Chapter 02: The History of Public Health and Public and Community Health Nursing Stanhope: Foundations for Population Health in Community/Public Health Nursing, 5th Edition,100% CORRECT

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Chapter 02: The History of Public Health and Public and Community Health Nursing Stanhope: Foundations for Population Health in Community/Public Health Nursing, 5th Edition MULTIPLE CHOICE 1. ... A nurse is considering applying for a position as a public health nurse. Which of the following would be a reason this position would be appealing? a. Its autonomy and independence b. Its focus on acute care and immediately visible outcomes c. Its collaboration with other health care professionals d. Its flexibility and higher wages ANS: A Public health nursing is known for its autonomy and independence. In many instances, there are limited other health care professionals and staff with whom to interact. In-patient acute care nurses focus on acute care with outcomes known fairly quickly. Acute care nurses collaborate frequently with other health care professionals. Depending on the position there may be more flexibility, but typically public health nurses do not receive higher wages. 2. The Elizabethan Poor Law of 1601 is similar to which current law? a. Welfare b. Food stamps c. Medicaid d. Medicare ANS: C NURSINGTB.COM The Elizabethan Poor Law guaranteed medical care for poor, blind, and “lame” individuals, similar to Medicaid. Welfare and food stamps do not provide for medical care. Medicare provides medical care to primarily the elderly population. 3. How did the Industrial Revolution result in previous caregiving approaches, such as care by families, friends, and neighbors, becoming inadequate? a. Economic and political wars resulted in frequent death and injuries. b. Incredible plagues consistently and constantly swept the European continent. c. Migration and urbanization resulted in increased demand for care. d. Caregivers could easily find other employment, so they demanded to be paid. ANS: C Care became inadequate because of the social changes in Europe, with great advances in transportation, communication, and other technologies. The increased mobility led to migration and urbanization, which in turn led to increased need for care. The Industrial Revolution was a time of great advances in technology, transportation, and communication, not a time of economic and political unrest or a time where incredible plagues occurred in Europe. Caregivers during this time period were typically poorly educated and untrained, so there was not an issue related to wages or employment. 4. A colonist is working in the public health sector in early colonial America. Which of the following activities would have likely been completed? a. Establishing schools of nursing b. Developing vaccines to administer to large numbers of people c. Collecting vital statistics and improving sanitation d. Developing public housing and almshouses ANS: C Collecting vital statistics and improving sanitation are examples of activities from the early colonial America. Establishing schools of nursing, developing vaccines to administer to large numbers of people, and developing public housing and almshouses all happened after the colonial period. 5. Why did American citizens become interested in establishing government-sponsored boards of health? a. They were afraid of infectious diseases such as yellow fever. b. The government could force the poverty-stricken to accept care. c. Such boards could tax and thereby ensure adequate funds to pay for care. d. Such a system would allow for accurate records of births and deaths. ANS: A Threat of disease, especially yellow fever, led to public interest in establishing government-sponsored, or official, boards of health. The threat of disease was the impotus for creation of the boards of establishing boards of health. The primary interest of the boards of health was to provide public health services for the entire population and not only those who were poverty-stricken. The primary purpose of the boards of health was not to collect accurate vital statistics or receive tax dollars rather its purpose was to ensure the health of the population. 6. A nurse was employed by the Marine Hospital Service in 1800. Which of the following interventions would the nurseNmUoRsSt lIikNelGy ThaBv.e CcoOmMpleted? a. Setting policy on quarantine legislation for immigrants b. Establishing hospital-based programs to care for the sick at home c. Identifying and improving environmental conditions d. Providing health care for merchant seamen ANS: D Providing health care to seamen was an early effort by the federal government to improve public health. The purpose of the Marine Hospital Service was to secure its maritime trade and seacoast cities. Quarantine legislation was enacted by legislation during this time period, but the nurse would not have been responsible for setting these policies. Nursing care for clients in the home began in the first half of the 1800s through a variety of agencies including the Ladies’ Benevolent Society of Charleston South Carolina. Identifying and improving environmental conditions was a focus of the public boards of health, not necessarily specifically a role of the nurse. 7. What was the outcome of the Shattuck Report? a. Efforts to control alcohol and drug abuse, as well as tobacco use, were initiated. b. Environmental sanitation efforts became an immediate priority. c. Guidelines for modern public health organizations were eventually developed. d. Local and state governments established boards of health after its publication. ANS: C It took 19 years for the first of Shattuck’s recommendations to be implemented, but his report was the first effort to create a modern public health organization. This report called for broad changes to improve the public’s health to take place; however, these changes did not happen immediately after publication. They took 19 years to be implemented in the first state of Massachusetts. The report included establishment of a state heatlh department and local health boards in every town, sanitary surveys, and food, drug, and communicable disease control, but none of these changes happened quickly. 8. Which of the following nurses is famous for creating public health nursing in the United States? a. Florence Nightingale b. Frances Root c. Lillian Wald d. Mrs. Solomon Loeb ANS: C Lillian Wald established the Henry Street Settlement and later emerged as the established leader of public health nursing during its early decades. Mrs. Solomon Loeb was a wealthy layperson who assisted Mary Brewster in the establishment of the Henry Street Nurses Settlement. Francis Root was the first trained nurse in the United States who was salaried as a visiting nurse. Florence Nightingale had many accomplishments, but none of these occurred in the United States. 9. Which of the following would have been the focus of a school nurse in the early 20th century? a. Investigating causes of absenteeism b. Teaching school as well as being a nurse c. Promoting nursing as an NautoRnomIouGs prBac.ticCe M d. Providing medical treatment to enable children to return to school ANS: A Early school nursing focused on investigating causes of absenteeism. Providing medical treatment was the responsibility of physicians. School nurses did not teach in the schools nor were they part of an autonomous practice during this time period. 10. A nurse is reviewing the original work of the National Organization for Public Health Nursing. Which of the following accomplishments of today was started within this organization? a. Requiring that public health nurses have a baccalaureate degree in nursing b. Standardizing public health nursing education c. Developing public health nursing competencies d. Opening the Henry Street Settlement ANS: B The National Organization for Public Health Nursing sought to improve the educational and services standards of public health nursing. The Henry Street Settlement was already in existence and was opened by Lillian Wald and Mary Brewster. The baccalaureate degree in nursing was not developed yet. Public health nursing competencies were developed by the Quad Council. 11. Why were nurses so unprepared for public health nursing in the early 20th century? a. Public health nursing had not yet been created as a field. b. No one would teach the nurses how to engage in public health activities. c. Nightingale’s textbook did not include content on public health nursing. d. Nurses were educated in diploma schools, which focused on care of hospitalized clients. ANS: D Nursing school courses taught in diploma schools of nursing emphasized hospital care of patients; thus, nurses were unprepared for home visiting. The specialty of public health nursing practice was developed in the early 1800s. There was not a lack of teachers for this activity, rather the focus of nursing care was in the acute care setting and not in the community. Nightingale did not have a published textbook. 12. A nurse is considering joining the American Public Health Association (APHA). What information about this organization should be considered when making this decision? a. APHA focuses on the public health concerns of the medical profession. b. APHA represents concerns of nursing specialty practices. c. APHA provides a national forum for nurses to discuss their public health concerns. d. APHA focuses on providing health promotion education to the public. ANS: C APHA was formed to facilitate interprofessional efforts and promote the “practical application of public hygiene.” The Public Health Nursing Section within APHA provides nurses with a national forum to discuss their concerns and strategies within the larger context of the major public health organization. It also serves as a focus of leadership and policy development for community/public health nursing. The focus of public health concerns of the APHA is broader than only the medical profession. The APHA focuses on concerns of public health nurses, not all nursing specialty practice. The APHA focuses on practical application of public hygiene, which is broader than only heNaUlthRpSroImNoGtiTonBe.dCucOatMion. 13. Why did the Metropolitan Life Insurance Company establish and retain for several years the first community nursing health program for policyholders? a. Creating such a service was the morally correct thing to do. b. Employing nurses directly was less expensive than paying taxes to the city for the same purpose. c. Having the company’s nurses make home visits increased worker morale. d. Having public health nurses visit policyholders and their families led to a decline in policyholder deaths, thus lowering costs for the insurance company. ANS: D Metropolitan Life saw an average decline of 7% in the mortality rate of policyholders and almost a 20% decline in the deaths of children under the age of 3 years. The insurance company attributed this improvement and the associated reduced costs to the work of visiting nurses. There was limited funding in the early twentieth centurty to extending nursing services in the community; thus, home visiting was a very expensive service to provide. Although Metropolitan Life Insurance Company may have increased worker morale that was not the primary reason for continuation of the program. 14. Which client would have been most likely to receive care from the Frontier Nursing Service? a. An injured soldier b. A homebound, elderly male c. A woman in labor d. A child with a broken femur ANS: C The Frontier Nursing Service nurses were trained in nursing, public health, and midwifery and provided care to rural and inaccessible areas, which led to reduced mortality. Care for soldiers, elderly, and children was not the focus of the care provided by the Frontier Nursing Service. 15. A public health nurse is determining what type of programming should be developed for the community. Which of the following is the most crucial factor that will influence program development? a. Comprehensive assessment and planning done in the community b. Documented needs of the local community c. Federal funding for priority diseases or groups d. Nursing staff’s expertise and skills ANS: C Programs are designed to fit funding priorities; thus, the areas supported by Congress determine the categories in which most effort is focused locally. A need in the community may be identified through community assessment, planning, and looking at needs in the community; however, without funding there will not be a way to create necessary programming. The expertise of the staff should not be the determining factor when deciding on programming in the community. 16. A nursing student during World War II would likely join which group? a. The US Public Health Service b. The Marine Nurse Corps c. The Frontier Nursing SerNviUceRSINGTB.COM d. The Cadet Nurse Corps ANS: D The Bolton Act of 1943 established the Cadet Nurse Corps during World War II, which increased enrollment in schools of nursing at undergraduate and graduate levels. The U.S. Public Health Serive began to use nurses during World War I to establish a public health nursing program for military outposts. The Marine Hospital Service was established well before World War II in 1798. The Frontier Nursing Service was established by Mary Breckinridge in 1925 and provided health care to the rural and often inaccessible populations in the Appalachian region of southeastern Kentucky. 17. A public health nurse is compiling information about how to promote early detection of breast cancer in women. Which document would most likely provide useful information about this topic? a. The Future of Public Health b. Healthy People 2020 c. Patient Protection and Affordable Care Act d. Scope and Standards of Public Health Nursing Practice ANS: B The Healthy People 2020 documents propose a national strategy to improve significantly the health of Americans by preventing or delaying the onset of major chronic illnesses, injuries, and infectious diseases. The disarray resulting from reduced political support, financing, and effectiveness is described in the The Future of Public Health. The Scope and Standards of Public Health Nursing Practice describes the processes of assessment, analysis, and planning that are carried out by the public health nurse. The Patient Protection and Affordable Care Act improved access to health insurance for Americans. 18. A public health nurse is involved in health care reform. Which of the following best explains why the nurse is involved in these efforts? a. To promote the nursing profession b. To increase funding for public health nursing c. To address the concerns of nurses d. To help improve health care access ANS: D Public health nurses have been involved in health care reform for several years. An emphasis of reform is that health promotion and disease prevention appear to yield reduction in costs and illness/injury incidence while increasing years of healthy life. Health care reform has a larger scope than only the profession of nursing and public health nursing. It addresses the concerns of nurses as well as many other health care professions. MULTIPLE RESPONSE 1. How did Florence Nightingale help bring about community health nursing? (Select all that apply.) a. She convinced socially pNroUmRinSenIt NwGeaTltBhy.wCoOmMen to volunteer to give care. b. She focused on all soldiers and their environment. c. She interacted with each individual person, assessing his or her needs and acting to meet those needs. d. She kept careful records on what was done and what were the results. ANS: B, D Nightingale progressively improved the soldiers’ health using a population-based approach that improved both environmental conditions and nursing care. Using simple epidemiology measures, she documented a decreased mortality rate to demonstrate the outcomes. While Nightingale was part of a wealthy family, the role of nurses during this time period was typically fulfilled by poor women. The focus of Nightingale’s care was to identify health care needs and interventions that influenced the health of the entire population, not individuals. 2. A nurse working with Mary Breckinridge would have likely assisted with: (Select all that apply.) a. establishing the Henry Street Settlement. b. developing health programs geared toward improving the health care of the rural populations. c. blazing a nursing trail through the Rockies, providing nursing care to miners and their families. d. ensuring positive outcomes for pregnancies among women in the Appalachian region. ANS: B, D Mary Breckinridge developed health programs geared toward improving the health care of the rural and often inaccessible populations in the Appalachian regions of the Southern Kentucky. Breckinridge introduced the first nurse-midwives into the United States when she deployed FNS nurses trained in nursing, public health, and midwifery. Their efforts led to reduced pregnancy complications and maternal mortality, and to one-third fewer stillbirths and infant deaths in an area of 700 square miles. Lillian Wald established the Henry Street Settlement. Mary Breckinridge developed health programs geared toward improving the health care of the rural and often inaccessible populations in the Appalachian regions of southern Kentucky, not the Rockies. 3. How did nursing education change in the 1950s? (Select all that apply.) a. Baccalaureate nursing programs typically included public health nursing concepts. b. Diploma schools of nursing continued to expand their student numbers. c. Junior and community colleges began offering nursing programs. d. Nurses were strongly encouraged to have a scientific basis for their practice. ANS: A, C In the 1950s public health nursing became a required part of most baccalaureate nursing education programs. In 1952 nursing education programs began in junior and community colleges. Associate degree programs began to expand their enrollments, not diploma schools. The need for evidence-based practice continues to grow, but was not a change in the 1950s. 4. How did health care and its delivery change during the 1980s? (Select all that apply.) a. Funding to public health increased as funding for acute hospital care decreased. b. Laws began to be passed that discouraged the use of alcohol, drugs, and tobacco. c. Nurse practitioners were increasingly used to provide care. d. Public health programs sufUfereSd reNducTed politOical support, financing, and effectiveness. ANS: B, C, D During the 1980s funding began to shift to meet the costs of acute hospital care, medical procedures, and institutional long-term care. The use of health maintenance organizations was encouraged, and the use of nurse practitioners increased. Consumer and professional advocacy groups urged the passage of laws to prohibit unhealthy practices such as smoking and driving under the influence of alcohol. By the late 1980s, public health had declined in political support, financing, and effectiveness. [Show More]

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