Population Health and Nursing Study Guide

Population Health and Nursing Study Guide

 

1) The nurse is designing a program for pregnant adolescents in the community. The program will focus on fetal development, appropriate nutrition, developing social support systems, and screening for potential abuse by partners or others. This is an example of:

1. Community-driven care.
2. Community-focused care.
3. Community-based nursing.
4. Population health nursing.

Answer:  4

Explanation:  4. Population health nursing is the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences. The population will benefit from the program because the adolescents will be healthier and deliver healthier infants, thus saving on health care costs. Community-based nursing is nurses providing sick care in community settings. Community-focused care is bringing nursing knowledge and expertise to the community, but it does not have a population focus. Community-driven care focuses on the needs of the community as a whole and emphasizes community participation in determining those needs. It can limit the focus of practice to health needs identified by the population group, and could thus exclude pregnant adolescents.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  1-1

 

2) The nurse meets with members of the community in open forums to help determine ways to improve health. The nurse identifies health problems in the community based on the community input and the nurse’s community assessment. In this situation, the nurse is practicing:

 

1. Public-health nursing.
2. Community-driven care.
3. Community-focused care.
4. Community-oriented care.

Answer:  3

Explanation:  3. Community-focused care brings nursing knowledge and expertise to the community. Public health nursing has a perceived focus of environmental sanitation and controlling communicable diseases. Community-driven care focuses on the needs of the community as a whole, but can be limited to only addressing needs identified by community members. Community-oriented care is limited and focuses program development on small aggregates while potentially ignoring health issues affecting larger population groups.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  1-1

 

3) The nurse holds community forums to gain input in determining the health needs for the community. Issues raised the forum focus on the need for nutrition education, but the nurse notices that many community members are outside smoking before entering the building. The nurse acknowledges the importance of nutrition education, but addresses the incorporation of smoking cessation education as part of a total lifestyle choice program. Which type of nursing is the nurse implementing?

 

1. Public health nursing.
2. Community-driven nursing.
3. Population-focused nursing.
4. Community-focused nursing.

Answer:  3

Explanation:  3. The nurse gained input from the community as to their concerns, but also noted that a health concern was smoking. This is population-focused in that it incorporates other population health issues based on the nurse’s assessment and are not focused solely on the community’s concerns. Community-driven care focuses on the needs of the community as a whole and emphasizes community participation in determining those needs. Community-focused nursing is defined as the bringing of nursing knowledge and expertise to the community but such care may not have a population focus. Public health nursing is indicative of governmental or official agency oversight and jurisdiction with a focus on control of communicable diseases and environmental sanitation.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  1-1

 

 

4) The population health nurse reviews the standards for population-focused care prior to meeting with a group of patients. On which standards should the nurse focus to determine this population’s risk for developing health problems related to obesity? (Select all that apply.)

 

1. Standard 1: Assessment.
2. Standard 2: Diagnosis.
3. Standard 8: Competency.
4. Standard 12: Ethics.
5. Standard 13: Evidence-based practice.

Answer:  1, 2, 5

Explanation:  1. The first standard addresses assessment where the population health nurse collects data needed to assess the health status of the population and to identify factors contributing to health and illness in the population. Under Standard 2, the nurse analyzes health assessment data to derive population health diagnoses, which are then prioritized to promote effective action. Standard 13 is the integration of research findings into evidence-based practice. This is important for this population because of the disease process and related health problems. Standard 8 focuses on attaining knowledge and maintaining competency in nursing and public health practice. There is no specific evidence to suggest that the nurse needs to attain additional knowledge. Standard 12 emphasizes the need for ethical behavior on the part of the population health nurse. There is no specific evidence to suggest that extra emphasis is needed on ethic for this patient population.

2. The first standard addresses assessment where the population health nurse collects data needed to assess the health status of the population and to identify factors contributing to health and illness in the population. Under Standard 2, the nurse analyzes health assessment data to derive population health diagnoses, which are then prioritized to promote effective action. Standard 13 is the integration of research findings into evidence-based practice. This is important for this population because of the disease process and related health problems. Standard 8 focuses on attaining knowledge and maintaining competency in nursing and public health practice. There is no specific evidence to suggest that the nurse needs to attain additional knowledge. Standard 12 emphasizes the need for ethical behavior on the part of the population health nurse. There is no specific evidence to suggest that extra emphasis is needed on ethic for this patient population.
3. The first standard addresses assessment where the population health nurse collects data needed to assess the health status of the population and to identify factors contributing to health and illness in the population. Under Standard 2, the nurse analyzes health assessment data to derive population health diagnoses, which are then prioritized to promote effective action. Standard 13 is the integration of research findings into evidence-based practice. This is important for this population because of the disease process and related health problems. Standard 8 focuses on attaining knowledge and maintaining competency in nursing and public health practice. There is no specific evidence to suggest that the nurse needs to attain additional knowledge. Standard 12 emphasizes the need for ethical behavior on the part of the population health nurse. There is no specific evidence to suggest that extra emphasis is needed on ethic for this patient population.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  1-4

 

 

5) While working with a local community on an immunization program, the nurse is developing an evaluation tool that incorporates the standards of care for population health nursing practice. What standards should the nurse include in this tool? (Select all that apply.)

 

1. Advocacy.
2. Research.
3. Collegiality.
4. Autonomy.
5. Leadership.

Answer:  1, 2, 3, 5

Explanation:  1. The standards of care for population health nursing practice have been developed within the framework of the nursing process and the core functions of public health. They relate to the areas of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation. Additional standards address expected levels of professional performance and deal with quality of practice, education, professional practice evaluation, collegiality, ethics, collaboration, research, resource utilization, leadership, and advocacy.

2. The standards of care for population health nursing practice have been developed within the framework of the nursing process and the core functions of public health. They relate to the areas of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation. Additional standards address expected levels of professional performance and deal with quality of practice, education, professional practice evaluation, collegiality, ethics, collaboration, research, resource utilization, leadership, and advocacy.
3. The standards of care for population health nursing practice have been developed within the framework of the nursing process and the core functions of public health. They relate to the areas of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation. Additional standards address expected levels of professional performance and deal with quality of practice, education, professional practice evaluation, collegiality, ethics, collaboration, research, resource utilization, leadership, and advocacy.
4. The standards of care for population health nursing practice have been developed within the framework of the nursing process and the core functions of public health. They relate to the areas of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation. Additional standards address expected levels of professional performance and deal with quality of practice, education, professional practice evaluation, collegiality, ethics, collaboration, research, resource utilization, leadership, and advocacy.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  1-4

 

6) The nurse is reviewing the eight domains of competencies for population health nursing before structuring a program to address an identified health problem. What should the nurse keep in mind when reviewing these competencies?

 

1. They reflect the practice of the experienced population health nurse at only the specialist level and include cultural competence.
2. They reflect the practice of the experienced population health nurse at the generalist level and exclude communication.
3. They include expectations, which range from awareness through knowledge to proficiency and include financial planning.
4. They must all be incorporated into any population health nursing position and include advanced public health practice.

Answer:  3

Explanation:  3. The competencies address eight domains of practice: (a) analytic assessment, (b) policy development and program planning, (c) communication, (d) cultural competence, (e) community dimensions of practice, (f) basic public health science, (g) financial planning and management, and (h) leadership and systems thinking. The competencies were intended to reflect the practice of experienced community health nurses at both generalist and specialist levels, not novices, and expectations ranged from awareness through knowledge to proficiency on any given item. The competencies were revised to address three tiers of practice. Tier 1 competencies are skills to be possessed by public health nurses who engaged in day-to-day care in official state and local public health agencies. Tier 2 competencies address the practice of program managers or supervisors. Tier 3 competencies are intended for public health nurses in senior management and leadership positions with responsibility for major programs and strategy development. Any particular population health nursing position may incorporate components from some or all domains.

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  1-5

 

7) The population health nurse is helping a client identify alternative solutions for a health problem. In which focus and role is the nurse functioning in this situation?

 

1. Client-oriented and educator.
2. Delivery-oriented and case manager.
3. Client-oriented and counselor.
4. Population-oriented and counselor.

Answer:  3

Explanation:  3. This is an example of client-oriented community health nursing and of a counselor role. The role of counselor includes helping the client identify alternative solutions. This is an example of a client-oriented focus but not of an educator role. The role of educator is to assess the need for education, develop the education plan, present health education, and evaluate outcome of the health education. This is not an example of a delivery-oriented focus, which are roles designed to enhance the operation of the health care delivery system itself; and the role of case manager does not include identification of alternative solutions. This is not an example of a population-oriented focus, which is directed toward promoting, maintaining, and restoring the health of the population. The counselor role is not population-oriented.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  1-6

 

8) The population health nurse is demonstrating behavior to be learned by a client and the family. In which focus and role is the nurse providing care?

 

1. Client-oriented and role model.
2. Delivery-oriented and educator.
3. Client-oriented and referral resource.
4. Population-oriented and collaborator.

Answer:  1

Explanation:  1. The focus of nursing care in this situation is the client and the behavior is role modeling. Delivery-oriented nursing involves the operation or the health care delivery system, and role model is a better description of this behavior than educator. The focus of nursing care is the client but this is not a referral resource. Population-oriented care involves promotion, maintenance, and restoration of the population. The behavior that the nurse is demonstrating is not collaboration.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Analysis

Learning Outcome:  1-6

 

9) The nurse is functioning as a liaison within a local clinic. What action is the nurse performing in this role?

 

1. Serving as initial point of contact between client and agency.
2. Coordinating and directing the use of health care services.
3. Organizing and integrating services.
4. Creating alliances of individuals or groups to achieve a specific purpose.

Answer:  1

Explanation:  1. The liaison role is one of serving as the initial point of contact between the client and agency. The case manager role is one of coordinating and directing the selection and use of health care services. As a coordinator the nurse organizes and integrates services to best meet client needs in the most efficient manner possible. Coalition building is the creation of temporary or permanent alliances of individuals or groups to achieve a specific purpose.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Analysis

Learning Outcome:  1-6

 

10) The nurse is caring for a specific population within a community. Which nursing action should the nurse use to exemplify the population health nurse’s case finding role?

 

1. Assess a client’s need for education.
2. Advocate for a mother who is being seen in a clinic.
3. Carry out an investigation of meningitis cases.
4. Develop an educational plan for a group of adolescents.

Answer:  3

Explanation:  3. Case finding has been described as basic to population health nursing. Case finding involves identifying individual cases or occurrences of specific diseases or other health-related conditions requiring services. In the educator role, the population health nurse provides clients and others with information and insights that allow them to make informed decisions on health matters. As an advocate, the population health nurse engages in a number of activities or functions including determining the need for advocacy, determining the point at which advocacy will be most effective, collecting facts related to the problem, and presenting the case to the appropriate decision makers.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Analysis

Learning Outcome:  1-6

 

11) The nurse is creating a program to address cigarette smoking by community members. Which Healthy People 2020 topical areas are relevant to this program? (Select all that apply.)

 

1. Tobacco.
2. Oral health.
3. Substance abuse.
4. Environmental quality.
5. Clinical preventive services.

Answer:  1, 4

Explanation:  1. For the topical area of Tobacco, objectives include reducing tobacco use by adults and adolescents.

4. For the topical area of Environmental Quality, a leading health indicator objective is to reduce tobacco use by adults. Tobacco is not a leading health indicator objective for the topical area of Oral Health. Tobacco is not a leading health indicator objective for the topical area of Substance Abuse. Tobacco is not a leading health indicator objective for the topical area of Clinical Preventive Services.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  1-2

 

12) After completing a community assessment the nurse is preparing a plan to address behavioral determinants of health. Which topics should the nurse include in this plan? (Select all that apply.)

 

1. Use of park and bicycle trails.
2. Intake of fresh fruits and vegetables.
3. Ease of obtaining marijuana and cocaine.
4. Hours that the community health clinic is open.
5. Use of protective gear when bicycling.

Answer:  1, 2, 3, 5

Explanation:  1. Behavioral determinants involve personal behaviors that either promote or impair health. Behavioral factors are often those most amenable to change in efforts to prevent disease and promote health. Health-related behaviors include recreation and exercise, dietary patterns, substance use and abuse, and use of protective measures. Hours that the community health clinic is open is considered a health system determinant.

2. Behavioral determinants involve personal behaviors that either promote or impair health. Behavioral factors are often those most amenable to change in efforts to prevent disease and promote health. Health-related behaviors include recreation and exercise, dietary patterns, substance use and abuse, and use of protective measures. Hours that the community health clinic is open is considered a health system determinant.
3. Behavioral determinants involve personal behaviors that either promote or impair health. Behavioral factors are often those most amenable to change in efforts to prevent disease and promote health. Health-related behaviors include recreation and exercise, dietary patterns, substance use and abuse, and use of protective measures. Hours that the community health clinic is open is considered a health system determinant.
4. Behavioral determinants involve personal behaviors that either promote or impair health. Behavioral factors are often those most amenable to change in efforts to prevent disease and promote health. Health-related behaviors include recreation and exercise, dietary patterns, substance use and abuse, and use of protective measures. Hours that the community health clinic is open is considered a health system determinant.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  1-2

 

13) The population nurse becomes aware of a treatment plant that is depositing waste materials into the drinking water. Efforts to have this plant change its behavior have failed and the nurse has been asked by community members to intervene. Which action should the nurse perform when advocating for the community members?

 

1. Provide a list of community members who are employees of the treatment plant.
2. Analyze other community approaches used to address similar water treatment issues.
3. Collect information about the waste materials being introduced into the water supply.
4. Examine community members for health problems believed to be caused by the contaminated water.

Answer:  3

Explanation:  3. As an advocate, the population health nurse engages in four activities or functions. The first function is determining the need for advocacy and factors that prevent clients from acting on their own behalf. A second function involves determining the point at which advocacy will be most effective. Collecting facts related to the problem is the third advocacy-related function and the fourth function is presenting the case to the appropriate decision makers. Collecting information about the waste materials being introduced into the water supply exemplifies advocacy for this community issue. Providing a list of community members who are employees of the treatment plan demonstrates advocacy for the treatment plant and not the community. Analyzing other community approaches used to address similar water treatment issues does not advocate for the community members in any way. Examining community members for health problems believed to be caused by the contaminated water suggests that the nurse does not believe that the treatment plant is causing health problems and does not advocate for the community members.

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  1-3

 

14) The population health nurse is meeting with school district administrators to discuss strategies to promote healthy behaviors in the students who attend schools in the district. Which strategy should the community nurse emphasize as being important for the schools to implement?

 

1. Provide fresh fruit for morning and afternoon snacks.
2. Schedule scoliosis screening for all female students aged 12 through 16.
3. Examine the quality of repairs made to the school pool after a recent landslide.
4. Ensure safety equipment is available for all student use during sports activities.

Answer:  1

Explanation:  1. Health promotion entails activities designed to foster a healthy lifestyle and develop a state of good health in the population. This includes advocacy for access to healthy foods, designed to foster good nutrition as a health promoting strategy. The resolution level of health care is eliminating an existing health problem. At this level, a health problem has already occurred and population health nursing interventions are directed toward its solution and preventing further serious consequences. An example of this would be screening for scoliosis. Restoration, or rehabilitation, involves activities designed to assist the client’s or population’s return to a prior state of good health and functional ability. Rebuilding damaged buildings and highways would constitute restoration. An example of this would be examining the quality of pool repairs made after a recent landslide. Prevention involves strategies aimed at preventing the occurrence of specific health problems such as safety equipment for sports activities.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  1-7

 

15) A group of community members committed to increasing physical activity asks the nurse for help in implementing bicycle lanes on community roads. Which approach would the nurse use that demonstrates social marketing of this community goal?

 

1. Determine the number of community members who use bicycles for transportation.
2. Conduct a telephone survey of community members asking for their support for a bicycle lane.
3. Approach elected officials and ask if the bicycle lane can be discussed during the next council meeting.
4. Create a display explaining the advantages of a bicycle lane to be posted during the upcoming community health fair.

Answer:  4

Explanation:  4. Social marketing is a population health nursing intervention that applies commercial marketing technologies to the analysis, planning, execution, and evaluation of programs designed to influence the voluntary behavior of target audiences to improve their personal welfare or that of their society. Social marketing is consumer focused in that it is tailored to the needs and characteristics of a specific target population and is designed to address societal problems at the population level. The best approach would be for the nurse to create a display to be posted during the community health fair which explains the benefits of having a bicycle lane. Determining the number of community members who use bicycles for transportation does not support the goal of increasing physical activity by community members. Conducting a telephone survey of community members asking for support of a bicycle lane does not identify barriers or identify perceived benefits. Approaching elected officials to discuss a bicycle lane during the next meeting does not gain the community’s support for the change.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  1-7