Chapter 003

Potter & Perry: Fundamentals of Nursing, 7th Edition Test Bank Chapter 3: Community-Based Nursing Practice MULTIPLE CHOICE 1. The student nurse is investigating different types of practice settings. In looking at community health nursing, the student recognizes that it: 1. Is the same as public health nursing 2. Focuses on the incidence of disease 3. Requires graduate-level educational preparation 4. Includes direct care and services to subpopulations ANS: 4 Community health nursing strives to s
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  Potter & Perry: Fundamentals of Nursing, 7 th  Edition Test Bank Chapter 3: CommunityBased Nursing Pra!ti!e #$T%P$E C'%CE 1.The student nurse is investigating different types of practice settings. In looking at community health nursing, the student recognizes that it:1.Is the same as public health nursing2.Focuses on the incidence of disease.!e uires graduate#level educational preparation$.Includes direct care and services to subpopulations%&':$(ommunity health nursing strives to safeguard and improve the health of populations in the community as )ell as providing direct care services to subpopulations )ithin a community. *ublic health nursing is concerned )ith trends and patterns influencing the incidence of disease )ithin populations. % community health nurse may be involved in direct client care for disease )ithin a community. *ublic health nursing focuses on the needs of populations. (ommunity health nursing has a broader focus, )ith an emphasis on the health of a community. The community health nurse merges public health kno)ledge )ith nursing theory. The community health nurse considers the needs of  populations and is prepared to provide direct care services to subpopulations )ithin a community. &urses )ho become e+pert in community health practice may have advancednursing degrees, yet the baccalaureate#prepared generalist also can become uite competent in formulating and applying population#focused assessments and interventions.IF:%!-F:$/0:(omprehensionT*:&ursing *rocess: %ssessment'(:&(-34 test plan designation: 'afe, -ffective (are -nvironment2.%s a community health nurse assisting the client and family )ith nutritional needs the nurse should first:1.Identify for the client the best foods to buy2.*urchase foods at the lo)est cost for the client.%sk the client and family )hat they think they should eat$.*rovide information on stores )ith the most reasonable pricing%&': osby items and derived items 5 2667, 2668 by osby, Inc., an affiliate of -lsevier Inc.  Test /ank 9ith the goal of helping clients assume responsibility for their o)n health care, the community health nurse must assess a clients learning needs and readiness to learn )ithin the conte+t of the individual, the systems the individual interacts )ith, and the resources available for support. %sking the client about )hat foods he or she thinks should be eaten may help the nurse assess the clients level of kno)ledge regarding nutrition as )ell as the clients food preferences. It also enables the client to become a  participant in his or her care. Telling the client )hat foods to buy does not encourage the client to assume responsibility for managing his or her health care. The nurse should first assess the resources available, and then encourage the client to do his or her o)n shopping. *roviding information on food sources and stores )ith reasonable pricing may  be appropriate after the nurse has determined )hat information the client re uires to meetnutritional needs.IF:(!-F:$6/0:%nalysisT*:&ursing *rocess: %ssessment'(:&(-34 test plan designation: ;ealth *romotion and aintenance.9hich one of the follo)ing clients from a vulnerable population currently appears to be at the greatest risk<1.% physically abused client in a shelter 2.% schizophrenic client in outpatient therapy.%n older adult taking medication for hypertension$.% substance abuser )ho shares drug paraphernalia %&':$% client )ith substance abuse has health and socioeconomic problems. These clients fre uently may avoid health care for fear of =udgmental attitudes by health care providers and concern over being turned in to criminal authorities. %n abused client in a shelter has sought protection so currently should be at less risk. %lthough considered to be a member of a vulnerable population, the older adult )ho takes medication for a chronic disease, such as hypertension, is taking measures to maintain health. % schizophrenic client in outpatient therapy is currently at less risk because he or she is receiving treatment.IF:(!-F:>/0:%nalysisT*:&ursing *rocess: %ssessment'(:&(-34 test plan designation: ;ealth *romotion and aintenance$.% client )ith a history of a gastrointestinal disorder eats a )ell#balanced diet that keeps his ?I symptoms suppressed. 9hich level of prevention corresponds to his dietary management<1.;ealth promotion2.*rimary prevention .Tertiary prevention$.'econdary prevention%&': osby items and derived items 5 2667, 2668 by osby, Inc., an affiliate of -lsevier Inc. #2  Test /ank The goal of tertiary prevention is to preclude further deterioration of physical and mental function in a person )ho has an e+isting illness, and to have the client use )hatever residual function is available for ma+imum en=oyment of and participation in lifes activities. ;ealth promotion is aimed at reducing the incidence of disease and its impact on people. *rimary prevention is aimed at general health promotion.'econdary prevention is aimed at early recognition and treatment of disease.IF:%!-F:@/0:(omprehensionT*:&ursing *rocess: -valuation'(:&(-34 test plan designation: ;ealth *romotion and aintenance8.9hich of the follo)ing statements by the home health nurse best reflects client advocacy in response to the clients concern over the e+pense of the therapy<1.A;ave you considered the possibility of a renal transplant<B2.AThis peritoneal dialysis is less e+pensive than hemodialysis.B.ACou must feel a)ful about this situation, but this is the best course of treatment for you.B$.Aets call the regional dialysis center and e+plore options for reducing the cost of your home dialysis.B%&':$(alling the regional dialysis center and e+ploring options for reducing cost demonstrates the nurse acting as client advocate by identifying and assisting the client in contacting theappropriate agency for information and resources to meet the clients needs. %sking the client )hether he has considered renal transplantation does not demonstrate client advocacy. *ointing out the difference in cost for dialysis in the home versus the hospital does not meet the clients need to reduce the e+penses of his therapy. The nurse is not demonstrating patient advocacy. Telling the client that this is the best treatment for him does not address his financial concerns. The nurse is not demonstrating patient advocacy )ith this response.IF:(!-F:$6/0:%nalysisT*:&ursing *rocess: %ssessment'(:&(-34 test plan designation: ;ealth *romotion and aintenance>.In assessing the structure of the community in order to identify the needs of its  population, the nurse )ill focus on:1.(ollecting demographic data on age distribution2.Disiting neighborhood schools to revie) health records.Intervie)ing clients to determine the cultural composition of the subgroups$.bserving locations )here services, such as )ater sanitation, are provided%&':$ osby items and derived items 5 2667, 2668 by osby, Inc., an affiliate of -lsevier Inc. #  Test /ank 9hen assessing the structure or locale of a community, the nurse should travel around theneighborhood or community and observe its designE the location of services, such as )ater and sanitationE and the locations )here residents congregate. (ollecting demographic data on age distribution )ould be an assessment of the communitys  population. Disiting neighborhood schools to revie) health records is an e+ample of assessing a social system )ithin a community. Intervie)ing clients to determine the cultural composition of subgroups is an e+ample of assessing the population )ithin a community.IF:%!-F:$1/0:(omprehensionT*:&ursing *rocess: %ssessment'(:&(-34 test plan designation: ;ealth *romotion and aintenance@.To facilitate change )ithin a community, the nurse )orking as an effective change agent should:1.Inform community members ho) to effectively manage their health needs2.9ork )ith clients and groups to select alternative health care sites and treatments.Formulate decisions for individual clients regarding their health care options$.*rovide instruction in the )ay the community should address health issues%&':2%s a change agent, the nurse seeks to implement ne) and more effective approaches to  problems. The nurse creates change by )orking )ith and empo)ering individuals and their families to solve problems or to become instrumental in changing aspects affecting their health care. Telling community members ho) to manage their health care needs may meet resistance. It also does not enable clients and their families to take responsibility for their health care. aking decisions for clients does not enable individuals to assume responsibility for their health care decisions. The community#basednurse acting as a change agent may be an e+cellent resource for health information to members of the community. ltimatelyE ho)ever, the community members )ill take an active role to create change for themselves and )ill assume responsibility for their health care decisions.IF:%!-F:7#$6/0:(omprehensionT*:&ursing *rocess: %ssessment'(:&(-34 test plan designation: ;ealth *romotion and aintenanceG.The client is being discharged from an acute care facility follo)ing a total hip replacement. 'he )ill need follo)#up for her rehabilitation and e+ercise plan. In addition to a home health care nurse, )hat referral should be discussed<1.ietitian2.'ocial )orker .*hysical therapist$.!espiratory therapist%&': osby items and derived items 5 2667, 2668 by osby, Inc., an affiliate of -lsevier Inc. #$
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