Test Bank for Population And Community Health Nursing 6 Ed By Mary JO Clark

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Population And Community Health Nursing 6 Ed By Mary JO Clark

Population and Community Health Nursing, 6e (Clark)

Chapter 6   Economic Influences on Population Health

 

1) The population health nurse is reviewing information to include in a presentation on the economics of health care. Which statements should the nurse include in this presentation?
(Select all that apply.)

  1. Health insurance guarantees a healthy workforce.
  2. Educational level is associated with health outcomes.
  3. Society benefits from an employed and healthy workforce.
  4. Chronic illness in a stable workforce does not impact productivity.
  5. Lost productivity from illness has minimal effect on societal outcomes.

Answer:  2, 3

Explanation:  2. The higher the educational level, the higher the societal productivity, which leads to better health outcomes through informed health choices. Health affects the national economic welfare, so an employed and healthy workforce is necessary for an economically healthy society. Chronic illness in a stable workforce impacts productivity, as people with chronic diseases may take more time off for the chronic illness. Lost productivity from illness has a direct effect on societal outcomes. Health insurance does not guarantee a healthy workforce as the insurance may be limiting in coverage or expensive to purchase.

  1. The higher the educational level, the higher the societal productivity, which leads to better health outcomes through informed health choices. Health affects the national economic welfare, so an employed and healthy workforce is necessary for an economically healthy society. Chronic illness in a stable workforce impacts productivity, as people with chronic diseases may take more time off for the chronic illness. Lost productivity from illness has a direct effect on societal outcomes. Health insurance does not guarantee a healthy workforce as the insurance may be limiting in coverage or expensive to purchase.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  6-1

 

2) The population health nurse learns that the state of practice received a block grant to address a health problem. Which problem should the nurse advocate to receive this grant?

  1. Developing public education programs to address smoking.
  2. Developing a research program to address causes of poverty.
  3. Increasing coverage for those meeting qualifications for Medicaid coverage.
  4. Opening statewide immunization centers to provide childhood immunization coverage.

Answer:  4

Explanation:  4. A block grant is a sum of money given to states by the federal government, intended to be used by each state as it sees fit but within broadly defined parameters. All choices could be potential uses for a block grant; however, opening statewide immunization centers to provide immunization coverage is the better choice because it represents a primary prevention mechanism that will protect the population from communicable diseases and improve health status. It will also not use additional health care services. Conducting research and developing education programs are appropriate, but the immunization program is an active direct-services approach. Increasing Medicaid coverage is not an appropriate use for a block grant because federal and state guidelines address Medicaid eligibility.

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  6-1

 

3) The population nurse becomes aware of an increase in social instability in one neighborhood. This instability can affect societal health because it can lead to:

  1. Poverty.
  2. Social conflict.
  3. Developing alternative methods of health care.
  4. Ill health that results from disruptive economic conditions.

Answer:  4

Explanation:  4. While poverty can impact health, it is not a necessary outcome of social instability. Economic conditions can be disrupted as a result of social instability, which can lead to ill health because economic conditions and access to health care services can be affected. Alternative methods to health care are not dependent on social instability and can be developed at any time. Social conflict is not necessarily a result of social instability.

Nursing/Int.Conc:  Nursing Process: Evaluation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  6-1

 

) The population health nurse attends a seminar on health care economics. What should the nurse realize as one of the biggest concerns influencing the economic health status of the United States?

  1. Aging of citizens.
  2. Declining birth rate.
  3. Rise in asthma among children.
  4. Rise of adolescent mental health problems.

Answer:  1

Explanation:  1. Factors that have contributed to increasing health care spending include an aging population. An aging population contributes to greater demand for and use of services, particularly as the prevalence of chronic diseases with high costs for disease management increases in older age groups. The size of the older population relative to other age groups in the United States has increased consistently over the last several decades. People over age 65 consume a large portion of the health care services provided each year. The birth rate in the United States is not declining and while there are concerns about adolescent mental health problems and the rise of childhood asthma, these do not represent immediate priority concerns regarding the economic health status.

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Analysis

Learning Outcome:  6-2

 

5) The population health nurse is participating in a discussion about the number of physicians in the United States being able to meet health care needs. What should the nurse identify as the primary reason for physicians contributing to escalating health care costs?

  1. Decreased hospital beds nationwide.
  2. Increased numbers of uninsured citizens.
  3. The higher number of specialists than generalists.
  4. More expensive prescription medications being prescribed.

Answer:  2

Explanation:  2. Specialists have higher reimbursements and fees, and represent two-thirds of the physician workforce in the United States; as such, specialists contribute to escalating health care costs. Nationwide hospital beds have not decreased. While there is a large segment of the population who is uninsured, this is not reflected in the number of physicians and there is no evidence that physicians are necessarily prescribing more expensive medications.

Nursing/Int.Conc:  Nursing Process: Diagnosis

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Analysis

Learning Outcome:  6-2

 

6) The population health nurse providing care in an economically disadvantaged city is aware of many people receiving their health care through charity systems that are set up by local physicians. The nurse is concerned because this practice can contribute to rising health care costs by:

  1. Utilizing hospital beds.
  2. Affecting the consumer price index.
  3. Increased use of technology in diagnostic tests.
  4. Uncompensated care, which can lead to cost shifting.

Answer:  4

Explanation:  4. Reimbursement is limited or nonexistent in charity care, so people who utilize this system tend to be uninsured or underinsured. Uncompensated care can lead to cost shifting, where these costs are passed along to those who are able to pay, either out of pocket or through insurance. The consumer price index is not dependent on uncompensated care. Traditionally there is decreased use of technology for underinsured and uninsured populations. There is a finite number of hospital beds, which is unaffected through utilization.

Nursing/Int.Conc:  Nursing Process: Evaluation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  6-2

 

7) The population health nurse is attending a community town hall meeting where an elected official is discussing the importance of extending tax cuts for the upcoming fiscal year. What should the nurse consider as the impact of these cuts on health care? (Select all that apply.)

  1. Scarcity of health resources.
  2. Reduction in chronic diseases.
  3. Increased number of care providers.
  4. Improved access to health care services.
  5. Negative effects on the health of the population.

Answer:  1, 5

Explanation:  1. Tax cuts maintain expenditures while at the same time reducing revenues that could fund them. Although tax cuts and low interest rates will stimulate the economy in the short run, they are likely to cause a long-term imbalance leading to increasing deficits, lower rates of national savings, higher interest rates, and a slowed economy as well as reductions in government-supported services. All of these factors will lead to a greater scarcity of health resources and more severe effects on the health of the population. Tax cuts will have no impact on chronic diseases, the number of care providers, or access to health care services.

  1. Tax cuts maintain expenditures while at the same time reducing revenues that could fund them. Although tax cuts and low interest rates will stimulate the economy in the short run, they are likely to cause a long-term imbalance leading to increasing deficits, lower rates of national savings, higher interest rates, and a slowed economy as well as reductions in government-supported services. All of these factors will lead to a greater scarcity of health resources and more severe effects on the health of the population. Tax cuts will have no impact on chronic diseases, the number of care providers, or access to health care services.

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Analysis

Learning Outcome:  6-3

8) The population health nurse is assisting with a booth at a health fair to help community members sign up for health insurance. For which reasons should the nurse promote the importance of having health insurance? (Select all that apply.)

  1. Eliminates health disparities.
  2. Means the individual has full-time employment.
  3. Guarantees no difficulty in obtaining health care.
  4. Ensures the individual has a regular source of care.
  5. The individual has a greater likelihood of receiving health promotive services.

Answer:  4, 5

Explanation:  4. Having health insurance is associated with having a regular source of care and a greater likelihood of receiving health promotive services. Health disparities address the differences in measures of health status or access to health services, which have been associated with insurance status as well as other factors. Having health insurance does not lessen the difficulty in obtaining health care because there may be restrictions on the type of health insurance a person has. Not all who are employed full-time can afford health insurance as their incomes may be within the gap that is between federal coverage but too expensive to purchase privately.

  1. Having health insurance is associated with having a regular source of care and a greater likelihood of receiving health promotive services. Health disparities address the differences in measures of health status or access to health services, which have been associated with insurance status as well as other factors. Having health insurance does not lessen the difficulty in obtaining health care because there may be restrictions on the type of health insurance a person has. Not all who are employed full-time can afford health insurance as their incomes may be within the gap that is between federal coverage but too expensive to purchase privately.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  6-4

 

9) During a home visit the population nurse learns that the family’s father has recently lost his job, and the mother continues to be unemployed but takes care of the family’s five children. The mother is concerned because charitable organizations are not eager to provide resources to help the family as they have in the past. What should the nurse explain as the primary reason for charitable organizations to have less funds to distribute?

  1. Charitable organizations are going out of business.
  2. Charitable giving decreases during hard economic times.
  3. The family is viewed as having received the maximum support.
  4. The parents’ ability to work is negatively impacting the response from charities.

Answer:  2

Explanation:  2. Charitable giving tends to decrease during hard economic times and frequently does not keep pace with inflation and the cost of providing charity care. In addition, many nonprofit organizations are faced with growing demands for assistance during economic downturns stretching their resources even further. Charitable organizations are not going out of business. There is no information to support that the family has received maximum support or the parents’ ability to work is negatively impacting the response from charities.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  6-3

 

10) The population health nurse is creating a tool to assess the economic status of a small rural neighborhood. What should the nurse include in this tool? (Select all that apply.)

  1. Number of members who are unemployed.
  2. Average income of neighborhood members.
  3. Number of members who are at poverty level.
  4. Average education level of neighborhood members.
  5. Ways in which health care is funded by the members.

Answer:  1, 2, 3, 5

Explanation:  1. When assessing economic status of a population the nurse should focus on the number of members who are unemployed, the average income of the members, the number of members who are at poverty level, and the ways in which health care is funded by the members. Although important, education level is not included in an assessment of economic status for a population.

  1. When assessing economic status of a population the nurse should focus on the number of members who are unemployed, the average income of the members, the number of members who are at poverty level, and the ways in which health care is funded by the members. Although important, education level is not included in an assessment of economic status for a population.
  2. When assessing economic status of a population the nurse should focus on the number of members who are unemployed, the average income of the members, the number of members who are at poverty level, and the ways in which health care is funded by the members. Although important, education level is not included in an assessment of economic status for a population.
  3. When assessing economic status of a population the nurse should focus on the number of members who are unemployed, the average income of the members, the number of members who are at poverty level, and the ways in which health care is funded by the members. Although important, education level is not included in an assessment of economic status for a population.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  6-3

 

 

11) An older community member is concerned about the rising cost of prescription medications. Which part of Medicare should the population health nurse review with this individual?

  1. Part A.
  2. Part B.
  3. Part C.
  4. Part D.

Answer:  4

Explanation:  4. Part D is the Medicare Prescription Drug Plan, which was designed to provide drug subsidization for those enrolled in Medicare. Part C, which is the Medicare Advantage permits Medicare enrollees to exercise similar health care options as others in the population. Part B covers medically necessary provider services not covered under Part A. Part B coverage is optional and requires an additional payment premium. Part A covers medically necessary hospitalization, skilled nursing facility (SNF) care, some home health care, hospice, and blood products administered in in-patient facilities.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  6-4

12) The population health nurse is preparing material for an educational seminar on the differences between Medicare and Medicaid. What should the nurse include in this teaching?

  1. Medicare only covers health care services for people over age 65.
  2. Medicare does not cover preventive services, but Medicaid provides such coverage.
  3. Medicare funding is solely on the federal level and Medicaid has no federal funding.
  4. Medicare provides partial coverage for health services when eligible for Social Security benefits and Medicaid provides health services to the indigent.

Answer:  4

Explanation:  4. As originally legislated, Medicare provided partial coverage of health services to the population who reached the age for receiving Social Security benefits at age 65. Medicaid was established to provide health services to the medically needy, categorically needy, and certain special groups who fell outside of the mainstream for any health care services. Medicare does not cover all health care services, nor does Medicaid. While Medicare traditionally does not cover preventive care, it has started to provide limited coverage of preventive services, as does Medicaid in such services as immunizations. Funding for Medicare comes from the federal level. Medicaid funding is administered by the states but with block grants given by the federal government.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  6-4

 

 

13) The population health nurse is reviewing the State Children’s Health Insurance Programs (SCHIP) with a mother who has seven children. During this conversation the nurse explains that this program was established by Congress to provide health insurance coverage for low-income children whose parents did not have insurance coverage or who did not qualify for Medicaid benefits and is administered by the state. What process is the nurse reviewing that highlights the transfer of federal oversight and responsibility to the states for this program?

  1. Devolution.
  2. Shared responsibility.
  3. Block grant funding.
  4. Health care innovation.

Answer:  1

Explanation:  1. The establishment of SCHIP was an attempt by the federal government to provide for health services for low-income children. The federal government gave the states the option of expanding existing Medicaid programs or creating separate Children’s Health Insurance Programs (CHIP). This is devolution, the transfer of responsibility for an area from federal to state government. It is not shared responsibility, block grant funding, or health care innovation.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  6-4

14) The population health nurse is explaining to a patient about the type of health services that are paid for by a third party such as private health insurance. What is the nurse explaining to this patient?

  1. Capitation payment.
  2. Deductible payment.
  3. Prospective reimbursement.
  4. Retrospective reimbursement.

Answer:  3

Explanation:  3. Third party payment is made through reimbursement for services rendered. Prospective payment is most commonly utilized today, with payment given at a predetermined fixed rate for a specific set of services. Retrospective reimbursement was formerly the primary form of third party payment for services rendered based on the cost of the services. Rising health prices and spiraling insurance health care costs now limit this form of reimbursement because some services were given solely for reimbursement purposes and not for health reasons. Deductible payments are those payments the person makes out of pocket until a limit is reached where the insurance company will take over responsibility for payment. Capitation refers to a prospective payment system that pays health plans or providers a fixed amount per enrollee per month for providing a defined set of health needs.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  6-5

 

 

15) A community member tells the population health nurse that a new health insurance program expects the patient to pay deductibles and other costs. What other type of cost sharing should the nurse explain to the individual?

  1. Capitation system.
  2. Co-payment made with each health service rendered.
  3. Out-of-pocket payment for services not covered by the insurance plan.
  4. Current Procedural Terminology (CPT) code utilized by the health service provider.

Answer:  2

Explanation:  2. Co-payments are out-of-pocket payments that the insured has agreed to pay as part of the contract with the insurance provider. Typically, co-payments are made with each health service visit. Out-of-pocket payments as complete payment are made for services not covered under an insurance plan. CPT codes refer to health services coded for billing purposes and reimbursement by providers and do not involve direct payment from the insured person. Capitation does not require co-payment.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  6-5

 

Population and Community Health Nursing, 6e (Clark)

Chapter 7   Health System Influences on Population Health

 

1) The client is experiencing nasal congestion from a cold. The client self-administers an over-the-counter cold product to alleviate symptoms. The best description of the health care system the client is using is:

  1. Complementary health care.
  2. Scientific health care.
  3. Personal health care.
  4. Popular health care.

Answer:  4

Explanation:  4. The popular health care subsystem is where care is provided by oneself, family, or friends. Complementary health care consists of providers and practices outside the mainstream health care system. The scientific health subsystem is care based on scientific research-derived evidence. Personal health care is the sector that provides health-related services to individual clients.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  7-2

 

2) The client is being treated for chronic headache pain in a local clinic. In addition to the medical care the client is receiving, the client also visits an acupuncture clinic and states that both therapies help the headache pain. This type of health care subsystem the client is employing is:

  1. Complementary.
  2. Personal.
  3. Popular.
  4. Alternative.

Answer:  1

Explanation:  1. Using acupuncture therapy in conjunction with standardized medical care is an example of complementary therapy. Complementary health care practices are used in conjunction with scientific care to complement and enhance its effects. Personal health care provides health-related services to individual clients. Popular health care is what an individual does for oneself. Alternative health care is used in place of scientific interventions.

Nursing/Int.Conc:  Nursing Process: Evaluation

Client Need:  Physiological Integrity

Cognitive Level:  Analysis

Learning Outcome:  7-2

 

3) West Nile virus has been diagnosed in the state. The state health department has ordered mosquito spraying in the affected area and public service announcements are being broadcast in the local media to alert the population to drain water from loose tires and other areas where there may be stagnant water. What obligations are being addressed by the state health department? (Select all that apply.)

  1. Prevent epidemics and the spread of disease.
  2. Protect the public from environmental hazards.
  3. Prevent injury.
  4. Promote healthy behavior and good mental health.
  5. Respond to disasters and assist.

Answer:  1, 2, 3

Explanation:  1. By ordering the mosquito spraying and using the public service announcements, the state health department is preventing the spread of West Nile virus and protecting the public from environmental hazards, thus also preventing potential further injury. The actions are not geared to promoting healthy behavior and good mental health. This action is not responding to a disaster and assisting with recovery.

  1. By ordering the mosquito spraying and using the public service announcements, the state health department is preventing the spread of West Nile virus and protecting the public from environmental hazards, thus also preventing potential further injury. The actions are not geared to promoting healthy behavior and good mental health. This action is not responding to a disaster and assisting with recovery.
  2. By ordering the mosquito spraying and using the public service announcements, the state health department is preventing the spread of West Nile virus and protecting the public from environmental hazards, thus also preventing potential further injury. The actions are not geared to promoting healthy behavior and good mental health. This action is not responding to a disaster and assisting with recovery.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  7-3

 

4) After a hurricane has devastated an area, the United States Public Health service sends a group of health care workers to open satellite clinics in the area. This action is best considered:

  1. Preventing epidemics and the spread of disease.
  2. Preventing injury.
  3. Ensuring quality and accessibility of needed health care services.
  4. Promoting healthy behavior and good mental health.

Answer:  3

Explanation:  3. Sending health care personnel to staff and open clinics is ensuring accessibility of needed health care services to an area that has been devastated by a natural disaster. It is not preventing epidemics and spread of disease as such, nor does this action prevent injury. While having accessibility to health care services can promote healthy behavior, this is not the best answer.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Analysis

Learning Outcome:  7-3

5) The organizational structure of the United States health care delivery system can best be described by three subsystems:

  1. Personal health system, popular health system, and scientific health system.
  2. Popular health system, alternative health system, and scientific health system.
  3. Scientific health system, complementary health system, and alternative health system.
  4. Scientific health system, complementary health system, and popular health system.

Answer:  4

Explanation:  4. There are three health care subsystems that describe the organizational structure for the United States, which are the scientific, complementary/alternative, and popular. Complementary/alternative health system is a combined system, not divided into separate systems. Answers that have one without the other do not describe the full organizational structure of health subsystems in the United States

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  7-1

 

6) The March of Dimes has instituted a public awareness campaign to decrease premature births. It has also conducted media campaigns to raise public awareness of this health problem in addition to research about prematurity and government lobbying efforts. Official government efforts to address prematurity include research and public awareness. As a voluntary agency the primary emphasis of the March of Dimes campaign is on:

  1. Funding, research, and education.
  2. Research, education, and policy development.
  3. Education, policy development, and funding.
  4. Policy development, research, and public health practice.

Answer:  2

Explanation:  2. The primary emphasis of voluntary agencies such as the March of Dimes is on research, education, and policy development, primarily through lobbying. Official health agencies can develop policy independently and do research. Education is one of the components of official health agencies. Voluntary health agencies are accountable to their supporters, whereas official health agencies are accountable to the population.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  7-4

 

 

7) The “Tour for Cure” is an annual bike relay sponsored by the Multiple Sclerosis (MS) Society. Entrants are sponsored for each mile by voluntary donations, which go to the MS Society to fund research activities and provide services to those diagnosed with MS. The Tour highlights awareness and public education of the disease. As a voluntary health agency, which additional functions can the MS Society accomplish? (Select all that apply.)

  1. Promote legislation through lobbying.
  2. Health planning and organization.
  3. Ensure sufficient health professionals to care for those with MS.
  4. Enforce laws and regulations that help to diagnose and treat those with MS.
  5. Hire individuals with chronic diseases to assist with fund-raising efforts.

Answer:  1, 2

Explanation:  1. The bike relay helps to fund research that specifically addresses multiple sclerosis. The mission of the MS Society is to find a cure for this disease. The awareness raised by the bike relay educates the public and health professionals about MS. Clients with MS can receive services funded by the MS Society. Though focused on one disease, lobbying efforts are directed to legislation that addresses those who have MS, which also advocates for the public health and can assist in planning and organization. A voluntary health agency is not responsible for providing sufficient health professionals to care for those diagnosed with this disease, though it can have funds to help train them. A voluntary health agency does not have the authority to enforce laws and regulations. Hiring individuals to assist with fund-raising efforts would be an operational action made by the leaders within the MS Society and not something that would be identified as being conducted by a voluntary health agency.

  1. The bike relay helps to fund research that specifically addresses multiple sclerosis. The mission of the MS Society is to find a cure for this disease. The awareness raised by the bike relay educates the public and health professionals about MS. Clients with MS can receive services funded by the MS Society. Though focused on one disease, lobbying efforts are directed to legislation that addresses those who have MS, which also advocates for the public health and can assist in planning and organization. A voluntary health agency is not responsible for providing sufficient health professionals to care for those diagnosed with this disease, though it can have funds to help train them. A voluntary health agency does not have the authority to enforce laws and regulations. Hiring individuals to assist with fund-raising efforts would be an operational action made by the leaders within the MS Society and not something that would be identified as being conducted by a voluntary health agency.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  7-4

 

 

8) The nurse has been monitoring the community’s rates of cardiac disease and sees that they are increasing. The nurse holds a community forum to address the impact of cardiac disease on the community’s health. Those attending are given information about cardiac disease including interventions related to diet and exercise to decrease risk. Several church groups who attend the forum offer to host health fairs to provide additional information to the community as well as transportation to physician visits for older community members. Public health services exemplified in this situation include: (Select all that apply.)

  1. Monitoring health status to identify health problems.
  2. Diagnosing and investigating health problems and hazards.
  3. Informing, educating, and empowering people regarding health issues.
  4. Mobilizing community partnerships to identify and solve health problems.
  5. Engaging physicians to see older community members.

Answer:  1, 3, 4

Explanation:  1. While monitoring the community’s health, the nurse has identified cardiac disease as a health problem in the community. Convening a community forum is informing, educating, and empowering the community. Community partnerships are mobilized and the church groups are offering to host health fairs and linking people to health services by providing transportation. Diagnosis and investigating health problems and hazards are not services utilized in this forum. Engaging physicians to see older community members is not a public health service.

  1. While monitoring the community’s health, the nurse has identified cardiac disease as a health problem in the community. Convening a community forum is informing, educating, and empowering the community. Community partnerships are mobilized and the church groups are offering to host health fairs and linking people to health services by providing transportation. Diagnosis and investigating health problems and hazards are not services utilized in this forum. Engaging physicians to see older community members is not a public health service.
  2. While monitoring the community’s health, the nurse has identified cardiac disease as a health problem in the community. Convening a community forum is informing, educating, and empowering the community. Community partnerships are mobilized and the church groups are offering to host health fairs and linking people to health services by providing transportation. Diagnosis and investigating health problems and hazards are not services utilized in this forum. Engaging physicians to see older community members is not a public health service.

Nursing/Int.Conc:  Nursing Process: Evaluation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  7-3

 

 

9) The population health nurse is diagnosing and investigating health problems and hazards in the community. Which action did the nurse most likely complete?

  1. Correlating pediatric asthma visits to the local ED with local emissions from a nearby fuel plant.
  2. Providing asthma education programs to local elementary school teachers.
  3. Informing the local health department about the increased rise in asthma attacks.
  4. Lobbying the local fuel plant to decrease its emissions.

Answer:  1

Explanation:  1. Correlating pediatric asthma visits to the ED with emissions from the local fuel plant is linking health problems and is diagnosing a health problem within the community. Lobbying the fuel plant to decrease emissions is not diagnosing or investigating. Informing the health department is providing information, but not diagnosing or investigating. Providing asthma education programs to elementary school teachers informs and educates them as to asthma in the pediatric population.

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  7-3

10) A member of the community with tuberculosis (TB) refuses to be compliant with prescribed TB treatment protocol and is sent to a minimum security correctional facility to ensure that the TB medications are done with directly observed therapy (DOT) by the medical personnel. The client initiates legal action to prevent this from happening but is overruled by the judge. Which government level of authority authorizes this power?

  1. Local government.
  2. County government.
  3. State government.
  4. Federal government.

Answer:  3

Explanation:  3. The state, not the federal, county or local governments have primary authority in matters of health. The state government retains the ultimate responsibility for the health of the public and can enforce laws and regulations regarding health.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Safe and Effective Care Environment

Cognitive Level:  Application

Learning Outcome:  7-5

 

11) The population nurse is participating on a committee to improve the way health care is provided to individuals who live in the state. What characteristic of the population should the nurse identify to improve the organization and effectiveness of health care delivery? (Select all that apply.)

  1. Technological advances.
  2. Changes in delivery systems.
  3. Changing population demographics.
  4. More uninsured members in the state.
  5. Reduced numbers of healthcare providers.

Answer:  1, 2, 3, 4

Explanation:  1. Health system observers have identified several forces that influence the technological advances, changes in delivery systems, changes in population demographics, and growing numbers of uninsured residents. The numbers of healthcare providers is not a characteristic of the population that impacts the organization and effectiveness of health care delivery.

  1. Health system observers have identified several forces that influence the technological advances, changes in delivery systems, changes in population demographics, and growing numbers of uninsured residents. The numbers of healthcare providers is not a characteristic of the population that impacts the organization and effectiveness of health care delivery.
  2. Health system observers have identified several forces that influence the technological advances, changes in delivery systems, changes in population demographics, and growing numbers of uninsured residents. The numbers of healthcare providers is not a characteristic of the population that impacts the organization and effectiveness of health care delivery.
  3. Health system observers have identified several forces that influence the technological advances, changes in delivery systems, changes in population demographics, and growing numbers of uninsured residents. The numbers of healthcare providers is not a characteristic of the population that impacts the organization and effectiveness of health care delivery.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  7-1

 

12) During a meeting held at the county health department the population health nurse learns that to change the culture of health care from one of disease treatment to health promotion three aims must be achieved. What actions should the nurse take to help achieve these aims? (Select all that apply.)

  1. Teach the population ways to improve health.
  2. Structure care delivery so that the patient experience is enhanced.
  3. Critically analyze the utilization of resources when providing care.
  4. Support the delivery of population health services at the state level.
  5. Negotiate with voluntary agencies for grant moneys to help provide care.

Answer:  1, 2, 3

Explanation:  1. The “Triple Aim” identified by the Institute for Healthcare Improvement is to improve population health, enhance patient experience of care, and reduce or control costs. The population health nurse would help achieve these aims by teaching the population ways to improve health, structure care delivery so that the patient experience is enhanced, and critically analyze the utilization of health resources when providing care. Supporting the delivery of population health services at the state level and negotiating with voluntary agencies for grant money to help provide care are not actions that support the triple aim.

  1. The “Triple Aim” identified by the Institute for Healthcare Improvement is to improve population health, enhance patient experience of care, and reduce or control costs. The population health nurse would help achieve these aims by teaching the population ways to improve health, structure care delivery so that the patient experience is enhanced, and critically analyze the utilization of health resources when providing care. Supporting the delivery of population health services at the state level and negotiating with voluntary agencies for grant money to help provide care are not actions that support the triple aim.
  2. The “Triple Aim” identified by the Institute for Healthcare Improvement is to improve population health, enhance patient experience of care, and reduce or control costs. The population health nurse would help achieve these aims by teaching the population ways to improve health, structure care delivery so that the patient experience is enhanced, and critically analyze the utilization of health resources when providing care. Supporting the delivery of population health services at the state level and negotiating with voluntary agencies for grant money to help provide care are not actions that support the triple aim.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  7-2

 

13) The population health nurse is comparing the provisions of the Patient Protection and Affordable Health Care Act with the National Health Service approach used in the United Kingdom. What feature of both health care coverage approaches has been identified as a need?

  1. Promote efficiency.
  2. Implement research.
  3. Reduce chronic illnesses.
  4. Limit caregiver autonomy.

Answer:  1

Explanation:  1. Out of the six nations studied, the United States ranked last on overall efficiency of its health system and proposed reforms to the National Health services include promote efficiency. Identify implementing research, reducing chronic illnesses, and limiting caregiver autonomy have not been identified as needs by these healthcare approaches.

Nursing/Int.Conc:  Nursing Process: Assessment

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Analysis

Learning Outcome:  7-6

 

 

14) The population health nurse is preparing an educational seminar to be provided during the next community health fair that focuses on preventive health services. What topics should the nurse include in this educational session? (Select all that apply.)

  1. The need to explore emotional issues.
  2. The need for school-age children to have an annual eye examination.
  3. The need for annual blood pressure assessments for people with hypertension.
  4. The importance for older community members to receive annual influenza inoculations.
  5. The importance for people with diabetes to have a specific set of preventive measures.

Answer:  1, 3, 4, 5

Explanation:  1. The United States ranks lower than other countries on preventive measures such as flu shots for older citizens, recommended preventive measures for patients with diabetes, exploration of emotional issues, and annual blood pressure and cholesterol checks for people with hypertension. The need for an annual eye examination for school-age children is not a topic that is of high importance for the population health nurse to include in the community education session.

  1. The United States ranks lower than other countries on preventive measures such as flu shots for older citizens, recommended preventive measures for patients with diabetes, exploration of emotional issues, and annual blood pressure and cholesterol checks for people with hypertension. The need for an annual eye examination for school-age children is not a topic that is of high importance for the population health nurse to include in the community education session.
  2. The United States ranks lower than other countries on preventive measures such as flu shots for older citizens, recommended preventive measures for patients with diabetes, exploration of emotional issues, and annual blood pressure and cholesterol checks for people with hypertension. The need for an annual eye examination for school-age children is not a topic that is of high importance for the population health nurse to include in the community education session.
  3. The United States ranks lower than other countries on preventive measures such as flu shots for older citizens, recommended preventive measures for patients with diabetes, exploration of emotional issues, and annual blood pressure and cholesterol checks for people with hypertension. The need for an annual eye examination for school-age children is not a topic that is of high importance for the population health nurse to include in the community education session.

Nursing/Int.Conc:  Nursing Process: Planning

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  7-6

 

 

15) While reviewing the indicators of healthy life the population health nurse decides that additional attention is needed on individuals in the community with specific health problems. On which community members should the nurse focus to help improve these indicators? (Select all that apply.)

  1. Persons being treated for cancer.
  2. Families with members identified with obesity.
  3. Individuals who have had myocardial infarctions and strokes.
  4. Individuals who continue to smoke after being advised to stop.
  5. Individuals with arthritis who have received joint replacements.

Answer:  1, 2, 3, 4

Explanation:  1. Examining other indicators of healthy life, the United States has a considerably higher prevalence of obesity and greater numbers of productive years of life lost due to respiratory diseases, diabetes, heart disease, and cancer than many countries. Individuals with arthritis who have had joint replacements have not contributed to the low indicators of healthy life scores that the United States has received.

  1. Examining other indicators of healthy life, the United States has a considerably higher prevalence of obesity and greater numbers of productive years of life lost due to respiratory diseases, diabetes, heart disease, and cancer than many countries. Individuals with arthritis who have had joint replacements have not contributed to the low indicators of healthy life scores that the United States has received.
  2. Examining other indicators of healthy life, the United States has a considerably higher prevalence of obesity and greater numbers of productive years of life lost due to respiratory diseases, diabetes, heart disease, and cancer than many countries. Individuals with arthritis who have had joint replacements have not contributed to the low indicators of healthy life scores that the United States has received.
  3. Examining other indicators of healthy life, the United States has a considerably higher prevalence of obesity and greater numbers of productive years of life lost due to respiratory diseases, diabetes, heart disease, and cancer than many countries. Individuals with arthritis who have had joint replacements have not contributed to the low indicators of healthy life scores that the United States has received.

Nursing/Int.Conc:  Nursing Process: Implementation

Client Need:  Health Promotion and Maintenance

Cognitive Level:  Application

Learning Outcome:  7-6