Community and Public Health Nursing Promoting the Public's Health, Tenth Edition Cherie Rector Test Bank

Chapter 1, The Journey Begins: Introduction
Format: Multiple Choice
Chapter: 1
Client Needs: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analyze
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Page and Header: 2, Introduction
1. A nurse has taught a group of nursing students about the similarities and
differences between public health and community health. Which statement by one of
the nursing students would best describe the similarities and differences between
public health and community health?
A) “Community health nursing is defined as nursing care that is provided in
a community setting, rather than an institutional setting.”
B) “Public health nursing is defined as nursing care that is provided in an
institutional setting.”
C) “Public health nursing is focused on the health of individuals.”
D) “Community health nursing can shape the quality of community health
services and improve the health of the general public.”
Ans: D
Feedback:
Operating within an environment of rapid change and increasingly complex
challenges, this nursing specialty holds the potential to shape the quality of
community health services and improve the health of the general public by promoting
healthy behaviors such as weight loss and smoking cessation. Community health can
encompass both acute and institutional settings. Public health nursing involves
focusing not only on the individual as the client but the community as the client as
well.

Chapter: 1
Difficulty: Difficult
Objective: 1
Page and Header: 3, Community Health
2. A nurse is reviewing the similarities and differences between public health
nursing and community health nursing. Which statement would best describe the
difference between public health nursing and community health nursing?
A) Public health nursing is focused on the private aspects of health, and
community health nursing is focused on the public aspects of health.
B) Community health practice refers to a focus on specific, designated
communities and is a part of the larger public health effort.
C) Public health nursing and community health nursing relate to the very
same types of services and perspectives.
D) Both public health nursing and community health nursing are practiced
exclusively within institutions.
Ans: B
Feedback:
In this textbook, community health practice refers to a focus on specific,
designated communities. It is a part of the larger public health effort and recognizes
the fundamental concepts and principles of public health as its birthright and
foundation for practice. Public health nursing is focused on the public aspects of
health. Public health nursing and community health nursing have distinctive types of
services and perspectives. Neither public health nursing nor community health
nursing is practiced exclusively within institutions.
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Chapter: 1
Page 3
Cognitive Level: Apply
Objective: 1
3. Which statement is most accurate about the concept of community?
A) A community is a collection of people who share some important features
of their lives.
B) Community members live in the same geographic location.
C) Community members are biologically related.
D) A community is made up of people who do not necessarily interact with
one another and do not necessarily share a sense of belonging to that group.
Ans: A
Feedback:
The broad definition of a community is a collection of people who share some
important features of their lives. Community members may not live in the same
geographic location as in a common-interest community or a community of solution.
A population is made up of people who do not necessarily interact with one another
and do not necessarily share a sense of belonging to that group.

Chapter: 1
Page 4
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Objective: 1
Page and Header: 7, Populations and Aggregates
4. A group of students are reviewing material for a test on populations,
communities, and aggregates. Which statement indicates that the students
understand these concepts?
A) Members of a population share a sense of belonging.
B) Communities and populations are types of aggregates.
C) Individuals of a community are loosely connected.
D) Members of an aggregate share a strong bond.
Ans: B
Feedback:
An aggregate refers to a mass of grouping of distinct individuals who are
considered as a whole and who are loosely associated with one another. Communities
and populations are types of aggregates. A population is made up of people who do
not necessarily interact with one another and do not necessarily share a sense of
belonging to the group. A community is a collection of people who chose to interact
with one another because of common interests, characteristics, or goals, which form
the basis for a sense of unity or belonging.

Chapter: 1
Objective: 1
Page 5
Page and Header: 5, The Concept of Community
5. Which would a community health nurse identify as a community of common
interest?
A) The global community
B) Small rural town in a northern state
C) National professional organization
D) Counties addressing water pollution
Ans: C
Feedback:
A common-interest community shares a common interest or goal that binds
the members together. Membership in a national professional organization is one
example. The global community and a small rural town in a northern state would be
examples of a geographic community. Counties addressing a water pollution problem
would be an example of a community of solution.

Chapter: 1
Objective: 1
Page 6
Page and Header: 6, Community of Solution
6. The nurse is working with a community of solution. Which would the nurse
expect to find?
A) A health problem affecting the group
B) Common goal binding members together
C) Sharing of a similar goal
D) Locational boundaries
Ans: A
Feedback:
A community of solution involves a group of people coming together to solve
a health problem that affects them. A common-interest community involves a
collection of people widely scattered geographically who have an interest or goal that
binds the members together. A geographical community is defined by its
geographical or locational boundaries.

Chapter: 1
Objective: 1
Page 7
Page and Header: 9, The Health Continuum: Wellness–Illness
7. Which statement made by a student would the nurse educator recognize as
evidence that a student understands the health continuum?
A) The distinction between health and illness is well demarcated.
B) Illness refers to a state of being relatively unhealthy.
C) The term health is limited to reflect an individual’s state.
D) Treatment of acute conditions reflects the current focus of health care.
Ans: B
Feedback:
Although society typically depicts an absolute line of difference between being
either well or ill, health is considered a relative term. Thus, illness is viewed as a state
of being relatively unhealthy. Health is typically described as a continuum that
involves a range of degrees from optimal health at one end to total disability or death
at the other. The line of demarcation is not clear. Health applies to individuals,
families, and communities. Traditionally, most health care has focused on the
treatment of acute and chronic conditions at the illness end of the continuum, but this
emphasis is shifting to focus on the wellness end.

Chapter: 1
Page 8
Objective: 1
Page and Header: 9, The Health Continuum: Wellness–Illness
8. When discussing the concept of the health continuum with a class, the nurse
educator would be certain to include which statement in the description?
A) Wellness is a relative concept, and illness is a state of being relatively
unhealthy.
B) A client’s placement on the health continuum is static throughout time.
C) Health is best described as cyclic.
D) The health continuum can only be applied to individuals.
Ans: A
Feedback:
Wellness is a relative concept, not an absolute, and illness is a state of being
relatively unhealthy. The continuum can change. Because health involves a range of
degrees from optimal health at one end to total disability or death at the other, it is
often described as a continuum and not cyclic. The health continuum applies not only
to individuals but also to families and communities.

Chapter: 1
Page 9
Objective: 4
Page and Header: 12, Proposed Leading Health Indicators
9. The nurse leading a classroom discussion about leading health indicators and
asks the students to give an example of one of these indicators. Which condition
given as an example by a student would indicate that the class has understood the
lesson?
A) Cardiac disease
B) Mental health
C) Sedentary lifestyle
D) Respiratory disease
Ans: B
Feedback:
Mental health is a leading health indicator. Other leading health indicators
include physical activity, overweight and obesity, tobacco use, substance use,
responsible sexual behavior, injury and violence, environmental quality,
immunization, and access to health care. Cardiac disease, respiratory disease, and
sedentary lifestyle are specific details assessed as part of overall health indicators

Chapter: 1
Difficulty: Easy
Objective: 1
Page 10
Page and Header: 14, Promotion of Health
10. Which statement best describes the difference between health promotion and
disease prevention?
A) Health promotion and disease prevention include all efforts that seek to
move people closer to optimal well-being or higher levels of wellness.
B) Disease prevention differs from health promotion in that disease
prevention is targeted toward a specific disease or diseases.
C) Health promotion can be described in terms of primary, secondary, and
tertiary prevention.
D) The goal of disease prevention is to raise levels of wellness for
individuals, families, populations, and communities.
Ans: B
Feedback:
Health promotion includes all efforts that seek to move people closer to
optimal well-being or higher levels of wellness. The goal of health promotion is to
raise levels of wellness for individuals, families, populations, and communities.
Disease prevention is targeted toward a specific disease or diseases and consists of
primary, secondary, and tertiary prevention.

Chapter: 1
Objective: 1
11. A group of community health nursing students designs a health education
program for a group of pregnant teens. During the program, they plan to teach the
group about nutrition during pregnancy, demonstrate helpful exercises, and discuss
group members’ concerns. This is an example of:
A) health promotion.
B) treatment of disorders.
C) rehabilitation.
D) evaluation.
Ans: A
Feedback:
The student nurses are engaged in health promotion activities. Health
promotion incorporates all efforts that seek to move people closer to optimal
well-being or higher levels of wellness. Treatment of disorders would include direct
care for issues involving the group, such as complications that might arise in this
population. Rehabilitation would involve activities to minimize disability or restore or
preserve function. Evaluation would involve an analysis of the effectiveness of these
activities.

Format: Multiple Selection
Chapter: 1
Objective: 2
12. The community health nurse is developing a plan of primary prevention
activities for the community. Which activities might the nurse include? Select all that
apply.
A) Teaching about safe sex practices to high school students
B) Encouraging older adults to install safety devices in the bathroom
C) Providing regular immunization programs for communicable diseases
D) Participating in cholesterol screening programs at health fairs
E) Providing skin testing for tuberculosis for children over 1 year of age
F) Working with a group testing water samples for contamination
Ans: A, B, C
Feedback:
Primary prevention activities are those taken to keep illnesses or injuries from
occurring. These include teaching about safe sex practices, encouraging older adults
to use safety devices in the bathroom, and providing regular immunization programs
for communicable diseases. Cholesterol screening programs, skin tests for
tuberculosis, and working with a group testing water samples for contamination are
examples of secondary prevention activities.

Chapter: 1
Integrated Process: Caring
Objective: 4
Page 13
Page and Header: 19, Clients as Equal Partners
13. A community health nurse is preparing a presentation for a group of nursing
students about community health nursing. Which description of community health
nursing would the nurse most likely include in the presentation?
A) Focusing on addressing continuous needs
B) Working with the client as an equal partner
C) Engaging in tertiary prevention as the priority
D) Encouraging clients to reach out to the nurse
Ans: B
Feedback:
The community health nurse works with the client as an equal partner,
encouraging autonomy. At any time, the nurse deals with continuous and episodic
needs simultaneously. The community health nurse engages in primary, not tertiary,
prevention as the priority and is obligated to actively reach out to all who might
benefit from a specific activity or service.

Chapter: 1
Objective: 4
Page 14
Page and Header: 20, Interprofessional Collaboration
14. A community health nurse is working with other members of a team that will
be implementing a city-wide immunization program. The nurse is coordinating the
services and addressing the needs of the population groups to demonstrate:
A) involvement of the community.
B) client participation.
C) continuity of service.
D) plan for follow-up.
Ans: C
Feedback:
Working in cooperation with other team members and coordinating services
and addressing the needs of population groups are essential to interprofessional
collaboration. In doing so, the community health nurse is preventing fragmentation
and gaps thereby ensuring continuity of service. The involvement of the community
and client participation are important, but both help to ensure that the clients are
viewed as equal partners of the health care team. A plan for follow-up is a possible
element of such a program, but it is not what the nurse seeks to demonstrate with the
program overall.

Chapter: 1
Integrated Process: Caring
Objective: 4
Page 15
Page and Header: 19, The Greatest Good for the Greatest Number of People
15. A community health nurse works to ensure the greatest good for the greatest
number of people by applying:
A) secondary prevention activities.
B) autonomy.
C) justice.
D) utilitarianism.
Ans: D
Feedback:
The ethical theory of utilitarianism promotes the greatest good for the
greatest number. Primary prevention activities, not secondary prevention, are the
priority. Autonomy refers to the freedom of choice. Justice involves treating people
fairly.

Chapter: 1
Objective: 4
Page 16
Page and Header: 9, FIGURE 1-4
16. Using Healthy People 2020 as a guide, the community health nurse would
include which factor in a teaching plan to demonstrate that the targeted population
understands the basic information provided during an educational session?
A) Self-care
B) Health disparities
C) Health literacy
D) Episodic needs
Ans: C
Feedback:
Consumers are often intimated by health professionals and are uninformed
about health and health care affecting the quality of care. Adopting a teaching plan to
ensure that the population understands the basic information addresses health
literacy, the ability to read, understand, and use health care information
appropriately. Doing so helps to ensure that the teaching plan will be effective.
Self-care refers to the process of taking responsibility for developing one’s own health
potential by actively participating in promoting one’s own health. Health disparities
reflect differences in all aspects of health care related to vulnerable populations.
Episodic needs are one-time specific negative health events that arise and are not an
expected part of life.

Chapter: 1
Page 17
Difficulty: Easy
Objective: 1
Page and Header: 9, FIGURE 1-4
17. Which would be crucial for the community health nurse to address as the
priority when dealing with policymakers about the development of community
health programs?
A) Research-based best practices
B) Population’s make-up
C) Amount of services to be provided
D) Scarcity of the available resources
Ans: A
Feedback:
Decisions for programs or services are often made based on cost-effectiveness
or cost-benefit. Therefore, community health nurses must provide policymakers with
information about best practices, grounded in research. Although population’s
make-up, amount of services to be provided, and scarcity of the available resources
are factors that may need to be considered, the community health nurse must first
demonstrate evidence-based practice.

Chapter: 1
Page 18
Objective: 3
18. After a class that described the differences between acute care nursing and
community health nursing, which statement by the class about community health
nurses indicates successful teaching?
A) Use a reactive approach.
B) Seek out potential health problems.
C) Concentrate on the illness end of the continuum.
D) Emphasize curative care.
Ans: B
Feedback:
Community health nurses, in contrast to acute care nurses, seek out potential
health problems by identifying high-risk groups and instituting preventive programs.
They use a proactive, rather than reactive, approach and concentrate on the wellness
end of the health continuum. They place less emphasis on curative care.

Chapter: 1
Objective: 1
19. Which activities would be associated with a community health nurse? Select all
that apply.
A) Examining infants in a city well-baby clinic
B) Caring for elderly stroke victims in their homes
C) Providing emergency care in an acute care facility
D) Carrying out epidemiologic research
E) Participating in health policy analyze
Ans: A, B, D, E
Feedback:

Community health nurses work in every conceivable kind of community
agency, from a state public health department to a community-based advocacy
group. Their duties range from examining infants in a well-baby clinic or teaching
elderly stroke victims in their homes to carrying out epidemiologic research or
engaging in health policy analysis and decision-making. Providing care in an acute
care facility would not be an activity associated with a community health nurse.
Chapter: 1
Objective: 1
20. The term “health” can be described in many different ways. How would the
community health nurse define health?
A) The absence of disease
B) The potential to lead a productive life
C) An environment free of toxins
D) A holistic state of well-being
Ans: D
Feedback:

Community health nurses view health as a holistic state of well-being, which
includes soundness of the mind, body, and spirit. Along with this, foundational view
is the emphasis on wellness, which includes the definition of health as well as the
capacity to develop a person’s potential to lead a fulfilling and productive life. Health
is more than just the absence of disease or an environment free of toxins.
Chapter: 1
Difficulty: Difficult
Objective: 4
Page and Header: 13, Subjective and Objective Dimensions of Health
21. While interviewing a client, which statement would a nurse identify as
reflecting an objective dimension of health?
A) “I’m feeling better since I started taking that medication.”
B) “Life is pretty good right now, except for an occasional upset stomach.”
C) “I’m able to wash myself in the mornings with just a bit of help.”
D) “Sometimes when I wake up, I don’t even want to face the day.”
Ans: C
Feedback:
The objective dimension of health involves one’s ability to function in daily
activities. The statement about being able to care for one’s self is an example. The
statements of feeling better with medication, life being pretty good, and not wanting
to face the day are examples of the subjective dimension of health, which involves
how people feel.

Chapter: 1
Objective: 1
Page 22
Page and Header: 18, Population Focused
22. When employing a population-oriented focus, which would the community
health nurse do?
A) Assess the groups’ relationships looking for a common need.
B) Consider the members individually for similarities.
C) Focus on the geographical area of the population.
D) Promote the groups’ dependency on improving health.
Ans: A
Feedback:
A population-oriented focus requires the assessment of relationships,
considering the groups or communities in relation to the rest of the community to
discover common needs or risks for a common health problem. The nurse does not
consider the groups or communities separately but rather in context. The population
may or may not be delineated by the geographical area. The community health nurse
encourages individuals’ participation to promote their autonomy rather than
permitting dependency.

Chapter: 1
Objective: 4
Page 23
Page and Header: 12, BOX 1-5
23. A community health nurse is involved in a project to evaluate the health of a
city. Which finding would suggest that the city would most likely need additional
programs?
A) Citizens are actively involved in the city’s department of recreation and
after-school programs.
B) The construction of affordable organized housing developments and
communities is nearing completion.
C) Approximately one-third of the people are recently unemployed due to
the closure of the automotive factory.
D) Several new recreational facilities for adults and children have been
created at several locations.
Ans: C
Feedback:
A healthy city is one in which there is continual creation and improvement in
the physical and social environments with the expansion of community resources so
that people can mutually support one another. It is characterized by the meeting of
basic needs for all of the city’s people. This would include food, water, shelter,
income, safety, and work. Loss of employment of one-third of the city’s workforce
would be a threat to the health of the city and necessitate intervention. Active
involvement in the city’s functioning, affordable housing, and recreational facilities
are suggestive of a healthy city.

Chapter: 1
Client Needs: Physiological Integrity: Physiological Adaptation
Objective: 2
Page 24
24. The community health nurse is developing a plan of secondary prevention
activities. Which actions might the nurse include? Select all that apply.
A) Participating in skin cancer screening programs at health fairs
B) Encouraging parents to install safety devices in electrical outlets
C) Providing annual flu vaccinations
D) Participating in hypertension screening programs at health fairs
E) Providing skin testing for tuberculosis for children over 1 year of age
F) Teaching college-age students about the importance of meningococcal
vaccinations
Ans: A, D, E
Feedback:
Secondary prevention activities are those used to detect and treat existing
health problems at the earliest possible stage, when disease or impairment is already
present. Activities may include hypertension and cholesterol screening programs to
identify high-risk individuals and encourage early treatment to prevent heart attacks
or stroke. Other examples are encouraging breast and testicular self-examination,
regular mammograms, and Pap smears for early detection of possible cancers and
providing skin testing for tuberculosis (in infants at 1 year of age and periodically
throughout life, with increasing frequency for high-risk groups). Secondary
prevention attempts to discover a health problem at a point when intervention may
lead to its control or eradication.

Chapter: 1
Objective: 2
activities. Which actions would the nurse incorporate into the plan? Select all that
apply.
A) Encouraging monthly self-breast examinations during a women’s health
fair
B) Teaching parents to place infants on their backs to sleep
C) Providing BMI measurements during a health fair
D) Participating in cholesterol screening programs at health fairs
E) Educating high-risk community groups about the importance of exercise
at a hypertension clinic
F) Teaching elementary students about the importance of using “MyPlate”
Ans: A, C, D, E
Feedback:

Chapter: 1
Objective: 2
Page 26
activities. Which actions would the nurse incorporate into the plan? Select all that
apply.
A) Encouraging monthly testicular self-examinations during a men’s health
fair
B) Teaching preschool children the importance of daily activity
C) Providing height and weight measurements during a health fair
D) Participating in diabetes screening programs at health fairs
E) Educating high school students about safe sex practices
F) Encouraging women to schedule yearly mammograms
Ans: A, C, D, F
Feedback:

Chapter: 1
Objective: 2
Page 27
27. The community health nurse is developing a plan of tertiary prevention
activities. Which actions might the nurse include? Select all that apply.
A) Developing a nutritional plan of care for clients with eating disorders
B) Developing an exercise plan for COPD clients
C) Providing bicycle safety education during a health fair for children
D) Participating in hypertension screenings at health fairs
E) Participating in bone density screenings at health fairs
F) Educating children on swimming safety
Ans: A, B
Feedback:
Tertiary prevention measures attempt to reduce the extent and severity of a
health problem to its lowest possible level, in order to minimize disability and restore
or preserve function. Examples include treatment and rehabilitation of persons after
a stroke to reduce impairment, postmastectomy exercise programs to restore
functioning, and early treatment and management of diabetes to reduce problems or
slow their progress.

Chapter: 1
Objective: 2
28. The community health nurse is developing a plan of tertiary prevention
activities. Which actions might the nurse incorporate into the plan? Select all that
apply.
A) Providing a support group for breast cancer survivors
B) Encouraging women to schedule yearly Pap smears
C) Providing height and weight measurements during a health fair
D) Participating in diabetes screening programs at health fairs
E) Educating high school students about bullying
F) Providing a community-based stroke rehabilitation program
Ans: A, F
Feedback:
Tertiary prevention measures attempt to reduce the extent and severity of a
health problem to its lowest possible level, in order to minimize disability and restore
or preserve function. Examples include treatment and rehabilitation of persons after
a stroke to reduce impairment, postmastectomy exercise programs to restore
functioning, and early treatment and management of diabetes to reduce problems or
slow their progress.

Community and Public Health Nursing Promoting the Public's Health, Tenth Edition Cherie Rector Test Bank

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Community and Public Health Nursing Promoting the Public's Health, Tenth Edition Cherie Rector Test Bank