Q & A (Chapter 3) – Flashcards
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Which of the following statements is NOT true about the "thinking upstream" model of community health nursing practice? A. It is a conceptual model to assist the nurse in community health planning. B. It helps to focus the time, energy, and programmatic resources available to community health nursing clients. C. It focuses the nurse on short-term, individual-based nursing interventions. D. It focuses the nurse on long-term, "bigger picture" issues related to community health practice, such as social justice or power.
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C. The upstream model uses the analogy of a river flowing upstream toward the bigger picture to focus community health nursing practice. This differentiates population-focused and individual-focused nursing interventions. The community health nurse needs to have a "critical eye" for the bigger picture to focus time, energy, and resources and provide quality care.
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A microscopic approach to the community health problem of childhood obesity would focus on: A. asking an obese child and his or her parent(s) to complete a 24-hour food diary. B. analyzing aggregate Body Mass Indexes (BMIs) of school-age children in a school. C. advocating for a change in health policy related to school lunches. D. exploring changing cultural changes and societal values related to activity.
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A. A microscopic approach to the conceptualization of the problem of childhood obesity focuses on the individual child. A macroscopic approach focuses on the societal factors that influence health status. Analyzing aggregate BMIs, advocating a change in school lunches, and exploring societal and cultural values related to activity are examples of a macroscopic approach to the community health problem of childhood obesity.
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Which of the following theories is based on the assumption that individual needs and related activities are the focus of nursing care? A. Orem's self-care deficit theory B. The health belief model C. Milio's framework D. Critical social theory
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A. Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing interventions required to assist clients to obtain optimal health. The health belief model (HBM) evolved from the premise that the world of the perceiver determines action. Milio's framework for prevention (1976) provides a complement to the HBM and a mechanism for directing attention upstream and examining opportunities for nursing intervention at the population level. Critical social theory uses societal awareness to expose social inequalities that keep people from reaching their full potential.
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A community health nurse explores a group of teenagers' beliefs about the seriousness of eating disorders and their related susceptibility. The nurse is applying principles from which theory? A. Orem's self-care deficit theory B. The health belief model C. Milio's framework D. Critical social theory
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B. The health belief model (HBM) offers indicators of the perceived seriousness, perceived susceptibility, and cues to action related to specific health behaviors. Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing interventions required to assist clients to obtain optimal health. Milio's framework for prevention (1976) provides a complement to the HBM and a mechanism for directing attention upstream and examining opportunities for nursing intervention at the population level. Critical social theory uses societal awareness to expose social inequalities that keep people from reaching their full potential.
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A major limitation of the health belief model is that the burden of action related to health behaviors is exclusively on the aggregate. A. True B. False
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B. False - A major limitation of the health belief model is that the burden of responsibility for health behaviors is on the individual client.
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The belief that health deficits result from an imbalance between the population's health needs and its health-sustaining resources is the premise of which theory? A. Orem's self-care deficit theory B. The health belief model C. Milio's framework D. Critical social theory
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C. Milio's theory demonstrates upstream conceptualization of understanding the community's health needs and resources; this theory complements the health belief model (HBM). The HBM offers indicators of the perceived seriousness, perceived susceptibility, and cues to action related to specific health behaviors. Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing interventions required to assist clients to obtain optimal health. Critical social theory exposes people to inequities to help them reach their full potential.
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The community health nurse is teaching a prenatal class and includes the societal cost of fetal alcohol syndrome in one of the educational sessions. The nurse is demonstrating an understanding of: Orem's self-care deficit theory. B. the health belief model. C. Milio's framework. D. critical theoretical perspective.
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D. Critical theoretical perspective exposes people to inequities to help them reach their full potential. Orem's self-care deficit theory is based on individual self-care needs and explains the level of nursing interventions required to assist clients to obtain optimal health. The health belief model (HBM) evolved from the premise that the world of the perceiver determines action. Milio's framework for prevention (1976) provides a complement to the HBM and a mechanism for directing attention upstream and examining opportunities for nursing intervention at the population level.
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Which of the following nurse leaders formulated the first theory-based conceptual model for nursing care? A. Nancy Milio Incorrect B. Lillian Wald C. Florence Nightingale Correct D. Dorthea Orem
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C. Most nursing scholars identify Florence Nightingale as the first nurse theorist. Lillian Wald helped establish community health nursing in the United States. Nancy Milio created the framework for prevention theory. Dorthea Orem conceptualized the self-deficit theory.
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Using theory to guide community health nursing practice serves to: (Select all that apply.) A. guide data collection and interpretation in a clear and organized manner. B. provide uniformity in community health nursing practice. C. improve community health nursing practice. D. validate traditional community health nursing beliefs. E. focus the student on factors that are critical to understanding the situation.
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A, C, & E. Theory-based practice guides data collection and interpretation in a clear and organized manner. Although using theory makes it easier to plan standardized care for aggregates, the goal of theory is to improve nursing practice, thereby ensuring quality care. Through the process of integrating theory and practice, the student can focus on factors that are critical to understanding the situation. The lack of uniformity in theory definitions reflects the evolution of thought and the individual differences in the understanding of relationships among theory, practice, and research.
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The use of theory in population-focused community health nursing encourages which of the following? (Select all that apply.) A. A reactive approach to care B. A proactive approach to care C. Development of population-focused programs D. Development of individual-focused health protocols for community use
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B & C. Theory assists the community health nurse in applying upstream thinking, including a proactive approach to population-focused care. A reactive or individual approach prevents progress toward "big picture" initiatives and population-based programs.
