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Chapter 2

1. A community health nurse is engaging in assurance activities. Which of the following would best explain these activities?
A) Gathering and analyzing information that will affect the health of the people to be served
B) Providing leadership in facilitating community groups toward meeting their needs, often involving changes in and additions to existing laws
C) Being involved in activities to make certain that necessary services are being provided to the community
D) Accessing relevant data that enable identification of strengths, weaknesses, and needs within the community
Ans: C
Feedback:
Assurance activities are those activities that make certain that services are provided and include focusing on the availability of necessary health services throughout the community, maintaining the ability of public health agencies and private providers to manage day-to-day operations as well as the capacity to respond to critical situations and emergencies. Assessment involves gathering and analyzing information that will affect the health of those to be served and accessing relevant data to enable the nurse to identify strengths, weaknesses, and needs. Policy development involves providing leadership in facilitating community groups.

2. When fulfilling the function of assessment, which of the following would be most important for the community health nurse to do?
A) Secure the trust of the clients
B) Gather appropriate information
C) Interact with key community leaders
D) Use a variety of assessment tools
Ans: A
Feedback:
Although securing and maintaining the trust of others is pivotal to all nursing practice, it is even more critical when working in the community. Trust can afford a nurse access to client populations that are difficult to engage, to agencies, and to health care providers. As difficult as it may be for the nurse to gain the trust and respect of the community, if it is ever lost, these attributes can be difficult if not impossible to regain. Gathering information, interacting with key community leaders, and using a variety of assessment tools are important, but they can only occur after trust is established.

3. The community health nurse is engaging in the core function of policy development. With which of the activities would the nurse most likely be involved?
A) Monitoring health status to identify community health problems
B) Empowering communities about important health issues
C) Linking individuals to needed personal health services
D) Ensuring a competent health care workforce is available
Ans: B
Feedback:
With policy development, the community health nurse would be involved in informing, educating, and empowering people about health issues. Monitoring health status is associated with the assessment function. Linking individuals to needed personal health services and ensuring a competent public health and personal health care workforce are associated with assurance.

4. A community health nurse is collaborating with local community leaders to prepare a community disaster plan. Which function is the nurse fulfilling?
A) Research
B) Assurance
C) Policy development
D) Assessment
Ans: B
Feedback:
Community health nurses perform the assurance function at the community level when they collaborate with community leaders in the preparation of a community disaster plan. Research is demonstrated by gaining new insights and innovative solutions to health problems. Policy development would involve client information, education and empowerment, mobilization of community partnerships, and the development of plans and policies to support community health efforts. Assessment involves monitoring health status for community health problems and diagnosing and investigating health problems and hazards in the community.

5. A community health nurse has collected data for several months on the birth weights of newborns to mothers who smoked throughout their pregnancy. This nurse is acting in which role?
A) Collaborator
B) Manager
C) Researcher
D) Clinician
Ans: C
Feedback:
The nurse is assuming the role of a researcher, that is, engaging in systematic investigation that includes data collection. In the collaborator role, the nurse would work with numerous members of the health team, working jointly with others in a common endeavor. In the manager role, the nurse exercises administrative direction toward the accomplishment of specified goals. In the clinician role, the nurse ensures the provision of health care services to individuals, families, groups, and populations.

6. A nurse in community health nursing setting works with police officers, social workers, health educators, and other nurses to promote the health of clients. The nurse is acting in which role?
A) Clinician
B) Educator
C) Researcher
D) Collaborator
Ans: D
Feedback:
The nurse is assuming the role of collaborator. In this role, the community health nurse works jointly with many individuals to benefit client care. In the clinician role, the nurse ensures the provision of health care services to individuals, families, groups, and populations. As an educator, the nurse is the health teacher and provides information to community clients. In the researcher role, the community health nurse engages in systematic investigation, collection, and analysis of data for solving problems and enhancing community health practice.

7. A community health nurse is interviewing for employment. The interviewer describes some of the typical activities that the nurse would be involved in, such as making home visits to families, holding immunization clinics for infants and children, and setting up flu-shot clinics for elders. The interviewer is describing which role?
A) Educator
B) Advocate
C) Clinician
D) Manager
Ans: C
Feedback:
The interviewer is describing direct care activities associated with the clinician role. As an educator, the nurse is the health teacher and provides information to community clients. In the advocate role, the nurse pleads for the clients’ cause or acts on their behalf. In the manager role, the nurse exercises administrative direction toward the accomplishment of specified goals.

8. A community health nurse is reviewing his or her schedule for the day. Included in his or her activities are planning client care, leading a staff conference, and supervising a new staff member. This nurse is fulfilling which role?
A) Advocate
B) Manager
C) Collaborator
D) Researcher
Ans: B
Feedback:
When functioning in the manager role, the nurse exercises administrative direction toward the accomplishment of specified goals. Overseeing client care as a case manager, supervising ancillary staff, managing caseloads, running clinics, or conducting community health needs assessment projects are examples of activities associated with the manager role. In the advocate role, the nurse pleads for the clients’ cause or acts on their behalf. In the collaborator role, the nurse would work with numerous members of the health team, working jointly with others in a common endeavor. In the researcher role, the community health nurse engages in systematic investigation, collection, and analysis of data for solving problems and enhancing community health practice.

9. While providing care to a family at a local center, the community health nurse contacts the local department of social services to help the family attain assistance with health insurance coverage. The nurse also gives the family a list of pharmacies where they can get their prescriptions filled. The nurse is acting in which role?
A) Educator
B) Leader
C) Clinician
D) Advocate
Ans: D
Feedback:
The nurse is acting in the role of advocate, by pleading their cause and acting on their behalf. The nurse acts as an advocate by showing clients what services are available, the ones to which they are entitled, and how to obtain them. As an educator, the nurse is the health teacher and provides information to community clients. As a leader, the nurse directs, influences, or persuades others to effect change that will positively impact people’s health and move them toward a goal. In the clinician role, the nurse ensures the provision of health care services to individuals, families, groups, and populations.

10. Which of the following best exemplifies the attributes of a community health nurse in the researcher role?
A) Gaining the trust and respect of the staff members
B) Interpreting abstract ideas so others can understand
C) Implementing a staff development program for a technique
D) Evaluating the correlation between variables in specific health conditions
Ans: D
Feedback:
Attributes of a researcher include a spirit of inquiry, careful observation, analytic skills, such as evaluating the possible cause and effect of a situation, and tenacity. Gaining the trust and respect of staff, interpreting abstract ideas, and implementing a staff development program are examples of the management skills used in the role of manager.

11. Which of the following statements about the role of educator within the framework of public health nursing functions is true?
A) The educator role has the potential for finding greater receptivity and providing higher-yield results.
B) People are unable to recognize the value of health and are not well motivated to achieve higher levels of wellness.
C) It is only possible for a nurse to reach a limited number of persons.
D) The public’s higher level of health consciousness hinders the educator’s role.
Ans: A
Feedback:
The educator role has the potential for finding greater receptivity and providing higher-yield results. People are recognizing the value of health and are increasingly motivated to achieve higher levels of wellness. With an emphasis on populations and aggregates, the educational efforts of community health nursing are appropriately targeted to reach many people. One factor that enhances the educator role is the public’s higher level of health consciousness.

12. Which of the following statements about the importance of the role of collaborator is true?
A) Community health nurses frequently practice in isolation.
B) Successful community health practice depends on multidisciplinary collegiality and leadership.
C) Community health nurses must assert themselves as the most powerful person on the health care team to ensure each client receives services that are necessary.
D) It is best for community health nurses to focus on what they, as nurses, can do for their clients.
Ans: B
Feedback:
Community health nurses seldom practice in isolation. As collaborators, nurses work jointly with others in a common endeavor, cooperating as partners. Successful community health practice depends on multidisciplinary collegiality and leadership. The community health nurse’s collaborator role requires skills in communicating, in interpreting the nurse’s unique contribution to the team, and in acting assertively as an equal partner.

13. Which of the following statements about the community health nurse’s selection and practice of each role is true?
A) Within a given time, a community health nurse may practice multiple roles.
B) The knowledge that vulnerable populations need someone to guide them through the complexities of the health care system and the nurse can serve as an advocate for them
C) The researcher role for community health nurses involves only the use of quantitative statistics.
D) The leadership role consists solely of managing staff.
Ans: B
Feedback:
Community health nurses wear many hats while conducting day-to-day practice. At any given time, however, one role is primary. They need someone to guide them through the complexities of the system and assure the satisfaction of their needs. This is particularly true for minorities and disadvantaged groups. Although research technically involves a complex set of activities conducted by persons with highly developed and specialized skills, research also means applying that technical study to real-practice situations. As leaders, community health nurses seek to initiate changes that positively affect people’s health.

14. A community health nurse is involved in education, screening, referral, and support for the individuals of a specific religious congregation. The nurse is practicing in which setting?
A) Occupational health nursing
B) Faith community nursing
C) School nursing
D) Residential institution nursing
Ans: B
Feedback:
In faith community nursing, the practice focal point is the faith community and the religious belief system provided by the philosophical framework. It may be called church-based health promotion, parish nursing, or primary care parish nursing practice. Occupational health nursing occurs in business and industry settings. School nursing, as the name implies, involves practicing in the school system, including from preschools to colleges and universities. Residential institution nursing occurs in any facility where the clients reside such as a halfway house or continuing care center.

15. Which of the following differentiates the home setting for community health nursing from other settings?
A) The nurse acts primarily as an educator.
B) The client is viewed within his or her environment.
C) Technologically advanced care is limited.
D) The home is being used less frequently today.
Ans: B
Feedback:
In the home, unlike most other health care settings, clients are on their own “turf,” such that the client is the host, comfortable and secure in familiar surroundings, and the nurse is a guest. Although education may be a major component of care in the home, all community health nursing roles are performed to varying degrees. In addition, technologically advanced care in the home is increasing in demand, with the home being the most frequently used setting for community health nursing.

16. After teaching a group of students about the various settings for community health nursing, the instructor determines that this teaching was successful when the students identify which of the following as an example of ambulatory service setting?
A) Local preschool
B) Halfway house
C) Continuing care center
D) Family planning clinic
Ans: D
Feedback:
Ambulatory service setting includes a variety of venues for community health nursing in which clients come for day or evening services that do not include overnight stays. One example is a family planning clinic. A local preschool would be an example of a school setting. A halfway house and continuing care center are examples of residential institutions.

17. After teaching a group of students about the changing roles of the community health nurse in the occupational setting, the instructor determines that the students need additional teaching when they state which of the following?
A) Occupational health nurses are increasing their role as employee advocates.
B) Health education is a key function of the occupational health nurse.
C) There is a greater emphasis on the occupational health nurse’s role as a clinician.
D) Collaboration with other health care providers fosters the offering of better services.
Ans: C
Feedback:
The clinician role was primary for many years, as nurses continued to care for sick or injured employees at work. However, recognition of the need to protect employees’ safety and, later, to prevent their illness led to the inclusion of health education in the occupational health nurse role. Occupational health nurses also act as employee advocates, assuring appropriate job assignments for workers and adequate treatment for job-related illness or injury. They collaborate with other health care providers and company management to offer better services to their clients. They act as leaders and managers in developing new health services in the work setting, endorsing programs such as hypertension screening and weight control.

18. A community health nurse is working as a lobbyist for health legislation for AIDS research at the state capital. This nurse is practicing in which setting?
A) Faith community
B) Ambulatory service
C) Residential institution
D) Community at large
Ans: D
Feedback:
The community at large is not confined to a specific philosophy, location, or building. It serves as the setting for practice of a nurse who serves on health care planning committees, lobbies for health legislation at the state capital, runs for a school board position, or assists with flood relief in another state or country. Faith community nursing focuses on activities involving the faith community and religious belief system. Ambulatory service settings include a variety of venues in which clients come for day or evening services that do not include overnight stays. Residential institutions include any facility where clients reside.

19. Which of the following is included in the most accurate description of school nursing?
A) This is one community health setting where the role is static.
B) The primary role of school nurses is clinician.
C) The practice of school nurses is widening.
D) School nurses rarely act as advocates.
Ans: C
Feedback:
School nurses, whose primary role initially was that of clinician, are widening their practice to include more health education, interprofessional collaboration, and client advocacy.

20. A community health nurse is assuming the role of a manager. Which function would be most important for the nurse to address first?
A) Planning
B) Organizing
C) Leading
D) Controlling
Ans: A
Feedback:
The management process incorporates a series of problem-solving activities or function: planning, organizing, leading, and controlling and evaluating. Although these activities occur simultaneously, they are sequential with planning being the first activity.

21. A nursing student is interviewing a community health nurse about the various roles the nurse assumes and the skills and behaviors necessary to perform each role. Which of the following would the community health nurse identify as being essential to the role of an advocate? Select all that apply.
A) Assertiveness
B) Ability to plan
C) Ability to negotiate
D) Risk taking
E) Holistic view
F) Questioning attitude
Ans: A, C, D
Feedback:
As an advocate, the community health nurse must be assertive, willing to take risks, be able to communicate and negotiate well, and be able to identify resources and obtain results. The ability to plan is associated with the manager role. A holistic view is critical to the community health nurse acting as a clinician. A questioning attitude is necessary for the role as a researcher.

22. A community health nurse works in a busy community health nursing practice. Today, the nurse is devoting the day to the educator role. With which of the following activities would the nurse be involved? Select all that apply.
A) Planning seven home visits today
B) Working on a new curriculum for high-risk teens
C) Meeting with colleagues to discuss organizational changes in the office
D) Ordering pamphlets over the Internet to be used in a parenting class
E) Tabulating data from surveys distributed to elders during a flu-shot clinic
F) Going to social services to speak up for a family in his or her caseload
Ans: B, D
Feedback:
In the educator role, the nurse would work on a new curriculum for high-risk teens and order pamphlets for use in a parenting class. Planning seven home visits would be part of the clinician role. Meeting with colleagues to discuss organizational changes would be part of the manager role. Tabulating data from surveys would be part of the researcher role. Speaking up for a family in the nurse’s caseload would be an example of the advocate role.

23. A community health nurse is devoting the day to being a manager. Which activities would the nurse expect to perform? Which of the following activities are part of this role? Select all that apply.
A) Orienting three new community health nurses in the agency
B) Attending a strategy meeting for a new service the community will be offering
C) Working with a team to direct a smoking cessation program in public areas
D) Investigating an outbreak of Salmonella in the community
E) Tabulating the findings of exploring immunization practices among teens
F) Reviewing the staff evaluations to assist with planning future in-services
Ans: A, B, F
Feedback:
As a manager, a community health nurse would be involved in orienting new nurses in the agency, attending meetings for new services to be offered, and reviewing staff evaluations. Working with a team to direct a smoking cessation program in public areas exemplifies the leadership role. Investigating an outbreak of Salmonella and tabulating the findings of immunization practices depict the researcher role.

24. Of all the nursing roles assumed by community health nurses, which role must be assumed in every situation?
A) Researcher
B) Manager
C) Leader
D) Clinician
Ans: B
Feedback:
The type and number of roles that are practiced vary with each set of clients and each specific situation, but the nurse should be able to successfully function in each of these roles as the particular situation demands. The role of manager is one that the nurse must play in every situation, because it involves assessing clients’ needs, planning and organizing to meet those needs, directing and leading clients to achieve results, and controlling and evaluating the progress to ensure that the goals and clients’ needs are met.

25. Which of the following are core values of professional behavior that are unique to public health nursing? Select all that apply.
A) Community/population as client
B) Prevention
C) Rehabilitation
D) Partnership
E) Healthy environment
F) Diversity
Ans: A, B, D, E, F
Feedback:
Core values of professional behavior emphasize community/population as client, prevention, partnership, healthy environment, and diversity. Rehabilitation is not population centered.

 

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