2

Community-Based Nursing Practice

I. Interpretation, Completion, and Comparison

Multiple Choice. Read each question carefully. Circle your answer.

1. The shift in health care delivery from acute care to community-based care is primarily the result of:
a. belief in health promotion as part of the c. earlier discharge from hospital.
health care system. d. all three of these conditions.
b. increased numbers of hospital bed closures.
2. Choose an alternative health care delivery system that has dramatically reduced patient-care days in acute
care settings.
a. Health Maintenance Organizations c. Preferred Provider Organizations
b. Managed Health Care Systems d. Each of the three is equally significant.
3. The most frequent users of home health services are:
a. children with chronic, debilitating disorders. c. the frail and elderly who need skilled care.
b. newborns who are sent home with apnea d. young adults on prolonged intravenous therapy.
monitors.
4. Discharge planning from the hospital to home care begins when the:
a. discharge order is written. c. physician notifies the insurance company.
b. nurse receives the physician’s order for d. patient is admitted to the hospital.
discharge.
5. Nurses working in elementary schools are educated to deal with the leading health care problem of:
a. dental disease c. infections.
b. emotional problems. d. injuries.
6. Nurses working in high schools expect to deal with the common health care problem of:
a. anorexia. c. alcohol and drug abuse.
b. cancer. d. malnutrition.

Fill-In. Read each statement carefully. Write your response in the space provided.
1. List specific skills a nurse will need to function in community-based care.

Copyright © 2008 by Lippincott Williams & Wilkins, a Wolters Kluwer Business. Student Access to thePoint Solution for the Study Guide
6 for Brunner & Suddarth’s Textbook of Medical–Surgical Nursing, First Canadian Edition, by Pauline Paul, Rene A. Day, and Bev Williams
 2. Distinguish between the terms “community-based nursing” and “public health nursing.”

3. List several examples of “skilled” nursing services provided by home care nurses.

4. The first step in preparing for a home visit is for the nurse to:

5. Explain the purpose of the initial home visit.

6. List some examples of ambulatory health care settings.

7. Name several subspecialities for nurse practitioners.

8. Common chronic health problems of the homeless are:

II. Critical Thinking Questions and Exercises

Discussion and Analysis

1. Describe a common clinical care situation for a patient outside the hospital. Determine whether the role,
responsibilities, and suggested scope of practice are within the realm of community-based nursing or
community health nursing.
2. Compare the educational preparation, job description, and expanded role of advanced practice nurses
working in a clinic, an ambulatory care setting, an elementary school, and an industrial setting.
3. Discuss the four roles of the school nurse and give a clinical example of each.
4. Distinguish between primary, secondary, and tertiary levels of preventive care and cite a clinical case
example of each level.

Recognizing Contradictions
Rewrite each statement correctly. Underline the key concepts.
1. Community health nursing focuses on promoting and maintaining the health of individuals and groups.
2. Tertiary prevention is a level of community nursing practice that focuses on the early detection of disease.
3. The primary purpose of the initial home care visit is to give the patient and his or her family information
about care and treatments.

Copyright © 2008 by Lippincott Williams & Wilkins, a Wolters Kluwer Business. Student Access to thePoint Solution for the Study Guide
for Brunner & Suddarth’s Textbook of Medical–Surgical Nursing, First Canadian Edition, by Pauline Paul, Rene A. Day, and Bev Williams 7