Chapter 21: The Nursing Center: A Model for Nursing Practice in the Community

MULTIPLE CHOICE

1. Which type of nursing center actively integrates service, education, and research in its model?
a. Special care
b. Freestanding organization
c. Fee-for-service
d. Academic
ANS: D
Academic nursing centers actively integrate service, education, and research in their model.

DIF: COG: Understanding REF: 463|465 OBJ: 1

2. Which type of nursing center operates under a service model?

a. Free-standing center
b. Affiliated center
c. Comprehensive primary care center
d. Community center
ANS: C
The service model includes comprehensive primary care centers, wellness centers, and special care centers.

DIF: COG: Understanding REF: 464 OBJ: 1

3. What is the focus of a special care nursing center?

a. A particular demographical group or those with special care needs
b. An affiliation with a school of nursing
c. Providing services while maintaining a not-for-profit status
d. Providing fee-for-service care with designated HMO providers
ANS: A
Special care centers focus on a particular demographical group or those with special needs. Examples are those
that focus on persons with HIV/AIDS, adolescent mothers, and the frail elderly.

DIF: COG: Understanding REF: 464 OBJ: 1

4. Which characteristic is common among all nursing centers?

a. Provision of community-based culturally competent care
b. Services provided by physicians and health care providers
c. Focus on the biological factors contributing to the development of disease
d. Fee-for-service reimbursement model
ANS: A
One characteristic that is common among all nursing centers is the provision of community-based culturally
competent care that is accessible, acceptable, and responsive to the populations being served.

DIF: COG: Understanding REF: 463 OBJ: 1

5. What type of services will a client receive when visiting a nursing center?
a. Illness-oriented care
b. Direct access to nursing services
c. Free services
d. Physician diagnosis of health problems
ANS: B
A nursing center deemphasizes illness-oriented care, is reimbursed for services, and uses nurses to diagnose and
treat.
DIF: COG: Applying REF: 463 OBJ: 1

6. A client would like to enroll in a smoking cessation program. Which type of nursing center would be most likely to
provide this type of programming?
a. Academic Nursing
b. Wellness
c. Comprehensive Primary Care
d. Special Care
ANS: B
Wellness centers focus on health promotion, disease prevention, and management programs.

DIF: COG: Applying REF: 464|477 OBJ: 1

7. A nurse executive reports that the nursing center receives reimbursement through contracted rates. What type of
reimbursement mechanism is being used?
a. Fee-for-service
b. Federally Qualified Health Center (FQHC)
c. HMO provider
d. Third-party reimbursement
ANS: C
HMO providers pay at contracted rates.

DIF: COG: Applying REF: 464 OBJ: 1

8. Which health promotion topic would most likely be discussed in a class held at a nursing center?
a. Advanced care of the chronically ill elderly at home
b. Smoking cessation and weight management techniques
c. How to provide primary services
d. Providing financial support for nursing students
ANS: B
Smoking cessation and weight management techniques focus on health promotion.

DIF: COG: Analyzing REF: 463-464 OBJ: 1

9. Individuals, families, groups, organizations, policy makers, and staff who are involved in community collaboration
are known as:
a. Nursing Center workers
b. Policy makers
c. Stakeholders

d. Diversity
ANS: C
Stakeholders offer diversity in perspective in community collaborative efforts.

DIF: COG: Remembering REF: 467 OBJ: 2

10. How can a nursing center best be responsive to the needs of the community?
a. Having staff examine the needs of the community
b. Determining the services to be established by the center
c. Involving the community in assessing its own needs
d. Addressing the problems in the community
ANS: C
Nurses work in close partnership with the communities. As the community and center work together, a multilevel
approach is needed. For comprehensive community health improvement, strategies are needed at organizational,
community, and sociopolitical levels. Thus, it is important to involve the community in the planning of a nursing
center.
DIF: COG: Applying REF: 468|472 OBJ: 2

11. A nursing center is going to be placed in a rural community. Who has the most power and influence on model
development and team composition?
a. The rural community
b. The mayor
c. The nursing executive
d. The center’s staff
ANS: A
The fundamental premise of any nursing center is that the community has the most power and influence.

DIF: COG: Applying REF: 470 OBJ: 2

12. Which factor is the most important for the nurse to consider when facilitating successful collaboration?
a. Focus of the group
b. Planned change that will occur
c. Decisions made by executive director
d. Open and frequent communication
ANS: D
Although the focus of the group and its planned change are important, they are not the most important factor for the
nurse to consider. To accomplish anything with the group open and frequent communication is necessary.

DIF: COG: Evaluating REF: 467-468 OBJ: 2

13. What was the overarching concept upon which Healthy People 2020 was built?
a. Establish nursing centers for the purpose of health promotion.
b. Create partnerships among individuals, communities, and systems.
c. Eliminate disease in lesser-developed countries.
d. Further the agenda of the World Health Organization.
ANS: B
Healthy People 2020 builds upon shared responsibility to improve the nation’s health. Powerful, productive
partnerships among diverse people and groups and long-term commitments to community collaboration are needed
to achieve these goals.

DIF: COG: Understanding REF: 467 OBJ: 3

14. Which level of prevention is being used when a community conducts blood lead screenings on a regular basis
for children under 6 years old?
a. Tertiary prevention
b. Primary prevention
c. Secondary prevention
d. Health education
ANS: C
Secondary prevention often involves screening. Primary prevention involves education.

DIF: COG: Applying REF: 469 OBJ: 3

15. Which term addresses the multiple levels of intervention required for bringing about and sustaining change?
a. Community collaboration
b. Community assessment
c. Strategic planning
d. Partnership
ANS: C
Strategic planning addresses the multiple levels of intervention required for bringing about and sustaining change.

DIF: COG: Remembering REF: 468 OBJ: 4

16. A nurse develops a plan to describe the development and direction of the nursing center and identifies how the
center will meet its goals. This plan is called a(n):
a. Feasibility study
b. Business plan
c. Strategic plan
d. Organizational strategies
ANS: B
A business plan describes the development and direction of the nursing center and how goals will be met.

DIF: COG: Applying REF: 472 OBJ: 4

17. When making a final decision about establishing a nursing center, which factor is the most important for the
nurse to consider?
a. Legal and regulatory considerations
b. Community involvement
c. Nursing interest
d. Potential grant funding
ANS: A
Several essential areas must be explored before a final decision is made about establishing a nursing center,
including legal and regulatory considerations.

DIF: COG: Applying REF: 471-472 OBJ: 4

18. When examining the strengths, limitations, and capacity of an organization and the community to support the
establishment and viability of a nursing center, a nurse is completing a:
a. Data collection
b. Feasibility study
c. Focus groups
d. Community forums
ANS: B
A feasibility study reveals the strengths, limitations, and capacity of an organization and community to support the
establishment and viability of a nursing center.

DIF: COG: Applying REF: 472 OBJ: 4

19. Which essential step of program evaluation is completed when a nurse executive publishes information about
the effectiveness of a prenatal program?
a. Focusing on design
b. Engaging stakeholders
c. Ensuring use and sharing lessons learned
d. Gathering credible evidence
ANS: D
A nurse executive providing materials on the effectiveness of a prenatal program is an example of gathering credible
evidence.

DIF: COG: Applying REF: 477 OBJ: 4

20. A nurse executive would like to hire a neighborhood resident who is trained in community outreach to work at
the nursing center. What would be the title of this position?
a. Community health worker
b. Support staff member
c. Clinical specialist
d. Specialty care provider
ANS: A
Community health workers are typically neighborhood residents who are trained in community outreach, family case
management, or on-site services.

DIF: COG: Applying REF: 470-471 OBJ: 4

21. In which situation would a nurse be using the Health Insurance Portability and Accountability Act (HIPAA)?
a. When counseling an employee that his insurance will remain the same after changing jobs
b. When supervising staff to ensure that all work has been completed
c. When adhering to client confidentiality when providing care
d. When an employee takes additional time off of work to care for a sick family member
ANS: C
HIPAA also states that staff must monitor and keep client records secure, and have mechanisms to transfer client
information securely and appropriately.

DIF: COG: Analyzing REF: 474 OBJ: 4

22. A nurse has recently completed a research study in a nursing center. Based on the historical pattern of research
in nursing centers, what would likely have been the focus of this research?
a. The development and characteristics of nursing centers
b. The effects of nursing models of care in nursing centers
c. Client outcomes
d. Managed competition in nursing centers
ANS: A
Typically, descriptive data has been collected about clients, types of services, the financial supports, and community
relationships over the past three decades.

DIF: COG: Applying REF: 476-477 OBJ: 5

23. A nurse executive is managing a nursing center. What would be an expected responsibility of a nurse in this
role?
a. Managing the business operations
b. Managing the data systems
c. Providing patient care and referral
d. Overseeing contracts and grants
ANS: D
The nurse executive has many leadership roles and responsibilities including responsibility for overseeing contracts
and grants, annual reports, development of the advisory board, and hiring and retention of highly qualified staff.

DIF: COG: Applying REF: 470 OBJ: 5

24. What is an appropriate role for a nursing student to engage in while working in a nursing center?
a. Leader
b. Follower
c. Advocate
d. Researcher
ANS: C
Students most often play the role of advocate in a nursing center. Students have the opportunity to promote social
justice while engaging in community service learning activities with underserved, vulnerable populations. A student
needs to be a leader, but with supervision. A student can collect data, but is not yet a researcher.

DIF: COG: Evaluating REF: 471 OBJ: 5

25. A nurse is presenting information to community members about the potential development of a retail care clinic
in the neighborhood. What information would the nurse include in this presentation?
a. These clinics are typically staffed by physicians.
b. These clinics are usually located in community centers.
c. These clinics focus on providing information related to health promotion.
d. These clinics are many times owned by for-profit organizations.
ANS: D
Retail care clinics are typically staffed by nurse practitioners, located in a high volume retail business, and provide a
limited scope of care including immunizations, routine school physicals, and care for common acute problems. The
majority of retail clinics are owned by for-profit organizations and its management does not consider the clinics as
nurse-managed health centers.
DIF: COG: Applying REF: 477 OBJ: 6

26. A nursing faculty member is discussing the importance of joining a professional organization as a registered
nurse with a group of undergraduate students. Which statement would be most appropriate for the faculty member
to include in this discussion?
a. “All nurses should be members of the American Nurses Association.”
b. “Membership in a professional organization helps nurses organize around critical health issues.”
c. “Dues for professional organizations are expensive, so it is important to set aside money to pay these dues.”
d. “Membership in a professional organization will foster change in legislation.”
ANS: B
Membership in a professional organization helps nurses to organize around one or more critical health threats and
strategize about what interventions work locally, regionally, and nationally. Membership in organizations should be
based on interest, clinical and academic preparation, and employment. Dues for professional organizations vary, but
most are not extremely expensive. One of the benefits of membership in a professional organization is that
legislation can be influenced, however this in only one of the benefits of belonging to a professional organization.

DIF: COG: Analyzing REF: 478 OBJ: 6

MULTIPLE RESPONSE

1. Which would be an appropriate source for a nurse to look for financial support when developing a nursing center?
Select all that apply.
a. Grant funding
b. Charitable organizations
c. Private pledges
d. Foundations
ANS: A, B, C, D
Support for nursing centers can come from grants, charitable organizations, private pledges, and foundations.

DIF: COG: Applying REF: 473 OBJ: 1

2. A nurse is performing the role of researcher in a nurse center. Which type of data would most likely be collected
by a nurse in this setting? Select all that apply.
a. Client use of services
b. Trends in community characteristics
c. Staff compliance with HIPAA
d. Client satisfaction
ANS: A, B, D
Trends in health care services, client responses, and changes in community characteristics must be documented
and summarized periodically. Outcome measurements such as client use of on-site services, childhood and adult
immunization patterns, pregnancy outcomes, emergency department and hospital use, and other health indexes
including client satisfaction and quality-of-life measures should also be collected. Staff compliance with HIPAA is a
legal responsibility of staff and data should not need to be collected about this topic.

DIF: COG: Applying REF: 474 OBJ: 5