Question 1

A community health nurse is using the health belief model (HBM) as a basis for providing client care. Which of the following best describe the problems associated with using the HBM? (Select all that apply.)

Accepted Answer

A major problem with this model is that the burden for taking action is totally with the client. The model requires health professionals to assume responsibility for modifying the client's perceptions so they recognize the need to act. Although the line between persuading and educating is a fine one, nurses are responsible for education. Persuasion may border on coercion. Further, the model assumes that all responsibility is personal, ignoring barriers in the health care system, which may make it difficult for an individual to take appropriate action.

Question 2

A nurse is using the critical theoretical perspective in daily nursing practice. Which of the following activities would the nurse most likely complete?

Accepted Answer

Improvements can only be made if societal and personal values are made explicit. Once these values are recognized, they are more easily confronted. Change may be sought toward a more just society.

Question 3

A nurse has accepted a new position in a public health department. Which of the following characteristics is crucial to the nurse's success?

Accepted Answer

Rather than nursing to the community, the nurse must work with the community to be successful. Listening, being patient, providing accurate information, and respecting the experiences of community members are essential for success.

Question 4

A client did not attend the clinic for required follow-up care after his extensive surgery. Which of the following would be the most appropriate conclusion for the nurse to make?

Accepted Answer

Although it is easy to blame the patient for being noncompliant or neglecting himself or herself, or to blame the nurse for not "educating" the patient appropriately, it is equally plausible that the health care system is not meeting the client's perceived needs. Clients can have many reasons for not keeping an appointment, such as family emergencies, lack of funds, or lack of trtansportation. Sociocultural and ethnic barriers can also be factors. This is part of the health belief model where the premise is that the world of the perceiver determines the action.

Question 5

A nurse is using a macroscopic approach when providing care. Which of the following would the nurse most likely demonstrate?

Accepted Answer

All the choices focus on individual client care except for the nurse who is politically involved as demonstrated by providing testimony relevant to proposed legislation.

Question 6

Which of the following assumptions of the health belief model (HBM) is problematic?

Accepted Answer

The HBM assumes that people have access to health resources, but such resources are not always available to certain groups. Economic, political, and environmental constraints interfere with free choice.

Question 7

Which of the following statements best describes the major assumption of the health belief model (HBM)?

Accepted Answer

The HBM is based on the assumption that the primary reason people act is disease avoidance. Such avoidance means they perceive themselves as susceptible to a serious disease, there is some cue to action, and there are more benefits than barriers to acting.

Question 8

A nurse is using Milio's approach when caring for a client. Which of the following advantages will the nurse experience?

Accepted Answer

As the model focuses on sociopolitical and environmental constraints to a client's free choice, it also encourages assessment of such constraints, as well as suggesting alternative avenues to helping the patient obtain needed care. Milio encourages the practice of nursing from a broad understanding of health and illness.

Question 9

Which of the following statements best describes a weakness of early nursing theories?

Accepted Answer

Most nursing theories have an extremely narrow focus on individual nurse-patient care situations. This microscopic focus ignores the broader global social macroscopic perspective.

Question 10

Which of the following assumptions makes Orem's theory difficult to use?

Accepted Answer

Orem's theory is focused on patient-nurse interaction within institutional settings. It assumes that the client can control his or her environment, whereas most persons cannot control work, school, or neighborhood environments.

Question 11

A nurse is using the critical theoretical perspective in practice. Which of the following best describes how the nurse would respond when a client suggests that the physician prescribe a widely advertised medication for tension and anxiety? (Select all that apply.)

Accepted Answer

The best answer is to ask what is going on in the client's life at that moment because situational stresses often occur to everyone. Next, asking what previously has been effective in relieving the symptoms may suggest more appropriate actions than medication. Al-
though generics would be less expensive than brand-name medication, medication should not be the first approach to resolving a symptom before even examining why the symptom is occurring.

Question 12

Which of the following best describes the primary purpose of nursing theory?

Accepted Answer

Although nursing theory does serve as a basis for ongoing research, does help demonstrate that nursing is a profession, and may help nurses organize their knowledge, its primary purpose is to improve nursing practice.

Question 13

Which of the following statements best summarizes Lillian Wald's achievements?

Accepted Answer

Lillian Wald improved health in a community by using diplomacy and neighborhood power. She was elected president of a national nursing organization and created new nursing specialties such as school nursing. However, she is primarily known for her creation of Henry Street House (see Chapter 2 of text), which led to the Visiting Nurses Association and notably improved health in many communities.

Question 14

A nurse is using Healthy People 2020 as a guide to improve the health and well-being of the community. Which of the following strategies would the nurse most likely implement?

Accepted Answer

The chapter emphasizes the need to go beyond individual lifestyle behaviors to the social, economic, political, and value-laden processes of daily life that affect health.

Question 15

Which of the following statements best describes "thinking upstream"?

Accepted Answer

Upstream thinking actions focus on modifying economic, political, and environmental factors that are the precursors of poor health throughout the world.

Question 16

Which of the following health-related variables is examined by the critical theoretical perspective?

Accepted Answer

Critical theoretical perspective examines social inequalities within the broader political, economic, and social systems of society that keep people from reaching their full potential.

Question 17

Which of the following is most closely associated with morbidity and mortality outcomes?

Accepted Answer

Tremendous disparities for access exist between insured and uninsured people in the United States. Access to care is associated with economic, social, and political factors, and depending on individual and population needs, it can be a primary determinant of health status and survival. Structural variables such as race-ethnicity, educational status, gender, and income are highly predictive of health status.

Question 18

A nurse has a broad, aggregate focus when providing care to clients. Which of the following best describes how this approach will help improve client outcomes? (Select all that apply.)

Accepted Answer

Having a broader focus will help both nurse and patient make appropriate decisions. Unfortunately, it cannot ensure that others will help. Ideally, it will help both parties recognize that health problems are not just an individual's responsibility but often a result of environmental, sociopolitical, and economic factors as well. Encouraging the nurse to allocate time for population-focused health promotion efforts will also help the nurse's individual clients over the long term.

Question 19

A nurse is using Milio's framework for prevention to improve the health of clients. Which of the following would the nurse most likely implement?

Accepted Answer

The range of available choices is critical in shaping a society's overall health status. Policy decisions in governmental and private organizations shape these choices. Hence, national-level policy making is the best way to impact the health of most Americans rather than continue to concentrate on imparting information in an effort to change individual behaviors.

Question 20

A nurse is using Milio's framework to promote healthy eating choices among members of the community. Which of the following interventions would the nurse most likely implement?

Accepted Answer

One of the propositions of Milio's framework is that alteration in patterns of behavior resulting from decision making of a significant number of people in a population can result in social change. Some behaviors, such as tobacco use, have become difficult to maintain in many settings or situations in response to organizational and public policy mandates. Increasing taxation on unhealthy food choices may make it more difficult for community members to make these unhealthy choices.

Quiz 3: Thinking Upstream: Nursing Theories and Population-Focused Nursing Practice