goal “health for all”?
a.	Self-actualization	
b.	A system for health	
c.	Elimination of lower- and upper-class categories	
d.	Total compliance with immunizations and vaccines with all groups	

ANS:	B
The requirements identified to reach the “health for all” goal include 1) basic needs, 2) belonging and engagement, 3) healthy living, and 4) a system for health.

DIF:	Cognitive Level: Knowledge	REF:	p. 23	OBJ:	5
TOP:	CRNE Competency: Health and Wellness	

	22.	Which of the following is the simplest definition of primary health care?
a.	It is based on a multidisciplinary group of health care providers working as a team.	
b.	It provides essential care that is universally accessible to persons in a community and encourages self-management, self-reliance, and competence.	
c.	It focuses on health promotion and disease prevention among those who can afford to engage in behaviours that facilitate them.	
d.	It is based on local efforts to meet the Declaration of Alma-Ata, known as Health for All.	

ANS:	B
Primary health care is generally defined as essential care made universally accessible to individuals and families in a community with their full participation and at a cost that the community can afford.

DIF:	Cognitive Level: Knowledge	REF:	p. 22	OBJ:	1
TOP:	CRNE Competency: Health and Wellness