Public health nursing practice is guided by the communitys priorities as identified by community

North’s Carolina’s local health department nurse-driven
model of providing public health services.

In North Carolina, PHNs have been at the core of public health providing care for individuals, families, and communities prior to the evolution of clinical services that we now embrace as standard in North Carolina public health departments. PHNs then and now provide screenings for chronic disease, cancer, sexually transmitted disease, wellness assessments for children, prenatal, post-partum and newborn home visits, case management, nutrition education, and an array of other educational and prevention services all on our license as a registered nurse. Some of the services PHNs provide require standing medical orders, but most do not.  

North Carolina Public Health has always operated on a nurse-driven model (practice models/theories that emphasize the more holistic approach to disease) vs. the medical model (focused on the physical and biologic aspects of specific diseases and conditions) and continue to operate this way today despite the addition of comprehensive primary care and other specialty medical services in many of our health departments.

Public health nursing practice is guided by the community's priorities as identified by community:

The three components of the Intervention Wheel are:

Population base, levels of practice, and public health interventions.

The intervention used to influence the knowledge, attitudes, values, beliefs, behaviors, and practices of the population of interest is referred to as:

Promotion of the creation of immunization registries that combine immunization information from different sources into a single electronic record to provide official immunization records for schools, daycare centers, health departments, and clinics is a goal of:

When confirmed cases of the mumps, a vaccine-preventable disease, emerged on college campuses in fall 2006, public health nurses conducted outreach at campuses and collaborated with student health officials to increase the number of students with full immunization compliance. This is an example of:

Community-level practice.

A nurse identifies higher-than-normal levels of lead when screening a 3-year-old child. The nurse works with the local health department to put together a team to address the environmental issues responsible for the child's abnormal lead level. Team members should include the following specialists:

Specially trained housing inspector, pediatric specialist, lead-based paint intervention team, and laboratory specialists to test the child's home and the surrounding neighborhood.

An occupational health nurse practitioner's physical assessment of a factory worker identifies an acute-onset pruritic dermatitis extending over the face, hands, neck, and forearms. The nurse's priorities should be to:

Treat the client and obtain a comprehensive exposure history; if an onsite environmental exposure is suspected as the cause, screen other at-risk workers and ensure that the environmental risk is identified and eliminated.

A community health nurse manager has integrated exposure history elements into the assessment practices of the health department that are relevant to the urban industrial community served. This strategy indicates that the nurse manager is aware of the relationship between:

Environment and human health/disease.

The monitoring and public reporting of air quality in a local community to assist individuals with asthma or other respiratory conditions best illustrates the application of:

Environmental epidemiology.

When applying the nursing process to environmental health, the nurse would:

Include outcome measures that involve mitigation and elimination of the contributing factors.

A state public health region reported 39 cases of meningitis in children 15 years of age and younger to date this year. Seven of those children died. The total population of the region is 780,000, of whom 84,000 are children age 15 years old and younger. Only four cases of meningitis were reported in the public health region during the previous year. No other public health region in the state has an incidence of meningitis that is higher than expected for that region. Based on the information given, the relative frequency of meningitis in the region at this time can best be described as:

John Snow played a critical role in the development of modern disease surveillance when he:

Used geographic mapping to demonstrate the connection between water supply and cholera.

A business executive develops flu-like symptoms 1 day after returning by air from a trans-Atlantic 2-day conference that involved lengthy meetings into the evening. The scenario best illustrates the interaction of:

Host, agent, and environment.

A nurse teaches an asthmatic client to recognize and avoid exposure to asthma triggers and assists the client's family in implementing specific protection strategies in the home, such as removing carpets and avoiding pets. This nurse's activities can best be described as:

A nurse is concerned about the accuracy of the purified protein derivative (tuberculin) test in screening individuals with tuberculosis exposure for followup chest radiography. The nurse's concern is related to which aspect of the test's validity?

When the association between maternal alcohol use and low birth weight is being studied, the nurse investigator's failure to consider the variable of smoking could introduce bias into the observed association, because smoking has a correlation with both factors. This effect could best be described as:

A 6-year-old is brought to the emergency department with a full-body rash and fever. During the nursing assessment, which of the following findings would be most relevant to recognizing the case as potential smallpox rather than varicella?

Fever of 101° F was present for several days before the rash appeared.

A school nurse notes that 60 children have missed days of high school because of pertussis this past year and this rate has been relatively constant for the past 5 years. The nurse plans to work with the community to increase awareness of the seriousness of this disease for children younger than 6 months of age and to raise and maintain the immunization rates, because in this community the pertussis is:

The World Health Organization (WHO) developed the Five Keys to Safer Food campaign in 2001 to address the problem of foodborne and waterborne diarrheal diseases worldwide. This campaign emphasizes which of the following practices?

Keep clean, separate raw and cooked, cook thoroughly.

An example of secondary prevention of infectious disease is:

In an effort to address West Nile virus, a community increased livestock immunization, began a vector control program, and initiated a community campaign to eliminate standing water reservoirs. This best exemplifies communicable disease control through:

When a situation exists in which there is potential contact with blood or body fluids, health care workers must always perform hand hygiene and wear gloves, masks, protective clothing, and other indicated personal protective barriers. The underlying reason for requiring these practices, known as universal precautions, is that:

Blood and body fluids of all clients need to be handled as if they were infected.

Although infectious disease epidemics are still the major cause of death worldwide, they have subsided in the United States because of improvements in nutrition and sanitation, the discovery of antibiotics, and the development of vaccines. Infectious diseases have not vanished, however, and remain a continuing cause of concern. Healthy People 2020 has a number of objectives aimed at reducing these illnesses because of the morbidity, mortality, and costs associated with infectious diseases. One such costly disease trend related to an increase in the performance of invasive diagnostic and surgical procedures, the use of broad-spectrum antibiotics, and treatment with immunosuppressive drugs is the rise of:

Hospital acquired infections.

A school nurse is teaching a class of sophomores about the relationship between the risk of sexually transmitted disease (STD) and risk-taking behaviors. A key point to include is:

A) All STDs are easily preventable with consistent condom use.

Use of alcohol and drugs makes a student more likely to make decisions that result in exposure to and infection with STDs.

The clients most at risk of reactivation of latent infections of tuberculosis (TB) are:

Immunocompromised persons, substance abusers, and those with diabetes.

A client comes to the local clinic with acute symptoms of fever, nausea, lack of appetite, malaise, and abdominal discomfort. During the course of the assessment, the nurse determines that the client is a health care aide working at a daycare center. These facts are important because:

Hepatitis A outbreaks commonly occur in facilities where staff change diapers.

A population-level tertiary prevention intervention typically carried out by nurses caring for those with communicable disease in the community is:

Instruction in standard precautions.

Today, an evidence-based nursing practice can best be defined as which of the following?

Approach to the integration of the best research available, nursing expertise, and the preferences/values of the clients served.

Community-oriented nurses use evidence-based practice (EBP) most effectively when they:

Base care on nationally accepted clinical guidelines, involve clients in individual care decisions, and include community input when applying evidence in practice.

When a public health nurse uses evidence-based interventions to evaluate the effectiveness, accessibility, and quality of population-based services within the community, the nurse is addressing the core public health function of:

Randomized controlled trials are often inappropriate for evaluating many public health interventions. The most common approach to establishing evidence in public health is the use of:

Which action by the community-oriented nurse best illustrates a partnership for health?

Helping a group of citizens concerned about potential environmental hazards collect relevant health data and develop needed interventions.

The most important aspect of the nursing community assessment phase can best be described as:

Formulating a community nursing diagnosis.

Public health nurses are challenged to respond to public health-related trends of the twenty-first century, which include:

Racial, ethnic, and economic health disparities; rise of drug-resistant pathogens; unequal access to health care; and violence.

A public health nurse in the local health department assists the community in identifying the health need priorities and the services that can best meet these needs in a cost-effective manner. This is an example of the tertiary prevention public health nursing function of:

State public health agency responsibilities include:

Monitoring health status.

The public health nurse serves as a bridge between at-risk populations and the community's health care resources. This role is based on the nurse's responsibility to:

Ensure that all populations have access to affordable, quality health care.

The public health nurse ensures that a local community coalition for improving school lunches takes the time to listen to each stakeholder's view, develops a common validated language for discussing the initiative, and shares the credit for the success of the initiative. The public health nurse is adhering to the principles of:

The public health nurse applies knowledge in working with a local school board coalition to develop a helmet safety campaign in the middle and high schools. This best exemplifies which aspect of public health?

A public health nurse leader is encountering barriers when trying to shift the public health agency's efforts to a population-focused practice. The reasons peers are not supportive of the proposed shift to a population focus are most likely related to:

Opinions that nursing should focus on the provision of direct client care and services.

The role and goals of the community health nursing practice can best be described as:

Population-level strategies aimed at promoting, preserving, and maintaining the health of populations through the delivery of personal health care services to individuals, families, and groups in an effort to improve the health of the community as a whole.

A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing:

The nurse working in a community health clinic for refugees plans care knowing which health condition(s) are common in this population? Select all that apply.

Measles

Tuberculosis

Poor nutrition

Pregnancy complications

The community health nurse is conducting an education session for community members regarding measures to prevent skin cancer and is providing instructions for use of sunscreen protection. The nurse determines that teaching was effective if a community member states that chemical sunscreens are most effective when applied at what time?

One hour before exposure to the sun

The community health nurse is conducting a research study and is identifying clients in the community at risk for latex allergy. Which client population is most at risk for developing this type of allergy

Hairdressers

Individuals most at risk for developing a latex allergy include health care workers; individuals who work in the rubber industry; those who have had multiple surgeries, have spina bifida, or wear gloves frequently (i.e., food handlers, hairdressers, and auto mechanics)

Which public nursing practice is guided by the community from which priorities are identified?

What is the role of the public health nurse in the community?

What is the focus of public health nursing and community health nursing?

How is public health nursing different from community health nursing?