Deck 16: Community Diagnosis, planning, and Intervention

Question 1

People in the community are feeling insecure and vulnerable because the neighborhood is considering closing one of the local elementary schools.Which of the following actions should a nurse take?

A)Ask the formal leader of the group to speak out against the closure.
B)Ask the informal leader to offer a rationale for the closure.
C)Offer help and support for those involved.
D)Offer to write legislators opposing the decision.

Answer 1

Offer help and support for those involved.

Question 2

What was the result of the prospective payment system legislation?

A)Hospital stays were shortened,which placed a greater responsibility on family care.
B)Payments to the hospitals and physicians that fulfilled the new rules were higher.
C)Nursing staffing was increased to meet the needs of more acutely ill patients.
D)Diagnoses were more accurate and complete before clients were admitted to acute care.

Answer 2

Hospital stays were shortened,which placed a greater responsibility on family care.

Question 3

Lewin's change theory is being applied as the community is addressing improvements in public safety.Which of the following would be one of the first steps in creating change?

A)Determining whether anyone else agrees
B)Having a careful plan as to what change is desirable
C)Making community members aware of the need for change
D)Assessing community needs to determine whether change is possible

Answer 3

Making community members aware of the need for change

Question 4

Which of the following facts is a drawback of the community empowerment model?

A)Bankers and other money people are very busy and often uninterested.
B)Grants,although beautifully written,may not get funded.
C)It is hard to persuade experts to volunteer their time.
D)It is the slowest approach and takes the longest to obtain results.

Question 5

What was the significance of the National Health Planning and Resources Development Act of 1974?

A)It created the program that yielded the first evidence that managed care reduced costs.
B)It funded nationwide health planning to improve health care and reduce costs.
C)It provided additional federal money to the states to spend on health care.
D)It allowed states to take responsibility for planning health care services.

Question 6

Whether a nurse's plan of care for a community is acceptable is probably determined by which aspect of the plan?

A)It was created in coordination with community members.
B)It was financially feasible.
C)It was politically correct and feasible.
D)It was something in which the nurse really believes.

Question 7

A community/public health nurse is using the social action model to facilitate change in the community.Which of the following aspects of this model may make the nurse feel uncomfortable?

A)Admitting that the nurse may not know the best approach
B)Cooperating with a large number of community agencies
C)Confronting power brokers directly
D)Sharing decision making with other people

Question 8

A nurse is preparing to write a community diagnosis.Which of the following actions must the nurse take?

A)Choosing a diagnosis from the 12 functional health patterns
B)Choosing from an agency-approved list of NANDA International diagnoses
C)Describe a situation and suggest an etiologic component focused on an aggregate
D)Use appropriate NANDA International wellness-focused diagnoses

Question 9

A community/public health nurse employed by the local health department is told by the director to engage in health planning.Which of the following actions will the nurse perform?

A)Collecting and analyzing data
B)Serving vulnerable populations
C)Planning for health care needs of individuals
D)Applying the nursing process to community-based care

Question 10

A nurse would like to facilitate a change within the community.Which of the following actions is the nurse likely to take,in view of Lewin's theory of change?

A)Freezing the change by constant persuasion,reinforcement,and use of focus groups
B)Increasing driving forces,decreasing restraining forces,or doing both
C)Stabilizing change by decree,rules and procedures,or legislation
D)Unfreezing the change by using the three techniques described by Lewin

Question 11

A nurse is reviewing the collected data and discovers some information is not available.Which of the following conclusions will the nurse make?

A)There is a data gap.
B)There is insufficient information to draw appropriate conclusions.
C)Further effort by the team is required.
D)Further analysis needs to be performed.

Question 12

Which of the following data would be more typical of an acute care diagnosis than a community/public health nursing diagnosis?

A)A child in the school system admitted for insulin overdose
B)Health promotion needs for the neighborhood school
C)Mortality and morbidity rates for the city
D)Services unavailable in the county

Question 13

The director of a public health agency suggested that the community/public health nurse select the target population for a new program.Of the following populations,which would be considered the target population?

A)Persons for whom the nurse is most comfortable caring
B)Persons for whom some change in health or lifestyle behaviors is desired
C)Persons eligible for care according to federal guidelines
D)Persons that can afford to pay for their care

Question 14

How might the social planning model best be defined?

A)A process of experts engaging in rational,deliberate problem solving
B)A process of group meetings that take place until everyone reaches consensus
C)A process of collaboration to write grants to fund health care programs
D)A process of using democratic decision making through a grassroots approach

Question 15

Which of the following actions should the nurse perform when analyzing collected assessment data?

A)Categorizing the data and identifying the implications
B)Creating graphs,charts,and maps to display the data
C)Determining the aggregates at high risk for specific problems
D)Identifying target populations by demographic characteristics

Question 16

What is the purpose of Planned Approach to Community Health (PATCH)?

A)To enable assessment by different health institutions in order to maximize resources
B)To encourage assessment of high-risk groups so that efforts can be focused
C)To engage entire geopolitical communities in assessing their health needs
D)To suggest that states cooperate with federal departments to ensure continuity

Question 17

According to the American Nurses Association (ANA)and the American Public Health Association (APHA),the community/public health nurse is responsible primarily for whom?

A)The community as a whole
B)The employer who is paying the nurse's salary
C)The individual for whom the nurse is caring
D)The governmental unit that is responsible for its citizens

Question 18

A nurse is initiating program planning.Which of the following actions will the nurse perform first?

A)An accurate and thorough assessment of the community
B)A confirmation of the formal and informal leaders of the community
C)A determination of the budget available for obtaining relevant data
D)An analysis of the employer's perspective on potential program needs

Question 19

Which of the following actions is a nurse most likely to perform in an approach to community health planning with the community empowerment model?

A)Motivating bankers and financial advisers to help the community in its development
B)Obtaining the best experts available to help the community develop
C)Using a grassroots approach and democratic decision making
D)Writing grants to obtain money for the community and health care programs

Question 20

How might the social action approach be summarized?

A)A process of experts engaging in rational,deliberate problem solving
B)A process of group meetings that take place until everyone reaches consensus
C)A process in which groups seek redistribution of power or basic change in organizational policies
D)A process in which groups work together to write several grants to get money for health care programs

Question 21

The intervention that a nurse and a planning group proposed was not accepted,primarily because of poor timing and lack of funds.Which of the following is helpful for the nurse to remember?

A)At least an effort was made to intervene.
B)The situation will probably not get worse.
C)The communities can function without the proposed program.
D)There are always other options that might meet the same goals.

Question 22

Which of the following is the most common type of intervention used to improve the health of a community?

A)Providing direct care to individuals at high risk for health problems and for their families
B)Offering health education and screening programs
C)Using media campaigns to raise awareness of the health needs
D)Teaching fellow staff professionals about community needs and beliefs

Question 23

Which of the following situations will cause difficulties when a nurse tries to persuade a community to accept a particular intervention?

A)The solution is oriented to the future,not the present.
B)Powerful groups in the community may not be committed to this intervention.
C)The intervention is inconsistent with cultural,ethnic,or religious beliefs.
D)The intervention may need more tax dollars than have currently been funded.

Question 24

Which of the following groups should be included in any planning group to ensure that weaknesses are addressed and counterarguments are known?

A)Administrators from the local hospital or hospitals
B)Administrators of the health care agency
C)Leaders in the community
D)Those initially expected to resist the proposal

Question 25

What is the primary reason why every step of an intervention is planned before the intervention is implemented?

A)It is required by the nursing process procedure.
B)It is the way in which agencies expect to see performance by the nurse.
C)It saves time,and the implementation process goes more smoothly.
D)It allows the nurse to remember what was going to be done.

Question 26

A health screening was held,and the nurse reported the number and names of persons with positive test results to the agency director.What,however,is even more important than reporting this information?

A)Being sure that each client had identification so that no false names could be used
B)Keeping legal documentation of both negative and positive results
C)Telling the person with positive test results where they might go for treatment
D)Using the cheapest screening approach possible

Question 27

What is the primary usefulness of a Program Evaluation and Review Technique (PERT)chart?

A)It creates a flowchart of activities in sequence with time estimates.
B)It identifies potential program problems and possible solutions.
C)It identifies the process needed to achieve a certain result.
D)It outlines the steps of the assessment process.

Question 28

Which of the following actions must the nurse take when confirming the diagnosis before final decisions are made?

A)Ensuring that it is a diagnosis used in the Omaha diagnosis system
B)Checking to see whether the diagnosis is reimbursable
C)Prioritizing the diagnosis within the agency's mission
D)Validating the diagnosis/conclusion with the community or client

Question 29

What is the primary usefulness of a Gantt chart?

A)It creates a deadline for each step.
B)It describes potential program problems.
C)It identifies the process needed to achieve a certain result.
D)It outlines the steps of the assessment process.

Question 30

A nurse decided to set up a planning group.All of the following groups of people expressed interest in being involved in the planning along with the nursing staff.If the nurse must eliminate one group to keep the size of the group manageable,which of the following groups should the nurse eliminate?

A)A convenience selection of local citizens
B)Formal and informal leaders of the community
C)Those who are probably going to be against the intervention
D)The aggregate for which the intervention is going to be implemented

Question 31

Why should nursing,as a profession,be involved in program planning? (Select all that apply.)

A)As a result of time spent in direct contact with clients in the community,nurses possess useful information.
B)Nurses have enough political power to create barriers if they are not included in the planning process.
C)Nurses,who constitute one third of all health care providers,implement the majority of planned programs.
D)Nurses make up a large portion of health care consumers.
E)Politically,it is wise to include all professions in planning groups.
F)Nurses provide the most expertise of the health care professions.

Question 32

Which of the following aspects of a solution to a problem allows the nurse to identify it as the best choice?

A)It must be financially reimbursable.
B)It must have the support of the clinical agency.
C)It must represent the values,beliefs,and perceptions of the involved aggregate.
D)It must have the most advantages and the fewest disadvantages.

Question 33

The nurse is planning to present an educational program.Which of the following is important for the nurse to remember?

A)Having many handouts so that the audience can remember what was said
B)Ordering a microphone so that everyone in the room can hear easily
C)Using pictures and posters of professionals demonstrating the needed behaviors
D)Using many different methods of presentation with multimedia art

Question 34

Which of the following is the most effective way of prioritizing nursing diagnoses?

A)Ensuring that the diagnoses are reimbursable by third-party payers
B)Determining the degree of community concern about the problem
C)Comparing the diagnoses with the agency's mission statement
D)Discussing conclusions with another community/public health nurse

Question 35

What do most community/public health nursing diagnoses include?

A)The afflicted individual or family,risk factors,and the desired outcome
B)The aggregate at high risk and the nurse's decision as to appropriate care
C)The target population,the health response desired,and host or environmental factors
D)The NANDA International terminology with associated evidence and outcomes