Population and Community Health Nursing 6th Edition Clark Test Bank

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Population and Community Health Nursing 6th Edition Clark Test Bank

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== SAMPLE ==
Population and Community Health Nursing, 6e (Clark)
Chapter 2 Population Health Nursing: Yesterday, Today, and Tomorrow

1) The population health nurse is reviewing the recommendations within the Report of the Massachusetts Sanitary Commission drafted by Lemuel Shattuck. What should the nurse identify as being the most important effect of this document?
1. Establishing state boards of health.
2. Establishing workhouses for the sick poor.
3. Mobilizing social reform to sanitary engineering.
4. Refuting that poverty was the result of deficiencies in moral character.
Answer: 1
Explanation: 1. The Massachusetts Sanitary Commission was established in response to concern over the effects of crowded living conditions, poverty, and poor sanitation on health. In 1850, Lemuel Shattuck drafted the commission’s findings. The Report of the Massachusetts Sanitary Commission included recommendations for establishing state and local health departments, systematic collection of vital statistics, and sanitation inspections, and for instituting programs for school health and control of mental illness, alcohol abuse, and tuberculosis. Other recommendations included public education regarding sanitation, control of nuisances, periodic physical examinations, supervision of the health of immigrants, and construction of model tenements. In addition, the report recommended improved education for nurses and the inclusion of content on preventive medicine and sanitation in medical school curricula. Until the late 19th century, it was held that poverty was the result of one’s moral character. Workhouses for the poor had been in place since the late 18th century. Chadwick’s Inquiry into the Sanitary Conditions of the Labouring Population of Great Britain shifted the view from social reform to sanitary engineering.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-1

2) The nurse is reviewing the evolution of national health care systems in countries throughout Europe and the United States for a school project. In which century should the nurse emphasize that national health insurance in the United States was first proposed?
1. Late 20th century.
2. Mid-20th century.
3. Early 20th century.
4. Mid-19th century.
Answer: 3
Explanation: 3. National health insurance was proposed as early as 1912 as an element of Theodore Roosevelt’s 1912 election platform. Germany initiated a national health program in the 1860s, as did Great Britain, though the latter was unsuccessful. While efforts to address national health insurance in the United States had been proposed in the mid- and late 20th century, its earliest origin was at the turn of the century.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-3
3) In preparation for a health fair the nurse wants to explain the role of ancient civilizations on water purification. Which civilizations should the nurse highlight as being advocates for clean water supplies? (Select all that apply.)
1. Aztecs.
2. Greeks.
3. Romans.
4. Germans.
5. Egyptians.
Answer: 1, 3, 5
Explanation: 1. The Egyptians, Romans, and Aztecs were all known to emphasize the importance of clean water supplies. Other civilizations developed some measures to protect their water supplies but not quite to the extent of the Egyptians, Romans, and Aztecs.
3. The Egyptians, Romans, and Aztecs were all known to emphasize the importance of clean water supplies. Other civilizations developed some measures to protect their water supplies but not quite to the extent of the Egyptians, Romans, and Aztecs.
5. The Egyptians, Romans, and Aztecs were all known to emphasize the importance of clean water supplies. Other civilizations developed some measures to protect their water supplies but not quite to the extent of the Egyptians, Romans, and Aztecs.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-1

4) The population health nurse is discussing the first organized approach to home nursing of the sick that was established in 1813 by the Ladies’ Benevolent Society of Charleston, SC, in response to a yellow fever epidemic. What important aspect of the care provided by this organization should the nurse emphasize?
1. Restricted to women and children.
2. Directed to those residing in the Jewish community.
3. Restricted to those who were able to pay for services.
4. Nondenominational and nondiscriminatory in an era of racial discrimination.
Answer: 4
Explanation: 4. Though the care was given by upper class women to those who needed nursing care, the Ladies’ Benevolent Society of Charleston was notable in that its services were nondenominational and nondiscriminatory in a region and time where racial discrimination was the prevailing behavior. Payment for services was not a hallmark of the Ladies’ Benevolent Society. Services to the Jewish Community were organized in Philadelphia in 1819 by Rebecca Gratz. There were no restrictions to the people whom the Ladies’ Benevolent Society provided nursing care.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-3

5) The population health nurse is researching the activities of Margaret Sanger for a school paper. The nurse should explain the actions of Ms. Sanger as combining social activism with nursing to her clients by:
1. Advocating for better care for the mentally ill.
2. Reducing rural childbirth morbidity and mortality rates.
3. Providing information about contraceptive services to women.
4. Providing education regarding improved nutrition for families.
Answer: 3
Explanation: 3. Margaret Sanger combined social activism with nursing by providing contraceptive information to poor women. Among population health nursing care, education was always a component in the early efforts of activists like Sanger. Reducing rural childbirth mortality and morbidity rates was done by Mary Breckenridge in the Frontier Nursing Service. Dorothea Dix was an early activist for advocating for the mentally ill.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-2

6) Prior to providing care to a family the population health nurse reflects on the achievements of historical nurses who influenced approaches used today to provide care. Which historical figure should the nurse attribute to the combination of political activism with health promotion and disease prevention to improve individual and societal conditions affecting health?
1. Lillian Wald.
2. Lavinia Dock.
3. Lina Struthers.
4. Mary Brewster.
Answer: 1
Explanation: 1. Lillian Wald is the person most closely aligned with population health nursing and coined the term public health nurse. She accomplished many reforms to improve the health of New York and was politically active in lobbying for these improvements in addition to providing nursing care to the immigrant population served by the Henry St. Settlement. All the other nurses worked with Wald at the Henry St. Settlement but branched out to other aspects of nursing and political activism.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-2

7) The nurse is preparing a seminar on population health for a group of staff nurses in a community health clinic. Which events that demonstrated the effectiveness of population health nursing in the United States should the nurse emphasize? (Select all that apply.)
1. Formation of the Red Cross.
2. School nursing program in New York City.
3. Improvement of sanitary conditions in slum areas.
4. Formation of benevolent societies to care for the sick poor.
5. Visiting nurse services of Metropolitan Life Insurance Company.
Answer: 2, 5
Explanation: 2. Use of a single school nurse in New York City and the impact of reducing absenteeism resulted in the establishment of school nurses throughout the city. The visiting nurse services of Metropolitan Life Insurance Company were an overwhelming success in decreasing insurance costs for the company. These services were provided on a three-month pilot, and because of its success, the Metropolitan Life Insurance Company extended this program until the 1950s. The formation of the Red Cross had no bearing on population health, but was organized primarily to help people in times of war and disaster. While improving sanitary conditions improved overall health, this was an ongoing process and not a discrete event. Benevolent societies preceded the formal development of population health nursing.
5. Use of a single school nurse in New York City and the impact of reducing absenteeism resulted in the establishment of school nurses throughout the city. The visiting nurse services of Metropolitan Life Insurance Company were an overwhelming success in decreasing insurance costs for the company. These services were provided on a three-month pilot, and because of its success, the Metropolitan Life Insurance Company extended this program until the 1950s. The formation of the Red Cross had no bearing on population health, but was organized primarily to help people in times of war and disaster. While improving sanitary conditions improved overall health, this was an ongoing process and not a discrete event. Benevolent societies preceded the formal development of population health nursing.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-3

8) While conducting a training class for hospice nurses, the nurse explains the actions taken by William Rathbone, a Quaker philanthropist who implemented nursing care at home for the sick in England. Mr. Rathbone enlisted Florence Nightingale’s assistance to develop a concept of nursing care, which he later adopted in the United States after witnessing its benefits to his dying wife. Which aspect of care should the nurse attribute to Mr. Rathbone?
1. Home nursing.
2. Parish nursing.
3. District nursing.
4. Community nursing.
Answer: 3
Explanation: 3. After seeing the effectiveness of the nursing care to his wife, Rathbone conceived of district nursing to improve the overall health of set populations in local districts. Early efforts were not successful, however, until Rathbone solicited Nightingale’s help. She made this concept successful. Although district nursing evolved into population nursing and later parish nursing, the original idea was for district nursing as conceived by Rathbone. Home nursing was already done by either trained nurses or by family members.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-1

9) The clinical trainer for a group of population health nurses is planning to present the historical events that shaped and formed the development of population nursing in the United States. Which events should the trainer include? (Select all that apply.)
1. Creation of district nursing.
2. Settlement house movement.
3. Passage of immigration limiting legislation.
4. Standardization of community nursing practice.
5. Passage of legislation specific to community nursing.
Answer: 2, 4, 5
Explanation: 2. The settlement house movement was started in answer to the rise of immigration to the United States to help the immigrants assimilate to U.S. culture and mores. The immigrant population in the United States drew Lillian Wald and her followers to provide nursing care to this group and thus improve their overall health, which then translated to the overall population. Standardization of practice resulted in the formation of the National Organization of Public Health Nurses in 1912. Wald and other nurses then advocated for legislation specific to the population health, most notably with the Sheppard-Towner Act in 1921. District nursing was a movement primarily located in Great Britain.
4. The settlement house movement was started in answer to the rise of immigration to the United States to help the immigrants assimilate to U.S. culture and mores. The immigrant population in the United States drew Lillian Wald and her followers to provide nursing care to this group and thus improve their overall health, which then translated to the overall population. Standardization of practice resulted in the formation of the National Organization of Public Health Nurses in 1912. Wald and other nurses then advocated for legislation specific to the population health, most notably with the Sheppard-Towner Act in 1921. District nursing was a movement primarily located in Great Britain.
5. The settlement house movement was started in answer to the rise of immigration to the United States to help the immigrants assimilate to U.S. culture and mores. The immigrant population in the United States drew Lillian Wald and her followers to provide nursing care to this group and thus improve their overall health, which then translated to the overall population. Standardization of practice resulted in the formation of the National Organization of Public Health Nurses in 1912. Wald and other nurses then advocated for legislation specific to the population health, most notably with the Sheppard-Towner Act in 1921. District nursing was a movement primarily located in Great Britain.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-3

10) A group of nursing students are researching governmental efforts to address health promotion-focused public health. Which legislation should the students identify as starting this change in providing care?
1. Hill-Burton Act.
2. Child Health Act.
3. Social Security Act.
4. Sheppard-Towner Act.
Answer: 4
Explanation: 4. The Sheppard-Towner Act represented the first federal legislation that specifically targeted an aspect of population health, most notably maternal-child health. The Child Health Act was not passed until 1967 and recommended the use of nurses in extended roles. The Social Security Act did not originally focus on health promotion efforts. The Hill-Burton Act, passed after World War II, focused on the building of hospitals rather than population health.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis
Learning Outcome: 2-5
11) While reviewing the history of health care services as part of an education program the nurse learns that the passage of the amended Social Security Act created Medicare and Medicaid, which increased demands for health care services. How did The National Health Planning and Resources Development Act of 1974 attempt to address the demand for health care services?
1. Increasing funds to improve the health status of the indigent poor.
2. Recognizing that increased hospitals improved the public health status.
3. Increasing funds for more health services to improve public health status.
4. Recognizing the contribution of health practitioners to the public health status.
Answer: 4
Explanation: 4. The 1974 Act recognized health practitioner efforts to improve public health status, which was an early legislative shift to recognize health promotion as an effective effort to improve public health status. Increasing funds to improve indigent health status was not addressed in the 1974 Act, though it was for the 1965 amended Social Security Act. Increased hospital building was not a public policy shift of recognizing an emphasis on health promotion. Increasing funding for health services was not the goal of the 1974 act.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis
Learning Outcome: 2-5

12) The nurse case manager is explaining to a group of health care providers how insurance expenditures for health spending led to the development of diagnosis-related groups (DRGs) in efforts to control spending. What should the case manager emphasize as the driving force for directing health efforts with DRGs?
1. Organize services to be more cost-effective.
2. Decreasing length of stays for hospitalizations.
3. Placing the emphasis on the community to improve population health status.
4. Emphasizing health promotion to decrease hospitalizations and medical costs.
Answer: 4
Explanation: 4. The effect of DRGs has shifted emphasis to health promotion of populations rather than medical care for conditions preventable by health promotion efforts. DRGs have not been proven to make services more cost-effective, though that has been one of its objectives. DRGs pay a flat fee in advance for client diagnosis, which may not benefit the client health status during hospitalizations. DRGs have not emphasized the community as a whole to improve a population’s health status. That is achieved through a variety of methods, not solely DRGs.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-4
13) As part of a school assignment the graduate nursing student is reviewing documents that address population health nursing practice in the United States. Which document should the student emphasize as being the most current policy promulgated by the U.S. Department of Health and Human Services?
1. Lalonde Report.
2. Healthy People 2010.
3. Future of Public Health.
4. Declaration of Alma Alta.
Answer: 2
Explanation: 2. Healthy People is the most current policy of the U.S. government to address improving the population health and targets population health nursing practice. The Lalonde Report addressed Canadian population health. The Future of Public Health is a document of the Institute of Medicine, which impacts population health but is not the national health policy. The Declaration of Alma Alta is an international document addressing primary health care.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-5

14) The population health nurse is reviewing the concept of health-for-all with a group of new nurses. What should the nurse explain as the significance of the Ottawa Charter for Health Promotion to population health nursing practice?
1. Created specific mechanisms to categorize nursing services.
2. Provided a mechanism for prospective payment for hospital services.
3. Identified assessment, policy formation, and assurance as key indicators for global health.
4. Focused on social, economic, and political reforms as strategies to improve global health.
Answer: 4
Explanation: 4. The health-for-all concept was further developed in the World Health Organization’s (WHO) Global Strategies for Health for All by the Year 2000, published in 1981, and the Ottawa Charter for Health Promotion, developed at the First International Conference on Health Promotion in 1986. Both focused on social, economic, and political reform and empowerment as strategies for improving the health of the world’s populations. The Nursing Interventions Classification (NIC) created a mechanism to categorize nursing services. Prospective payment of services was the feature of DRGs. The Future of Public Health by the Institute of Medicine (IOM) focused on assessment, policy formation, and assurance as key indicators.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-4
15) The nurse is identifying events that can shape the future of population health nursing practice for a group of nursing students. Which event should the nurse emphasize?
1. International effort to eradicate smallpox.
2. Prospective payment for nursing services.
3. Surveillance of the CDC on population health.
4. Threat of terrorism to harm the public’s health.
Answer: 4
Explanation: 4. Terrorist threats and governmental focus on terrorism may serve to detract attention to overall population health. Population health nursing efforts will be focused on maintaining a balance between terrorist threats and safeguarding population health. Smallpox was eradicated in 1977, so international efforts are not geared toward this aspect of global health. DRGs emphasize prospective payment. Surveillance of the CDC focuses on diseases that affect population health, not population health nursing practice.
Nursing/Int.Conc: Nursing Process: Implementation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-5

16) The mental health nurse is seeing patients recovering from post-traumatic stress disorder in an out-patient health clinic. Which historical figure should the nurse recognize as being instrumental in improving the care provided to patients with mental disabilities?
1. Clara Barton.
2. Dorothea Dix.
3. Harriet Tubman.
4. Sojourner Truth.
Answer: 2
Explanation: 2. Dorothea Dix was a social reformer who did much to improve the conditions of people with mental illness in institutions throughout the nation. Clara Barton was instrumental in the establishment of the Red Cross of the United States of America. Harriet Tubman, a former slave who functioned as a nurse during the Civil War, is probably best known for her activities with the Underground Railroad in bringing approximately 300 former slaves to freedom in the north. Sojourner Truth was an African American who served during the Civil War and then for the Freedman’s Relief Association during reconstruction.
Nursing/Int.Conc: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis
Learning Outcome: 2-2
17) A graduate nurse has scheduled an appointment with the director of the Center for Nursing Research within the National Institutes of Health. What types of research should the graduate nurse prepare to discuss during this meeting?
1. Medication compliance.
2. Reduction in sentinel events.
3. Health promotion and illness prevention.
4. Elimination of hospital-acquired infections.
Answer: 3
Explanation: 3. Growing evidence indicates a shift to greater emphasis on health promotion and illness prevention in national and international health policy. Evidence of this shift is the 1988 creation of the Center for Nursing Research within the National Institutes of Health (NIH). One reason given in Senate testimony favoring the center was the health promotion and illness prevention focus in much of nursing research. Medication compliance, reduction in sentinel events, and elimination of hospital-acquired infections might be topics for future nursing research; however, these topics do not explain the type of research being conducted within the Center for Nursing research.
Nursing/Int.Conc: Nursing Process: Planning
Client Need: Health Promotion and Maintenance
Cognitive Level: Application
Learning Outcome: 2-4

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