Specialization in Public Health Nursing-1.docx

Population-Focused Practice The Foundation of Specialization in Public Health Nursing 1. The twenty-first century has brought new concerns for nurses about ways to improve the health of the American people. They include: 1. Bioterrorism and global health threats 2. Delivery of individual care and hygiene 3. The need for increased hospital and acute care 4. The same problems that existed before with many added ANS: 1 There are new concerns, and one of the most serious is bioterrorism. The others are not related to public health or are concerns that have been present for many years. 2. The threat of bioterrorism highlighted by the events of September 11, 2001, and the anthrax scare have the potential to: 1. Dissolve community-based programs 2. Cause the health care systems to collapse 3. Divert health care funds and resources from other public safety health care programs 4. Increase the need for shelters ANS: 3 Bioterrorism may have a big impact on the availability of resources for health care. 3. Population-based preventive programs launched in the 1970s are responsible for all of the following except: 1. Changes in tobacco use 2. Automobile safety restraints 3. Dietary patterns and blood pressure control 4. Decrease in obesity rates ANS: 4 Obesity is on the rise. The others listed in the text are outcomes of preventive programs launched in the 1970s. 4. The public health nurse must participate in the essential services of public health. These include: 1. Monitoring health status to solve community problems 2. Diagnosing and investigating health problems in the world 3. Informing, educating, and empowering people about health issues 4. Working in law enforcement to regulate health and ensure safety ANS: 3 The public health nurse would not “solve” community problems, but would identify them. The public health nurse would not diagnose or solve “world” problems, or work in law enforcement. Rather, the public health care nurse would participate with local regulators to protect communities and empower people to address health issues. 5. Which of the following is an example of the mission of public health according to the Institute of Medicine? 1. Tracking avian flu outbreaks and doing surveillance in the United States 2. Providing a flu shot for an elderly person at the health department 3. Keeping track of alternative therapies in use in the United States 4. Keeping snake antivenom at the Centers for Disease Control and Prevention in Atlanta ANS: 1 The Institute of Medicine’s stated mission on public health is “to generate organized community and technical knowledge to prevent disease and promote health.” Therefore choice 1 most closely describes its mission. 6. Making sure that essential community-oriented health services are available defines which of the core public health functions? 1. Policy development 2. Assessment 3. Assurance 4. Scientific knowledge-based care ANS: 3 Public health is based on scientific knowledge, but is not a core function. The definition does not fit the terms assessment or policy development. 7. According to the Community Health Profile, the number and proportion of persons aged 25 or older with less than a high school education is an example of: 1. Sociodemographical characteristics 2. Health status 3. Health risk factors 4. Health care resource consumption. ANS: 1 The number and proportion of people is a demographical characteristic. 8. The Council on Linkages developed a list of core competencies for all public health practitioners. All of the following are competencies except: 1. Cultural competency 2. Analytic/assessment 3. Acute care services 4. Basic public health services. ANS: 3 Acute care service is not considered public health. 9. Public health nursing is a specialty because: 1. It has a distinct focus and scope of practice and requires a special knowledge base. 2. It must be done by a registered nurse with a master’s degree. 3. It is focused on disadvantaged citizens. 4. Interventions are made at the acute care level. ANS: 1 Public health nursing has a distinct focus and requires a special knowledge base. The other answers are not characteristics of a specialty. 10. A group of nursing students and their instructor set up a blood pressure screening clinic at the local community center. This is an example of which of the characteristics that distinguishes public health nursing as a specialty? 1. Population focused 2. Community orientation 3. Health and preventative focus 4. Concern for health for all members of the community ANS: 3 Although all the answers may be slightly correct, the blood pressure screening is clearly a health and preventive measure. 11. The necessary basic preparation for public health nursing is: 1. An associates degree in nursing 2. A baccalaureate degree in nursing 3. A master’s degree in nursing 4. A PhD in nursing ANS: 2 A BSN is the necessary basic preparation to function as a beginning staff public health nurse. 12. Specialists in public health nursing usually have a degree with a focus in public health sciences. These practitioners are prepared at the graduate level. These specialists should be able to: 1. Teach public and community health nursing 2. Work with population groups and be able to assess and intervene successfully at the aggregate level 3. Diagnose and treat disease including having prescriptive authority 4. Run for political office as experts in public health policy ANS: 2 According to the Consensus Conference, specialists should have assessment skills that allow them to intervene at the aggregate level. Although teaching at a School of Nursing often requires a master’s degree, nurses who want to teach nursing would usually get their master’s in nursing education. 13. Which of the following is an example of an aggregate or population? 1. Students in a county school system 2. Christians around the world 3. A patient in the intensive care unit at the local hospital 4. People who play cards together once a week at private homes ANS: 1 A population or aggregate is a collection of individuals who have one or more personal or environmental characteristics in common. They can be defined in terms of geography or a special interest. The clients in choice 1 have a geographical characteristic. 14. A public health nurse provides a clinic for HIV-positive citizens in the community. This is an example of: 1. Primary prevention 2. Secondary prevention 3. Tertiary prevention 4. Policy making ANS: 3 This clinic is for clients who already have a disease process; therefore it is tertiary prevention. 15. According to the Eight Principles of Public Health Nursing, which of the following best demonstrates the principle of “the obligation to actively reach out to all who might benefit from a specific activity or service”? 1. Giving a demonstration of tooth brushing at an elementary school 2. Conducting a diabetes screening at a rural church 3. Contacting local officials about mental health financing 4. Going to a senior citizens center to give flu shots ANS: 4 Giving flu shots is an activity and a service. A diabetes screening is a prevention strategy, also important in public health, but it does not fit the principle as stated. 16. Community health nurses practice in the community whether or not they have had preparation in public health nursing. All of the following are examples of a community health nurse except: 1. School nurse 2. Nurse in a clinic 3. Nurse who makes home visits to provide tertiary care 4. Director of nursing at a rehabilitation center ANS: 4 The director of nursing at a rehabilitation center is not a community health nurse role. 17. What is the difference between community health nursing practice and public health nursing practice? 1. Community health nursing practice includes the delivery of personal health services to individuals, families, and groups. 2. Public health nursing practice involves public health theory only. 3. There is no difference between the two: public health is old nomenclature. 4. Community health requires a BSN, whereas public health practice requires a master’s degree. ANS: 1 By definition, choice 1 is correct and the others are misstatements. 18. The key opportunities for population-focused practice exist because: 1. Population-focused care will replace acute care. 2. Universal health insurance coverage for all Americans will become a reality and subgroups will not need to be monitored. 3. The primary focus of the health care system of the future will be on community-oriented strategies for health promotion and disease prevention. 4. As more nurse leaders are trained, more students will choose community health nursing as a career. ANS: 2 Future prediction is stating our health care system will be more focused on disease prevention and health promotion. 19. Implementing quality performance standards in public health is important because: 1. They are used to guide improvement in the public health system. 2. They rigidly control public health. 3. Administrators will not monitor public health at the local level, but instead at the national level. 4. They can be used as hiring guidelines for nurses. ANS: 1 These standards were developed by the Centers for Disease Control and Prevention in 1998. 20. Which of the following statements about public health is accurate? 1. Prevention of early deaths can be more effectively accomplished by medical treatment than by public health approaches. 2. Expenditures and resources for public health have increased in recent years. 3. Historically, gains in the health of populations have been related largely to changes in safety, sanitation, and personal behavior. 4. Reform of the medical insurance system is the single change needed to improve the health of Americans. ANS: 3 Changes such as immunizations, tobacco use, blood pressure control, and automobile safety have helped increase the health of communities. 21. Which of the following actions is an example of the primary goal of public health? 1. Ensuring that a newly diagnosed 40-year-old hypertensive man takes his medication 2. Finding home care for a 70-year-old client recuperating from a hip replacement 3. Conducting an infant car seat safety check 4. Contacting a local hospice to admit a terminally ill 60-year-old ANS: 3 The correct answer is concerned with the health of many people, while the wrong answers are concerned with individuals. 22. The purpose of public health core functions is to: 1. Clarify the role of the government in fulfilling the mission of public health 2. Ensure the safety of populations in receiving quality health care 3. Provide community-based individualized care to every person in the United States 4. Unite public and private providers of care in a comprehensive approach to providing health care ANS: 1 As defined by the Institute of Medicine in its 1988 report The Future of Public Health, assessment, policy development, and assurance are core functions at all levels of government for the purpose of clarifying the government’s role. 23. Collecting data and monitoring the health status of the population defines which of the core public health functions? 1. Assessment 2. Prevention 3. Assurance 4. Policy development ANS: 1 Prevention is not a core function, assurance is making sure essential services are available, and policy development is needed to provide leadership in developing policies. Assessment consists of systematic data collection and monitoring health status. 24. The nurse who compares the rate of teenage pregnancy in various areas of the city is practicing the public health core function of: 1. Assurance 2. Assessment 3. Prevention 4. Policy development ANS: 2 Assessment refers to systematic data collection, which this nurse is doing for teenage pregnancy. 25. Public health nurses who develop and implement local public health policies in concert with agencies, organizations, and consumers within the community are providing an example of which core public health function? 1. Assessment 2. Prevention 3. Assurance 4. Policy development ANS: 4 Prevention is not a core function, assurance is making sure essential services are available, and assessment refers to systematic data collection. Policy development deals with developing and implementing health policies. 26. Providing for the availability of essential personal health services for people who would otherwise not receive health care defines which public health core function? 1. Assessment 2. Prevention 3. Assurance 4. Policy development ANS: 3 Assurance deals with the availability of health services. Prevention is not a core function, assessment refers to systematic data collection, and policy development refers to the need to provide leadership in developing health policies. 27. The nurse manager who makes sure that the nurses working in a local clinic are competent is an example of the public health core function of: 1. Assurance 2. Assessment 3. Prevention 4. Policy development ANS: 1 Assurance refers to making sure a competent health care workforce is available. 28. The number and type of U.S. Environmental Protection agency air quality standards not met is an example of which indicator used to develop a community health profile? 1. Sociodemographic characteristics 2. Health status 3. Health risk factor 4. Functional status ANS: 3 Breathing air of poor quality is a risk to health. 29. The nurse investigating environmental health problems caused by contaminated ground water is best described as practicing: 1. Community-oriented nursing 2. Community-based nursing 3. Policy development 4. Tertiary care ANS: 1 Community-oriented nursing emphasizes the prevention of disease and disability. 30. A population is best defined as a: 1. High-risk group 2. School or institutional setting 3. Collection of individuals who share at least one common characteristic 4. Geographical location within a community ANS: 3 The wrong answers are types of populations; they do not define a population. 31. The focus of population-focused practice is that problems or needs are defined and solutions are implemented for: 1. Individuals 2. Aggregates 3. Communities 4. Geographical regions ANS: 2 Aggregates are a defined population made up of individuals in communities of a specific geographical region. 32. Which of the following statements is true with regard to a population focus in public health nursing? 1. Priority is given to the highest risk population. 2. Direct caregiving is limited to preventive measures such as administration of immunizations. 3. Attention is given to the population or community as a whole, regardless of whether they do or do not access the health care system. 4. Only populations outside institutional settings are considered. ANS: 3 Public health nurses are concerned with the health of the entire population. 33. The term community-based nursing care refers to which of the following? 1. Assessing needs and planning care for defined communities 2. The provision of care to individuals and families in the community 3. The care provided to aggregate groups 4. Providing care to a subpopulation ANS: 2 The wrong answers are population-focused practices. 34. The nurse who provides care in the work setting is practicing: 1. Community-oriented nursing practice 2. Public health nursing practice 3. Community health nursing practice 4. Community-based nursing practice ANS: 4 This type of nursing is a setting-specific practice. MULTIPLE RESPONSE 1. There are many barriers to specializing in public health nursing. They include which of the following? Select all that apply. 1. The mindset that the only role for the nurse is at the bedside. 2. The structures within which nurses work and the process of role socialization within those structures. 3. Few nurses receive graduate-level preparation in the concepts and strategies of the disciplines basic to public health. 4. The number of job opportunities in the area has been steadily declining. ANS: 1, 2, 3 All are considered barriers to nurses specializing in public health nursing, except the number of job opportunities, which is not declining.