46 - Public Health Nursing at Local, State, and National Levels

Question 1

A nurse is providing information about safe-sex practices. Which of the following levels of prevention is being implemented?

a. ) Primary prevention
b. ) Secondary prevention
c. ) Tertiary prevention
d. ) Assessment

Answer 1

a.) Primary prevention

Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability—providing information about safe sex practices.

Secondary prevention focuses on early detection and screening.

Tertiary prevention focuses on treatment and rehabilitation. Assessment is not a level of prevention.

Question 2

A nurse is providing services for uninsured women. Which of the following best describes the role that the nurse is using?

a. ) Role model
b. ) Primary caregiver
c. ) Outreach worker
d. ) Case manager

Answer 2

b.) Primary caregiver

A nurse providing services for uninsured women is acting in the role of primary caregiver. The public health function of a nurse who assists a client in identifying the services needed the most at the least cost is a case manager. A nurse serves as a role model for the client by being a person for the client to look up to. As an outreach worker, the nurse is able to gain acceptance with the population served.

Question 3

Which is a principle of good practice for community partnerships?

a. ) Partnerships are easily formed among those working in public health.
b. ) Partnerships use their own roles to accomplish tasks.
c. ) Partnerships are built on identified strengths and assets.
d. ) Partnerships are loose associations among people.

Answer 3

c.) Partnerships are built on identified strengths and assets.

Partnerships are built upon identified strengths and assets, including areas that need improvement. This is one of the principles of good practice. An effective partnership is formed by balanced power and understanding among the partners. Partnerships use mutual trust and respect genuineness and commitment as part of their relationship.

Question 4

Which agency delegates the authority of the local health department?

a. ) The federal government
b. ) The state
c. ) Local authorities
d. ) Regional governing boards

Answer 4

b.) The state

The authority of the local health department is delegated by the state. The federal government, local authorities, and regional governing boards are not involved with delegating authority of the local health department.

Question 5

A nurse is implementing tertiary prevention strategies in the community. Which of the following best describes what the nurse is doing?

a. ) Providing immunizations
b. ) Conducting lead screening activities for children
c. ) Providing case management services for clients with chronic illness
d. ) Identifying and treating clients in a tuberculosis (TB) clinic

Answer 5

c.) Providing case management services for clients with chronic illness

Providing case management services for clients with chronic illness demonstrates tertiary prevention, as it is focused on treatment and rehabilitation. Providing immunizations is a primary prevention, and conducting lead screening activities and identifying and treating clients in a TB clinic are at the secondary level of prevention.

Question 6

A nurse considering working as a PHN refers to the American Public Health Association (APHA) Public Health Nursing Section to determine what level of educational preparation has been recommended. Which of the following best describes the educational preparation?

a. ) Associate degree
b. ) Baccalaureate degree
c. ) Master’s degree
d. ) Certification

Answer 6

b.) Baccalaureate degree

All PHNs should have a background in the social and behavioral sciences, epidemiology, environmental health, current treatment modalities, and health care delivery options in order to fully understand health policy, research, and treatment choices and to translate this knowledge into the promotion of healthy populations.

Question 7

Which is an example of a federal agency? (Select all that apply.)

a. ) The U.S. Department of Health and Human Services (USDHHS)
b. ) The Centers for Disease Control and Prevention (CDC)
c. ) The Health Resources and Services Administration (HRSA)
d. ) The Pentagon
e. ) The Congress

Answer 7

a.) The U.S. Department of Health and Human Services (USDHHS)

b.) The Centers for Disease Control and Prevention (CDC)

c.) The Health Resources and Services Administration (HRSA)

The USDHHS, the CDC, and the HRSA are all federal agencies. The Pentagon and the Congress are not federal agencies.

Question 8

Which event has the potential to weaken existing public health programs?

a. ) The shift in funding to support bioterrorism response efforts
b. ) The outbreaks of H1N1 influenza
c. ) The number of citizens with human immunodeficiency virus (HIV)
d. ) The lack of PHNs

Answer 8

a.) The shift in funding to support bioterrorism response efforts

The events of the twenty-first century have shifted funding to bioterrorism programs. This shift of funding has the potential to weaken existing important public health programs.

Question 9

What is the goal of local public health departments?

a. ) To monitor communicable diseases
b. ) To improve the health status of communities
c. ) To offer services for the uninsured
d. ) To enforce environmental codes and laws

Answer 9

b.) To improve the health status of communities

The goal of local public health departments is to safeguard the public’s health and improve the health status of communities. The federal and state levels monitor communicable diseases, offer services for the uninsured, and enforce environmental codes and laws.

Question 10

A PHN collaborates with agencies to address the problem of obesity in the community. Who would be the most appropriate people to include in this collaborative partnership? (Select all that apply.)

a. ) Local health department staff members
b. ) Restaurant owners
c. ) Parks and recreation department staff members
d. ) Church representatives
e. ) Appliance store managers

Answer 10

a.) Local health department staff members

b.) Restaurant owners

c.) Parks and recreation department staff members

d.) Church representatives

PHNs practice in partnership with each other at the local, state, and federal levels and with other public health staff, other governmental agencies, and the community to safeguard the public’s health and to improve the community’s health status. All of these people would provide valuable insight into the problem of obesity in the community.

Question 11

A nurse is implementing secondary prevention strategies in the community. Which of the following best describes what the nurse is doing?

a. ) Screening children for lead poisoning
b. ) Working with communities on emergency preparedness plans
c. ) Developing social networking interventions to modify community norms
d. ) Educating patients with strokes at rehab centers to help optimize their functioning

Answer 11

a.) Screening children for lead poisoning

Screenings are secondary prevention activities. Secondary prevention focuses on early detection and screening. Tertiary prevention focuses on treatment and rehabilitation— educating patients with strokes. Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability—working with communities on emergency preparedness plans and developing social networking interventions.

Question 12

The PHN aims to change behaviors such as poor hand washing skills and unsafe sex practices. Which of the following best describes the role that the nurse is using?

a. ) Case manager
b. ) Advocate
c. ) Educator
d. ) Role model

Answer 12

c.) Educator

The PHN works as an educator, teaching to the level of the client so that information received is information that can be used. The PHN who aims to change behaviors, such as poor hand washing skills and unsafe sex practices, is acting in the role of educator. The public health function of a nurse who assists a client in identifying the services needed the most at the least cost is a case manager. As an advocate, the PHN collects, monitors, and analyzes data and works with the client to identify and prioritize needed services, whether the client is an individual, a family, a community, or a population. A PHN discusses with a client which services are appropriate to meet her needs. A nurse serves as a role model for the client by being a person for the client to look up to.

Question 13

Which principles are included in the Scope and Standards of Public Health Nursing Practice? (Select all that apply.)

a. ) The client or “unit of care” is the population.
b. ) Primary prevention is given priority.
c. ) All processes must include partnering with representatives of the people.
d. ) Government agencies mandate requirements for public health.
e. ) The focus of many interventions should be on secondary prevention.

Answer 13

b.) Primary prevention is given priority.

c.) All processes must include partnering with representatives of the people.

The eight tenets of public health nursing distinguish public health nursing from other nursing specialties. Primary prevention is given priority and all processes must include partnering with representatives of the people as part of these established principles.

Question 14

A PHN is working with uninsured individuals. Which of the following is the most appropriate action for the nurse to take?

a. ) Providing direct care for this population in times of acute illness
b. ) Advocating for federal policy changes for this population
c. ) Assisting this population to access necessary health care services
d. ) Encouraging lifestyle changes for this population

Answer 14

c.) Assisting this population to access necessary health care services

PHNs serve vulnerable populations by acting as a bridge between these populations and the resource needs for this at-risk group by approaching health care providers on behalf of individuals seeking medical/health services and keeping the needs of this population on the political agenda.

Question 15

A PHN is involved in disaster planning. Which of the following best describes why this is important?

a. ) To be most effective as a disaster responder
b. ) To anticipate the potential disasters that may occur
c. ) To educate the public about their responsibilities if a disaster occurs
d. ) To demonstrate the importance of community partnerships

Answer 15

a.) To be most effective as a disaster responder

Question 16

A nurse is working in a public health department. Which of the following would most likely be the focus of the care that is provided?

a. ) Home visiting and hospice care
b. ) Care of communicable diseases
c. ) Health maintenance and health promotion
d. ) Illness prevention

Answer 16

c.) Health maintenance and health promotion

Public health nurses (PHNs) employed in local, state, and federal agencies work together to identify, develop, and implement interventions that will improve and maintain the nation’s health.

Question 17

After reviewing the objectives of Healthy People 2020, the PHN determines the focus for the programming for communicable diseases in the community. Which of the following would the nurse most likely select as the focus?

a. ) Encouraging community members to engage in healthy behaviors
b. ) Identifying high-risk sexual behaviors among community members
c. ) Monitoring the sexual activity of adolescents
d. ) Providing information about the hazards of multiple sexual partners

Answer 17

d.) Providing information about the hazards of multiple sexual partners

Healthy People 2020 lists communicable disease as an area of focus, including levels of HIV, acquired immunodeficiency syndrome (AIDS), and sexually transmitted infections. One method to reduce the risk of acquiring a communicable disease is by the PHN providing information on the hazards of multiple sexual partners and street drug use. Encouraging community members to engage in healthy behaviors does not specifically address communicable diseases. Identifying behaviors and monitoring sexual activity are not appropriate focuses for programming.

Question 18

A PHN assists a client in identifying the services needed the most at the least cost. Which of the following best describes the role that the nurse is using?

a. ) Role model
b. ) Advocate
c. ) Counselor
d. ) Case manager

Answer 18

d.) Case manager

The public health function of a nurse who assists a client in identifying the services needed the most at the least cost is a case manager. As an advocate, the PHN collects, monitors, and analyzes data and works with the client to identify and prioritize needed services, whether the client is an individual, a family, a community, or a population. A PHN discusses with a client which services are appropriate to meet her needs. As a counselor, the nurse is a person for the client to talk with to discuss feelings and concerns. A nurse serves as a role model for the client by being a person for the client to look up to.

Question 19

A PHN discusses with a client which services are appropriate to meet her needs. Which of the following best describes the role that the nurse is using?

a. ) Case manager
b. ) Advocate
c. ) Counselor
d. ) Role model

Answer 19

b.) Advocate

As an advocate, the PHN collects, monitors, and analyzes data and works with the client to identify and prioritize needed services, whether the client is an individual, a family, a community, or a population. A PHN discusses with a client which services are appropriate to meet her needs. In this case, the nurse’s public health function is that of an advocate. Case managers assist clients in identifying services they need the most at the least cost. As a counselor, the nurse is a person for the client to talk with to discuss feelings and concerns. A nurse serves as a role model for the client by being a person for the client to look up to.