Chapter 3: Community-Based Nursing Practice Nursing School Test Banks

Potter & Perry: Fundamentals of Nursing, 6th Edition

MULTIPLE CHOICE

1. The student nurse is investigating different types of practice settings. In looking at community health nursing, the student recognizes that it:

a.

Requires graduate level educational preparation

b.

Is the same as public health nursing

c.

Focuses on the incidence of disease

d.

Includes direct care and services to subpopulations

ANS: d

d. Community health nursing strives to safeguard and improve the health of populations in the community as well as providing direct care services to subpopulations within a community.

a. Nurses who become expert in community health practice may have advanced nursing degrees, yet the baccalaureate-prepared generalist also can become quite competent in formulating and applying population-focused assessments and interventions.

b. Public health nursing focuses on the needs of populations. Community health nursing has a broader focus, with an emphasis on the health of a community. The community health nurse merges public health knowledge with nursing theory. The community health nurse considers the needs of populations and is prepared to provide direct care services to subpopulations within a community.

c. Public health nursing is concerned with trends and patterns influencing the incidence of disease within populations. A community health nurse may be involved in direct client care for disease within a community.

REF: Text Reference: p. 42, Text Reference: p. 49

2. The community health nurse assumes different roles while working with clients. As an educator assisting the client and family with nutritional needs, the nurse should:

a.

Tell the client the best foods to buy

b.

Purchase foods at the lowest cost for the client

c.

Ask the client and family what they think they should eat

d.

Provide information on food sources and stores with reasonable pricing

ANS: c

c. With the goal of helping clients assume responsibility for their own health care, the community health nurse must assess a clients learning needs and readiness to learn within the context of the individual, the systems the individual interacts with, and the resources available for support. Asking the client about what foods he or she should eat may help the nurse assess the clients level of knowledge regarding nutrition, as well as the clients food preferences. It also enables the client to become a participant in his or her care.

a. Telling the client what foods to buy does not encourage the client to assume responsibility for managing health care.

b. The nurse should first assess the resources available, and then encourage the client to do his or her own shopping.

d. Providing information on food sources and stores with reasonable pricing may be appropriate after the nurse has determined what information the client requires to meet nutritional needs.

REF: Text Reference: p. 55

3. In community health, the nurse works with clients from different populations who are extremely vulnerable. Which one of the following clients from a vulnerable population currently appears to be at the greatest risk?

a.

A physically abused client in a shelter.

b.

An older adult taking medication for hypertension.

c.

A schizophrenic client in outpatient therapy.

d.

A substance abuser that shares drug paraphernalia.

ANS: d

d. A client with substance abuse has health and socioeconomic problems. Frequently these clients may avoid health care for fear of judgmental attitudes by health care providers and concern over being reported to criminal authorities.

a. An abused client in a shelter has sought protection, so currently should be at less risk.

b. Although considered to be a member of a vulnerable population, the older adult who takes medication for a chronic disease such as hypertension, is taking measures to maintain health.

c. A schizophrenic client in outpatient therapy is currently at less risk because he or she is receiving treatment.

REF: Text Reference: p. 52, Text Reference: p. 53

4. A client has a history of a gastrointestinal (GI) disease with eight hospitalizations over the past 21-year period. He eats a well-balanced diet that keeps his GI symptoms suppressed. Which level of prevention corresponds to his dietary management?

a.

Primary prevention

b.

Secondary prevention

c.

Tertiary prevention

d.

Health promotion

ANS: 3

c. The goal of tertiary prevention is to preclude further deterioration of physical and mental function in a person who has an existing illness, and to have the client use whatever residual function is available for maximal enjoyment of and participation in lifes activities.

a. Primary prevention is aimed at general health promotion.

b. Secondary prevention is aimed at early recognition and treatment of disease.

d. Health promotion is aimed at reducing the incidence of disease and its impact on people.

REF: Text Reference: p. 53

5. A client with chronic renal failure receives peritoneal dialysis in his home. He is emotionally upset because of the expenses of his therapy. Which of the following statements from his home health nurse reflects client advocacy in response to the clients concern?

a.

This peritoneal dialysis is less expensive than hemodialysis in the hospital.

b.

Have you considered a renal transplant?

c.

You must feel awful about this situation, but this is the best course of treatment for you.

d.

Lets call the regional dialysis center and explore options for reducing the cost of your home dialysis.

ANS: d

d. This response demonstrates the nurse acting as client advocate by identifying and assisting the client in contacting the appropriate agency for information and resources to meet the clients needs.

a. This response points out the difference in cost for dialysis in the home versus that in the hospital, but does not meet the clients need to reduce the expenses of his therapy. The nurse is not demonstrating patient advocacy.

b. Asking the client whether he has considered renal transplantation does not demonstrate client advocacy.

c. Telling the client that this is the best treatment for him does not address his financial concerns. The nurse is not demonstrating patient advocacy with this response.

REF: Text Reference: p. 56

6. Community assessments are important for the nurse to understand and respond to the needs of the population. In assessing the structure of the community, the nurse will focus on:

a.

Collecting demographic data on age distribution

b.

Visiting neighborhood schools to review health records

c.

Interviewing clients to determine the cultural make-up of the subgroups

d.

Observing locations where services, such as water sanitation, are provided

ANS: d

d. When assessing the structure or locale of a community, the nurse should travel around the neighborhood or community and observe its design, the location of services, such as water and sanitation, and the locations where residents congregate.

a. Collecting demographic data on age distribution would be an assessment of the communitys population.

b. Visiting neighborhood schools to review health records is an example of assessing a social system within a community.

c. Interviewing clients to determine cultural make-up of subgroups is an example of assessing the population within a community.

REF: Text Reference: p. 57

7. Change is not always easy for members of a community or a profession. The nurse working as an effective change agent in a community should:

a.

Tell community members how to manage their health needs.

b.

Work with clients and groups to select alternative health care sites and treatments.

c.

Make decisions for individual clients regarding their health care options.

d.

Provide instruction in the way the community should address health issues.

ANS: b

b. As a change agent, the nurse seeks to implement new and more effective approaches to problems. The nurse creates change by working with and empowering individuals and their families to solve problems or to become instrumental in changing aspects affecting their health care.

a. Telling community members how to manage their health care needs may meet resistance. It does not enable clients and their families to take responsibility for their health care.

c. Making decisions for clients does not enable individuals to assume responsibility for their health care decisions.

d. The community-based nurse acting as a change agent may be an excellent resource for health information to members of the community. Ultimately, however, the community members will take an active role to create change for themselves and will assume responsibility for their health care decisions.

REF: Text Reference: p. 56

8. The client is being discharged from an acute care facility after a total hip replacement. She will need follow-up for her rehabilitation and exercise plan. In addition to a home health care nurse, what referral should be discussed?

a.

Social worker

b.

Dietitian

c.

Physical therapist

d.

Respiratory therapist

ANS: c

c. Directing clients to appropriate resources and to improve continuity of care requires the nurse to know those resources well. A physical therapist is responsible for the patients movement system and is likely to be needed after hip-replacement surgery.

a. A social worker may or may not be necessary.

b. A dietitian may or may not be necessary.

d. A respiratory therapist would not be necessary unless the client experienced a respiratory complication or had a pre-existing respiratory condition.

REF: Text Reference: p. 56

9. The nurse recognizes that a greater need exists for comprehensive community health care. Which of the following is the largest contributing factor for the increase in the need for and use of home care?

a.

Government funding of the home care setting has increased greatly.

b.

The existence of more single-income families has increased the need for their elderly relatives to receive care in the home.

c.

Clients are more acutely ill when discharged from the acute care facility.

d.

Seven-days-per-week services are available for the elderly in home care agencies.

ANS: c

c. Because hospital stays are being shortened to control health care costs, clients are returning home more acutely ill. This is the largest contributing factor to the increase in the need for and use of home care.

a. Government funding of home care is not the largest contributing factor to the increase in the need for and use of home care.

b. The existence of more single-income families is not the largest contributing factor to the increase in the need for and use of home care.

d. Seven-days-per-week services are available for the elderly in a variety of settings, such as in acute care or long-term care, not just in the home care setting. Being able to provide daily services for the elderly in the home care setting is not the largest contributing factor to the increase in the need for and use of home care.

REF: Text Reference: p. 47

10. It is important that critical aspects of Healthy People 2010 be incorporated into health care delivery in the community. One of the overall goals of this plan is to:

a.

Increase life expectancy

b.

Decrease health care costs

c.

Promote managed care organizations

d.

Establish the credentials of professionals providing services

ANS: a

a. The overall goals of Healthy People 2010 are to increase the life expectancy and quality of life and to eliminate health disparities.

b. The initiative of Healthy People 2010 is to improve the delivery of health care services to the general public. The overall goal did not focus on reducing health care costs.

c. Although MCOs may increase in number, this was not a goal of the Healthy People 2010 initiative.

d. Establishing the credentials of care providers was not a goal of Healthy People 2010.

REF: Text Reference: p. 48

Copyright 2005 by Mosby, Inc. All rights reserved.

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