Foundations of Nursing in the Community 4th Edition by Marcia Stanhope-Test Bank
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Sample
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Chapter 03: The U.S. Health and Public Health Care Systems
Test Bank
MULTIPLE CHOICE
1. A
public health agency is planning to implement the electronic health record.
Which of the following is a benefit of this choice?
|
a. |
Facilitation of
interprofessional care |
|
b. |
Improved client compliance
with medical regimens |
|
c. |
Cost savings to the agency |
|
d. |
Compliance with JCAHO
standards |
ANS: A
The electronic medical record facilitates interprofessional care
in chronic disease management and coordination of referrals; 24-hour
availability of records with downloaded laboratory results and up-to-date
assessments; incorporation of protocol reminders for prevention, screening, and
management of chronic disease; improvement of quality measurement and
monitoring; increased client safety; and decline in medication errors.
DIF: Cognitive Level: Apply
(Application)
REF: p. 37
2. A
community health nurse is trying to increase enrollment in SCHIP. Which of the
following interventions would be most effective?
|
a. |
Explaining the program to
children enrolled in public school systems |
|
b. |
Handing out SCHIP
applications to uninsured children seen in local hospital emergency
departments |
|
c. |
Having a newspaper campaign
with information and applications printed in the newspaper |
|
d. |
Sending literature about
the SCHIP program home with schoolchildren each year |
ANS: B
SCHIP builds on Medicaid to provide insurance coverage to
low-income, uninsured children who are not eligible for Medicaid. Thus, the
population that needs to be targeted for SCHIP is those being seen for medical
care who do not have insurance.
DIF: Cognitive Level: Apply
(Application)
REF: p. 37
3. A
nurse is explaining the health care system in the United States to a group of
physicians visiting from South America. How would the nurse best describe the
current health care system?
|
a. |
“It is a logical, rational
approach to meeting expressed needs while still trying to control costs.” |
|
b. |
“It is a system in the
process of reform as problems have become increasingly apparent.” |
|
c. |
“It is divided primarily
into two components: private health care and public health care.” |
|
d. |
“It is the best in the
world with outstanding research and high-technology care available to all.” |
ANS: C
Health care in the United States consists of a personal care
system and a public health system, with overlap between the two.
DIF: Cognitive Level: Apply
(Application)
REF: p. 39
4. Which
of the following best describes ideal primary health care?
|
a. |
Based on a
multidisciplinary group of health care providers that work as a team |
|
b. |
Essential care available to
all community members, which encourages self-management |
|
c. |
Focused on health promotion
and disease prevention for everyone enrolled in the health center |
|
d. |
Local efforts to meet the
Declaration of Alma Ata principles |
ANS: B
Primary health care is generally defined as essential care made
universally accessible to individuals and families in a community with their
full participation and at a cost that the community can afford.
DIF: Cognitive Level: Understand
(Comprehension)
REF: p. 39
5. How
does managed care attempt to control costs of care?
|
a. |
By encouraging families to
use the point of service list of individual practice associates |
|
b. |
By requiring families to
choose a care provider from the MC network and not allowing access to other
services without their provider’s permission |
|
c. |
By moving Medicaid-eligible
families onto state Medicare enrollment |
|
d. |
By refusing permission for
families to use urgent care or emergency department services |
ANS: B
Managed care is a system in which care is delivered by a
specific network of providers. Each provider serves as a gatekeeper who
controls access to other providers and services. Cost is reduced because members
cannot use specialists or seek hospital or other care without permission from
their primary care providers. Thus, those enrolled in Medicaid managed care
have restrictions that help keep costs down for government (and for taxpayers).
DIF: Cognitive Level: Remember
(Knowledge)
REF: p. 40
6. An
80-year-old woman comes to the community health care facility with a large bag
of medications. She tells the nurse she can no longer afford these medications
because her only income is Social Security. Which statement is the best
response by the nurse?
|
a. |
“Let’s go through these
medications and see which ones we can delete.” |
|
b. |
“You can get these
medicines at this clinic for free.” |
|
c. |
“Let’s see if we can get
some help from Medicare to help you pay for these medications.” |
|
d. |
“These medications are
important. Do your best to pay for them.” |
ANS: C
This elderly patient probably is eligible for benefits through
Medicare Part D. Medicare Part D has been added to Medicare to help cover the
cost of prescriptions.
DIF: Cognitive Level: Analyze
(Analysis)
REF: p. 40
7. A
nurse is determining which health care services must be offered at a local
public health clinic. Which of the following factors is most important for the
nurse to consider?
|
a. |
Data available from the
most recent community assessment |
|
b. |
Suggestions from community
members about what is needed |
|
c. |
Recommendations of Healthy
People 2020 |
|
d. |
Services mandated by the
state government |
ANS: D
At the local level, health departments provide care that is
mandated by state and federal regulations.
DIF: Cognitive Level: Apply
(Application)
REF: p. 40
8. A
nurse is planning to conduct research on patient care outcomes. Which of the
following agencies would the nurse use as a resource?
|
a. |
Agency for Health Care
Research and Quality |
|
b. |
Federal Agency for Patient
Care Outcomes |
|
c. |
National Center for Nursing
Research |
|
d. |
U.S. Agency for Patient
Care Effectiveness |
ANS: A
The Agency for Health Care Research and Quality conducts
research on health care systems, health care quality and cost issues, access to
health care, and effectiveness of medical treatments. It provides
evidence-based information on health care outcomes and quality of care.
DIF: Cognitive Level: Apply
(Application)
REF: p. 42
9. How
does the Department of Agriculture promote the health of U.S. citizens?
|
a. |
By collecting surplus food
left after mechanical harvests and distributing it to the poor |
|
b. |
By inspecting food, so no
foodborne illnesses can occur |
|
c. |
By collaborating with
others to provide food or food stamps to needy persons |
|
d. |
By providing direct
education and grants to dietitians and nutritionists |
ANS: C
The Department of Agriculture collaborates with state and local
government welfare agencies to provide food stamps to needy persons to increase
their food-purchasing power. Other programs include school breakfast and lunch
programs; the Supplemental Food Program for Women, Infants, and Children (WIC);
and grants to states for nutrition education training. The Department of
Agriculture also engages in plant, product, and animal inspections, but limited
funding prevents absolute surety that food is safe to eat.
DIF: Cognitive Level: Understand
(Comprehension)
REF: pp. 43-44
10. Which
of the following best describes why local, state, and federal governmental
agencies have started to cooperate and collaborate more closely in the last few
years?
|
a. |
Increased administrative
pressures to demonstrate outcomes |
|
b. |
Increased focus on
emergency preparedness and response |
|
c. |
Increased taxpayers’
complaints and general unhappiness |
|
d. |
Increased pressure to
decrease overlap in services |
ANS: B
Since the tragedy of September 11, 2001, health departments have
increasingly focused on emergency preparedness and response. In case of an
emergency event, state and local health departments in the affected area will
be expected to collect data and accurately report the situation, to respond
appropriately to any type of emergency, and to ensure the safety of the
residents of the immediate area, while protecting those just outside the danger
zone. This goal—to enable public health agencies to anticipate, prepare for,
recognize, and respond to terrorist threats or natural disasters—has required
an unprecedented level of interstate and federal-local planning and cooperation
among these agencies.
DIF: Cognitive Level: Understand
(Comprehension)
REF: p. 45
11. Which
of the following principles has been used by the American Nurses Association
(ANA) when encouraging health care reform?
|
a. |
High-technology
interventions to reduce nursing time, effort, and medical errors must be
expanded. |
|
b. |
Nurses must be recognized
and rewarded for health promotion efforts. |
|
c. |
Nursing research into
patient care outcomes must be expanded and funded. |
|
d. |
Universal access to
essential health services should be available for all citizens. |
ANS: D
The ANA’s position is based on the belief that health care is a
basic human right. Thus, a restructured health care system must ensure
universal access to a standard package of essential health care services for
all citizens and residents.
DIF: Cognitive Level: Understand
(Comprehension)
REF: p. 47
12. African-American
females have a higher mortality rate from breast cancer than White females.
This is an example of:
|
a. |
Projection |
|
b. |
Disparity |
|
c. |
Racism |
|
d. |
A sentinel event |
ANS: B
Disparities are racial or ethnic differences in the quality of
health care, not based on access or clinical needs, preferences, or appropriateness
of an intervention.
DIF: Cognitive Level: Apply
(Application)
REF: p. 34
MULTIPLE RESPONSE
1. What
do demographic figures suggest about the ways in which the population of the
United States is changing? (Select all that apply.)
|
a. |
Approximately 12% of the
U.S. population was born in a different country. |
|
b. |
Hispanics are the largest
minority group population. |
|
c. |
Households consisting
primarily of intact families continue to grow. |
|
d. |
Mortality for both genders
in all age groups declined. |
ANS: A, B, D
Demographic figures confirm that 12% of the current U.S.
population is foreign-born, with most immigrants coming from Latin America and
about half as many from Asia. Families make up about 69% of all households, a
decline from 81% in 1970. Although African Americans used to be the largest
minority group, as of 2003, Hispanics now have that distinction. The population
of the United States continues to increase, and mortality for both genders from
all age groups has declined.
DIF: Cognitive Level: Remember
(Knowledge)
REF: pp. 34-35
2. Which
of the following statements are accurate descriptions of current social and
economic trends in the United States? (Select all that apply.)
|
a. |
Citizens are appreciating
the quality of life enjoyed in the United States. |
|
b. |
Enjoying life is not as
important as the need to take care of oneself. |
|
c. |
Many families are seeing
decreases in family income. |
|
d. |
Massive and unexpected
social and economic changes have occurred. |
ANS: A, C, D
One of the social trends influencing health care is a growing
appreciation of the quality of life. The first decade of the twenty-first
century has added massive and unexpected changes to health, economic, and
social conditions in the form of terrorist attacks, hurricanes, fires, floods,
and infectious diseases. In addition to layoffs, outsourcing, and other
economic forces, many families are seeing wage decreases.
DIF: Cognitive Level: Understand
(Comprehension)
REF: p. 35
3. Which
of the following provides evidence that the U.S. health care system is in
crisis? (Select all that apply.)
|
a. |
Full-time employees may not
have health insurance as a benefit. |
|
b. |
Incompetent or negligent
nurses are an ongoing source of medical errors. |
|
c. |
Long work hours and
provider fatigue are a major factor in medical errors. |
|
d. |
More punitive measures must
be taken to decrease provider errors. |
ANS: A, C
Although 61% of the non-elderly population continues to obtain
health insurance through their employer as a benefit, employment does not
guarantee insurance. As a result of the nursing shortage, nurses work longer
hours and provider fatigue is a major factor in errors. The Institute of
Medicine’s (IOM) report To
Err Is Human recommends that we stop blaming and punishing
individuals for errors and instead begin identifying and correcting system
failures by designing safety into the process of care.
DIF: Cognitive Level: Understand
(Comprehension)
REF: p. 37
4. A
nurse is working at a state health department. Which of the following duties
would most likely be completed in this setting? (Select all that apply.)
|
a. |
Administering the Medicaid
program |
|
b. |
Assessing the health needs
of the state’s citizens |
|
c. |
Employing and supervising
school health nurses |
|
d. |
Establishing and
maintaining free clinics for HIV-positive drug abusers |
ANS: A, B
State health departments try to prevent and respond to infectious
disease outbreaks. They also are responsible for health care financing and
administering Medicaid, providing mental health and professional education,
establishing health codes, licensing facilities and personnel, and regulating
the insurance industry. State health departments also give direct assistance to
local health departments in such areas as ongoing assessment of health needs.
DIF: Cognitive Level: Apply
(Application)
REF: pp. 38, 44
Chapter 04: Ethics in Community Health Nursing Practice
Test Bank
MULTIPLE CHOICE
1. When
and by whom was nursing’s first code of ethics written?
|
a. |
1893, by Lystra Gretter |
|
b. |
1950, by the ANA House of
Delegates |
|
c. |
1953, by the International
Council of Nurses (ICN) |
|
d. |
2001, by the ANA House of
Delegates |
ANS: A
The Nightingale Pledge, considered nursing’s first code of
ethics, was written by Lystra Gretter in 1893.
DIF: Cognitive Level: Remember
(Knowledge)
REF: p. 53
2. A nurse
didn’t know what to do when faced with a particular ethical dilemma because an
option that would have a good outcome didn’t seem possible. The nurse decided
to talk to the agency supervisor and decide what action to take. Which of the
following best describes the nurse’s actions?
|
a. |
Appropriate, because the
supervisor is responsible for the nurse’s choices |
|
b. |
Intelligent, because the
supervisor has access to resource persons (clergy, physicians,
administrators) who might know of options the nurse hadn’t considered |
|
c. |
Justified, because this
provides an opportunity to discuss the issue but the nurse maintains
responsibility for the decision |
|
d. |
Wise, because the
supervisor would be more knowledgeable concerning agency priorities and
traditional practices |
ANS: C
Ethically, each nurse is responsible for his or her own
decisions and cannot avoid ethical accountability by relying on obedience to a
supervisor or any external rule or policy.
DIF: Cognitive Level: Apply (Application)
REF: p. 54
3. Which
of the following is the first and most crucial step in the ethical
decision-making process?
|
a. |
Assess the context or
environment in which the decision must be made. |
|
b. |
Consider the various
ethical principles or theories. |
|
c. |
Identify the ethical
concerns. |
|
d. |
Make a decision and act on
it. |
ANS: C
The first step in the ethical decision-making framework is to
carefully identify the ethical issue or dilemma.
DIF: Cognitive Level: Understand
(Comprehension)
REF: p. 54
4. A
nurse is asked to meet with a family who recently emigrated from Botswana
(Africa). After the clinical doctor tells the husband the wife’s diagnosis of
breast cancer, the family thanks the physician and starts to leave. Ethically,
which of the following is the nurse’s most important action?
|
a. |
Emphasizing that the family
must set up a surgical appointment for the wife immediately |
|
b. |
Assessing the family’s
current living situation, including insurance and other assets |
|
c. |
Educating the family
concerning the usual treatment and the prognosis of breast cancer |
|
d. |
Interviewing the family
concerning their perspective of the threat to the family’s well-being |
ANS: D
Any of the actions might be taken. However, the United States is
a multicultural nation with diverse ethnic groups and diverse values. Before
any intervention can be made, the health care professionals must understand the
family’s cultural, psychological, social, communal, and environmental contexts,
because these contexts affect the way issues are formulated and decisions are
made. Consequently, it is crucial to interview the family to determine their
understanding of the situation before deciding what, if any, intervention must
be made. In many cultures the family, rather than the individual, is the unit
of primary concern.
DIF: Cognitive Level: Analyze
(Analysis)
REF: p. 54
5. The
nurse learns that a family has decided not to accept medical intervention for a
health care problem because paying for the care would drastically reduce the
family’s resources and ability to meet the needs of other family members.
Ethically, which of the following actions should be taken by the nurse?
|
a. |
Appreciate that the family
has made the decision that it feels is best and take no further action if it
is clear the family has made an informed choice. |
|
b. |
Stress that each individual
in society has a right to health care and the family will have to create some
way to raise funds for the needed treatment. |
|
c. |
Talk to the media to see
whether a campaign to raise funds for the family can be created. |
|
d. |
Try to convince the agency
to give the care for free, even if it means economic stress for the agency,
because the medical need is obvious. |
ANS: A
As Callahan described, although the nurse may attempt moral
persuasion to change the family’s values, in the absence of immediate and
grievous harm, no ethical requirement exists to interfere with the family’s
values.
DIF: Cognitive Level: Apply
(Application)
REF: p. 54
6. Some
nurses are debating about the appropriate action to take in relation to a
particular family. The father is ill, and the other family members have chosen
to continue working rather than take time off to care for the ill family
member. One nurse states, “It is a wife’s responsibility to care for an ill
husband.” Which of the following ethical approaches is being used by this
nurse?
|
a. |
Consequentialism |
|
b. |
Communitarianism |
|
c. |
Deontological ethics |
|
d. |
Principlism |
ANS: C
The nurse is focusing on duty, which is a deontological approach
based on the moral obligation to engage in certain actions.
DIF: Cognitive Level: Apply (Application)
REF: p. 55
7. Some
nurses are debating about the appropriate action to take in relation to a
particular family. One member of the family is ill, and the other family
members have chosen to continue working rather than take time off to care for
the ill family member. One nurse states, “The whole family is being affected
and will fall apart if they don’t focus on their family’s needs first before
anything else.” Which of the following ethical approaches is being used by this
nurse?
|
a. |
Communitarianism |
|
b. |
Deontological ethics |
|
c. |
Principlism |
|
d. |
Utilitarianism |
ANS: D
By focusing on the whole family, not individual members, and the
consequences or outcomes for the whole family during this time of stress, the nurse
is taking a utilitarian approach.
DIF: Cognitive Level: Apply
(Application)
REF: p. 55
8. Some
nurses are debating about the appropriate action to take in relation to a
particular family. One member of the family is ill, and the other family
members have chosen to continue working rather than take time off to care for
the ill family member. One nurse states, “But it doesn’t have to be an
either/or situation. Perhaps each family member could take a turn calling in
sick just 2 or 3 days. That way they could all take a turn at helping and yet
not upset their employers. Wouldn’t that be fair?” Which of the following
ethical approaches is being used by this nurse?
|
a. |
Communitarianism |
|
b. |
Deontological ethics |
|
c. |
Principlism |
|
d. |
Utilitarianism |
ANS: C
The nurse is focusing on ethical principles—in this case,
beneficence (do good for the ill family member), nonmaleficence (do no harm,
even to the employer), and justice (everyone takes a turn and shares equally).
DIF: Cognitive Level: Apply
(Application)
REF: p. 56
9. Some
nurses are debating about the appropriate action to take in relation to a
particular family. One member of the family is ill, and the other family members
have chosen to continue working rather than take time off to care for the ill
family member. One nurse states, “It’s not up to us; it’s the family’s
decision. They know what is best for them.” Which of the following ethical
approaches is being used by this nurse?
|
a. |
Communitarianism |
|
b. |
Deontological ethics |
|
c. |
Principlism |
|
d. |
Utilitarianism |
ANS: C
The nurse is using an ethical principle, namely autonomy, in
which each person or group can choose those actions that fulfill its values and
goals. Therefore, the nurse is using principlism—that is, basic principles are
the basis of the nurse’s actions.
DIF: Cognitive Level: Apply
(Application)
REF: p. 56
10. Which
of the following is the dominant issue in ethical debate around an issue such
as continuing or withdrawing treatment in acute health care?
|
a. |
Doing what is best for the
community |
|
b. |
Doing what is best for the
family |
|
c. |
Obeying legal mandates |
|
d. |
Upholding ethical
principles |
ANS: D
In acute care settings with a single localized issue, the
primary ethical principles are usually applied, with patient autonomy being the
dominant or most crucial principle.
DIF: Cognitive Level: Understand
(Comprehension)
REF: pp. 56-57
11. The
staff cannot reach an agreement on what is the right thing to do in relation to
a specific patient. Which of the following approaches should the nurse use in
personally deciding what is right?
|
a. |
Do whatever will not get
the nurse in trouble with employer |
|
b. |
Do whatever is supported by
an ethical expert, such as the hospital chaplain |
|
c. |
Do whatever the nurse would
recommend to anyone in a similar situation |
|
d. |
Do whatever the nurse
supervisor would feel comfortable reporting to administration |
ANS: C
One of the rules in deontological decision making is to
determine whether the proposed actions can be generalized so that all persons
in similar situations are treated similarly. In the same way, principlism
suggests the nurse examine the context and make the decision that can be
morally justified within that context.
DIF: Cognitive Level: Apply
(Application)
REF: p. 55
12. A man
entered the emergency department bleeding profusely and screaming, “I’ve got to
see a doctor right now! I’ve got a right to
see a doctor! I’m hurt. You have to take care of me!” Which of the following
premises would ethically justify such a demand for immediate attention?
|
a. |
All hospitals receive
federal money and all capable employed adults pay taxes, so all adults have a
right to what their tax money has purchased. |
|
b. |
Saving an individual’s life
improves society and upholds tradition. |
|
c. |
Our society believes that
all persons should be treated equally and that basic needs, such as not dying
if death can be avoided, should be met. |
|
d. |
The man has a property
right to his own body, and the government is responsible to ensure that
property rights are protected. |
ANS: C
The ethical theory of egalitarianism suggests that everyone is
entitled to equal rights, equal treatment, and an equal share of the goods of
society—and that the government’s role is to ensure this happens, at least on a
basic level. Therefore, the man has a right to emergency care.
DIF: Cognitive Level: Apply
(Application)
REF: p. 57
13. From
an ethical standpoint, what is the problem with the belief that everyone should
receive his or her fair share, that life should always be fair, and that everyone
should make his or her own decisions?
|
a. |
With this belief, the needs
of society as a whole are ignored. |
|
b. |
Insufficient resources
exist to give everyone a fair share. |
|
c. |
This belief leads to a
propensity for some people to like to be taken care of. |
|
d. |
Some people think they
deserve more than their fair share. |
ANS: A
All principles of justice focus on the individual, which ignores
the needs of society as a whole. Indeed, the rights of an individual may
conflict with the rights of the community as a whole.
DIF: Cognitive Level: Apply
(Application)
REF: p. 57
14. A
physician refuses to order pain medication for a drug addict who has been
severely injured in a car accident. When reminded by nurses that pain
medication has not been ordered, the physician merely replies that the
patient’s suffering from the pain of his injuries will build character and that
the addicted patient needs to get off drugs. Which of the following ethical
theories is the physician using (or misusing)?
|
a. |
Consequentialism |
|
b. |
Communitarianism |
|
c. |
Deontological ethics |
|
d. |
Virtue ethics |
ANS: D
Virtue ethics emphasizes practical reasoning applied to
character development. Although such action by a care provider is paternalistic
and unethical on many grounds, the physician may truly be concerned with
enabling the injured addict to learn from his experience and possibly develop
into a drug-free person.
DIF: Cognitive Level: Apply
(Application)
REF: p. 58
15. Which
of the following is considered the most important goal in nursing today?
|
a. |
Adapting to technological
advances such as electronic medical records |
|
b. |
Demonstrating caring as the
basis of nursing practice |
|
c. |
Distinguishing nursing care
from medical care |
|
d. |
Seeking evidence-based
outcomes to demonstrate nursing’s contribution to care |
ANS: B
Since the mid-1980s, nurses have written about caring as the
essence of nursing and as the ethical and moral ideal of nursing practice.
DIF: Cognitive Level: Remember
(Knowledge)
REF: p. 58
16. With
which of the following ethical approaches are Gilligan and Noddings associated?
|
a. |
Distributive justice
approach |
|
b. |
Feminine ethic |
|
c. |
Principled approach |
|
d. |
Virtue ethics |
ANS: B
Gilligan and Noddings are associated with the approach known as
the feminine ethic, which focuses on the morality of responsibility in
relationships that emphasize connection and caring as a moral imperative.
DIF: Cognitive Level: Remember
(Knowledge)
REF: pp. 58-59
17. How
are ethics and public policies similar?
|
a. |
Both are abstract
principles that often differ in actual practice. |
|
b. |
Both are best achieved by
persons in high political office who can effect change. |
|
c. |
Both strive for the public
good. |
|
d. |
Both use general principles
in making decisions. |
ANS: C
An important goal of both policy and ethics is to achieve the
public good, and both are involved in good citizenship.
DIF: Cognitive Level: Understand
(Comprehension)
REF: p. 60
18. A new
nurse states to a nursing colleague, “But why do I have to be involved in
politics? I just want to be the very best clinical nurse I can.” Which of the
following would be the best response from the nursing colleague?
|
a. |
“As long as you pay your
membership fee to the American Nurses Association, you have participated in
the profession’s political endeavors.” |
|
b. |
“Political action is the way
you try to fulfill your ethical responsibilities to clients.” |
|
c. |
“You’re absolutely right;
if you are good clinically, you have fulfilled your obligation.” |
|
d. |
“When you’ve completed your
clinical orientation, then you’ll have time to be involved in politics.” |
ANS: B
To be a good clinical nurse, the nurse needs resources and
supportive policies that can be obtained only through political action to
ensure those very resources and policies. Many clients are members of
vulnerable groups who have often previously lacked access to quality care at an
affordable cost. The American Nurses Association Code of Ethics for Nurses
emphasizes political action as the mechanism to effect social justice and
reform regarding homelessness, violence, and stigmatization.
DIF: Cognitive Level: Apply
(Application)
REF: p. 62
19. Which
of the following would confirm that the nurse’s advocacy has been truly
successful or effective?
|
a. |
Audiences agree with the
nurse who is serving as advocate. |
|
b. |
Legislators discuss
appropriate legislation to better allocate resources. |
|
c. |
People verbalize that the
disenfranchised should be better treated. |
|
d. |
Systematic social changes
are made to improve quality of life. |
ANS: D
Advocacy is the application of information and resources to
effect systematic changes that shape the way people in a community live to
reduce death and disability and improve quality of life in the community.
Although all of these options could be seen as beneficial, only when systematic
social changes are made to improve quality of life can advocacy be considered
truly effective.
DIF: Cognitive Level: Apply
(Application)
REF: p. 63
20. How
can nurses know whether they have been effective in assessing the community and
planning and implementing appropriate interventions?
|
a. |
Ask community leaders for
their opinion of the interventions. |
|
b. |
Examine the morbidity and
mortality rate of the community. |
|
c. |
Reassess the community to
determine whether obvious needs have been met. |
|
d. |
Systematically survey
community residents regarding their perception. |
ANS: B
Although all these options might be useful, the end products of
appropriate advocacy are decreased morbidity and mortality. In other words, if
advocacy has been effective, public health problems will be decreased.
DIF: Cognitive Level: Apply
(Application)
REF: p. 63
21. What
is the relationship between ethics and a community health nursing practice?
|
a. |
Ethics and actual nursing
practice are not related. |
|
b. |
Knowing ethics allows nurse
to recognize the source of most problems. |
|
c. |
Ethics is constantly
involved in nurses’ clinical decisions. |
|
d. |
Although ethics is
important, political and legal responsibilities are more important in
practice. |
ANS: C
Ethical problems in public health nursing include inequities in
power, unacceptable practices, inequitable resource allocation, conflict
between ethics and law, and inadequate systems support for nursing. Therefore,
ethics permeates every aspect of public health nursing as nurses attempt to
meet the needs of the community.
DIF: Cognitive Level: Analyze
(Analysis)
REF: p. 52
MULTIPLE RESPONSE
1. Three
nurses disagree over the appropriate treatment for a woman who is an excellent
candidate for hospice care. The first nurse believes that deciding on care
rather than cure is the woman’s decision and no one else can decide for her.
The second nurse says that it is the responsibility of the health care team to
do good for the woman, and if the physician thinks there is still a possibility
of cure, then the nurses should do everything they can to implement the
treatment plan. The third nurse states that it isn’t fair for the family
members to expend all their resources on the woman, who is probably going to
die anyway. Which of the following conclusions can be drawn from this dispute?
(Select all that apply.)
|
a. |
Ethical principles can
conflict with one another. |
|
b. |
The nurses are each using
different ethical approaches. |
|
c. |
The first nurse is correct
because autonomy demands that the woman decide for herself. |
|
d. |
There is no single accepted
approach for resolving such disagreements. |
ANS: A, D
One of the criticisms of using ethical principles is that they
can conflict with one another in any given situation. No rule exists for
helping resolve such conflicts.
DIF: Cognitive Level: Analyze (Analysis)
REF: p. 56
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