Chapter 01: Public Health Nursing and Population Health

Chapter 01: Public Health Nursing and Population Health

Stanhope: Foundations for Population Health in Community/Public Health Nursing,

6th Edition

MULTIPLE CHOICE

• Which statement best describes community-based nursing?
• A practice in which care is provided for individuals and families.
• Providing care with a focus on the group’s needs.
• Giving care with a focus on the aggregate’s needs.
• A value system in which all clients receive optimal care.

ANS: A

By definition, community-based nursing is a setting-specific practice in which care is provided for “sick” individuals and families where they live, work, and attend school. The emphasis is on acute and chronic care and the provision of comprehensive, coordinated, and continuous care. These nurses may be generalists or specialists in maternal–infant, pediatric, adult, or psychiatric mental health nursing. Community-based nursing emphasizes acute and chronic care to individuals and families, rather than focusing on groups, aggregates, or systems.

• Which statement best describes the goal of community-oriented nursing?
• Providing care to individuals and families
• Providing care to manage acute or chronic conditions
• Giving direct care to ill individuals within their family setting
• To preserve, protect, promote, or maintain health and prevent disease

ANS: D

By definition, community-oriented nursing has the goal of preserving, protecting, or maintaining health and preventing disease to promote the quality of life. All nurses may focus on individuals and families, give direct care to ill persons within their family setting, and help manage acute or chronic conditions. These definitions are not specific to community-oriented nursing.

• Which of the following is the primary focus of public health nursing?
• Families and groups
• Illness-oriented care
• Individuals within the family unit
• Health care of communities and populations

ANS: D

In public health nursing, the primary focus is on the health care of communities and populations rather than on individuals, groups, and families. The goal is to prevent disease and preserve, promote, restore, and protect health for the community and the population within it. Community-based nurses deal primarily with illness-oriented care of individuals and families across the life span. The aim is to manage acute and chronic health conditions in the community, and the focus of practice is on individual or family-centered illness care.

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• Which of the following is responsible for the dramatic increase in life expectancy during

the 20th century?

• Technology increases in the field of medical laboratory research
• Advances in surgical techniques and procedures
• Sanitation and other population-based prevention programs
• Use of antibiotics to fight infections

ANS: C

There has to be indisputable evidence collected over time that public health policies and programs were primarily responsible for increasing the average life span from 47 in 1900 to 78.6 years in 2017, an increase of approximately 60% in just over a century plus through improvements in (1) sanitation, (2) clean water supplies, (3) making workplaces safer, (4) improving food and drug safety, (5) immunizing children, and (6) improving nutrition, hygiene, and housing. Although people are excited when a new drug is discovered that cures a disease or when a new way to transplant organs is perfected, it is important to know about the significant gains in the health of populations that have come largely from public health accomplishments.

• A nurse is developing a plan to decrease the number of premature deaths in the

community. Which of the following interventions would most likely be implemented by the nurse?

• Provide free health care to all citizens
• To increase the number of individuals with access to effective health care benefits
• Lower the cost of health care to the American population
• To lessen the governmental burden of providing health care to Americans

ANS: B

The central feature in the Patient Protection and Affordable Care Act (ACA) of 2010 are the mechanisms to increase the number of people with health insurance. The care provided is not necessarily free. While the cost of health care and the burden it places on the American government are serious concerns, they are not the primary focus of ACA.

• What is the basic assumption stated by Healthy People 2010 as it relates to public health

efforts?

• Health disparities among any groups are morally and legally wrong.
• Health care is the most important priority in government planning and funding.
• The health of individuals cannot be separated from the health of the community.
• The government is responsible for lengthening the life span of Americans.

ANS: C

The major premise of Healthy People 2010 was that the health of the individual cannot be entirely separate from the health of the larger community. Public health practice focuses on the community as a whole, and the effect of the community’s health status (resources) on the health of individuals, families, and groups. The goal is to prevent disease and disability and promote and protect the health of the community as a whole. Public health can be described as what society collectively does to ensure that conditions exist in which people can be healthy. The basic assumptions of public health do not judge the morality of health disparities. The focus is on prevention of illness not on spending more on illness care. Additionally, individual responsibility for making healthy choices is the directive for lengthening life span not the role of the government.

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• Which of the following actions would most likely be performed by a public health nurse?
• Asking community leaders what interventions should be chosen
• Assessing the community and deciding on appropriate interventions
• Using data from the main health care institutions in the community to determine

needed health services

• Working with community groups to create policies to improve the environment

ANS: D

Although the public health nurse might engage in any of the tasks listed, he or she works primarily with members of the community to carry out core public health functions, including assessment of the population as a whole and engaging in promoting health and improving the environment. The interventions of asking community leaders which interventions should be chosen, assessing the community and deciding on appropriate interventions, and using data from health care institutions do not demonstrate the engagement of the community when making decisions about what the community actually wants and needs.

• Which public health nurse most clearly fulfills the responsibilities of this role?
• The nurse who met with several groups to discuss community recreation issues
• The nurse who spent the day attending meetings of various health agencies
• The nurse who talked to several people about their particular health concerns
• The nurse who watched the city council meeting on local cable television

ANS: B

Any of these descriptions might represent a nurse communicating, cooperating, or collaborating with community residents or groups about health concerns. A major challenge for the future is the need for public health nursing specialists to be more aggressive in working collaboratively with various groups in the community as well as professional colleagues in institutional settings to deal with barriers to health. However, the nurse who spent the day attending meetings of various health agencies is the most representative, because in public health, concerns are addressed from a broader perspective. In public health, broad concerns of the community should be addressed.Concerns are broader than recreation, individual concerns are not as important as aggregate priorities, and watching television (a one-way form of communication) is less effective than interacting with others.

• Which of the following best defines aggregate?
• A large group of persons
• A collection of individuals and families
• A collection of people who share one or more characteristics
• Another name for demographic group

ANS: C

An aggregate is defined a collection of people who share one or more personal or environmental characteristics. Members of a community can be defined in terms of either geography (e.g., a county, a group of counties, or a state) or a special interest (e.g., children attending a particular school). These members make up a population. The term population may be used interchangeably with the term aggregate. A large group of persons, a collection of individuals and families, and another name for demographic group are not accurate definitions of the term aggregate.

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• Which question asked by a novice nurse would be the most reflective of an understanding

of the role of a public health nurse?

• “Which groups are at the greatest risk for problems?”
• “Which patients should I see first as I begin my day?”
• “With which physicians will I be most closely collaborating?”
• “With which nursing assistants will I partner the most?”

ANS: A

Asking which groups are at greatest risk reflects a community-oriented perspective. The incorrect responses reflect a focus on individuals rather than a community-oriented perspective.

• Making sure that essential community-oriented health services are available defines which

of the core public health functions?

• Policy development
• Assessment
• Assurance
• Scientific knowledge-based care

ANS: C

Assurance includes making sure that essential community-oriented health services are available in the community. The definition does not fit the terms assessment, policy development. Scientific knowledge-based care is not a core function of public health.Assessment is systematic data collection on the population, monitoring the population’s health status, and making information available about the health of the community. Policy development refers to efforts to develop policies that support the health of the population, including using a scientific knowledge base to make policy decisions.

• When talking to a women’s group at the senior citizens’ center, the nurse reminded them

that the only way the center would be able to afford to provide transportation services for them would be for them to continue to write letters to their local city council representatives requesting funding for such a service. What was the nurse trying to accomplish through this action?

• Ensure that the women did not expect the nurse to solve their problem.
• Demonstrate that the nurse understood the women’s concerns and needs.
• Express empathy, support, and concern.
• Help the women engage in political action.

ANS: D

Public health nurses engage themselves and others in policy development and encourage and assist persons to communicate their needs to those with the power to take action. The nurse is demonstrating the role of advocate through this action, it goes beyond merely understanding the women’s concern, and instead mobilizes them to take action. This action does not demonstrate the nurse showing empathy rather the nurse is empowering these women.

• The public health nurse has a clear vision of what needs to be done and where to begin to

improve the health of the community. Why would the nurse spend time meeting with community groups to discuss the most important task to be addressed first?

• To increase the group’s self-esteem
• To maintain communication links with the groups
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