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advanced nursing practice. Here are the common questions:

1. A public health nursing department seeks data to confirm that its service is most efficiently using limited resources. This type of analysis is known as:
 A. a cost-benefit analysis.
 B. a cost-effectiveness analysis.
 C. cost documentation.
D. productivity analysis.

2. The author of a research study states that the lack of statistical significance in the results may be related to the sample size and suggests that the study be replicated with a larger sample. Which statement is accurate?
A. An exact replication may produce the same results.
B. Replication of a well-designed study is appropriate.
C. Sample size is not important if the appropriate statistical techniques are applied.
D. Sample size is not related to statistical significance, so the author's suggestion is illogical.

3. Which rate is produced by dividing the number of deaths during one year by the estimated (mid-year) population?
A. Crude deaths
B. Morbidity incidence
C. Mortality prevalence
D. Proportional population rate

4. Within an epidemiological framework, interrelationships among a multitude of factors constitute the:
 A. confounding variables.
 B. natural history of a disease.
 C. systems effect.
 D. web of causation.

5. A statistical source for population age distributions, dependency ratios, and socioeconomic characteristics is:
 A. census data.
 B. morbidity data.
 C. service utilization data.
 D. vital statistics.

6. Which scale refers to levels of magnitude or ranking?
A. Interval
B. Nominal
C. Ordinal
D. Ratio        

7. Which type of power is associated with the role of the advanced public health nurse?
A. Expert
B. Legitimate
C. Referent
D. Reward

8. A grant proposal for a domestic violence prevention program addresses which characteristic of the target population?
A. Current health care needs
B.  Prevalent risk factors
C.  Specific health conditions
D.  Utilization of health care services

9. Surveying clients' knowledge of resources, identifying resource eligibility criteria, and comparing income levels with agency fee structures are steps in which part of the grant proposal process?
A. Budgeting
B. Evaluation
C. Needs assessment
D. Program design

10. When assessing a community's health care needs, an advanced public health nurse interviews a first-grade teacher and the editor of the weekly news bulletin. The nurse is using which data collection method?
A. Key informant
B. Nominal group
C. Participant observer
D. Social survey

11. The primary role of an advisory board for a community-based health organization is to:
A. advocate for the community.
B. determine services to be provided.
C. develop policies and regulations.
D. provide funding advice to the health director.

12. The primary purpose for establishing nursing standards in public/community health settings is to:
 A. describe and measure health care outcomes.
 B. evaluate the performance of health care professionals.
 C. implement current nursing skills and knowledge.
D. provide guidelines for improving the quality of care.

13. The results of a cost-effectiveness analysis of a health care service are usually expressed in terms of:
  A. a particular health objective.
 B. consumer satisfaction.
  C.the type of service provided.
  D. utilization of specific health programs.

14. The three essential elements of informed consent are:
 A. accountability, beneficence, and paternalism.
 B. confidentiality, truthfulness, and advocacy.
 C. financial risk, rule of utility, and protection of privacy.
 D. information, comprehension, and freedom from coercion.

15. Which program is an example of secondary prevention?
 A. A community-wide nutrition program at fast-food establishments
 B. A program to immunize persons exposed to infectious disease with immunoglobulin G within two weeks of exposure
 C. Alcoholics Anonymous
 D. An exercise program for persons who have had a stroke

16. A community receives a grant for a health promotion program in a local school. The community health department plans to appoint one representative from its nursing division to serve on the implementation planning committee. Who is the most appropriate representative?
 A. An advanced public health nurse from the health department clinic whose own children attend the school
 B. An advanced public health nurse who is the nursing supervisor for the school's geographic area
 C. An advanced public health nurse who precepts nursing students in providing school-based health care
 D. The school nurse who is responsible for one census tract in the geographic area

17. A foodborne outbreak of salmonellosis has twice occurred at a day-treatment program. The environmental health worker has requested that an advanced public health nurse be included in the next inspection of the program's kitchen. During the visit, the nurse's primary concern is to:
 A. educate the kitchen workers about safe food preparation.
 B. ensure the workers' understanding of various microorganisms.
 C. identify other resources for providing food service.
 D. promote the health of clients affected by the previous outbreaks.

18. The normative-reeducative strategy of change theory assumes that:
 A. attitudes and practices are determined by cultural norms and knowledge is insufficient to change behavior.
 B. client compliance can be achieved through the use of power to effect change.
 C. people are rational and will adopt a new practice if it is in their best interest.
 D. the driving and restraining forces needed for unfreezing can be identified in order to facilitate change.

19. The most effective way to assess the health care needs of older adults in a community is to:
 A. conduct personal interviews with local health care and social services professionals.
 B. rely on intuitive impressions obtained from working with older persons.
 C. review demographic data from the most recent census.
 D. survey a random sample of adult children who do not reside in the community.

20. A tornado strikes a mobile home community in a small rural town. Approximately 10 families are left without food and shelter. Which reaction demonstrates the community's viability?
 A. Community leaders activate the community disaster plan.
 B. Community leaders contact the federal government about disaster relief.
 C. Relief workers run out of bottled water and bedding supplies.
 D. Tornado victims are sent to a boarding home in the nearest urban area.

21. Mortality rates from two communities can best be compared after calculating:
 A. the age-adjusted rates.
 B. the crude rates.
 C. the gender-specific rates.
 D. the prevalence rates.

22. Who established the Frontier Nursing Service to address the rural health needs of people in Kentucky?
 A. Lillian Wald
 B. Mary Breckenridge
 C. Mary Brewster
 D. William Rathborne

23. In planning a telehealth consultation system for a rural community, an advanced public health nurse first focuses on the:
 A. distances between the hub and the spoke servers.
 B. needs of the community's residents and providers.
 C. number of anticipated contacts per week.
 D. sources of funding for capital and operating expenses.

24. Two days after a tornado, an advanced public health nurse meets with a group of survivors. Which emotional reaction by the survivors does the advanced public health nurse expect?
 A. Confusion and disillusionment
 B. Enthusiasm and high optimism
 C. Frustration with bureaucratic delays
 D. Intense excitement

25. An advanced public health nurse investigates a cluster of cases of learning disabilities, hearing impairment, and developmental delays in school-age children who live in an apartment complex that was built in 1971. The nurse suspects exposure to:
 A. carbon monoxide.
 B. lead.
 C. nitrogen dioxide.
 D. radon.

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