1. Which are recommendations made by the World Health Organization's Commission on Social Determinants of Health (CSDH)? (Select all that apply.)
A) Improve conditions under which all people are born, grow, live, work, and age
B) Provide increased funding
Ans: A, C, E
Feedback: The three overall recommendations of the CSDH are to: (1) improve the conditions under which all people are born, grow, live, work, and age to minimum standards; (2) ensure more equitable distribution of power, money, and resources;
2. The nurse is in charge of a local community program that uses a logic model as a planning and communication tool. Which key components are included in this model? (Select all that apply.)
A) Milestones for completing a community health clinic
B) Plan t
Ans: A, B, C, E
Feedback: A logic model for a community health program is a visual representation of the logic behind the operation of the program�who will receive services (target population), what will be done (activities), when it will happen (timeline
3. Which characterize health inequities? (Select all that apply.)
A) Necessary
B) Unfair
C) Resulting from social injustices
D) Avoidable
E) Natural
Ans: B, C, D
Feedback: According to Falk-Rafael and Betker (2012), "Health disparities become health inequities when they are unnecessary, unfair, and preventable resulting from social injustices that become engrained in the fabric of society through its
4. Which changes in the environment (second level from the bottom of the health impact pyramid) make the choice for a healthy behavior the default or easy choice? (Select all that apply.)
A) Iodization of salt
B) Restrictions on smoking in public places
C
Ans: A, B, D
Feedback: At the second level from the bottom of the health impact pyramid are interventions that change the environment or options available so that making the choice for a healthy behavior is the "default" or easy choice whereas choosing a
5. Which exemplify clinical interventions (the level just above the middle of the health impact pyramid)? (Select all that apply.)
A) Administration of insulin injections for diabetes
B) Restrictions on smoking in public places
C) Community immunization p
Ans: A, E
Feedback: At the level just above the middle of the pyramid are clinical interventions such as treatment of hypertension, hyperlipidemia, and diabetes. At the second level from the bottom of the health impact pyramid are interventions that chang
6. The nurse prepares community program objectives that are specific, measurable, achievable, relevant, and time bound (SMART) to help in planning interventions and establishing measurement systems to evaluate programs and outcomes. Which is a measurable
Ans: C
Feedback: Blood pressure for children aged 12 to 18 years in Marks School will be reduced by 5% after petting the dog for 1 day in March 2019 is an example of a measurable objective. The other objectives listed are not SMART objectives because the
7. Which aspects of Lewin's change theory will help people visualize and create needed change? (Select all that apply.)
A) Unfreezing the status quo
B) Changing or moving to a new state
C) Enforcing the status quo
D) Refreezing to sustain the change or ch
Ans: A, B, D
Feedback: In Lewin's model of change, the change process can be visualized as three steps: unfreezing the status quo, changing or moving to a new state, and refreezing to sustain the change or changes made. Force field analysis is a tool used
8. Which most accurately describes the purpose of force field analysis?
A) Unfreezing the status quo
B) Changing or moving to a new state
C) Identifying the forces driving the change and those resisting it
D) Refreezing to sustain the change or changes ma
Ans: C
Feedback: Force field analysis involves identifying factors within a community or organization that are driving or reinforcing change in the desired direction, as well as those that are restraining or resisting change. The change process in Lewin's
9. The nurse researches whether the community would benefit from monthly blood pressure clinics. Which system level would such an intervention address?
A) Upstream
B) Mainstream
C) Sidestream
D) Downstream
Ans: D
Feedback: Mainstream interventions effect change at the population or community level, as in this scenario. Upstream interventions effect change at the societal, environmental, or policy level. Downstream interventions effect change at the individu
10. As an advocate for leukemia research, the nurse along with many others succeeded in urging the U.S. Congress to debate and vote on a bill that significantly increases federal funding for this research. Which system level would such an intervention add
Ans: A
Feedback: Upstream interventions effect change at the societal, environmental, or policy level; such is the case in this scenario. Mainstream interventions effect change at the population or community level. Downstream interventions effect change a
11. Select the examples of social marketing. (Select all that apply.)
A) Ad campaign for a new brand of toothpaste
B) Brochure placed in obstetricians' offices promoting the benefits of breastfeeding
C) Infomercial on television presenting the advantages
Ans: B, D, E
Feedback: Social marketing is the use of marketing principles and practices to change health behaviors or beliefs, social or cultural norms, or community standards to improve health or benefit society. Examples include the use of social marke
12. The nurse decided to approach local organizations for financial and in-kind support for a new community health initiative. On which local resources can the nurse draw? (Select all that apply.)
A) Catholic church
B) Branch of Bank of America
C) Car dea
Ans: A, B, C
Feedback: Local banks and other businesses, faith communities, civic groups such as Rotary International or the Junior League, and other local resources may provide seed money, matching funds, or in-kind support for community health programs.
13. The nurse researches the role of nurse-managed health centers in the city. Which are common characteristics of these centers? (Select all that apply.)
A) Led by advanced-practice nurses
B) Serve upper-income mothers and children
C) Emphasize health pr
Ans: A, C, D, E
Feedback: Nurse-managed health centers (NMHCs) are a unique model of community health services led by advanced-practice nurses and providing a wide range of services and programs to vulnerable and underserved populations. The communities s
14. The nurse is reviewing the sources of funding for the local community health intervention program on smoking cessation. In the federal grant proposal, the nurse elaborates on all the various local organizations and private foundations that have pledge
Ans: A
Feedback: Sustainability is an important consideration in program planning and a key factor in grant making. Most funding agencies expect programs to give a clear and convincing plan outlining how efforts started with grant funding will be continue
15. After successfully implementing and managing a smoking cessation program in an inner-city neighborhood for 5 years, the group expands the efforts to include a nearby rural community. After a challenging first year, the nurse finds that with a few modi
Ans: B
Feedback: The ability to replicate or reproduce a successful program within a different community or with a new population aggregate is a test of the strength of the design of an intervention. Sustainability is an important consideration in program
16. The nurse reviews the job descriptions of the community health workers who work with community health nurses and other members of the program team. These workers are responsible for: (Select all that apply.)
A) Serving as a cultural and language bridg
Ans: A, C, D
Feedback: Community health workers provide a cultural and language bridge to the members of the target population. They work with community health nurses and other members of the program team in both urban and rural areas to provide health ed
17. The nurse reviews the logic model and formal evaluation plan of a grant proposal on a community rabies program. Which requirements should be included in the plan to support accountability? (Select all that apply.)
A) Regular communication about funds
Ans: A, B, C
Feedback: Accountability includes regular communication about how funds were used, details of program activities, and progress toward achieving program goals. Proof that the program can be reproduced effectively in other settings would establ
18. Which best defines program replication?
A) Ability to replicate a successful program in the same community a second time
B) Ability to reproduce a successful program within a different community
C) Ability to replicate a successful program with a new
Ans: B
Feedback: The ability to replicate or reproduce a successful program within a different community or with a new population aggregate is a test of the strength of the design of an intervention and is called program replication.
19. The nurse is in the process of forming a coalition to support a community flu shot program. Which step should the nurse take as part of this process? (Select all that apply.)
A) Assign members of the coalition to tasks in a random manner.
B) Seek out
Ans: C, D, E
Feedback: Organizers of a coalition should do the following: (1) Make use of the expertise of individual members by asking for their help and input on matters directly related to their field. (2) Seek out people with a range of opinions and r
20. Which best illustrates systems theory?
A) School systems in two different counties each setting up their own independent afterschool exercise programs
B) Father being challenged to stop smoking because his daughter learned of the hazards of smoking fr
Ans: B
Feedback: A community is a complex system of human activity conducted within the context of the social and ecological environment. Every family, neighborhood, workplace, school, and recreational facility is itself a system with its own boundaries,
21. Which is the first step in developing a plan for evaluating a community-level intervention?
A) Determine indicators or measures to answer evaluation questions
B) Decide what method you will use to collect data
C) Develop evaluation questions
D) Decide
Ans: C
Feedback: Steps in developing a plan for evaluating a community-level intervention include the following: (1) Develop evaluation questions "focused on what happened, how well it happened, why it happened the way it did, and what the results were";