MedConnoisseur © 2022 Chapter 01: Health: A Community View Nies: Community/Public Health Nursing, 8th Edition MULTIPLE CHOICE 1. Which best describes the primary reason that Americans are concerned about health care? a. Politicians are discussing how to improve health care. b. The media has provided mixed messages about the health care system. c. Our national health care costs keep increasing. d. The new health care system offers free services to Americans. ANS: C The primary reason for the focus on health care is the constantly increasing costs, which cannot be sustained. The costs of caring for the sick accounted for the majority of escalating health care dollars, which increased from 5.7% of the gross domestic product in 1965 to 17.8% in 2015. Politicians and the media both influence Americans’ perceptions abou t health care; however, they are not the primary reason why Americans are concerned. The new health care system will change the health care access and availability, but will not necessarily be offering any free services to Americans. DIF: Cognitive Level: Understand (Comprehension) 2. A nurse has begun to lobby with politicians for changes to the health care system. Why is this involvement important? a. Nurses, as central characters in several popular TV series, are currently very visible in American me diNa. b. Nurses are prim arily responUsibSle foNr mTanagingOthe various uni ts in our h ealth care system. c. Nurses are the largest segment of health care providers. d. Nurses are the only group that is employed both inside and outside of hospitals. ANS: C As the largest segment of health care providers, nurses are informed about the current health care system and all the problems that result from people not seeking care until they are desperately ill. Nurses, as the American Nurses Association (ANA) emphasize, usu ally believe that health care is a right, not a privilege. Therefore, nurses, whose work is central to our current health care delivery system, can also be instrumental in working politically to create a health care delivery system that will meet health ne eds. While nurses are in several current TV series and are employed both inside and outside of hospitals, physicians and other health care providers are as well. Nurses are often managers, but managers often have other backgrounds, such as business administration. DIF: Cognitive Level: Understand (Comprehension) 3. What conclusion can be drawn from examining where nurses are employed? a. There is a trend toward consolidation of health care into large central medical MedConnoisseur © 2022 centers. b. There is an increased emphasis on community -based health care. c. There is an obvious need to decrease health care costs by cutting positions. d. Managed care organizations (MCOs) are employing nurses to improve customer relations. ANS: B MCOs are employing nurses in many capacities. Although hospitals are closing and acute care is increasingly found in central medical centers, the same trend may be seen in an increase in neighborhood -based practice centers. While position s are cut in most industries, health care is recognized as an area where growth in employment is expected. However, nurses are increasingly employed in community settings as opposed to hospitals. This change reflects the move toward community -based care ra ther than hospital -based tertiary care. To help decrease the continued rise in health care costs, the increased emphasis is on disease prevention rather than high-cost treatment. DIF: Cognitive Level: Understand (Comprehension) 4. Which ethical belief would be most helpful in the current health care crisis? a. Emphasis should be on individual and corporation freedom in the marketplace. b. Emphasis should be on individual autonomy and freedom of choice. c. Emphasis should be on social justice and collective respo nsibility. d. Emphasis should be on the effectiveness of technology in resolving problems. ANS: C Public health recognizes the necessity of collective action in keeping the environment safe and in egalitarian tradition and vision. An overinvestment in technology and seeking of cures within the market justice system has stifled the evolution of a health system to protect and preserve the health of the population. Although individual autonomy and freedom of choice are important, so is the recognition of collective responsibility in ensuring social justice, which entitles all people to basic necessities. DIF: Cognitive Level: Apply (Application) 5. What is the primary problem seen in Healthy People 2020’s emphasis on choosing healthy lifestyle behaviors, such as daily exercise or healthy food choices? a. Emphasis on other lifestyle choices, such as not smoking and minimal use of alcohol or drugs, is also needed. b. All of us must work together to make unhealthy behaviors socially unacceptable. c. It costs more to make healthy choices, such as buying and eating fresh fruits and vegetables as opposed to quick and cheap fast-food choices. d. Public policy emphasizes personal responsibility but ignores social and environmental changes needed for well -being. ANS: D Although all responses are accurate, the primary problem is the emphasis on personal choices in the Healthy People 2020 objectives. Emphasis on personal choices ignores the need for community responsibility and action that addresses environmental or cultural restraints to health. DIF: Cognitive Level: Apply (Application) 6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of the nurse beyond giving excellent care to patients? MedConnoisseur © 2022 a. Accept longer work schedules to ensure that professional care is always available to clients. b. Recognize the need for experienced nurses to mentor new graduates to help increase and expand the number of professionals available. c. Support health legislation to improve accessibility and cost of health care. d. Volunteer to work overtime as needed to ensure maximum quality of care. ANS: C The ANA Code of Ethics promotes social reform by focusing on health policy and legislation to positively affect accessibility, quality, and cost of health care. The code does not directly address workplace issues, such as work schedules or need for overtime. DIF: Cognitive Level: Analyze (Analysis) 7. What is the community health nursing definition of health? a. Health is a person’s goal -directed purposeful process toward well -being or wholeness. b. Health is an individual’s physical, mental, and social well -being, not merely the absence of disease or infirmity. c. Health is the mutual adaptation between a person and his or her environment in meeting daily existence. d. Health is families and aggregates choosing actions to ensure safety and well-being. ANS: D The text stresses that health is not just the result of an individual’s choices, but choices and actions of individuals, families, groups, and communities that lead to better health. DIF: Cognitive Level: Apply (Application) 8. How does community health nursing define community? a. A group of persons living within specific geographic boundaries b. A group of persons who share a common identity and environment c. A group of persons who work together to meet common goals d. A group of persons who resolve a community concern ANS: B Community health nurses work with both geopolitical groups (within specific geographic boundaries) and phenomenological groups (who have a common identity based on culture, history, or goals). A particular phenomenologica l group may or may not have been a planned group —that is, a group that came together to resolve a recognized common problem or to meet a common goal. However, of all the choices, a group of persons who share a common identity (phenomenological group) and environment (which implies a specific geographic setting) is the broadest and most complete definition. DIF: Cognitive Level: Apply (Application) 9. Which variable has a major influence on a community’s health? a. Behavior choices made by persons in the community b. Number of health care providers and hospitals in the community c. Quality of the public safety officers (police officers, firefighters, etc.) d. The number and credentials of public health officials in the community ANS: A MedConnoisseur © 2022 Individual behavior choices are responsible for about 50% of health outcomes. Individual choices are affected through interaction with other individuals, and their mutual social and physical environments. The number of health care providers has not played a major role in the health outcomes in the community in comparison to individual health behaviors. The quality of public safety officers and number of public health officials have not been identified as major contributors to the determinants of health. DIF: Cognitive Level: Apply (Application) 10. What change could most effectively lead to a longer life span in Americans? a. Parenting and sexual behavior classes in all public school systems b. Legislation restricting alcohol and drug use c. Notably reducing speed limits on all state and federal highways, and changing the age limit for driving to 21 years of age d. The belief that smoking is shameful and disgusting, as well as expensive, becoming the social norm ANS: D Smoking is responsible for almost 20% of all deaths in the United States. Although smoking is an individual’s choice, all people are affected by social norms. Parenting and sexual behavior classes and legislative changes may influence health, but may not necessarily lead to a longer lifespan. Community health nurses should recognize that health is influenced by a web of factors, some that can be changed and some that cannot. Influencing social norms may better promote change among Americans. DIF: Cognitive Level: Apply (Application) 11. What is the health issue causNinUg RthSe ImNosGt TcoBnc.eCrnOinMthe United States today? a. Diabetes epidemic b. Increase in cardiac disease c. Increase in obesity d. Rise in cancer rates ANS: C The widespread increase in incidence of overweight and obesity has led to calls for population -based measures to address this issue. The overarching problem of obesity has led to an increase in diabetes as well as cardiac disease. If this health issue was controlled, there should be in a decreas e in the other health issues. DIF: Cognitive Level: Understand (Comprehension) 12. What factors are most responsible for the increasing length of life of Americans over the past 100 years? a. Better nutrition and family planning options b. Education concerning the need to reduce salt and fat in the diet c. Improved medical care, including exciting new technologies d. More efficient cancer screenings and early intervention ANS: A Average increased life span over the past 100 years can be largely attributed to higher standards of living, better nutrition, a healthier environment, and having fewer children.
