Chapter 04: Community Health Nursing Practice

Test Bank
MULTIPLE CHOICE
1. Which of the following is true in regard to public health nursing?
a. The main focus of public health nursing is on political processes for healthy public

policy.
b. Public health nursing is the same as community health nursing.
c. Public health nursing focuses on the incidence of disease.
d. Public health nursing includes direct care and services to various populations.
ANS: D
Feedback
A
B
C
D

Although public health nursing looks at political processes to influence healthy

public policy, this is not its main focus.
Public health nursing is not the same as community health nursing. Public health
nursing is one aspect of community health nursing, among many others.
Public health nursing has a much more inclusive focus than just the incidence of
disease, including health promotion, health protection, and healthy public policy.
Public health nursing strives to safeguard and improve the health of populations
in the community, including providing direct care and services.

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Planning

REF: page 44
OBJ: 4
MSC: CRNE: CH-7

2. Which of the following is true in regard to social justice?

a. The focus of social justice is on disease prevention.
b. Social justice is used only with people in precarious situations.
c. Social justice is rooted in societal responsibility and fairness.
d. Social justice is a process to exercise the ability to enhance control.
ANS: C
Feedback
A
B
C

Social justice does not focus on disease prevention.

Social justice applies to many groups of people and communities, not only those
in precarious situations.
Social justice is rooted in notions of societal responsibility and fairness of justice.
It encompasses equity, human rights, democracy and civil rights, capacity
building, just institutions, enabling environments, poverty reduction, ethical
practice, advocacy, and partnerships.
Social justice is not a process to exercise the ability to enhance control.

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Planning

REF: page 44
OBJ: 1
MSC: CRNE: PP-1

3. Which of the following clients presents the highest risk for health-related concerns?
a. Ms. Madison, a 25-year-old woman living in a womans shelter

b. Mr. Saliman, a 62-year-old man taking medication for chronic hypertension and

diabetes
c. Mr. Joseph, a 17-year-old man attending an outpatient mental health clinic
d. Ms. Tray, a 31-year-old woman addicted to cocaine
ANS: D
Feedback
A
B

Ms. Madison has sought protection in a womans shelter and should not present
the greatest risk for health-related concerns.
Mr. Saliman is taking medication for his chronic disease, engaging in measures to
maintain his physical health rather than increasing his risk of health-related
concerns.
Mr. Joseph is receiving treatment at an outpatient mental health clinic, engaging
in measures to maintain his mental health rather than increasing his risk of healthrelated concerns.
Ms. Tray, because she is a substance user, presents the greatest risk for healthrelated concerns. Clients who abuse substances also frequently have additional
health and socioeconomic problems.

DIF: Cognitive Level: Application

TOP: Nursing Process: Planning

REF: page 49
OBJ: 5
MSC: CRNE: HW-20

4. Community assessments are important in order for the nurse to understand and respond to the

needs of the population. What will the nurse focus on when assessing the structure of the
community?
a. Collecting demographic data on age distribution
b. Visiting neighbourhood schools to review health records
c. Interviewing clients to determine the cultural makeup of subgroups
d. Observing the physical environment and location of services
ANS: D
Feedback
A
B
C
D

Collecting demographic data on age distribution is an example of assessing the

communitys population.
Visiting neighbourhood schools to review health records is an example of
assessing a social system within the community.
Interviewing clients to determine the cultural makeup of subgroups is an example
of assessing the population within the community.
When assessing the structure or locale of a community, the nurse should travel
around the neighbourhood and observe the physical environment, the location of
services, and the locations where residents congregate. Locale and structure make
up one of the three components of community assessment.

DIF: Cognitive Level: Application

TOP: Nursing Process: Planning

REF: page 52
OBJ: 7
MSC: CRNE: HW-27

5. Among the following nursing skills, which one must be demonstrated to successfully fulfill

the role of facilitator?

a. Advocacy

b. Paternalism
c. Autonomy
d. Negotiation
ANS: A
Feedback
A
B
C
D

Community health nurses work within a participatory process; leadership and

advocacy are critical skills needed for the role of facilitator.
Paternalism is not a skill critically needed for the role of facilitator.
Autonomy is not a skill critically needed for the role of facilitator.
Negotiation is a characteristic of appropriate communication skills in community
health nursing practice, rather than a reflection of the nurse in the role of
facilitator.

DIF: Cognitive Level: Application

TOP: Nursing Process: Implementation

REF: page 50
OBJ: 6
MSC: CRNE: NCP-4

6. Unsafe sexual practices remain high among young people. Which of the following actions

should the nurse initially undertake to address unsafe sexual practices with a client?
Document the unsafe practices.
Complete a physical assessment.
Decide what strategies would work best for the client.
Assess the circumstances that contribute to the unsafe practices.

a.
b.
c.
d.

ANS: D
Feedback
A
B

Documenting the unsafe practices is not the initial action to undertake.

Completing a physical assessment is not the initial action to undertake, although
it may be the appropriate follow-up to an assessment of the circumstances that
contribute to the unsafe practices.
Deciding what strategies would work best for the client is not the initial action to
undertake and does not reflect the collaborative nature of community health
nursing.
The nurse should initially partner with the client to assess the circumstances that
contribute to substance use, unsafe sexual practices, or other risk behaviours, and
identify strategies to address clients often multiple and interrelated concerns.

DIF: Cognitive Level: Application

TOP: Nursing Process: Assessment

REF: page 49
OBJ: 6
MSC: CRNE: HW-15

7. Which of the following statements describes a population?

a. A group of people who live in a given community
b. Geographic groupings, such as individuals, who live in neighbourhoods
c. A collection of individuals who have personal and environmental characteristics in

common
d. A group of individuals who are engaged in collective relationships that create a

supportive living environment

ANS: C

Feedback
A
B
C

Population is different from community. A community is a group of people who

share a geographic (locational) dimension and a social (relational) dimension.
Individuals who live in neighbourhoods are part of a community.
A population is defined as a collection of individuals who have one or more
personal or environmental characteristics in common. Examples of populations
include Canadians inclusively, or, more specifically, high-risk infants, older
adults, or cultural groups such as Aboriginals.
A healthy community is a group of individuals who are engaged in collective
relationships that create a supportive living environment.

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Planning

REF: page 44
OBJ: 1
MSC: CRNE: CH-7

8. Which of the following is a key characteristic of a healthy community?

a. A collective capacity to solve problems
b. Proximity to lakes and forests
c. Access to recreational facilities
d. Government interventions to solve community problems
ANS: A
Feedback
A

B
C
D

Key characteristics of healthy communities include a collective capacity to solve

problems, adequate living conditions, a safe environment, and sustainable
resources such as employment, health care, and educational facilities.
Proximity to lakes and forests is not a key characteristic of a healthy community.
Access to recreational facilities is important when defining a healthy community,
but is not a key characteristic.
Government should attempt to solve community problems in conjunction with the
community.

DIF: Cognitive Level: Application

TOP: Nursing Process: Planning

REF: page 44
OBJ: 7
MSC: CRNE: CH-7

9. Which of the following must the nurse do in order to be culturally competent?

a. Be sensitive to a clients cultural uniqueness.
b. Evaluate a clients beliefs and values about health in terms of the nurses own

experience.
c. Be able to appraise and understand a clients cultural beliefs, values, and practices.
d. Be ready to discuss a clients beliefs and values with him or her.
ANS: C
Feedback
A
B
C

Being culturally competent involves more than being sensitive to a clients

cultural uniqueness.
The nurse cannot judge a clients beliefs and values about health in terms of that
nurses own culture.
The nurse must be able to appraise and understand a clients cultural beliefs,

values, and practices in order to work with him or her to determine the needs and
interventions most likely to improve health.
Being ready to discuss a clients beliefs and values with him or her could be
interpreted as judging the clients beliefs and values.

DIF: Cognitive Level: Application

TOP: Nursing Process: Planning

REF: page 47
OBJ: 6
MSC: CRNE: NCP-7

10. Which of the following groups of health concerns affect youth, young men, and those in

Aboriginal communities in particular?

Depression, suicide, unemployment, and unintentional injuries
Chronic illness, mental illness, impaired function, and nutrition
Physical abuse, emotional abuse, sexual abuse, and neglect
Substance abuse, alcoholism, sexually transmitted diseases, and AIDS

a.
b.
c.
d.

ANS: A
Feedback
A
B
C

Depression, suicide, unemployment, and unintentional injuries are concerns that

affect youth, young men, and those in Aboriginal communities.
Chronic illness, mental illness, impaired function, and nutrition are not specific to
youth, young men, or those in Aboriginal communities.
Physical abuse, emotional abuse, sexual abuse, and neglect are major public
health problems affecting older adults, women, and children. Abuse occurs in
many settings, including the home, workplaces, schools, health care facilities, and
public areas, and is most often committed by an acquaintance of the victim.
Substance abuse, alcoholism, sexually transmitted diseases, and AIDS are health
problems that are related to vulnerable populations.

DIF: Cognitive Level: Analysis

TOP: Nursing Process: Planning

REF: page 48
OBJ: 5
MSC: CRNE: HW-15

11. A client is being discharged home from an acute care facility following a total hip

replacement. She will require follow-up for health care and also exercise. In addition to a
home health nurse, what other service will this client require?
a. Dietitian
b. Social worker
c. Physiotherapist
d. Respiratory therapist
ANS: C
Feedback
A
B
C

A dietitian may not be required.

A social worker may not be required.
Community health nurses bring together resources to improve continuity of care
for clients. In collaboration with clients, health care and social service providers,
and other community members, they coordinate health care services, locate
appropriate services, and develop innovative approaches to address clients health
care issues. A physiotherapist would be an appropriate service to facilitate an

exercise program for a client after a hip replacement.

A respiratory therapist may not be required.

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Planning

REF: page 45
OBJ: 4
MSC: CRNE: CH-14

12. The nurse is planning interventions for the clients of a homeless shelter. Which of the

following activities represents a primary level intervention regarding sexually transmitted

infections?
a. HIV screening for all residents
b. Sex education for teenage residents
c. Treatment for residents diagnosed with AIDS
d. Gynecological referrals for female residents
ANS: B
Feedback
A
B
C
D

Screening a disease is a secondary level intervention.

Primary health care focuses on education, rehabilitation, support services, health
promotion, and disease prevention.
Treatment of disease is a tertiary level intervention.
Referrals are secondary level interventions.

DIF: Cognitive Level: Comprehension

TOP: Nursing Process: Planning

REF: page 44
OBJ: 5
MSC: CRNE: HW-23

13. The nurse is working in a free clinic and caring for a homeless client diagnosed with paranoid

schizophrenia. The client reports, I hurt my foot running away from them. It hurts so bad I
can hardly walk now. On assessment, the nurse notices bruising on the clients back, arms,
and thighs, a red rash on her neck and face, and poor personal hygiene, in addition to edema
of the left ankle. Which of the following pose a risk to this client?
a. Physical abuse and assault
b. Drug addiction relating to pain
c. Communicable immune disorders
d. Hospitalization due to a mental disorder
ANS: A
Feedback
A

B
C
D

When a client has a severe mental illness, multiple health and socioeconomic
challenges must be explored. Many such clients are homeless or marginally
housed. The clients report of needing to run away from others requires further
assessment in order to rule out physical abuse or assault.
Drug addiction may be a consideration, even though the client is not seeking
drugs.
Communicable disease is a risk factor. However, this is not the best available
option, since several factors relate to abuse or assault.
Hospitalization may be required for medical treatment, but there is no indication
that this client requires hospitalization for psychiatric crisis.

DIF: Cognitive Level: Analysis

TOP: Nursing Process: Planning

REF: page 47
OBJ: 5
MSC: CRNE: HW-17

14. When assessing members of a vulnerable population, which of the following should the

community health nurse realize is their primary need?

Obtaining a culturally competent assessment
Receiving food security
Providing a comfortable, nonthreatening environment
Assessing for indications of mental or physical abuse

a.
b.
c.
d.

ANS: C
Feedback
A
B
C

Obtaining a culturally competent assessment is not the primary need.

Receiving food security is not the primary need.
When assessing members of a vulnerable population, it is important to create a
comfortable, nonthreatening environment. The nurse may only have one
opportunity to work with the vulnerable person or family. Creating a comfortable
and nonthreatening environment will encourage the client to participate in the
assessment.
Assessing for indications of mental or physical abuse is important but is not the
primary need.

DIF: Cognitive Level: Analysis

REF: page 48, Box 4-4
OBJ: 5
TOP: Nursing Process: Planning
MSC: CRNE: NCP-4
15. Which of the following is an example of a harm reduction program?
a. A nutrition clinic
b. A prenatal clinic
c. A needle exchange program
d. An exercise program
ANS: C
Feedback
A
B
C

A nutrition clinic is not a harm reduction program.

A prenatal clinic is not a harm reduction program.
Harm reduction initiatives such as needle exchange programs, which are now
available in most Canadian provinces, exemplify community nursing practice
guided by primary health care, health promotion, empowerment, and ethical
principles.
An exercise program is not a harm reduction program.

DIF: Cognitive Level: Application

REF: page 50, Box 4-6
OBJ: 6
TOP: Nursing Process: Planning
MSC: CRNE: HW-4