# Situation: A public health nurse is assigned to a coastal barangay of 3,200 residents that has never had a community assessment. The Rural Health Unit (RHU) needs baseline data for its multi-year plan. A year after the baseline assessment, dengue cases rise, and the RHU asks the nurse to prepare data for planning a dengue control program. She gathers the ages and home locations of cases, water storage and garbage disposal practices, residents' beliefs about dengue, and the dengue services available. Which type of community diagnosis is she doing?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627272  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: A public health nurse is assigned to a coastal barangay of 3,200 residents that has never had a community assessment. The Rural Health Unit (RHU) needs baseline data for its multi-year plan.

A year after the baseline assessment, dengue cases rise, and the RHU asks the nurse to prepare data for planning a dengue control program. She gathers the ages and home locations of cases, water storage and garbage disposal practices, residents' beliefs about dengue, and the dengue services available. Which type of community diagnosis is she doing?

## 보기

1. Comprehensive diagnosis
2. Problem-oriented diagnosis **✔ 정답**
3. Rapid community appraisal
4. Health facility assessment

**정답: 2**

## 해설

A problem-oriented (task-oriented) community diagnosis focuses on a specific, already recognized problem or program area, such as a rise in dengue or planning a single program. The nurse draws on several parameters (demographic, environmental, cultural, and health services data), but all of them are selected for one problem, so the diagnosis is problem-oriented. A comprehensive diagnosis gathers a broad picture of the whole community for a baseline, which was already done.

## 심화 해설

Understanding the question

The nurse is not starting from scratch. A baseline comprehensive community diagnosis was already completed one year earlier. Now the focus has narrowed to a single, recognized health issue: the rise in dengue cases. The data being gathered—ages and locations of cases, water storage and garbage disposal practices, beliefs about dengue, and available dengue services—are all selected because they relate to one problem and one program.

When assessment data are organized around one specific health problem or program area, the process is called a problem-oriented community diagnosis. This is sometimes also called a task-oriented diagnosis because the nurse is completing a task: preparing data to plan a dengue control program.

Watch out! The presence of multiple data categories—demographic, environmental, cultural, and health services—does not make the diagnosis comprehensive. What matters is the purpose. Here, every piece of information is chosen to understand and address dengue, not to describe the whole community.

Why the other options do not fit

| Option | Why it is incorrect |
| --- | --- |
| 1. Comprehensive diagnosis | A comprehensive diagnosis gathers a broad picture of the entire community—health status, resources, environment, culture, and more—to establish a baseline. That was already done one year earlier. The current activity is narrower and problem-specific. |
| 3. Rapid community appraisal | Rapid appraisal uses quick, low-cost methods such as key informant interviews, focus groups, and secondary data to get a fast overview. The scenario describes a more structured, data-rich collection focused on one disease, not a rapid scan. |
| 4. Health facility assessment | This evaluates the capacity, services, and performance of a health facility. Although the nurse gathers information on available dengue services, the assessment extends well beyond the facility to include household practices, community beliefs, and case distribution. |

Connecting to dengue control practice

The data categories in the scenario reflect what dengue control programs actually need. Water storage and garbage disposal practices matter because Aedes aegypti mosquitoes breed in clean, stagnant water found in containers and discarded items around homes. Community beliefs about dengue influence whether residents will accept and sustain preventive behaviors. Knowing the ages and home locations of cases helps identify high-risk groups and geographic clustering.

Community participation and local behavioral change are central to dengue prevention, not just vector spraying by health workers. The patio limpio strategy in Mexico demonstrated that mobilizing residents to clean their patios and eliminate breeding sites is a core component of integrated dengue control . Understanding residents' knowledge, attitudes, and practices is therefore essential for designing targeted education and vector control interventions .

Key point! A problem-oriented diagnosis does not mean collecting less data. It means selecting data that are relevant to one problem. The nurse still examines multiple parameters—demographic, environmental, cultural, and service-related—but all are filtered through the lens of dengue.

How this appears on licensure exams

Questions like this test whether you can distinguish the purpose of an assessment from the type of data collected. The same data set could be part of a comprehensive diagnosis if the goal were to describe the entire community. It becomes problem-oriented when the goal is to plan for one identified problem.

The trigger phrase in the stem is "a year after the baseline assessment" combined with "planning a dengue control program." That tells you the comprehensive phase is finished and the nurse is now working on a focused, task-specific diagnosis.

Watch out! Do not select "comprehensive" simply because the nurse gathers many types of data. Look at why the data are being collected. If the purpose is one program for one problem, the diagnosis is problem-oriented regardless of how many parameters are included.

## 임상 시나리오

Problem-Oriented Community DiagnosisWhen baseline data exists and a specific issue emerges
A problem-oriented diagnosis focuses on a single recognized health problem or program area. Data collected—demographic, environmental, cultural, health services—are all selected for one problem, such as a dengue outbreak.

If a comprehensive baseline was already completed, subsequent focused data collection for a specific program is problem-oriented, not comprehensive. The purpose determines the type, not the number of data categories.

CautionMultiple data categories do not make a diagnosis comprehensive. Assess the purpose: broad community picture versus targeted program planning.

## 핵심 개념

- **Problem-oriented diagnosis** — Community diagnosis focused on a specific recognized health problem or program area, selecting only data relevant to that issue
- **Comprehensive diagnosis** — Broad assessment of the entire community's health status, resources, environment, and culture to establish a baseline
- **Rapid community appraisal** — Quick, low-cost assessment method using key informant interviews and focus groups for timely decision-making
- **Community diagnosis** — Systematic process of identifying community health needs, problems, and resources to guide planning

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