Question 1

A public health nurse is discussing the concept of the community being served as the client. Which factors should the nurse include in the discussion when describing a competent community? Select all that apply.

Accepted Answer

A competent community is able to collaborate effectively identifying community needs and problems. A competent community is able to achieve a working consensus on goals and priorities. A competent community is able to agree on ways and means to implement the agreed-upon goals. A competent community is able to collaborate effectively to take the required actions. All communities have problems.

Question 2

A group of students are preparing a presentation describing Healthy People 2030. Which goals for the nation will the instructor expect the students to include in the presentation? Select all that apply.

Accepted Answer

The four overarching goals for the health of the nation are the following: to attain high-quality, longer lives free of preventable disease, disability, injury, and premature death; to achieve health equity, eliminate disparities, and improve the health of all groups; to create social and physical environments that promote good health for all; to promote quality of life, healthy development, and healthy behaviors across all life stages.

Question 3

The nursing instructor is discussing the concept of serving the community as the client. The instructor recognizes that the students understand the teaching when they identify which concepts are used to identify the health of a community?

Accepted Answer

The three dimensions of the health of the community are status/people, structure, and process. Assessment, policy development, and assurance are the three core public health functions. Primary, secondary, and tertiary are the levels of prevention. Function, structure, and process are the descriptions of Human Anatomy and Physiology.

Question 4

A community health nurse is a member of the health planning team that is trying to determine how best to help the pregnant teenagers in the community. Which factors will the nurse recognize as vital to assess in making decisions? Select all that apply.

Accepted Answer

Population variables include size, density, composition, rate of growth or decline, cultural characteristics, social class structure, and mobility. Pregnant teens are a subculture of teenagers. Cultural differences are population variables along with the numbers, social class, and mobility. Health needs vary among subculture and ethnic populations. Geographic placement reflects location. Functions of community organizations and social class reflect the social system.

Question 5

A nursing instructor is discussing the fundamental concepts of community health nursing with a group of students. The instructor recognizes that the students understand the discussion by identifying which entity as the primary client?

Accepted Answer

It was proposed by Mundinger and Jauron that the use of nursing diagnoses in the community could be formulated by substituting the terms, client, family, group, or aggregate for the word patient. Community health nurses look for evidence of all kinds of needs that relate to or influence a client's levels of wellness. Needs cover the whole span of the health illness continuum and the total person, family, group, aggregate, population, or community-the total system. Not all clients are communities. They may be individuals or families. Not all clients are in the category of groups, aggregates, or populations. A client can be an individual or a family. When using the epidemiological triad, there are three components: host, agent, and environment. A client would be considered the host. An agent is a factor that causes or contributes to a health problem or condition.

Question 6

Community health nurses must recognize the unique position they hold in providing adequate health care for their clients. Which action would be a priority for the community health nurse?

Accepted Answer

Community health nurses serve as a valuable partner in identifying community health needs and connecting communities with available resources. They also serve as community educators, empower people with information to make healthy choices while working to create environments where healthy choices are more accessible and affordable. While they do strive to help each individual who comes for assistance, the main goal is to help the community as a whole. They also strive to work with all community leaders to achieve the common goal and not just a few who may be more supportive.

Question 7

The class discussing Donabedian's theory demonstrates understanding of the structure element by identifying which factors as pertinent to understanding this dimension? Select all that apply.

Accepted Answer

Structure of a community refers to its services and resources. Community associations, groups, and organizations provide a means for accessing needed services. Adequacy and appropriateness of health services can be determined by examining patterns of use, number and types of health and social services, and quality measures. Demographic data, such as socioeconomic and racial distribution, age, gender, and educational level, are important indicators of community structure. Status/people is the most common measure of the health of a community.

Question 8

The community health nurse is reviewing the health status of the community. Which is the best factor for the nurse to examine?

Accepted Answer

Status typically comprises morbidity and mortality data identifying the physical, emotional, and social determinants of health. Physical and social indices include vital statistics, leading causes of death and illness, suicide rates, and rates of drug and alcohol addiction. Social determinants can be identified by crime rates and functional ability level or by high school dropout rates or average income levels. Adequacy of health services and socioeconomic distributions reflect structure. Strengths of the community involve process.

Question 9

The nursing instructor is discussing Donabedian's theory with the class. Which statement by the class would best demonstrate understanding of the process?

Accepted Answer

Process reflects the community's ability to function effectively. Structure of a community refers to its services and resources. Status/people dimension usually refers to the morbidity and mortality data and the physical, emotional, and social determinants of health.

Question 10

A community health nurse is conducting orientation for new nurses to the clinic. Which factor should the nurse emphasize as most important when dealing with the community?

Accepted Answer

Although the nursing process is cyclical, deliberative, flexible (adaptable), client focused, and need oriented, interaction is an essential first consideration for community health nursing. All steps of the nursing process depend on interaction.

Question 11

The community health nurse has identified a health care issue and believes that a local coalition of various community members will be the best approach to handle the situation. Which initial step should the nurse take?

Accepted Answer

The initial step to coalition building is defining goals and objectives, followed by conducting a community assessment, identifying key players or leaders, and identifying potential coalition members.

Question 12

The public health department has opened a new clinic in a previously underserved area. What is the priority for the community health nurse at this clinic?

Accepted Answer

A familiarization assessment is a common starting place in evaluation of a community. It involves studying data already available on a community and then gathering a certain amount of firsthand data in order to gain a working knowledge of the community. A problem-oriented assessment begins with a single problem and assesses the community in terms of that problem. It is commonly used when familiarization is not sufficient and a comprehensive assessment is too expensive. A community subsystem assessment focuses on one dimension of community life. It is a useful way for a team to conduct a more thorough community assessment. A comprehensive assessment seeks to discover all relevant community health information.

Question 13

A group of community health nurses are evaluating the community to determine which issues should be addressed. As the group complete various assessments, they recognize that an assets assessment will be important to evaluate which factor of the community?

Accepted Answer

An assets assessment focuses on the strengths and capacities of a community rather than its problems. Key informants are important sources of information with a comprehensive assessment. Information about a specific health problem is gathered during a problem-oriented assessment. Information about an overall view of the community and its life is gathered with a familiarization or windshield survey.

Question 14

Nursing students in a community health nursing course identified toxic waste disposal to be a major problem in their community. The instructor recognizes that the students understand the appropriate approach to handle the situation by conducting which type of assessment?

Accepted Answer

The problem-oriented assessment is commonly used when familiarization is not sufficient, a comprehensive assessment is too expensive and not needed, and a subsystem assessment is too narrow to determine the extent of the problem.

Question 15

A community health nurse involved in assessing community health needs is planning to get a group of approximately 10 similar individuals together to obtain information about opinions on first pregnancies. The nurse is using which assessment method?

Accepted Answer

The nurse is using a focus group, similar to the community forum or town hall meeting in that it is designed to obtain grassroots opinion. Focus groups usually have only a small group of participants, usually 5 to 15 people, and the members chosen for the group are homogeneous with respect to specific demographic variables. A survey involves a series of questions, often to provide a broad range of data. Community forum is a qualitative method to obtain community opinions; the members typically represent all segments of the community involved with the issue. Descriptive epidemiologic studies examine the amount and distribution of a disease or health condition in a population by person, place, and time.

Question 16

A community health nurse is collecting data about the local community concerning a recognized health issues. Understanding there are various sources for the information, the nurse chooses to start with a primary source that would involve which entity?

Accepted Answer

Primary sources of information include community members, including formal leaders, informal leaders, and community members and can frequently offer the most accurate insights and comprehensive information. Information gathered by talking to people provides primary data, because the data are obtained directly from the community. The World Health Organization is an international source of information. State health department is a state source of data. Other community health nurses as well as health team members, client records, community health (vital) statistics, census bureau data, reference books, and research reports are secondary sources of information.

Question 17

A community health nurse is developing a community diagnosis which addresses an issue that has been identified. What should the nurse remember to do when writing the diagnosis?

Accepted Answer

Community diagnoses should include statements about the strengths of the community and possible sources for community solutions, as well as the community's weaknesses or problem areas. In addition, they should portray a community focus, include the community response, and identify any related factors that have potential for change through community health nursing. These may also include wellness diagnoses, which indicate maintenance or potential change responses (due to growth and development), when no deficit is present. Diagnoses statements should be narrow enough to guide interventions and use the standard nursing diagnosis format.

Question 18

The community health nurse is in the process of designing a plan to address a health need. The nurse recognizes that the plan is created during which stage of the health planning process?

Accepted Answer

During the health planning process, a community health nurse creates a plan during the analysis and design stage, which correlates with the planning phase of the nursing process. Assessment involves data collection, interpretation, and goal setting. Implementation involves how to operationalize the plan and a design for monitoring progress. Evaluation involves examining the costs and benefits, judging the potential outcomes, modifying the plan, presenting the plan to the sponsoring group or agency, and obtaining acceptance.

Question 19

A community health nurse is engaged in evaluation of a health plan using a formative evaluation. What will the nurse focus on?

Accepted Answer

The focus of formative evaluation is on process during the actual interventions. It uses performance standards that are developed to determine what is working and not working. Summative evaluation focuses on the outcome of the interventions and examines the programs' impact on clients' health.

Question 20

A group of students observing a local community notes that there has been positive changes and improved health care through collaboration among the citizens and leaders. Who will the students most likely identify as the agent of change if applying the community development theory to this situation?

Accepted Answer

When applying community development theory, the agent of change is most often the community health nurse who is considered a partner rather than an authority figure responsible for the community's health. Clients, families, and community leaders would be the care recipients.

Quiz 15: Community As Client