Chapter 09: Population-Based Public Health Nursing Practice: The Intervention Wheel Nursing School Test Banks

Stanhope: Public Health Nursing, 8th Edition

Chapter 09: Population-Based Public Health Nursing Practice: The Intervention Wheel

Test Bank

MULTIPLE CHOICE

1. Which statement about the Intervention Wheel is true?
a. It provides a graphic illustration of population-based public health practice.
b. It describes in detail the components of public health nursing.
c. It demonstrates the practice of community health nurses for policy and lawmakers.
d. It is a framework used by all health departments in the United States.
ANS: A
The Intervention Wheel provides a graphic illustration that gives public health nurses a means to describe the full scope and breadth of their practice.

DIF: COG: Understanding REF: 187 OBJ: 1

2. Since the Intervention Wheel was first published in 1998, it has:
a. Guided national policy
b. Been used as a tool in deciding licensure issues for State Boards of Nursing
c. Been incorporated into the public health curricula of many nursing programs
d. Gained wide acceptance internationally
ANS: C
Since being published, the Intervention Wheel has been incorporated into the public/community health coursework of numerous undergraduate and graduate curricula.

DIF: COG: Understanding REF: 188 OBJ: 1

3. Public health interventions are implemented with:
a. Legislators, policy makers, and community leaders
b. Individuals and families, communities, and systems
c. Children, adolescents, and adults
d. Health departments, public health agencies, and visiting nurses associations
ANS: B
It is important to know that public health nurses work with individuals and families, communities, and systems. The other answers may have true parts, but the second option lists the overall groups where public health nurses are intervening.

DIF: COG: Understanding REF: 188 OBJ: 1

4. Which statement is true about the origins of the Intervention Wheel?
a. A panel of nurses from Iowa, Minnesota, North Dakota, South Dakota, and Wisconsin developed and refined the Intervention Wheel.
b. It was conceived by a group of international nurses from Norway, Kazakhstan, and Japan.
c. It was a result of a qualitative analysis carried out by the State Boards of Nursing.
d. It resulted from a grounded theory process carried out by public health consultants at the Minnesota Department of Health.
ANS: D
Public health consultants with the Minnesota Department of Health carried out a grounded theory process in response to uncertainty about the contributions of public health nursing to population health-level improvement, resulting in the identification of the Intervention Wheel components.

DIF: COG: Understanding REF: 188 OBJ: 1

5. When public health nurses conduct an assessment of a communitys health, they
a. Define one problem that will be the focus for a year.
b. Assess a social network of interacting individuals usually in a defined territory.
c. Minimize the effects of health risks and hazards.
d. Intervene at the population-level by changing laws and regulations.
ANS: B
A community is defined as a social network of interacting individuals, usually concentrated in a defined territory. The community assessment generally results in a lengthy list of community problems and issues. Intervention and minimization do not take place during the assessment phase.

DIF: COG: Applying REF: 190 OBJ: 2

6. A public health nurse utilizes the nursing process at all levels of practice by:
a. Including specific goals for community health nurses
b. Developing an accurate nursing diagnosis
c. Analyzing the needs of the community, system, and individuals and families
d. Utilizing primary, secondary, and tertiary prevention
ANS: C
Public health nurses must customize the nursing process to consider the community, systems, and individual/family levels of practice.

DIF: COG: Analyzing REF: 191 OBJ: 2

7. Public health nurses use a common set of interventions to:
a. Describe the proper order of implementation.
b. Emphasize surveillance as the main focus of public health practice.
c. Guide practice and generate agency protocols.
d. Improve the health status of communities, systems, individuals, and families.
ANS: D
Interventions are actions taken on behalf of communities, systems, individuals, and families to improve or protect health status.

DIF: COG: Analyzing REF: 191 OBJ: 2

8. A public health nurse uses Assumption 2, Public health nursing practice focuses on populations, to guide practice. Which would be considered a population of interest?
a. Healthy school children
b. Homeless individuals
c. A person recently diagnosed with diabetes
d. Teenage parents
ANS: A
A population is a collection of individuals who have one or more personal or environmental characteristics in common. Populations of interest are populations that are essentially healthy but could improve factors that promote or protect health; one such population is healthy school children. Homeless individuals and teenage parents would both be considered a population at risk. A person recently diagnosed with diabetes is not a population.

DIF: COG: Analyzing REF: 189 OBJ: 2

9. What is the purpose of the color-coded wedges on the Intervention Wheel?
a. The interventions are grouped together in related wedges.
b. The wedges consist of referral information for each wedge.
c. The element of health teaching is the predominant feature of each wedge.
d. Coalition building must be implemented with each wedge.
ANS: A
Each wedge consists of related interventions. The other answers describe some of the individual wedges.

DIF: COG: Understanding REF: 191 OBJ: 3

10. A nurse who is involved in identifying individuals with unrecognized health risk factors or asymptomatic disease is using which intervention?
a. Screening
b. Referral and follow-up
c. Surveillance
d. Health teaching
ANS: A
Screening involves identifying individuals with unrecognized health risk factors or asymptomatic disease.

DIF: COG: Applying REF: 197 OBJ: 3

11. A nurse promotes alliances among organizations for a common purpose. Which public health intervention is being implemented?
a. Health teaching
b. Coalition building
c. Surveillance
d. Referral and follow-up
ANS: B
One example of coalition building is promoting alliances among organizations for a common purpose.

DIF: COG: Applying REF: 197|205 OBJ: 3

12. A nursing student develops a teaching plan about hand washing to present to a group of elementary school children at the local school. Which public health intervention is being implemented?
a. Collaboration
b. Surveillance
c. Health teaching
d. Screening
ANS: C
Health teaching communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, and practices of individuals, families, systems, and/or communities.

DIF: COG: Applying REF: 205 OBJ: 3

13. A public health nurse uses collaboration, coalition building, and community organizing when:
a. Providing case management, referral, and follow-up services with individuals
b. Carrying out collective action at the systems or community levels of practice
c. Conducting a community assessment
d. Implementing primary and secondary prevention strategies
ANS: B
Collaboration, coalition building, and community organizing are the interventions often carried out at the systems and community levels of practice. These interventions can be used at all levels of prevention.

DIF: COG: Evaluating REF: 191 OBJ: 3

14. The levels of practice encompassed by the Intervention Wheel are:
a. Communities, individuals and families, and systems
b. Assessment, diagnosis, and evaluation
c. Primary, secondary, and tertiary
d. Communities, populations, and aggregates
ANS: A
Communities, individuals and families, and systems are the three levels of public health nursing practice.

DIF: COG: Understanding REF: 196 OBJ: 4

15. Public health nurses utilize registries to identify children with delayed or missing immunizations. They subsequently follow up with families by phone calls or home visits. This is an example of ____-level of practice.
a. Systems
b. Community
c. Policy
d. Individual/family
ANS: D
The individual/family-level of practice focuses on interventions that involve working with individuals, either singly, or in groups, and with families.

DIF: COG: Applying REF: 196 OBJ: 4

16. A social marketing campaign urging community members to avoid driving motorized vehicles after consuming alcohol is implemented in a local community. This intervention is occurring the _____-level of practice.
a. Individual/family
b. Systems
c. Community
d. Government
ANS: C
Community-level interventions care carried out with the community as a whole.

DIF: COG: Applying REF: 188 OBJ: 4

17. An occupational health nurse works with an employer to develop a workplace wellness program for its employees. This intervention is occurring at the _____-level of practice.
a. Individual/family
b. Systems
c. Community
d. Government
ANS: B
Systems-level of practice consists of changing laws, policies, and practices that influence population-based issues.

DIF: COG: Applying REF: 196 OBJ: 4

18. When implementing interventions at the systems-level of practice, the public health nurse would:
a. Involve the entire community in solving the health problem.
b. Identify health problems in the community.
c. Change laws, policies, and practices that influence population-based issues.
d. Provide outreach services to populations at risk.
ANS: C
Systems-level practice consists of changing laws, policies, and practices that influence population-based issues.

DIF: COG: Analyzing REF: 196 OBJ: 4

19. Which is an example of a public health nurse conducting a community assessment?
a. Visiting an elderly person at home to assess and evaluate safety and fall risk
b. Developing diagnoses to identify nursing interventions at a health clinic
c. Evaluating services at an immunization clinic where a translator provides services
d. Compiling recent data from the county health department on child abuse cases
ANS: D
Compiling recent data from the county health department on child abuse cases is an example of community assessment, assessing needs and data within a community.

DIF: COG: Applying REF: 208 OBJ: 5

20. An example of a measurable outcome health status indicator at the individual-level of practice that would be used by a public health nurse is:
a. A 50-year-old woman receives annual mammograms
b. School absences in a community decline
c. Teachers have increased awareness of health problems
d. Those in poverty utilize the free mammogram program
ANS: A
Outcome health status indicators are used to measure the impact of the interventions on population health. In this case, a 50-year-old woman receiving an annual mammogram will have an impact on the population health when considering those who are receiving the screening. The other examples do not look at population health as an outcome or are not occurring at the individual-level.

DIF: COG: Applying REF: 210 OBJ: 5

21. Which nursing diagnosis would a public health nurse use when addressing the problem of obesity at the community-level of practice?
a. Alteration in nutrition: More than body requirements
b. Need for increased knowledge of proper nutrition
c. Families at risk for obesity because of inactivity
d. Overweight child related to poor dietary habits
ANS: C
Nursing diagnoses must be modified to meet the needs of population-focused care in public health nursing practice. Families at risk for obesity because of inactivity is the only nursing diagnosis that addresses a community group that is in need of further intervention.

DIF: COG: Evaluating REF: 208|212 OBJ: 5

22. A public health nurse implements the public health intervention of health teaching at the systems-level of practice by:
a. Participating in the Great American Smokeout
b. Working with a local employer to provide smoking cessation education
c. Providing one-on-one counseling to smokers
d. Advocating for increased taxes on tobacco products
ANS: B
Working with a local employer to provide smoking cessation education is the only example of health teaching at the systems-level of practice. Participating in the Great American Smokeout occurs at the community level and is not health teaching. Providing one-on-one counseling to smokers is health teaching at the individual-level of practice. Advocating for increased taxes on tobacco products occurs at the systems-level of practice, but it is not health teaching.

DIF: COG: Evaluating REF: 197|201 OBJ: 5

MULTIPLE RESPONSE

1. The cornerstones of public health nursing practice (select all that apply):
a. Focus on the health of the entire population
b. Reflect community priorities and needs
c. Promote health through strategies driven by epidemiological evidence
d. Are grounded in an ethic of collaboration
ANS: A, B, C
Cornerstones of public health nursing practice focus on the health of the entire population, reflect community priorities and needs, promote health strategies driven by epidemiological evidence, and are grounded in social justice. Nursing is grounded in an ethic of caring.

DIF: COG: Understanding REF: 195 OBJ: 2

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