Community As Partner Theory And Practice in Nursing 7th edition by Anderson – Test Bank A+

Description

To maintain a clear focus on ethics, it is helpful to contrast its domain to that of law, in order to avoid the tendency to confuse the two or to simplify the moral struggle to do the right thing by seeking a legal reason for action. Identify which statement best reflects the comparison between ethics and the law.
	A)	Ethics considers people as inherently good; the law considers them to be basically bad.
	B)	Ethics proposes what a person must do; the law proposes what a person should do.
	C)	Ethics imposes individuals to pay penalties; the law has no sanctions.
	D)	Ethics is a way to enforce the current values of society; the law changes the values of society.
	Ans:	A
	Feedback:
	Ethics considers people as inherently good; law presumes them to be basically bad. Ethics proposes what a person should do, whereas law specifies what one must do. An individual may be chastised if found in violation of ethical principles, but there are no definite sanctions, whereas law imposes penalties in terms of fines and imprisonment. Law is often seen as a way to enforce the current ethical values of a society because it responds more quickly to changing circumstances.

2.	Which definition best represents applied ethics?
	A)	When one considers only his/her individual good or self-interest
	B)	A branch of ethics that views everything as universally valid or where true moral principles apply
	C)	A systematic, logical framework for analysis, discourse, and decision making that assists in ensuring decisions are grounded in “good” actions
	D)	A system that focuses on those traits valued in personal relationships, such as compassion, love, sympathy, and trust
	Ans:	C
	Feedback:
	The function of applied ethics is to provide a systematic, logical framework for analysis, discourse, and decision making that helps ensure that decisions are grounded in the philosophy of “good” actions. Ethical/moral egoism occurs when one considers only his/her own good or self-interest. Ethical/moral objectivism is a branch of ethics that views everything as universally valid or where true moral principles apply. Ethics of care focuses on traits valued in personal relationships, such as compassion, love, sympathy, and trust.

3.	Although many philosophical approaches are discussed in the literature, when looking at the two approaches in applied ethics, deontology and teleology, how is deontology defined?
	A)	Decisions are made on the basis of the greatest good for the greatest number.
	B)	Actions are morally right when they are in accord with our nature and end as human beings.
	C)	A system that allows social and economic positions to be to everyone’s advantage and open to all
	D)	A rule-based approach in which decisions are made by applying a set of rules of good conduct
	Ans:	D
	Feedback:
	Deontology is a rule-based approach in which decisions are made by applying a set of rules of good conduct. Teleology decisions are made on the basis of the greatest good for the greatest number. Natural law is where actions are morally right when they are in accord with our nature and end as human beings. Social equity and justice allows social and economic positions to be to everyone’s advantage and open to all.

4.	When contrasting philosophical approaches in applied ethics, it would be important to know that an example of teleology is what?
	A)	All nurses need to follow personal moral codes in their personal and professional lives.
	B)	Nurses should subscribe to professional codes of ethics in their daily actions as a nurse.
	C)	All individuals in a research study have a complete understanding and informed consent of the study.
	D)	Preventing communicable disease benefits many more people in the community than does caring for individual illnesses.
	Ans:	D
	Feedback:
	Examples of deontology include all nurses need to follow personal moral codes in their personal and professional lives; nurses should subscribe to professional codes of ethics in their daily actions as a nurse; all individuals in a research study have a complete understanding and informed consent of the study. An example of teleology is preventing communicable disease benefits many more people in the community than does caring for individual illnesses.

5.	Choose the best description of the health care framework of paternalism.
	A)	The physician holds the role of the father, the nurse is the mother, and the client is the child.
	B)	The client and health care professional share in determining the options and selecting the best choice for that person.
	C)	The balance of authority in decision making shifts away from the provider to the user of health care services, and the client is clearly in control of choices among available options.
	D)	Interventions depend on the ability of the community health nurse to relinquish decision-making control to the community client and to trust its ability to make responsible decisions.
	Ans:	A
	Feedback:
	Paternalism is where the physician holds the role of the father, the nurse is the mother, and the client is the child. Contractualism occurs when the client and health care professional share in determining the options and selecting the best choice for that person. Consumerism occurs when the balance of authority in decision making shifts away from the provider to the user of health care services and the consumer is clearly in control of choices among available options. Community health interventions depend on the ability of the community health nurse to relinquish decision-making control to the community and to trust its ability to make responsible decisions.

6.	When a nurse is making a career choice, which clinical setting would best support the operative framework of consumerism?
	A)	Burn/trauma unit
	B)	Cardiac critical care unit
	C)	Plastic surgery unit
	D)	Surgical intensive care unit
	Ans:	C
	Feedback:
	Plastic surgery, an elective health care situation, represents the consumerism framework, in which the consumer is clearly in control of choices among available options, and the balance of authority in decision making shifts away from the provider to the user of health care services. Health care professionals working in areas such as trauma, intensive care, and critical care, care for people who are often in acute distress and may not be able to be active participants in making decisions regarding their care. These setting represent the paternalism framework.

7.	Which concept best describes the role of the health care professional, particularly applicable to community health nursing, as that of catalyst?
	A)	The concept involves understanding the world view, life circumstances, and priorities of those requesting or receiving care and exploring the possible options with them in light of their preferences.
	B)	The health care professional tries to imagine experiencing the situation of the person seeking care and offers an opinion of the best choice in full consideration of the other party’s individuality.
	C)	The community is seen to contain all the necessary qualities and resources for change, and the role of the health care professional is to provide the spark that will initiate change, as desired by the community and on its terms.
	D)	The concept attempts to describe action within political, economic, and social systems on behalf of health interests of communities.
	Ans:	C
	Feedback:
	In the model of catalyst, the community is seen to contain all the necessary qualities and resources for change, and the role of the health care professional is to provide the spark that will initiate change, as desired by the community and on its terms. Advocacy involves understanding the world view, life circumstances, and priorities of those requesting or receiving care and exploring the possible options with them in light of their preferences; the health care professional tries to imagine experiencing the situation of the person seeking care and offers an opinion of the best choice in full consideration of the other party’s individuality; and the concept describes action within political, economic, and social systems on behalf of health interests of communities.

8.	Which definition identifies the core value of European and American health care law and ethics?
	A)	The avoidance of harm
	B)	The desire to act in the best interest of others
	C)	The right of individuals to self-determination
	D)	The recognition that every person and community has intrinsic value
	Ans:	C
	Feedback:
	Autonomy is the right of individuals to self-determination and is the core value of European and American law and ethics. Nonmaleficence is the avoidance of harm. Beneficence is the desire to act in the best interest of others. Respect for people is the recognition that every person and community has intrinsic value.

9.	Which principle provides the umbrella concept of the community-as-partner model?
	A)	Autonomy
	B)	Fidelity
	C)	Justice
	D)	Veracity
	Ans:	A
	Feedback:
	Autonomy is the umbrella concept of the community-as-partner model. Many health care professionals will come and go, and any outside program, no matter how worthy, will endure only as long as those professionals remain active in the community, unless the community makes an autonomous investment to endorse and adopt the idea behind the program.

10.	The principle of justice has two aspects, although most often discussions of health-related justice center on distributive justice. It would be important to remember that distributive justice is defined as:
	A)	The commitment to tell the truth
	B)	The arena of reward and punishment
	C)	The fair distribution of rights and resources
	D)	Faithful in making promises and steadfast in keeping them
	Ans:	C
	Feedback:
	Distributive justice is based on the fair distribution of rights and resources. Retributive justice is the arena of reward and punishment. Veracity is the commitment to tell the truth. Fidelity is being faithful in making promises and steadfast in keeping them.

11.	The nurse is wondering if the cancer treatments might be more harmful than the progression of the disease because of the dangerous side effects of chemotherapy. What ethical principle is the nurse struggling with in this situation?
	A)	Autonomy
	B)	Beneficence
	C)	Justice
	D)	Nonmaleficence
	Ans:	D
	Feedback:
	Autonomy is the right of individuals to self-determination. Nonmaleficence is the avoidance of harm. Beneficence is the desire to act in the best interest of others. Justice is the fair distribution of rights and resources.

12.	A community health nurse has to start an IV on a client. The client has never had an IV. The client asks the community health nurse if this will be a painful procedure. The nurse tells the client the truth: that it will be uncomfortable while the needle is being inserted. What ethical principle is the nurse practicing?
	A)	Autonomy
	B)	Fidelity
	C)	Justice
	D)	Veracity
	Ans:	D
	Feedback:
	Veracity is the commitment to tell the truth. Autonomy is the right of individuals to self-determination. Fidelity is being faithful in making promises and steadfast in keeping them. Justice is the fair distribution of rights and resources.

13.	Which two ethical principles come into question when community health research projects involve health screening?
	A)	Autonomy and nonmaleficence
	B)	Fidelity and veracity
	C)	Respect for persons and beneficence
	D)	Beneficence and justice
	Ans:	B
	Feedback:
	Community health research raises serious questions of fidelity and veracity in projects that involve health screening. Many communities, particularly those with underrepresented population groups, are frequently visited by teams of researchers who screen residents for any number of health conditions or risk factors, including chronic illness and toxic exposure. Community health nurses, as community advocates, should help ensure that they and other researchers are honest with the community about exactly what is to be provided. All too often, residents do not understand that the only benefit from participation in a research study is the screening itself. Access to the results of health screening raises a separate issue of veracity, as well as issues of beneficence and nonmaleficence. It is of little benefit to know of a serious health condition if there is no access to treatment for it.

14.	The diversity and complexity of communities lead inevitably to a plethora of conflicts between and among ethical principles. What potential conflicts are prominent features of many of the Healthy People 2020 National Health Goals?
	A)	Respect for people and beneficence
	B)	Autonomy and justice
	C)	Beneficence and justice
	D)	Respect for people and autonomy
	Ans:	A
	Feedback:
	The potential conflict between autonomy and the public good (beneficence) is a prominent feature of many of the Healthy People 2020 National Health Goals. As delineated by the U.S. Department of Health and Human Services (2000), the health indicators used to measure progress toward reaching these goals include physical activity, overweight and obesity, tobacco use, substance abuse, responsible sexual activity, and immunization. Clearly, with the exception of immunization and substance abuse, these indicators are health behaviors that carry no mandates.

15.	As the cost of health care increases, so does the population of uninsured and underinsured. Combined with the cost of litigation and extravagant settlements, open access to care is coming into question. What specific ethical quandaries apply to this situation?
	A)	Autonomy, beneficence, fidelity
	B)	Respect for people, nonmaleficence, veracity
	C)	Veracity, justice, nonmaleficence
	D)	Autonomy, beneficence, justice
	Ans:	D
	Feedback:
	This scenario raises the ethical issues of autonomy, beneficence, and justice with regard to access to care.

16.	Working in partnership with communities requires careful consideration of all seven primary ethical principles and the interplay among them. Which three primary ethical principles are most often threatened by the community health nurse’s commitment to beneficence?
	A)	Autonomy, respect for people, and nonmaleficence
	B)	Fidelity, justice, veracity
	C)	Autonomy, justice, veracity
	D)	Nonmaleficence, fidelity, respect for people
	Ans:	A
	Feedback:
	Beneficence is acting in the best interest of others. Autonomy, respect for people, and nonmaleficence are the principles most often threatened by the community health nurse’s commitment to beneficence. Autonomy, the right to allow the other person to choose, is in direct conflict with beneficence. At times beneficence helps some but may cause potential harm to others (respect for people) if, for example, new industry brings jobs, but the effects of the new industry could cause harm to others, which is also contradictory to nonmalficence. Justice, the fair distribution of rights and resources, and which also involves reward and punishment, is not in direct conflict with beneficence. Fidelity, which is faithfulness, and veracity, which is the commitment to tell the truth, are also not in direct conflict with beneficence.

17.	When an ethical issue arises for the community health nurse, which is the most important nursing responsibility in managing the client care situation?
	A)	Analyzing the ethical principles at stake at any given decision-making point
	B)	Following the request of the client and family members exactly as they have verbalized
	C)	Ensuring the community health care team takes ultimate responsibility for deciding the solution to the situation
	D)	Remaining neutral and detaching all present beliefs when making ethical decisions
	Ans:	A
	Feedback:
	Conscious awareness of this risk and application of the principles of justice, both retributive and distributive; veracity; and fidelity will assist community health nurses to analyze the ethical principles at stake at any given decision-making point in their work with communities. Their actions, then, will reflect the best possible application of the principle of community as partner and will promote the optimal overall health of a community within its own culture.

18.	Following a motor vehicle accident, the wife of the victim requests that life support be continued in the absence of any brain function and that the client be allowed to go home on life support. The health care team believes that life support should be discontinued immediately and the client’s organs be donated. Which ethical principle applies to this situation?
	A)	Autonomy
	B)	Fidelity
	C)	Justice
	D)	Veracity
	Ans:	A
	Feedback:
	Autonomy is the right of individuals to self-determination. Fidelity is being faithful in making promises and steadfast in keeping them. Justice is the fair distribution of rights and resources. Veracity is the commitment to tell the truth.

19.	It is important the community health nurse agree to do no harm to clients in working to heal clients in the least painful and harmful way possible. Which ethical principle applies to the community health nurse?
	A)	Respect for person
	B)	Veracity
	C)	Beneficence
	D)	Nonmaleficence
	Ans:	D
	Feedback:
	Nonmaleficence is the avoidance of harm. Veracity is the commitment to tell the truth. Beneficence is the desire to act in the best interest of others. Respect for people is the recognition that every person and community has intrinsic value.

20.	The community health nurse has to provide an elderly client with a seasonal influenza immunization. The immunization will cause temporary discomfort at the injection site, but the benefits or protection from getting the flu outweigh any minor discomfort for the client. Which ethical principle applies to the situation?
	A)	Autonomy
	B)	Fidelity
	C)	Beneficence
	D)	Nonmaleficence
	Ans:	C
	Feedback:
	Beneficence is the desire to act in the best interest of others. Autonomy is the right of individuals to self-determination. Nonmaleficence is the avoidance of harm. Fidelity is being faithful in making promises and steadfast in keeping them.

1.	A community health nurse is working in a large urban city, situated in a culturally diverse area of the country. What does the nurse need to do to be culturally competent?
	A)	Recognize that people with cultural backgrounds different from our own have unique values, life ways, health practices, and interpersonal styles.
	B)	Understand and address the total context of the client’s situation, using knowledge, attitudes, and skills.
	C)	Be aware that people adapt to and borrow traits from another culture and change their own cultural patterns to those of the host society.
	D)	Remember that an individual’s own traditional beliefs and practices of their culture must always be observed.
	Ans:	A
	Feedback:
	Being culturally competent means that we understand how cultural beliefs and practices influence our daily lives and recognize that people with cultural backgrounds different from our own have unique values, life ways, health practices, and interpersonal styles. Cultural appropriateness occurs when a nurse understands and addresses the total context of the client’s situation, using knowledge, attitudes, and skills. Cultural acculturation is being aware that people adapt to and borrow traits from another culture and change their own cultural patterns to those of the host society. Heritage consistency relates to the observance of beliefs and practices of an individual’s traditional cultural system that may be observed.

2.	Which of the following best describes ethnocentric views?
	A)	Dual patterns of identification of two cultures, lifestyles, and sets of values
	B)	Belief that one’s own culture or ways of life are better than those of others
	C)	Belonging to a specific group of individuals who share a common social and cultural heritage
	D)	Research framework that is used to provide the ability to focus on the culture of the community where the nurse is practicing
	Ans:	B
	Feedback:
	Ethnocentric views come about through believing that one’s own culture or way of life is better than that of others. Biculture describes an individual with dual patterns of identification of two cultures, lifestyles, and sets of values. Being an ethnical individual occurs when one belongs to a specific group of individuals who share a common social and cultural heritage. Ethnography is a research that provides a framework to focus on the culture of a group of individuals.

3.	Which of the following is an overarching goal of Healthy People 2020?
	A)	Developing partnerships between individuals and community health
	B)	Believing that individual health is closely related to community health
	C)	Decreasing disparities among subgroups of the population
	D)	Increasing the length and improving the quality of healthy life
	Ans:	D
	Feedback:
	Healthy People 2020 initiatives are guided by two overarching goals: to increase the length and improve the quality of healthy life; and to eliminate disparities among subgroups of the population.

4.	Which of the following is a major reason that health disparities exist?
	A)	No sensitivity to the needs of the individuals to be served
	B)	Problems experienced in accessing and effectively utilizing health services
	C)	Belief that individual’s health is not closely related to community health.
	D)	Common ground exists among clients and communities to encourage culturally competent health care partnerships.
	Ans:	B
	Feedback:
	Health disparities exist and are due, at least in part, to problems experienced in accessing and effectively utilizing health services. Reducing and eventually eliminating disparities depends on building common ground among clients, providers, agencies, and communities so that culturally competent health care partnerships can grow in number and quality of services.

5.	Based on the population trends in the United States, descendants of European whites are emerging as a new minority. Which is a cause for this new minority?
	A)	Rapid growth rate in the population of racial and ethnic group diversity
	B)	Nurses that provide care to clients and families who represent global communities
	C)	Less-frequent interactions with clients of diverse ethnic and cultural backgrounds whose health beliefs differ from our own
	D)	Development of required partnerships with individuals of different ethnic groups and community health
	Ans:	A
	Feedback:
	Growth in racial and ethnic group diversity throughout the 21st century is causing changes in minority groups. Among descendants of European whites, the number of deaths exceeds the number of births. Racial and ethnic minorities now make up 49.9% of the under-five age group.

6.	Which of the following represents the best way for a new nurse to complete an in-depth self-examination of cultural competence?
	A)	Acknowledge and be aware of one’s own culture and willingness to explore one’s own feelings and biases
	B)	Be responsible for having excellent on-the-job motivation and commitment to caring for assigned clients
	C)	Complete a self-examination of superior social, cultural, and biophysical factors in the community
	D)	Become involved on a monthly basis in at least one cross-cultural interaction or workshop
	Ans:	A
	Feedback:
	A major component of cultural competence is an acknowledgment and awareness of one’s own culture and a willingness to explore one’s own feelings and biases.

7.	Which of the following best defines diversity?
	A)	Crosses two cultures, lifestyles, and sets of values
	B)	Condition of being different or having differences
	C)	Individuals with distinct identity that are related to a larger cultural group
	D)	Basic knowledge of the different culture’s health traditions in the community where the nurse is practicing
	Ans:	B
	Feedback:
	Derived from the Latin word divertere, meaning to turn in opposite directions, diversity is the condition of being different or having differences. Biculture is used to describe an individual who crosses two cultures, lifestyles, and sets of values. Subculture is where individuals with distinct identity are related to a larger cultural group. Cultural sensitivity is having basic knowledge of the different cultures’ health traditions in the community where the nurse is practicing.

8.	Which of the following best describes the composition of an ethnic group?
	A)	Associated with minority or majority populations who share the same cultural background
	B)	Associated with minority populations that do not share the traditions of their social heritage
	C)	Composed of individuals who share a unique cultural background and social heritage that is passed from one generation to the next generation
	D)	Composed of individuals that have distinct identity who relate well within the community at large
	Ans:	C
	Feedback:
	Ethnic groups are composed of people who share a unique cultural background and social heritage that is passed from one generation to another. Ethnicity is associated with minority or majority populations who share the same cultural background. An ethnic group is associated with populations who share the traditions of their heritage. Ethnic groups do not always relate well within a community at large but do within their own communities.

9.	Which question(s) can be helpful in examining one’s ethnic culture? Select all that apply.
	A)	What are the common bonds?
	B)	What cultural rituals are celebrated and with whom?
	C)	What types of things are shared when people get together?
	D)	What sexual orientations are celebrated when people get together?
	E)	What types of foods are prepared when people get together for an event?
	Ans:	A, B, C, E
	Feedback:
	Questions to think about one’s own ethnic culture include the following: With what group(s) do you identify, and why? What are your common bonds? What cultural rituals do you celebrate, and with whom? What are the purposes and meanings of your gatherings and celebrations? What types of things are shared and learned when people get together? What types of foods are prepared for the event? Are there dances, special rites, or ceremonies? Foods, languages, and other bonds of common ancestry are the cultural aspects of ethnicity that serve to offer consistency and structure to life and provide individuals with abilities to interpret life events as significant and meaningful. Sexual orientation is an individual state, not one determined by culture.

10.	A community health nurse is working with a home health client who immigrated to this country 15 years ago. The client has changed the country of origin’s cultural patterns and has adopted the health care belief system of the United States. The community health nurse recognizes this as which type of change in the individual?
	A)	Acculturation
	B)	Culture
	C)	Diversity
	D)	Ethnicity
	Ans:	A
	Feedback:
	Acculturation is when an individual adapts to or changes cultural patterns to those of the new country. Diversity is the condition of being different or having differences. Ethnicity is one’s identification with a group composed of people who share a unique cultural background and social heritage that is passed from one generation to another. Culture is the medium through which a person’s beliefs, standards, and norms for health and illness behaviors are structured, learned, shared, practiced, and judged.

11.	Arthur Kleinman studied members of many diverse ethnic groups. His findings showed that cultural beliefs are the basic guidelines people use to:
	A)	Establish cultural models of health
	B)	Recognize something is wrong
	C)	Interpret what might be wrong
	D)	Organize a plan of appropriate actions
	E)	Understand the link between cultural beliefs and health and illness
	Ans:	B, C, D
	Feedback:
	Arthur Kleinman found that cultural beliefs based in shared meanings, values, and norms are the basic guidelines people use for recognizing that something is wrong, interpreting what it might be, and organizing a plan of appropriate actions. The goal of his research was to study members of many diverse ethnic groups to gain an understanding of the links between cultural beliefs and health and illness behaviors and actions. From his findings, community health nurses established cultural models of health.

12.	Cultural beliefs based in shared meanings, values, and norms are key guidelines to consider when a person has a health problem. What is the first step an individual has to take when he or she is ill?
	A)	Examine all possible and probable causes of the illness.
	B)	Agree that the symptoms represent a problem.
	C)	Plan of action is decided upon.
	D)	Appropriate treatment is determined.
	Ans:	B
	Feedback:
	Cultural beliefs based in shared meanings, values, and norms are the basic guidelines people use for recognizing that something is wrong, interpreting what it might be, and organizing a plan of appropriate actions. For example, before action is taken in response to a problem, individuals and family members must first agree that the symptoms represent a problem. Next, there is an examination of all possible and probable causes, which may range from behaviors and foods to violations of cultural norms. Once a cause has been identified, a plan of action is made and appropriate treatment is determined.

13.	Which is most influential when determining how an individual acts when he or she is ill?
	A)	Community health nurse
	B)	Ethnic culture
	C)	Individual who is sick
	D)	Primary care provider
	Ans:	B
	Feedback:
	How an individual acts when “ill” is determined by ethnic culture. Some cultures have specific norms for sick role behavior, whereas other cultures suggest that you continue to carry out your everyday role to the best of your abilities.

14.	Each cultural health care system has several recognized sectors. Select the answer that best represents Kleinman’s model.
	A)	Cultural health care system
	B)	Popular and cultural health care system
	C)	Folk, personal, professional
	D)	Folk, popular, professional
	Ans:	D
	Feedback:
	The three sectors Kleinman’s model of the health care system addresses are referred to as popular, folk, and professional.

15.	Considering Kleinman’s model, which sector includes the family?
	A)	Cultural health system
	B)	Folk
	C)	Popular
	D)	Professional
	Ans:	C
	Feedback:
	The popular sector of cultural health care systems is made up of informal healing relationships that occur within one’s own social network. Although the family is at the nucleus of this sector, health care can take place between people linked by kinship, friendship, residence, occupation, or religion. The folk sector of cultural health care systems includes the interaction between a client and sacred and secular healers. The professional sector is composed of the licensed health professionals.

16.	According to Kleinman’s model, lay practitioners and healers are part of which sector?
	A)	Cultural health system
	B)	Folk
	C)	Popular
	D)	Professional
	Ans:	B
	Feedback:
	The folk sector of cultural health care systems includes the interaction between a client and sacred and secular healers. The popular sector is composed of ordinary people, families, groups, social networks, and communities. The professional sector is composed of the licensed health professionals.

17.	A community health nurse works with a variety of cultures providing health care services that include acute treatment for illness. Which client most likely would believe that sickness is a punishment from God?
	A)	Hispanic client
	B)	Chinese client
	C)	Female client whose culture is controlled by males
	D)	German client
	Ans:	A
	Feedback:
	Hispanics believe that susto results from a traumatic experience or that sickness is a punishment from God. Susto, or fright, is an emotional response to a traumatic experience and is recognized as an illness that involves the loss of one’s spirit from the body.

18.	Which sector of Kleinman’s model differs in their social and cultural values, beliefs, and assumptions?
	A)	Cultural health system
	B)	Folk
	C)	Popular
	D)	Professional
	Ans:	D
	Feedback:
	Unlike in the popular and folk sectors, the clients and the providers in the professional sector typically differ in their social and cultural values, beliefs, and assumptions.

19.	Which two sectors of Kleinman’s model are associated with belief systems that are nonscientific or subjective?
	A)	Folk and professional
	B)	Popular and cultural health system
	C)	Popular and professional
	D)	Popular and folk
	Ans:	D
	Feedback:
	Belief systems in the popular and folk sectors have often been termed as unorthodox, lay, subjective, or nonscientific, and have been associated with non-Western societies. A client’s preference for such healing practices may have been dismissed by some professional health care professionals.

20.	Community health nurses must make a commitment to gain knowledge about health beliefs and health practices that can be used in the delivery of culturally competent health care to at-risk populations. This knowledge is associated with which sector of Kleinman’s model?
	A)	Cultural health system
	B)	Folk
	C)	Popular
	D)	Professional
	Ans:	C
	Feedback:
	Conflicts, misunderstandings, and barriers to effective health care will be reduced only by commitment to gain knowledge about the popular sector, where health beliefs and health practices are activated and where 70% to 90% of all illness episodes are recognized and treated. The nursing profession’s commitment to health and holism and its capacity to understand complex sociocultural responses to real and potential health problems make it the most logical choice for a professional segment to act as a client advocate in facilitating interactions between the sectors.

1.	The nurse is using the community-as-partner model to complete a community health assessment. Which model would best be used for the community health assessment?
	A)	Disease oriented
	B)	Medical
	C)	Organ focused
	D)	Systems
	Ans:	D
	Feedback:
	Neuman’s total-person approach and, subsequently, the community-as-partner model are considered systems models.

2.	When using the community-as-partner model, which of the following would represent the concept of person?
	A)	Population or an aggregate
	B)	A network of people and their surroundings
	C)	Resource for everyday life, not the objective of living
	D)	Based on definitions of the other three concepts, it is prevention.
	Ans:	A
	Feedback:
	Person is a population or an aggregate. Environment is a network of people and their surroundings. Health is a resource for everyday life, not the objective of living. Nursing is based on definitions of the other three concepts; it is prevention.

3.	The nurse is using the community-as-partner model to complete a community health assessment. Which does the flexible line of defense represent?
	A)	Level of health the community has reached over time
	B)	Internal mechanisms that act to defend against stressors
	C)	Buffer zone representing a dynamic level of health resulting from a temporary response to stress
	D)	Tension-producing stimuli that have the potential of causing disequilibrium in the system
	Ans:	C
	Feedback:
	Flexible line of defense is the buffer zone representing a dynamic level of health resulting from a temporary response to stress. Normal line of defense is the level of health the community has reached over time. Lines of resistance are internal mechanisms that act to defend against stressors. Stressors are tension-producing stimuli that have the potential of causing disequilibrium in the system.

4.	What do the mortality and morbidity rates represent in the community-as-partner model?
	A)	Degree of reaction
	B)	People
	C)	Flexible line of defense
	D)	Normal line of defense
	Ans:	A
	Feedback:
	The degree of reaction is dependent on stressors and the lines of resistance. Whether the stressor (a disease process) is present and the lines of resistance (how well the person or community can resist the disease) will determine how widespread and how dangerous a disease could become (the degree of reaction). The core of the assessment wheel represents the people who make up the community. The flexible line of defense is a dynamic level of health resulting from the temporary response to stress. Normal line of defense is the level of health the community has reached over time.

5.	What does high rate of immunity represent in the community-as-partner model?
	A)	Normal line of defense
	B)	Flexible line of defense
	C)	Lines of resistance
	D)	Degree of reaction
	Ans:	A
	Feedback:
	Normal line of defense is the level of health the community has reached over time. Immunity increases the level of health and is considered a normal line of defense. Flexible line of defense is the buffer zone representing a dynamic level of health resulting from a temporary response to stress. Lines of resistance are internal mechanisms that act to defend against stressors. The degree of reaction is the amount of disequilibrium or disruption that results from stressors impinging on the community’s lines of defense.

6.	What do the demographics of the population represent in the community-as-partner model?
	A)	Degree of reaction
	B)	People
	C)	Flexible line of defense
	D)	Normal line of defense
	Ans:	B
	Feedback:
	The core of the assessment wheel represents the people who make up the community. The people in this core represent one aspect of demographics. The degree of reaction is the amount of disequilibrium or disruption that results from stressors impinging on the community’s lines of defense. Flexible line of defense is the buffer zone representing a dynamic level of health resulting from a temporary response to stress. Normal line of defense is the level of health the community has reached over time.

7.	What are stressors in the community-as-partner model?
	A)	Level of health the community has reached over time
	B)	Internal mechanisms that act to defend against stressors
	C)	Buffer zone representing a dynamic level of health resulting from a temporary response to stress
	D)	Tension-producing stimuli that have the potential of causing disequilibrium in the system
	Ans:	D
	Feedback:
	Stressors are tension-producing stimuli that have the potential of causing disequilibrium in the system. Flexible line of defense is the buffer zone representing a dynamic level of health resulting from a temporary response to stress. Normal line of defense is the level of health the community has reached over time. Lines of resistance are internal mechanisms that act to defend against stressors.

8.	The nurse is using the community-as-partner model to complete a community health assessment. Which assessment is completed first?
	A)	Community core
	B)	Community subsystems
	C)	Perceptions about community
	D)	Degree of reaction
	Ans:	A
	Feedback:
	The core of a community is its people—their history, characteristics, values, and beliefs. The first stage of assessing a community, then, is to learn about its people.

9.	Using the community-as-partner model to complete a community health assessment, the nurse gathers birth and death statistics for the community. What does this represent in the community core?
	A)	History of the community
	B)	Demographics and ethnicity
	C)	Vital statistics
	D)	Values, beliefs, and religion
	Ans:	C
	Feedback:
	Vital statistics include birth and death statistics. Demographics and ethnicity include age, sex, race, and ethnicity data. All ethnic and racial groups have values and beliefs that interact with each community system to influence the people’s health.

10.	When completing a community assessment, which source of information would be best to find the marital status of people in a community?
	A)	The census
	B)	The State Department of Health
	C)	The Chamber of Commerce
	D)	The library
	Ans:	A
	Feedback:
	The census collects data on marital status and would be the best source to find this information. The State Department of Health would have health-specific information related to diseases. The Chamber of Commerce would have demographic information such as racial diversity and ethnic distribution. The library would have historical data on the community.

11.	A community health nurse is completing a community assessment and needs to identify the monitoring, maintenance, and promotion of public health in the community. Which is the best source for this information?
	A)	Law enforcement department
	B)	County health planning board
	C)	County health department
	D)	State vital statistics office
	Ans:	C
	Feedback:
	To monitor, maintain, and promote the public’s health, each state has a state health department and accompanying regional, county, and sometimes city health departments. Law enforcement departments have statistics regarding incidence of crime, vandalism, and drugs. The county health planning board has information about health needs and practices.

12.	A community health nurse is completing a community assessment and needs to identify extracommunity and intracommunity health services. Which is the best source for this information?
	A)	Chamber of commerce
	B)	County health planning board
	C)	County health department
	D)	City health planning board
	Ans:	A
	Feedback:
	Extracommunity or intracommunity facilities are identified best through the chamber of commerce. Once these facilities are identified and grouped into categories, the city and county planning boards can provide specific information. To monitor, maintain, and promote the public’s health, each state has a state health department and accompanying regional, county, and sometimes city health departments. The county and city health planning boards have information about health needs and practices.

13.	The community health nurse is reviewing services provided at a county clinic. Which best describes the types of services that could occur as part of a well-child examination?
	A)	Physical assessment, education, and prescriptions filled
	B)	Physical assessment, referral for illness, immunizations, and screening
	C)	Physical assessment and monitoring for ongoing medical issues
	D)	Treatment and care instructions for chronic pediatric health conditions
	Ans:	B
	Feedback:
	Physical assessment, education, and prescriptions filled occur with family planning. Well-child examinations involve physical assessment, referral for illness, immunizations, and screening. Antepartum and postpartum services include physical assessment and monitoring for ongoing medical issues. Chronic disease counseling and treatment services provide treatment and care instructions for chronic pediatric health conditions.

14.	The community health nurse is trying to locate information about median household income, specifically the percentage of households below poverty level in the community. Which is the best source for these data?
	A)	Census records
	B)	Chamber of commerce
	C)	Department of Labor
	D)	Local union office
	Ans:	A
	Feedback:
	Census records are the best source of information about financial characteristics, including the percentage of households below poverty level in the community. Chamber of Commerce, Department of Labor, and local union office provide information about labor force characteristics.

15.	The community health nurse is trying to locate information about sanitation in the community. Which is the best source for this information?
	A)	Planning office
	B)	Waste and water treatment plants
	C)	Air control board
	D)	Census data
	Ans:	B
	Feedback:
	Waste and water treatment plants are the best source of information about sanitation in the community. The planning office provides information about protection services. The air control board provides information about air quality. Census data provide information about population and housing characteristics.

16.	Three nursing students are trying to locate source information about the adequacy, accessibility, and acceptability of education. Which is the best source for this information?
	A)	Teachers and staff
	B)	Students and staff
	C)	School administrator
	D)	Local board of education
	Ans:	B
	Feedback:
	Students and staff can address the issues related to adequacy, accessibility, and acceptability of education to students and staff. Teachers and staff can provide information about geographic distribution and demographic profiles for educational sources. The local board of education can provide information about the intracommunity and extracommunity for each educational facility. The school administrator and school nurse can provide information about educational, recreational, communication, and health services.

17.	Where can the community health nurse locate educational status information, including years of school completed, school enrollment by type of school, and language spoken?
	A)	Census data
	B)	Teachers and staff
	C)	School administrator
	D)	Local board of education
	Ans:	A
	Feedback:
	Educational status information, including years of school completed, school enrollment by type of school, and language spoken, can be located in the social characteristics section of the census data. Teachers and staff can provide information about geographic distribution and demographic profile for educational sources. The local board of education can provide information about the intracommunity and extracommunity for each educational facility. The school administrator and school nurse can provide information about educational, recreational, communication, and health services.

18.	The community health nurse needs to get a formal announcement about an upcoming health promotion program. Which is the best example of a formal communication method that can be used in the community?
	A)	Word of mouth
	B)	Posters
	C)	Hand-delivered flyers
	D)	Newspaper
	Ans:	D
	Feedback:
	Newspaper is a formal method of communication. Word of mouth, posters, and hand-delivered flyers are informal forms of communication.

19.	Where can the community health nurse locate information about private transportation sources and the number of individuals with a transportation disability who use these sources?
	A)	Local airport
	B)	State highway department
	C)	Local and city transportation authorities
	D)	Census data
	Ans:	D
	Feedback:
	The population and housing characteristics section of census data provides information about private transportation sources and the number of persons with a transportation disability. The local airport provides information about private and publicly-owned air service. The state highway department and local and city transportation authorities have information about roads, interstate highways, and the freeway system.

20.	Physical examination components are used in assessing individuals and communities. What information is obtained during a systems review of a community?
	A)	Housing, businesses, churches, and hangouts
	B)	Climate, terrain, natural boundaries, and resources
	C)	Listening to community sounds and residents
	D)	Walk through community
	Ans:	A
	Feedback:
	The systems review of the community reveals information about social systems, including housing, businesses, churches, and hangouts. Vital signs provide information about climate, terrain, natural boundaries, and resources. Auscultation involves listening to community sounds and residents. Inspection is used when walking through the community.