COHN Community Public Health Nursing 4 — Questions and Answers
Question 1: A nurse is applying the Precede-Proceed model to plan a diabetes prevention program. Which phase involves identifying predisposing, reinforcing, and enabling factors?
- Epidemiological assessment
- Educational and ecological assessment (Correct answer)
- Policy and organizational assessment
- Process evaluation
Correct answer: Educational and ecological assessment
The educational and ecological assessment phase (Phase 3) of Precede-Proceed identifies predisposing, reinforcing, and enabling factors that influence behavior.
Question 2: Which criterion distinguishes a 'sentinel event' in public health surveillance?
- High case fatality rate
- A case whose occurrence signals a possible failure of prevention or control (Correct answer)
- Disease affecting more than 100 people
- Any hospital-acquired infection
Correct answer: A case whose occurrence signals a possible failure of prevention or control
A sentinel event is one that, by its occurrence, signals that something went wrong in the prevention system and warrants investigation.
Question 3: A community health nurse advocates for fluoridation of the municipal water supply. This is an example of which public health role?
- Case manager
- Educator
- Policy advocate (Correct answer)
- Direct care provider
Correct answer: Policy advocate
Advocating for evidence-based policy changes such as water fluoridation reflects the policy advocate role in community/public health nursing.
Question 4: Which outbreak investigation step occurs IMMEDIATELY after establishing the case definition?
- Implementing control measures
- Finding and counting cases (Correct answer)
- Identifying the source
- Writing the epidemiological report
Correct answer: Finding and counting cases
After defining a case, the next step is to systematically search for and count all cases meeting that definition.
Question 5: The healthy immigrant effect refers to the observation that:
- Immigrants receive better health care than native-born citizens
- Newly arrived immigrants are often healthier than native-born peers but health deteriorates over time (Correct answer)
- Immigration causes stress that immediately worsens health
- Immigrants overuse emergency health services
Correct answer: Newly arrived immigrants are often healthier than native-born peers but health deteriorates over time
Newly arrived immigrants tend to be healthier than US-born counterparts due to self-selection, but this advantage diminishes with longer US residence.
Question 6: A school nurse notices increased absenteeism among students from one neighborhood after heavy rain. The nurse's BEST action reflecting environmental health practice is to:
- Send absence letters to parents
- Investigate potential environmental causes such as flooding or mold exposure (Correct answer)
- Increase on-site vaccination coverage
- Request a mental health counselor for students
Correct answer: Investigate potential environmental causes such as flooding or mold exposure
Linking absenteeism patterns to environmental events like flooding requires investigation into physical hazards such as mold or contaminated water.
Question 7: Primary care differs from public health nursing primarily because public health nursing focuses on:
- Diagnosing individual illness
- Prescribing evidence-based treatments
- Improving health across entire populations (Correct answer)
- Providing continuous personal care to individuals
Correct answer: Improving health across entire populations
Public health nursing's defining characteristic is its population focus — it aims to improve the health of communities rather than individual patients.
COHN Community Public Health Nursing 4
A nurse is applying the Precede-Proceed model to plan a diabetes prevention program.
Which phase involves identifying predisposing, reinforcing, and enabling factors?