Nursing Practice at the Local, State, and National Levels in Public Health Stanhope: Foundations of Population Health for Community/Public Health Nursing, 5th Edition,100% CORRECT

Document Content and Description Below

Nursing Practice at the Local, State, and National Levels in Public Health Stanhope: Foundations of Population Health for Community/Public Health Nursing, 5th Edition MULTIPLE CHOICE 1. Which ... of the following is the underlying science or area of study on which public health is based? a. Biostatistics b. Epidemiology c. Medicine d. Social sciences ANS: B It works across many disciplines and is based on the scientific core of epidemiology. Public health uses biostatistics in its practice. It is not a branch of medicine; it is an organized community approach designed to prevent disease, promote health, and protect populations. Public health is not based on the social sciences, which is the study of society and relationships. 2. A nurse is employed at the state department of public health. Which of the following is a fundamental principle guiding his practice? a. Decisions are made at the federal level, disseminated at the state level, and carried out at the community level. b. Health of populations is only as good as the health of individuals that live and work in the community. N R I G B.C M c. Oversight of community health departments is the most important function. d. The interaction of the local-state-federal partnership is critical to success. ANS: D In the United States, the local-state-federal partnership includes federal agencies, the state and territorial public health agencies, and the local public health agencies. Their effective interaction is critical to the effective use of both financial and personnel resources to address the health of populations. Nurses working in all of these agencies work together to identify, develop, and implement interventions that will improve and maintain the nation’s health. Decisions can be made and implemented at the federal, state, and local levels. The health of individuals and populations is influenced by the health policies that are in place. The state agency may provide some oversight of local health departments, but that is not its primary purpose. 3. The public health administrator is in the process of hiring a new public health nurse. Which of the following statements made by an applicant would most likely result in the applicant not being hired? a. “I like to be the only person working on a project because individuals in teams have their own ideas and plans and the resulting debate slows progress.” b. “I prefer to work in teams because no single person has too much responsibility because the burden is shared.” c. “Teamwork is better than work done by individuals because teamwork incorporates different perspectives.” d. “Whether teamwork is better than work done by individuals depends on the nature of the work being performed.” ANS: A An applicant who does not like to work in and with teams would not be appropriate to fill this position. Teamwork is a necessary skill when working as a public health nurse. Working in collaborative partnerships is an essential role of public health nursing. Partnerships and collaboration among groups are much more powerful in making change than the individual client and nurse working alone. Part of the reason is that multiple perspectives are examined in the process of coming to the best solution. 4. Which of the following federal agencies is most influential in public health activities? a. The Agency for Healthcare, Research, and Quality b. Centers for Disease Control and Prevention c. Department of Health and Human Services d. Food and Drug Administration ANS: C The U.S. Department of Health and Human Services (USDHHS) and the Environmental Protection Agency (EPA) are the federal agencies that most influence public health activities at the state and local levels. The Agency for Healthcare, Research, and Quality, the Centers for Disease Control and Prevention, and the Food and Drug Administration are all pieces of the broader USDHHS. 5. Which of the following agencies are responsible for implementing and enforcing local, state, and federal public health codes and ordinances and providing essential public health programs to a community? a. Community health clinicsNURSINGTB.COM b. Federal health agencies c. Local health agencies d. State health agencies ANS: C Local public health agencies are the agencies responsible for implementing and enforcing local, state, and federal public health codes and ordinances and providing essential public health programs to a community. State public heatlh ageencies are reponsible for monitoring health status and enforcing laws and regulations that protect and improve the public’s health; they do not provide essential public health programs to the community. Federal health agencies develop regulations that implement policies formuated by Congress. Community health clinics may provide essential public health programs to the community, but are not responsible for implementing and enforcing local, state, and federal public health codes and ordinances. 6. A nurse at a migrant clinic assists clients with completing the application process to receive supplemental food assistance. Which of the following roles of the nurse is being used? a. Advocate b. Case manager c. Outreach worker d. Primary caregiver ANS: A As an advocate, the nurse collects, monitors, and analyzes data and discusses with the client which services are needed and whether the client is an individual, a family, or a group. When using the role of case manager, the nurse assists in providing equal access to health care by identifying and alerting the community to gaps in services available. As an outreach worker, the nurse addresses the multiple needs of high-risk populations. Nurses provide direct client care when using the role of primary caregiver. 7. Which of the following best describes the primary reason life spans have notably lengthened over the past 100 years? a. Advances in hospital care and procedures b. Advances in medicine and medical research c. Advances in nursing practice d. Advances in public health ANS: D A person born today can expect to live 30 years longer than someone born in 1900. Medical care accounts for 5 years of that increase, but public health is responsible for the additional 25 years, through prevention efforts brought about by changes in social policies, community actions, and individual and group behavior changes. Advances in medical care only accounts for 5 of the additional 30 years that longevity has increased. Hospital and nursing care are not specifically noted when discussing the increase in life span. 8. Which of the following best describes how public health nurses (PHNs) differed from other health care professions in the early twentieth century? a. PHNs contributed without receiving any salary for doing so. b. PHNs created new settings where health care could be given. c. PHNs gave care to powerNlessRgroIupsG. B.C M d. PHNs worked outside any organized health care system. ANS: C During this period, public health nurses worked with populations and in settings that were not of interest to other health care disciplines or groups. Much public health service was delivered to the poor and to women and children, who did not have political power or voice. Public health nurses were employed by agencies and received pay for the work that they did. In the early twentieth century, new settings where health care could be delivered were not developed. Public health nurses wokred with a variety of partners to begin to include reproductive health, chronic disease prevention, and injury prevention activities. 9. Which of the following best describes the role of nursing in community health? a. Application of nursing and public health theory in promoting, preserving, and maintaining health of individuals, families, or communities b. Health care provision offered in primary and secondary institutions or in the client’s home c. Provision of health care services in institutions located in the community but outside the hospital d. Use of the nursing process and evidence-based practice to meet Healthy People 2020 objectives for community health improvement ANS: A Nursing practice in community health is the synthesis of nursing theory and public health theory applied to promoting, preserving, and maintaining the health of populations through the delivery of personal health care services to individuals, families, and groups. The focus of practice is health of individuals, families, and groups. Care is provided within the context of preventing disease and disability and promoting and protecting the health of the community as a whole. Healthy People 2020 addresses the role of multiple disciplines in improving the health of the population; thus, it does not use the nursing process or is specific for the nursing profession. 10. A community health nurse is trying to decrease the incidence of emerging infections caused by drug-resistant organisms. Which of the following actions would be most appropriate for the nurse to implement? a. Lobby for increased use of antibiotics in the treatment and prevention of communicable diseases. b. Notify the Centers for Disease Control regarding any unusual signs and symptoms related to a communicable illness. c. Reinforce the importance of receiving vaccinations according to recommended schedules. d. Teach parents that antibiotics should not be used for treatment of viral infections or for prevention of bacterial infections. ANS: D The widespread, often inappropriate, use of antimicrobial drugs has resulted in loss of effectiveness for some infections. Clients and health care providers are responsible for the inappropriate use of antibiotics. The nurse can influence this trend by objecting to inappropriate use of antibiotics by providers and by educating individuals, families, health care providers, and the commNuniRty aIbouGt theBd.aCngeMrs of misuse and overuse of antibiotics. Lobbying for increased use of antibiotics would not assist in decreasing the amount of drug-resistant organisms. Notifying the Centers for Disease Control or increasing the percentage of children who are vaccinated will not effect the increased development of drug-resistant organisms. 11. A nurse is considering applying for a public health nurse position at a local health department. Which of the following minimum levels of educational preparation should the nurse have obtained? a. Associate degree in nursing b. Baccalaureate degree in nursing c. Master of science degree in nursing d. Training as a licensed practical nurse ANS: B Educational preparation of nurses in community health should be at least a baccalaureate degree. Nurses need this level of education because of the increasing complexity of better care delivery in public health. A licensed practice nurse would need supervision for a registered nurse and would not be able to practice autonomously in this setting. Those registered nurses who have associate degrees are encouraged to seek further degrees because of the increasing complexity of better care delivery in public health. A master’s degree would be even more useful, but for many, advanced education may not be feasible. 12. A public health nurse has reviewed the objectives of Healthy People 2020. Which of the following should be the focus for programming in the community related to communicable diseases? a. Encouraging community members to engage in healthy behaviors b. Identifying high-risk sexual behaviors among community members c. Monitoring the sexual activity of adolescents d. Providing information about the hazards of multiple sexual partners ANS: D Healthy People 2020 lists communicable disease as an area of focus including levels of human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), and sexually transmitted infections. One method to reduce the risk of acquiring a communicable disease is by the public health nurse providing information on the hazards of multiple sexual partners and street drug use. Encouraging “healthy behaviors” is not specific to the prevention of communicable diseases. Monitoring the sexual activity of adolescents only addresses one segment of the population, and montoring does not provide an active intervention for the nurse to complete to influence the problem. Identification of high-risk behaviors is part of the assessemnt of the community and may assist the nurse in knowing what programs to develop, but this would not assist in decreasing the rates of communicable disease. 13. Which of the following is a core competency required of public health nurses? a. Knowledge in the use of high-technology diagnostics b. Knowledge of the implementation of electronic medical records c. Skill in the physical assessment of complex clients d. Skill in developing policy and planning programs ANS: D N R I G B.C M The core public health competeUnciSes aNre dTivided iOnto the following eight domains: (1) analytic assessment skills; (2) basic public health sciences skills; (3) cultural competency skills; (4) communication skills; (5) community dimensions of practice skills; (6) financial planning and management skills; (7) leadership and systems thinking skills; (8) policy development/program planning skills. The incorrect competencies are better suited for tertiary facilities such as hospitals. 14. Which of the following factors is causing nursing to change so quickly? a. Economic issues b. Increases in medical and nursing knowledge c. Legislative issues d. Technology changes ANS: A More than any other single factor, the driving force behind nursing changes is the economy and the increase in managed care to decrease or control health care costs in the United States. Changes in technology and knowledge are not influencing the rapid change in nursing knowledge. Legislative issues are not influencing nursing practice. 15. A nurse is implementing a primary prevention activity to decrease the incidence of communicable disease. Which of the following actions is the nurse most likely taking? a. Identifying and treating clients in a sexually transmitted disease clinic b. Partnering with schoolteachers to teach and observe hand washing techniques in elementary school children c. Providing case management services that link clients with communicable diseases to health care and community support services d. Performing directly observed therapy (DOT) for clients with active tuberculosis ANS: B An example of primary prevention is to educate daycare centers, schools, and the general community about the importance of hand hygiene to prevent transmission of communicable diseases. The goal of primary prevention is to prevent the disease from occurring. Identifying and treating clients is part of secondary prevention, as screening is being completed to determine at the earliest stage possible who has the disease. Providing case maangement services for those with communicable disease and performing DOT therapy with clients are both examples of tertiary prevention as the populations that the nurse is working with both already have the disease. Through tertiary prevention, the nurse is working to restore their health to the highest level possible. 16. A public health nurse traces sexual contacts of clients with sexually transmitted diseases for screening and treatment. Which of the following levels of prevention is being implemented? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Secondary and tertiary prevention ANS: B Tracing individuals exposed to a client with a sexually transmitted disease is secondary prevention because the nurse is attempting to find those exposed and screen them. Once the exposed persons have been located, screening is another secondary prevention activity. Through tertiary prevention, the nurse is working to restore their health to the highest level possible. If the nurse were toNpUroRviSdeIdNirGecTt Bca.reCtOo Mthe clients with sexually transmitted diseases this would be an example of tertiary prevention. The goal of primary prevention is to prevent the disease from occurring. Thus, when providing primary prevention the nurse could provide free condoms for sexually active persons or provide education about ways to prevent the tranmsission of these diseases. 17. A community mental health nurse is implementing a tertiary prevention activity. Which of the following interventions is most likely being completed? a. Disseminating information about mental health to community organizations b. Partnering with school health nurses for early identification of children who have evidence of mental health problems c. Providing case management services that link clients with serious mental illnesses to mental health and community support services d. Screening high-risk clients for the presence of mental disorders ANS: C An example of tertiary prevention is the provision of case management services that link clients identified with serious mental illnesses to mental health and community support services. Tertiary prevention aims to restore those with the disease to the highest level of functioning possible. Disseminating information about mental health is an example of primary prevention as the nurse is aiming to prevent a problem before it occurs. Partnering for early identification of children and screening high-risk clients are examples of secondary prevention. Secondary prevention occurs when the nurse conducts screenings and tries to identify diseases at the earliest possible stage. 18. A nurse is working at a local health department. Which of the following would most likely be completed by this agency? a. Enforcement of laws and regulations related to public health nationwide b. Filing of a certificate for any birth or death in a community c. Providing experts in various specialties to answer questions and respond as needed d. Surveying the state’s public health needs ANS: B Local public health agencies provide and disseminate health information, provide leadership in health planning, provide essential public health and environmental services, analyze statistics on births to monitor community health status, and file a certificate for every birth or death in the community. Enforcement of laws and regulations related to public health nationwide, providing experts in various specialties, and surveying the state’s public health needs would all occur at the state level. MULTIPLE RESPONSE 1. A nurse is employed by a state public health department. Which of the following functions would most likely be completed by this agency? (Select all that apply.) a. Delegating power to engage in certain activities such as quarantine b. Enforcing laws and regulations that protect public health c. Filing birth and death certificates whenever these occur within the state d. Monitoring health status of citizens within its geographic boundaries ANS: A, B, D State public health agencies are responsible for monitoring health status and enforcing laws and regulations that protect andUimSproNve tThe publiOc’s health. These agencies receive funding from federal agencies for the implementation of public health interventions such as the maternal and child health programs. State agencies distribute federal and state funds to the local public health agencies to implement programs and provide oversight and consultation for local public health agencies. State health agencies also delegate some public health powers, such as the power to quarantine, to local health officers. Local departments file birth and death certificates and often ask for volunteers to assist. 2. Which of the following activities are addressed by most public health departments on the federal, state, and local levels? (Select all that apply.) a. Collecting and analyzing various health statistics b. Fining and terminating business at any facility that engages in unsafe commercial practices c. Identifying and planning for high-risk populations d. Planning for and responding to emergencies ANS: A, C, D The majority of local, state, and federal public health agencies engage in collecting and analyzing vital statistics, providing health education and information, receiving reports about and investigating and controlling communicable diseases, protecting the environment to reduce the risk to health, providing some health services to particular populations at risk, planning for and responding to natural and human-made disasters and emergencies, identifying public health problems for at-risk and high-risk populations, conducting community assessments to identify community assets and gaps, and partnering with other organizations to develop and implement responses to identified public health concerns. Public health departments do not regulate the practices of businesses; thus, they would not be responsible for fining or terminating businesses. 3. What did events after September 11, 2001, clearly demonstrate? (Select all that apply.) a. A strong public health structure ready to respond effectively to a crisis b. Public health’s need for additional funding and resources c. The unrecognized importance of nurses in lowering health care costs d. Lack of adequate vaccines to meet community’s needs ANS: B, C, D The anthrax exposures after 9/11 alerted policymakers to the weakening public health infrastructure required to respond to bioterrorism events. Unprecedented influenza, tetanus, and childhood vaccine shortages and emerging infections competed with bioterrorism activities for resources. The general public was not informed about how immunizations by nurses improved health and lowered health care cost. For public health services to receive adequate funding, it is necessary for the public and the government to be aware of the benefits provided to a community by nurses. These events showed that the public health system needed to be strengthened in order to operate effectively to keep the public safe. NURSINGTB.COM [Show More]

Last updated: 1 year ago

Preview 1 out of 15 pages