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McEwen: Community-Based Nursing, 3rd Edition Test Bank Chapter 1: Opportunities in Community-Based Nursing Practice MULTIPLE CHOICE 1. Over the past two decades, the health care delivery system has changed dramatically. Among the changes are: 1. Care is becoming more focused on acute health care rather than health promotion and illness prevention. 2. Hospital-based health care delivery has received increasing emphasis. 3. There has been a change in emphasis from treating illness to maintaining health. 4. There has been a move from focusing on aggregates or populations to focusing on the individual. ANS: 3 OBJ: 1 DIF: Cognitive Level: Comprehension REF: Page Reference: 4 TOP: Introduction 2. Factors that have served to produce the current nursing shortage in the United States include all of the following except: 1. Heavy workloads and inadequate staffing. 2. Increasing age of the general population and growing need for long-term management of chronic diseases. 3. Perceived lack of opportunity for job placement and advancement. 4. Relatively low wages. ANS: 4 2 DIF: Comprehension REF: Page Reference: 5 (Box 1-1) OBJ: TOP: Trends in Nursing Employment 3. Currently, approximately what percentage of nurses in the United States do not work in acute care (hospital) settings? 1. 11% 2. 22% 3. 33% 4. 44% ANS: 4 OBJ: 2 DIF: Knowledge REF: Page Reference: 7 TOP: Trends in Nursing Employment 4. The two broad goals of Healthy People 2010 focus on: 1. Achieving access to preventive care for all Americans and increasing life expectancy. 2. Eliminating health disparities and increasing quality years of healthy life. 3. Promoting public health core functions (assessment, assurance, and health policy) and decreasing mortality. 4. Reducing mortality in infants, children, adolescents, adults, and elders and improving health surveillance. ANS: 2 OBJ: 3 DIF: Comprehension TOP: Healthy People 2010 REF: Page Reference: 9 5. All of the following are “focus areas” described in Healthy People 2010 except: 1. Access to quality health services. 2. Cancer. 3. Oral health. 4. Senior health. 5. Tobacco use. ANS: 4 DIF: Knowledge REF: Page Reference: 10 (Healthy People 2010 box) TOP: Healthy People 2010 OBJ: 3 6. Health promotion and illness prevention activities, such as well-child checkups, routine physical examinations, and prenatal care are examples of: 1. Comprehensive health care. 2. Primary health care. 3. Secondary health care. 4. Tertiary health care. ANS: 2 OBJ: 4 DIF: Application REF: Page Reference: 5 TOP: Primary, Secondary, and Tertiary Health Care 7. Secondary health care is becoming increasingly common in community-based settings. Examples of this are: 1. Alcohol counseling for a homeless veteran and cardiac testing for an overweight bank executive. 2. Care for a terminally ill elder and rehabilitation for a client with a spinal cord injury. 3. Home-based infusion therapy for a man with osteomyelitis and outpatient cholecystectomy for a middle-aged woman. 4. Prenatal care for a pregnant teen and diagnostic testing for a man with chronic back pain. ANS: 3 OBJ: 4 DIF: Application REF: Page Reference: 5 TOP: Primary, Secondary, and Tertiary Health Care 8. Tertiary health care refers to: 1. Health care delivered in the home. 2. Health promotion and illness prevention activities. 3. Management of chronic, complicated, long-term health problems. 4. Relatively serious or complicated care that has historically been provided to people who are inpatients in hospitals. ANS: 3 OBJ: 4 DIF: Comprehension REF: Page Reference: 5 TOP: Primary, Secondary, and Tertiary Health Care 9. There are differences in the scope of practice and foci between community-based nursing practice and community health nursing. Which of the following is more descriptive of community-based nursing practice? 1. Emphasis is on preservation and protection of health. 2. Main objective is managing acute or chronic conditions in community settings. 3. Primary focus is on populations or aggregates. 4. Provision of both direct and indirect health services is common. ANS: 2 OBJ: 1 DIF: Application REF: Page Reference: 6 TOP: Community-Based Nursing and Community Health Nursing 10. According to the findings from the survey of RNs conducted by the Department of Health and Human Services’ Division of Nursing, geographic maldistribution of nurses is a significant problem. Regions with the lowest rates of nurses per capita are: 1. The District of Columbia and Virginia. 2. Midwestern states and the Dakotas. 3. Mountain states (Nevada, Idaho) and the southwest (Oklahoma, Texas). 4. New England states (Massachusetts, Rhode Island, Vermont). ANS: 3 OBJ: 2 DIF: Knowledge REF: Page Reference: 7-8 TOP: Current Trends in Nursing Employment 11. It is anticipated that over the next decade, the number of nurses working in community-based settings will: 1. Decrease dramatically. 2. Decrease slightly. 3. Increase somewhat. 4. Remain the same. ANS: 3 OBJ: 2 DIF: Comprehension REF: Page Reference: 8 TOP: Current Trends in Nursing Employment 12. Community-based nursing practice is characterized by all of the following except: 1. An opportunity to provide holistic care in less structured settings. 2. Emphasis on health promotion and illness prevention. 3. Enhanced flexibility and autonomy. 4. Immediate access to support from other nurses and health personnel. ANS: 4 OBJ: 1 DIF: Analysis REF: Page Reference: 8 TOP: Community-Based Nursing and Community Health Nursing 13. Among the uses of Healthy People 2010 are all of the following except to: 1. Be used as a framework to promote healthy choices for individuals. 2. Encourage increased fiscal allocations by state and federal legislative bodies. 3. Incorporate objectives to guide health promotion activities and programs in schools, clinics, and worksites. 4. Serve as a benchmark for health promotion activities. ANS: 2 OBJ: 3 DIF: Application REF: Page Reference: 10 TOP: Healthy People 2010