Question 1

In which situations should self-determination be restricted? Select all that apply.

Accepted Answer

A)   When some objectives of individuals are contrary to the public interest or the interests of others in society.
B)   When a person's decision-making is so defective or mistaken that the decision fails to promote the person's own values or goals.
C)   When it interferes with self-interest.
D)   Self-determination and personal autonomy must never be restricted.
E)   When self-determination deteriorates into self-interest and poses a major roadblock to equitable care. A, B

Question 2

A public health nurse is faced with an ethical dilemma. Which question should the nurse consider first when deciding how to resolve the dilemma?

Accepted Answer

A)   "What exactly is the ethical dilemma?"
B)   "What are the alternative courses of action?"
C)   "What are the consequences of each alternative courses of action?"
D)   "How should this dilemma be solved?" A

Question 3

According to the Institute of Medicine's landmark report, the Future of Nursing, nurses should do what? Select all that apply.

Accepted Answer

A)   Work independently from other health professionals to promote the profession of nursing.
B)   Work collaboratively with other health professionals to promote health care.
C)   Attempt to redesign health care.
D)   Improve practices through evidence-based means.
E)   Provide the Future of Nursing report that does not express the importance of evidence-based nursing. B, C, D

Question 4

A community health nurse discovers that a bill in the legislature would eliminate a state law that currently funds child health promotion services for low-income children. Which action at the primary level of prevention would be most appropriate?

Accepted Answer

A)   Advocate for amendment to the passed law to allow some funding for children to remain.
B)   Once the bill has been passed, seek private resources to support funding of health promotion services for low-income children.
C)   Gather a group of health professionals to volunteer to provide the health promotion services eliminated by the passed bill.
D)   Advocate through active lobbying against the bill and gather community support.

Question 5

A nurse is researching a type of research which is housed in the Cochrane Collaboration and summarizes a known problem or situation. Which type of evidence is it classified?

Accepted Answer

A)   Systematic review
B)   Scoping review
C)   Meta-analysis
D)   Evidence based

Question 6

A community health nurse obtains a client's informed consent for care demonstrating the understanding that this is derived from which value?

Accepted Answer

A)   Self-interest
B)   Well-being
C)   Equity
D)   Self-determination

Question 7

Multiple reports such as To Err Is Human: Building a Safer Health System (2000), Crossing the Quality Chasm: A New Health System for the 21st Century (2001), and Priority Areas for National Action: Transforming Health Care Quality (2003) have supported evidence-based practice in the past decade. Which statement best summarizes evidence-based nursing practice?

Accepted Answer

A)   We must continue to cling to "the way we've always done it."
B)   We have spent billions of dollars each year researching new treatments and have translated that knowledge into clinical practice.
C)   We are not translating the knowledge that we are gaining into clinical practice.
D)   We have continued to spend more than a trillion dollars a year providing care and do translate that capacity into improved clinical practice.

Question 8

A community health nurse is working with a group of parents concerned with drug use within the school system. The nurse is open to hear their concerns and values their input when working toward the development of meeting the needs of the group. Which fundamental ethical principle is the nurse using to guide decision-making in this situation?

Accepted Answer

A)   Veracity
B)   Fidelity
C)   Justice
D)   Respect

Question 9

There are basic protections for research participants when a nurse is conducting research. Which statements pertain to protecting patients in research? Select all that apply.

Accepted Answer

A)   The research conducted should not inflect permanent or serious harm.
B)   At any time, research must be stopped if there is evidence of harm.
C)   A research participant may withdrawal from participation at any time.
D)   There needs to be a direct benefit to the participants who participate.
E)   Consents include full disclosure of the study and assurance of privacy.F)  Children sign their own consents.

Question 10

After teaching a class on values, which statement by the class indicates the need for additional teaching?

Accepted Answer

A)   "Some values are descriptive, while others are evaluative."
B)   "Keeping a promise is an example of a terminal value."
C)   "Values persist, remaining relatively stable over time."
D)   "Certain values have more importance than others."

Question 11

A community health nurse working with a group of families who come to local community health care center tells them that she is going to be setting up child care so that the families can participate in the various classes being offered by the center. Three months have passed, and the nurse still has not instituted the child care program. The nurse has violated which ethical principle?

Accepted Answer

A)   Veracity
B)   Fidelity
C)   Justice
D)   Respect

Question 12

After teaching a class on ethical principles, the instructor determines that the class needs additional instruction when they identify which as an ethical principle?

Accepted Answer

A)   Respect
B)   Autonomy
C)   Morality
D)   Justice

Question 13

Which action would the community health nurse take first when making an ethical decision?

Accepted Answer

A)   Engage in critical thinking.
B)   Choose a value.
C)   Identify isolated values.
D)   Clarify one's values.

Question 14

Application of nursing research results to community health nursing practice is essential. Which step must occur before results can be applied?

Accepted Answer

A)   Be informed about research findings.
B)   Demonstrate skill in examining research reports.
C)   Assess abstracts of relevant research studies.
D)   Check if the study was funded by a drug company.

Question 15

A community health nurse is applying the value of equity in decision-making with clients. Which statement best describes this value?

Accepted Answer

A)   Forming, revising, and pursuing personal life plans
B)   Promoting clients' health and a sense of well-being
C)   Fulfilling one's desires over those of others
D)   Treating similar cases in the same fair fashion

Question 16

A community health nurse is working with a community group to meet the various needs in the area. Which principle would the nurse apply when working with the community group?

Accepted Answer

A)   Tenacity
B)   Autonomy
C)   Advocacy
D)   Privacy

Question 17

Which statement about cultivating a spirit of inquiry is most accurate?

Accepted Answer

A)   It is not very important; research will be performed anyway.
B)   In order for effective change to occur, current practices must be continually examined, questioned, and challenged.
C)   It involves "asking the burning clinical question."
D)   The agency does not have an important role in cultivating a spirit of inquiry.

Question 18

A group of students are reviewing for an examination on values. Identification of which as an instrumental value indicates the need for continued study?

Accepted Answer

A)   Spiritual salvation
B)   Confidentiality
C)   Honesty
D)   Promise keeping

Question 19

A nurse is interviewing for a nursing job in a clinic. During the interview, the nurse manager asks the nurse to explain a situation using core nursing values. Which is an example of a nursing value?

Accepted Answer

A)   A nurse counsels the family of a dying patient to withdrawal treatment.
B)   A nurse commits to picking up another shift for another coworker.
C)   A nurse completes a nursing assessment every 4 hours on the assigned patients.
D)   A nurse assists the clinic staff to protect the clients in the building during a thunderstorm.

Question 20

Which statement about basic values that guide decision-making in community health nursing is true?

Accepted Answer

A)   Client empowerment means that the provider must use a paternalistic approach to health care.
B)   Self-interest does not interfere with self-determination.
C)   When matters of well-being are considered, the client's preferences and needs should not be considered.
D)   Equity is not possible in times of limited resources.

Exam 4: Evidence-Based Practice and Ethics in Communitypublic Health