Stanhope: Public Health Nursing, 8th Edition
Chapter 40: The Nurse Leader in the Community
1. Why are older adults in the community at high risk for medication errors?
a. They are not competent to take their own medications and need supervision.
b. They are often taking high-risk medications.
c. They are not motivated to take medications correctly.
d. They are in need of the assistance of community health nurses.
Older adults often take high-risk medications and cannot read instructions for medications.
DIF: COG: Understanding REF: 872 OBJ: 1
2. When a seamless system of care is created where all client needs are met through the same system, it is an example of:
a. Horizontal integration
b. Vertical integration
c. Managed care
Vertical integration means that the system owns all of the services that clients might need, such as clinics, hospitals, laboratories, and home health agencies.
DIF: COG: Applying REF: 872 OBJ: 1
3. Which intervention would a nurse perform when functioning in the role of a community-oriented nurse manager?
a. Help personnel perform their responsibilities effectively and efficiently.
b. Work with others to ensure a healthy community.
c. Serve as an advocate for vulnerable and high-risk populations.
d. Participate in establishing public and organizational policies.
One of the goals of nursing management is to help personnel perform their responsibilities effectively and efficiently, so it is most likely the nurse manager would perform this intervention. The others are goals of nursing leadership.
DIF: COG: Analyzing REF: 874 OBJ: 1
4. Which intervention would a nurse implement when providing nursing leadership?
a. Monitoring the budget for an immunization program
b. Influencing the improvement of the health of clients
c. Coordinating an interdisciplinary team
d. Using resources when providing clinical services
Nursing leadership refers to the influence that nurses exert on improving client health, whether clients are individuals, families, groups, or entire communities.
DIF: COG: Analyzing REF: 873 OBJ: 1
5. A community health center engages in a partnership with similar organizations agreeing to use common practices and share data when providing care for diabetic clients. This is an example of implementing a:
A collaborative is a group of similar organizations that agree to use common processes for providing clinical care and share certain types of data so all may learn.
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6. To facilitate the building of community partnerships, nurses must have the ability to:
a. Create seamless systems of care.
b. Lobby with legislators.
c. Listen and collaborate with lay community members.
d. Coordinate care across agencies.
The building of community partnerships includes increasing involvement of the public to address their needs and concerns. The nurse can best facilitate this by listening and collaborating with lay community members who may have goals and ideas different from that of health care professionals.
DIF: COG: Analyzing REF: 873 OBJ: 2
7. Which action would a nurse manager most likely take when evaluating the performance of an organization?
a. Examine best practices for organizational evaluation.
b. Analyze how the core functions of public health have been implemented.
c. Develop a standardized nursing language to be used within the organization.
d. Review the standards held by accrediting bodies and the guidelines for practice.
To know whether an agency is performing as expected, nurses must be familiar with their professional standards of care, the standards held by accrediting bodies, and guidelines for practice.
DIF: COG: Evaluating REF: 873 OBJ: 2
8. A nurse considers interdependence among organizations when planning health interventions for the community. Which category of theories is being applied?
a. Structural contingency
c. Resource dependence
Systems theories and systems thinking emphasize the interdependence of multiple parties.
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9. Which is an example of a clinical microsystem?
a. Evidence-based practices
b. Managed care organizations
c. Electronic health records
Clinical microsystems are the systems, people, information, and behaviors that take place at the point of client care.
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10. Which action will a nurse take first when implementing the consultation process?
a. Making initial contact with the client
b. Negotiating for higher fees
c. Applying interventions
d. Collecting data
The first step is the initial contact with the client. This is made when the client or someone in a family, group, agency, or community communicates with the nurse about a potential problem that requires intervention.
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11. When a nurse focuses on collaboration between the consultant and the consultee, which collaboration model is being applied?
a. Content model
b. Doctor-patient model
c. Process model
d. Purchase of expertise model
The consultation model that emphasizes collaboration between the consultant and the consultee is the process model.
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12. Which intervention is an example of secondary prevention?
a. Developing policies and procedures for referral programs
b. Designing protocols for lead screening
c. Serving as a chair to organize a smallpox vaccination program
d. Monitoring implementation of performance-improvement activities
Screening is performed at the secondary level of prevention.
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13. Which skills are most important for a nurse to have when working in the community?
a. Technical skills with acute care nursing as a background
b. Ability to lobby and collaborate with legislators
c. Computer and word-processing skills
d. Ability to build coalitions and work with partnerships
Community-oriented nurses must be able to work comfortably with different types of people and cultures. This can be best accomplished by building coalitions and working with partnerships.
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14. Which intervention would a nurse leader implement to create a motivating workplace?
a. Discuss with employees their personal life and home commitments.
b. Provide regular feedback to employees.
c. Allow employees to take off work whenever necessary.
d. Complete spot checks of employee’s work without notice.
Creating a motivating workplace involves providing regular feedback to employees.
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15. Which action is the nurse most likely to take to effectively manage time?
a. Prioritize goals.
b. Arrive at the site early in the morning.
c. Be available to others.
d. Complete all tasks.
Prioritizing goals is an important element of time management.
DIF: COG: Evaluating REF: 880 OBJ: 4
16. Which statement about responsibility, accountability, and authority by the registered nurse when delegating tasks is correct?
a. The nurse has the responsibility to delegate selected tasks to unlicensed assistive personnel.
b. Registered nurses are not accountable for tasks that have been indirectly delegated.
c. If a task has been delegated, it is the responsibility of the unlicensed assistive personnel to perform the task correctly.
d. Accountability for performing the task correctly is assumed by the registered nurse.
Although responsibility may be shared with the person to whom one is delegating, accountability of the nurse is never transferred. Nurses have the authority to delegate tasks to unlicensed assistive personnel, are accountable for all tasks (even those that have been indirectly delegated), and it is the responsibility of the nurse to assure that the delegated task is performed correctly.
DIF: COG: Understanding REF: 880 OBJ: 5
17. A nurse leader seeks input from staff nurses on a regular basis and allows for changes in practice to improve client outcomes with minimal barriers. This is an example of:
a. Decision making
b. Critical thinking
Empowerment includes increasing nurses’ authority by ensuring that they have the necessary knowledge, skills, and resources to effectively make the decisions for which they are held accountable. This means removing barriers to decision making and allowing staff nurses the authority to make client decisions in “real time,” as needs demand, rather than requiring nurses to obtain numerous approvals.
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18. A school has a policy in place which allows unlicensed assistive personnel to administer medications to students after having their competency evaluated by a registered nurse. Which type of delegation is being used?
Indirect delegation results when an agency has policies and procedures in place that allow tasks to be performed by someone other than the person who is accountable.
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19. Which action would a nurse leader most likely take when using critical thinking skills to address the problem of limited access to health care by low-income families in a community?
a. Use assertiveness when working with community leaders.
b. Read an evidence-based practice article about the problem.
c. Form a coalition to brainstorm effective methods to address the problem.
d. Promote diversity in the workplace by hiring minorities.
Critical thinking includes analyzing and synthesizing data, using knowledge and values in making judgments, and using creative approaches in decision making and problem solving.
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20. When developing a plan to coordinate health care services in the community, which action would be most appropriate for the nurse leader to take?
a. Apply a team approach to assure all points of view are represented.
b. Monitor that the plan is correctly implemented.
c. Organize the plan in a sequential manner.
d. Create a shared vision, goals, and measurable objectives.
Organizing and monitoring occur later in the process. Although planning is a collaborative activity, the foundation of planning rests with creation of the shared vision, goals, and measurable outcomes, which is achieved through a team approach.
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1. Which are goals of community-oriented nursing leadership? Select all that apply.
a. To work with others to ensure a healthy community
b. To serve as an advocate for vulnerable and high-risk populations
c. To work with inter-professional teams to design ways to coordinate care
d. To make policies for the public good
ANS: A, B, C
To make policies for the public good is not a goal of community-oriented nursing leadership.
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2. A nurse is developing a written contract. Which areas would most likely be included in this document? Select all that apply.
a. Number of students involved in the project
b. Client and consultant goals
c. Time commitments
d. Intervention strategies suggested
ANS: B, C, D
Client and consultant goals, time commitments, and intervention strategies suggested are areas to include in a written contract.
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3. Which skills will be demonstrated by a nurse who has effective communication? Select all that apply.
a. Active listening
b. Restatement of the main points
c. Use simple, direct words
d. Maintain eye contact
ANS: A, B, C
Active listening, restatement of the main points, and use of simple, direct words are all examples of effective communication skills. Maintaining culturally appropriate eye contact is important, which in some cultures may mean avoiding eye contact.
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4. Which information is included in an action plan? Select all that apply.
a. Timeframe for completing the activities
b. Identification of team members who created the plan
c. Program goals and objectives
d. Evidence-based practice literature
ANS: A, C
Information included in an action plan includes the timeframe for completing the activities, program goals and objectives, activities to meet the objectives, identification of those responsible for each activity, and the plan for evaluating achievement of the objectives.
DIF: COG: Understanding REF: 884 OBJ: 6