Chapter 2: Origins and Future of Community/Public Health Nursing(FREE)


Chapter 2: Origins and Future of Community/Public Health Nursing
Test Bank


1. With what aspect of the population being served have both nursing and public health always been most concerned?
a. Financial resources
b. Political beliefs
c. Religious faith
d. Social and physical environments
Community/public health nursing has always been most concerned with the interrelationship among people and their physical and social environments.

DIF: Cognitive Level: Knowledge REF: p. 32

2. A community/public health nurse is working for a local health department. Which of the following would be an appropriate goal for the nurse?
a. Assessing clients in their own home environment
b. Caring for whole families, not just individuals
c. Improving health over the long term for families
d. Striving for social betterment
The text stresses that community/public health nursing attempts to meet not only educational and other nursing needs but also social betterment, which includes social and political activism. Although all the other answers might seem appropriate, many community/public health nurses do not provide direct care.

DIF: Cognitive Level: Application REF: p. 32

3. What occurred as a result of industrialization?
a. People from lower socioeconomic classes were able improve their socioeconomic positions.
b. Problems such as overcrowding and disease developed.
c. Products were individualized to meet customers’ unique needs.
d. Taxes for roads and other community services increased.
Because workers flocked to cities for employment, overcrowding resulted, which enabled disease to spread rapidly.

DIF: Cognitive Level: Knowledge REF: p. 32

4. A district nurse in England during the 1860s was providing care for the community. With which of the following groups would the nurse most likely have interacted?
a. Church clergy
b. Business owners
c. Lobbyists
d. Government officials
In England, nurses were assigned a district associated with a church parish, whereas in the United States, district nurses often worked in conjunction with physicians who were employed in the local dispensary.

DIF: Cognitive Level: Application REF: p. 33

5. A nurse was working with William Rathbone and other social reformers to improve care in the homes of poor residents. What barrier was this nurse likely to have encountered?
a. Poor persons did not want nurses to enter their homes.
b. Providing home care to the poor was not accepted by the community.
c. Wealthy community members were reluctant to donate money for these services.
d. There were not enough nurses to provide adequate services.
Society has long accepted that some part of the population is always poor. Furthermore, nursing was a new profession with inadequate numbers. Consequently, Rathbone had to work to have more nurses trained.

DIF: Cognitive Level: Application REF: p. 33

6. A district nurse working with William Rathbone was visiting homes of persons suffering from contagious disease. Which of the following nursing interventions probably would have been implemented?
a. Providing information to family members without providing direct care
b. Assessing the client who was suffering from the disease
c. Donating money, food, bedding, and supplies to the families of the ill person
d. Referring the client and family to community resources
To avoid transmission from one household to another, nurses did not provide care directly but taught family members how to do so. Thus, it was unlikely that the client would be assessed by the nurse. It was not the responsibility of the nurse to donate supplies to the family, and during this period, available community resources to which a client and family could be referred were limited.

DIF: Cognitive Level: Application REF: p. 33

7. A public health nurse is addressing problems in the community. What would be the nurse’s primary concern?
a. Collecting and analyzing data
b. Assuring sufficient standard of living for clients
c. Providing direct care to clients living in the community
d. Assisting clients and families in adapting to their circumstances
Public health is committed to social betterment and recognizes the influence of poverty or socioeconomic class on health.

DIF: Cognitive Level: Application REF: p. 38

8. Who emphasized that public health must be concerned with the standard of living of citizens?
a. C. E. A. Winslow
b. Lemuel Shattuck
c. Florence Nightingale
d. John Snow
C. E. A. Winslow, the leading theoretician of the American public health movement, stated a standard of living adequate for the maintenance of health must be assured.

DIF: Cognitive Level: Knowledge REF: p. 37

9. Who was the first person to recognize the importance of the environment by noting that cholera rates were much higher among persons who drank water from a particular well?
a. C. E. A. Winslow
b. Edwin Chadwick
c. Lemuel Shattuck
d. John Snow
John Snow demonstrated that the cases of cholera in an 1854 outbreak were linked to water from a specific well.

DIF: Cognitive Level: Knowledge REF: p. 38

10. Which person established population-based objectives and used statistics to show that specific interventions dramatically decreased the death rate by 51%?
a. C. E. A. Winslow
b. Lemuel Shattuck
c. Florence Nightingale
d. John Snow
Florence Nightingale used biostatistics to demonstrate the decline in annual death rates from 70 per 1000 to 19 per 1000 after her reforms.

DIF: Cognitive Level: Knowledge REF: p. 38

11. How did Nightingale demonstrate the effectiveness of providing nursing care to soldiers?
a. Persuading military officers that clean air was necessary for the ill soldiers
b. Using biostatistics to demonstrate decline in death rates
c. Improving the living quarters for the injured soldiers
d. Bringing ranked officers of the military to see the improvements
The science of biostatistics was used to demonstrate the decline in death rates as a result of nursing reforms.

DIF: Cognitive Level: Comprehension REF: p. 38

12. For what is Clara Barton primarily known?
a. Helping found the American branch of the Red Cross
b. Exemplifying excellent military strategy skills
c. Working at the U.S. Patent Office
d. Facilitating reforms in prisons and mental institutions
Clara Barton, although employed at the U.S. Patent Office, was instrumental in creating the American branch of the Red Cross.

DIF: Cognitive Level: Knowledge REF: p. 38

13. Why would a nurse who was practicing in the 1900s have been considered to be part of the “golden age” of public health?
a. Antibiotics were discovered to fight infections.
b. Federal, state, and local funding to public health departments increased.
c. Pasteurization of milk and public water and sewage systems began.
d. Major plagues with high death rates had been stopped.
General sanitary reforms that occurred between 1880 and 1910 helped prevent communicable diseases.

DIF: Cognitive Level: Comprehension REF: p. 38

14. A nurse has recently been hired by a school to fulfill the role of the school nurse. What was the reason for the initial development of this specialty nursing practice?
a. In-school treatment reduced absenteeism.
b. Nurses were cheaper to employ than additional teachers.
c. In-school treatment was cost effective.
d. Nurses knew when to send young children home.
Daily treatment of illnesses such as ringworm and impetigo by the school nurses reduced illnesses and also dramatically reduced absenteeism.

DIF: Cognitive Level: Application REF: p. 40

15. A public health nurse newly employed by a local health department learns that the focus of her practice will be to prevent illness in the community. Why does the focus of practice not include the treatment and care of ill patients?
a. Ill people prefer to get care from physicians or in hospitals.
b. People do not trust public health department personnel.
c. Physicians have voiced opposition for fear of loss of income.
d. Visiting nurses associations are becoming part of health departments.
Physicians and nongovernmental visiting nurses associations feared loss of income if health departments treated patients, and so health officers limited nurses to preventing disease.

DIF: Cognitive Level: Application REF: p. 40

16. A nurse working in 1965 wondered how passage of the Medicare and Medicaid legislation would change health care in the United States. Which of the following accurately describes an outcome of this legislation?
a. It decreased the separation between government funding and private physicians.
b. It provided federal intervention for previous state responsibilities.
c. It helped the public realize that some persons had not been getting care.
d. It allowed the federal government to finance health care services.
The private sector had focused on diagnosis and treatment of the ill, whereas the state and local health departments had focused on health promotion and disease prevention. Under Medicare and Medicaid, government funds paid for the health care of ill elderly and poor persons.

DIF: Cognitive Level: Application REF: p. 41

17. A nurse works in an outpatient clinic. The care that the nurse provides is considered to be community-based because this term
a. Emphasizes the environment of care.
b. Describes care provided by nongovernmental employees.
c. Implies care that is provided to the very poor.
d. Is used by physicians and other health care professionals.
Although community health nursing is a synonym for public health nursing, public health nursing had become linked with nurses employed by governments. The term community health nursing emerged to include nursing sponsored by both private nonprofit organizations and governmental agencies.

DIF: Cognitive Level: Application REF: p. 43

18. A nurse supports Nursing’s Agenda for Health Care Reform. For which of the following actions would the nurse advocate?
a. Availability of third-party reimbursement to advanced-practice nurses under Medicare and Medicaid
b. Employment by local health departments of nurses to teach aggregates at high risk how to avoid health problems
c. Physicians’s ability to employ additional nurses in their practice to improve patients’ compliance with medical regimens
d. Permission to state governments to pay public health nurses to develop health promotion projects for communities
Medicare and Medicaid reimbursement was expanded to all nurse practitioners and clinical nurse specialists.

DIF: Cognitive Level: Analysis REF: p. 44

19. A public health nurse is discussing disaster planning in relation to bioterrorism preparedness with members of the county board of health. Which of the following topics is likely to be addressed?
a. Selection of drugs that should be stockpiled for future use
b. Limited resources for managing bioterrorism and day-to-day expenses
c. Inconsistencies in systems for distributing supplies to areas of need
d. Need for ongoing education for public health professionals
Because of the limited supply of personnel and funding, a tension exists between the use of resources for bioterrorism preparedness and their use for other public health issues. Selection of drugs that should be stockpiled and inconsistencies related to distribution of supplies would not occur at the county level. The need for ongoing education does not relate to the discussion of disaster planning.

DIF: Cognitive Level: Application REF: p. 45


1. During World War I, three acute care (hospital-based) nurses were hired to work in an industrial setting. What would have been a reason for their change of practice? (Select all that apply.)
a. Philanthropy from industrial business owners was encouraged.
b. Collective bargaining contracts required a nurse to be on site.
c. Efficiency and productivity improved if workers were at the workplace.
d. Employers feared the movement toward collective bargaining.
e. Legislation requiring employers to have first aid services was passed.
f. The National Safety Council required that a nurse teach first aid to staff.
ANS: A, C, D
Industrial nursing spread because factory efficiency was improved if workers were at the workplace and healthy, which was particularly important during World War I. Philanthropy, industrial justice, and fear of union movements were other motives for creating industrial nursing positions.

DIF: Cognitive Level: Application REF: p. 45

2. A nurse in the early twentieth century visited the homes of mothers with newborns. Which of the following would have been appropriate nursing interventions? (Select all that apply.)
a. Ensuring that the mothers complied with physician prescriptions
b. Referring the families to the Women, Infants, and Children program (WIC)
c. Administering the immunizations required by state law
d. Promoting breast-feeding
e. Supervising formula preparation and feeding
f. Teaching mothers how to care for and feed their infants
ANS: D, E, F
The nurses provided home visits to promote breast-feeding, to supervise formula preparation and feeding if necessary, to support mothers in following medical advice, and to teach mothers how to properly care for their infants. Mothers were encouraged to follow medical advice, but nurses could not ensure compliance. There were no state laws requiring immunizations, and the WIC program did not exist at that time.

DIF: Cognitive Level: Application REF: pp. 46-48

3. A community/public health nurse refers to Healthy People 2020 when providing community-based education. What is the significance of this document? (Select all that apply.)
a. It clarifies the importance of hospitals in community-based care.
b. It expands on what kinds of care the federal government is willing to fund.
c. It explains the federal goals for improved health of the nation.
d. It provides a guide for nurses when they speak with the public.
e. It specifies how federal health care funds will be spent.
f. It emphasizes appropriate nursing interventions when direct client care is provided.
Healthy People 2020 is a clear statement of national health goals and objectives and provides a guide for community/public health nurses speaking with people about healthy communities.

DIF: Cognitive Level: Application REF: p. 46

4. What are the basic goals of Healthy People 2020? (Select all that apply.)
a. Recognizing health disparities among all populations
b. Promoting healthy behaviors among all persons
c. Attaining high-quality, longer lives for all persons
d. Developing a plan for quality care for all clients
e. Achieving health equity for all groups
f. Creating environments that promote good health for all persons
ANS: B, C, E, F
The goals of Healthy People 2020 are to attain high-quality, longer lives free of preventable disease, disability, injury, and premature death; to achieve health equity, eliminate health disparities and improve health for all groups; to promote quality of life, healthy development, and healthy behaviors across all life stages; and to create social and physical environments that promote good health for all. Healthy People 2020 not only recognizes health disparities but also recommends ways to address them. It does not help with developing a plan for quality care.

DIF: Cognitive Level: Knowledge REF: pp. 49-50

5. A nurse was employed by the Frontier Nursing Service in the 1940s. What is significant about this agency? (Select all that apply.)
a. It paid nurses considerably more than persons in urban staff positions.
b. It had the first nurse–midwives and taught midwifery to others.
c. Its nurses improved sanitation efforts in rural communities.
d. Its nurses collected data to demonstrate nursing effectiveness.
e. It employed nurses who traveled by horseback through the mountains.
f. Its nurses continue to provide care even today.
ANS: D, E, F
Mary Breckinridge was a pioneer in community assessment, population-based planning, and partnership building. She created a system for rural nursing in which nurses on horseback were employed; furthermore, she used research to demonstrate effectiveness. Her vision of the Frontier Nursing Service continues today.

DIF: Cognitive Level: Application REF: p. 51