Chapter 1- Community Oriented Nursing and Community Based Nursing Quiz

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Jennifer is a nurse in a family medicine clinic. Today she is assessing Jose, a 4-yearold who is being seen for an earache. The type of nursing Jennifer practices is:
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In community-based nursing, the nurse focuses on “illness care” of individuals and families across the life span. The aim is to manage acute and chronic health conditions in the community, and the practice is family-centered illness care. Community-based nursing is not a specialty in nursing but, rather, a philosophy that guides care in all nursing specialties. Community-oriented nursing has as its primary focus the health care either of the community or populations as in public health nursing (PHN) or of individuals, families, and groups in a community.
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A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the public health core function of:
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Assessment
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A state agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored elder care programs. The public health core function applied is:
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Assurance Rationale – The public health core function of assurance focuses on the responsibility of public health agencies to be sure that activities are appropriately carried out to meet public health goals and plans. This role requires skill in assessment, investigative functions, collaboration, consultation, and cooperation. Assurance also includes assisting communities to implement and evaluate plans and projects.
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A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing:
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Community Oriented Care- Rationale Community-oriented nurses emphasize health protection, maintenance, and promotion and disease prevention, as well as self-reliance among clients. Regardless of whether the client is a person, a family, or a group, the goal is to promote health through education about prevailing health problems, proper nutrition, beneficial forms of exercise, and environmental factors such as safe food, water, air, and buildings. Community-based care is nursing care that is provided in a setting. A smoking cessation clinic is an example of primary prevention, not secondary or tertiary.
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Public health nursing is a specialty with a distinct focus and scope of practice and requires a special knowledge base different from other specialty areas of nursing. A public health nurse would first be interested in:
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populations with the highest rate of diabetes Rationale-The primary focus that has differentiated public health nursing from other specialties has been the emphasis on the population rather than on individuals or families. The primary goal of public health—the prevention of disease and disability—is achieved by ensuring that conditions exist in which people can remain healthy. Diabetes care and educational materials are provided to individuals and families by a nurse in the community or institutional setting.
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A nurse in a clinic that provides direct care services to clients with tuberculosis would be classified as practicing
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Community Based Nursing -Rationale The nurse practicing as a community-based nurse is more likely to give direct care to people than are nurses who practice from a community-oriented framework. A community-oriented framework includes community-oriented nursing and public health nursing. Institutional nursing care is generally delivered in a hospital or nursing home setting.
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A school nurse teaches three middle school students with asthma conditions techniques to minimize their incidence of bronchial spasms. This is an application of:
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Community Based Nursing- Rationale The goal of community-based nursing (CBN) is to manage acute or chronic conditions while promoting self-care among individuals and families. In CBN the nursing care is family centered, which means that the nurse works to improve the competencies of families to enable them to take better care of themselves. The nurse pays particular attention to the uniqueness of each family and works to plan the most useful interventions. Nurses practicing in the community and many staff public health nurses focus on providing direct care services, including health education, to persons or families outside of institutional settings, either in the home or in a clinic.
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In a community clinic that screens and treats individuals for cardiovascular disorders, the nurse practicing public health/population-focused nursing would most likely ascertain:
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The prevalence rate of cardiovascular disorders among various groups. Rationale–A public health nurse in a community clinic engaged in population-focused practice would ask the following questions: What is the prevalence rate of the diagnosis or condition among various age, race, and gender groups? Which subpopulations have the highest rates of untreated diagnosis or condition? What programs could reduce the problem of untreated diagnosis/condition and decrease the risk for further morbidity and mortality?
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In a federally funded preschool program such as Head Start, nursing services that include conducting developmental-level screening for cognitive and psychomotor development of individual children would most likely be considered communityoriented nursing care when:
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individual results are compared with established standards for children of the same age group. Rationale- Within federally funded programs for preschool children, from a communityoriented nursing care perspective, nursing services could be provided to individual children by conducting developmental-level screening tests to evaluate each child’s level of cognitive and psychomotor development in comparison with established standards for children of the same age. This is population-focused service. A community-based nurse may deliver illness care or direct services to individual children. A public health nurse may assess the program’s ability to achieve the overall goal of making its population of children healthier by evaluating the characteristics of the facility, program, and environment for their effectiveness in achieving the goal
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The public health nurse deals with the examination of a community setting to determine the community’s health status. Which of the following activities should be considered in the assessment phase?
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Include but not limited to: Collecting, analyzing, and disseminating information Evaluating the social, economic, and environmental characteristics of the population Questioning the availability of health services to the community

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