Community Public Health Nursing 8th Edition by Nies, Melanie McEwen Test Bank | All Chapters
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Community Public Health Nursing 8th Edition by Nies, Melanie
McEwen Full Test Bank
Chapter 01: Health: A Community View
Nies: Community/Public Health Nursing, 8th Edition
MULTIPLE CHOICE
- Which statement best describes the primary reason that Americans are
concerned about health care?
a. Politicians are discussing how to improve health care.
b. The media has provided mixed messages about the health care system.
c. Our national health care costs keep increasing.
d. The new health care system offers free services to Americans.
ANS: C
The primary reason for the focus on health care is the constantly increasing costs, which cannot be
sustained. The costs of caring for the sick accounted for the majority of escalating health care dollars,
which increased from 5.7% of the gross domestic product in 1965 to 18% in 2018. Politicians and the
media both influence Americans’ perceptions about health care; however, they are not the primary
reason why Americans are concerned. The new health care system will change the health care access
and availability but will not necessarily be offering any free services to Americans.
DIF: Cognitive Level: Understand (Comprehension) - Why is it important for nurses to lobby with politicians for changes to the health care system?
a. Nurses, as central characters in several popular TV series, are currently very
visible in American media.
b. Nurses are primarily responsible for managing the various units in our health care
system.
c. Nurses are the largest segment of health care providers.
d. Nurses are the only group that is employed both inside and outside of hospitals.
ANS: C
Nurses constitute the largest segment of healthcare workers; therefore, they are instrumental in
creating a healthcare delivery system that will meet the health-oriented needs of the people. As the
largest segment of health care providers, nurses are informed about the current health care system and
all the problems that result from people not seeking care until they are desperately ill. Nurses, as the
American Nurses Association (ANA) emphasize, usually believe that health care is a right, not a
privilege. Therefore, nurses, whose work is central to our current health care delivery system, can also
be instrumental in working politically to create a health care delivery system that will meet health
needs. While nurses are in several current TV series and are employed both inside and outside of
hospitals, physicians and other health care providers are as well. Nurses are often managers, but
managers often have other backgrounds, such as business administration.
DIF: Cognitive Level: Understand (Comprehension)
- What conclusion can be drawn from examining where nurses are currently being employed?
a. There is a trend toward consolidation of health care into large central medical
centers.
b. There is an increased emphasis on health promotion and preventive care.
c. There is an obvious need to decrease health care costs by cutting positions.
d. Managed care organizations (MCOs) are employing nurses to improve customer
relations.
ANS: B
The decline in the percentage of nurses employed in hospitals and the subsequent increase in nurses
employed in community settings suggests a shift in focus from illness and institution-based care to
health promotion and preventive care. This shift will likely continue into the future as alternative
delivery systems, such as ambulatory, home care, and hospice employ more nurses. MCOs are
employing nurses in many capacities. Although hospitals are closing and acute care is increasingly
found in central medical centers, the same trend may be seen in an increase in neighborhood-based
practice centers. While positions are cut in most industries, health care is recognized as an area where
growth in employment is expected. However, nurses are increasingly employed in community settings
as opposed to hospitals. This change reflects the move toward community-based care rather than
hospital-based tertiary care. To help decrease the continued rise in health care costs, the increased
emphasis is on disease prevention rather than high-cost treatment.
DIF: Cognitive Level: Understand (Comprehension) - Which ethical belief is the basis of public health nursing?
a. Emphasis should be on individual and corporation freedom in the marketplace.
b. Emphasis should be on individual autonomy and freedom of choice.
c. Emphasis should be on social justice and collective responsibility.
d. Emphasis should be on the effectiveness of technology in resolving problems.
ANS: C
The mission of public health is social justice, which entitles all people to basic necessities such as
adequate income and health protection and accepts collective burdens to make it possible. An
overinvestment in technology and seeking of cures within the market justice system has stifled the
evolution of a health system to protect and preserve the health of the population. Although individual
autonomy and freedom of choice are important, so is the recognition of collective responsibility in
ensuring social justice, which entitles all people to basic necessities.
DIF: Cognitive Level: Understand (Comprehension)
- What is the primary problem seen in Healthy People 2020’s emphasis on choosing healthy lifestyle
behaviors, such as daily exercise or healthy food choices?
a. Emphasis on other lifestyle choices, such as not smoking and minimal use of
alcohol or drugs, is also needed.
b. All of us must work together to make unhealthy behaviors socially unacceptable.
c. It costs more to make healthy choices, such as buying and eating fresh fruits and
vegetables as opposed to quick and cheap fast-food choices.
d. Public policy emphasizes personal responsibility but ignores social and
environmental changes needed for well-being.
ANS: D
Although all responses are accurate, the primary problem is the emphasis on personal choices in the
Healthy People 2020 objectives. Emphasis on personal choices ignores the need for community
responsibility and action that addresses environmental or cultural restraints to health.
DIF: Cognitive Level: Understand (Comprehension) - What responsibility does the American Nurses Association (ANA) Code of Ethics require of the nurse
beyond giving excellent care to patients?
a. Accept longer work schedules to ensure that professional care is always available
to clients.
b. Recognize the need for experienced nurses to mentor new graduates to help
increase and expand the number of professionals available.
c. Support health legislation to improve accessibility and cost of health care.
d. Volunteer to work overtime as needed to ensure maximum quality of care.
ANS: C
The ANA Code of Ethics promotes social reform by focusing on health policy and legislation to
positively affect accessibility, quality, and cost of health care. The code does not directly address
workplace issues, such as work schedules or need for overtime.
DIF: Cognitive Level: Understand (Comprehension) - What is the community health nursing definition of health?
a. Health is a person’s goal-directed purposeful process toward well-being or
wholeness.
b. Health is an individual’s physical, mental, and social well-being, not merely the
absence of disease or infirmity.
c. Health is the mutual adaptation between a person and his or her environment in
meeting daily existence.
d. Health is families and groups choosing actions to ensure safety and well-being.
ANS: D
The text stresses that health is not just the result of an individual’s choices, but choices and actions of
individuals, families, groups, and communities that lead to better health.
DIF: Cognitive Level: Understand (Comprehension) - How does community health nursing define community?
a. A group of persons living within specific geographic boundaries
b. A group of persons who share a common identity and environment
c. A group of persons who work together to meet common goals
d. A group of persons who resolve a community concern
ANS: B
Community health nurses work with both geopolitical groups (within specific geographic boundaries)
and phenomenological groups (who have a common identity based on culture, history, or goals). A
particular phenomenological group may or may not have been a planned group—that is, a group that
came together to resolve a recognized common problem or to meet a common goal. However, of all
the choices, a group of persons who share a common identity (phenomenological group) and
environment (which implies a specific geographic setting) is the broadest and most complete
definition.
DIF: Cognitive Level: Understand (Comprehension) - Which variable has a major influence on a community’s health?
a. Behavior choices made by persons in the community
b. Number of health care providers and hospitals in the community
c. Quality of the public safety officers (police officers, firefighters, etc.)
d. The number and credentials of public health officials in the community
ANS: A
Individual behavior choices are responsible for about 50% of health outcomes responsible for
premature deaths. Individual choices are affected through interaction with other individuals, and their
mutual social and physical environments. The number of health care providers has not played a major
role in the health outcomes in the community in comparison to individual health behaviors. The quality
of public safety officers and number of public health officials have not been identified as major
contributors to the determinants of health.
DIF: Cognitive Level: Understand (Comprehension) - What change could most effectively lead to a longer life span in Americans?
a. Parenting and sexual behavior classes in all public-school systems
b. Legislation restricting alcohol and drug use
c. Notably reducing speed limits on all state and federal highways, and changing the
age limit for driving to 21 years of age
d. The belief that smoking is shameful and disgusting, as well as expensive,
becoming the social norm
ANS: D
Smoking is responsible for almost 20% of all deaths in the United States. Although smoking is an
individual’s choice, all people are affected by social norms. Parenting and sexual behavior classes and
legislative changes may influence health but may not necessarily lead to a longer lifespan. Community
health nurses should recognize that health is influenced by a web of factors, some that can be changed
and some that cannot. Influencing social norms may better promote change among Americans.
DIF: Cognitive Level: Apply (Application)
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