Surprise 1
A nurse is studying the high infant mortality rate in a community with a mean household income below the poverty level within the larger community served by her hospital. She looks into the problem further and finds that the only prenatal care clinics available that accept Medicaid or offer a sliding scale payment system are not located within the community and require taking three different busses to get there. The lack of access to affordable prenatal care is an example of:
1.Health disparity.
2.Health inequity.
3.Health inequality.
4.Social justice.
2.Health inequity.
During a lecture on health disparities, a student asks the instructor how communities with great access to health care can still have poor health outcomes. How should the instructor respond?
1.Social determinants of health determine how people respond to health threats and how they access preventative care.
2.The student is incorrect. Communities with good access to care have good health outcomes.
3.This phenomenon only occurs in communities where the quality of health care is poor.
4.Members of these communities only have access to primary-care providers, which reduces the quality of care they receive.
1.Social determinants of health determine how people respond to health threats and how they access preventative care.
A nurse is caring for a young man who is squatting in an abandoned factory a mile away from the clinic. The nurse documents that he is experiencing what type of homelessness?
1.Primary
2.Secondary
3.Tertiary
4.He is not homeless because he has an indoor shelter in which to sleep.
1.Primary
A maternal child nurse working in Southern Sudan is faced with lack of which main factors that contribute to the high infant mortality rate? (Select all that apply.)
1.Physicians
2.Electricity
3.Transportation
4.Equipment
1.Physicians
2.Electricity
4.Equipment
Prevents the disease. Examples: Education
Which of the following programs was specifically designed to work toward optimal health for all Americans?
1.Racial and Ethnic Approaches to Health (REACH)
2.Universal Health Care
3.Healthy People
4.Agency for Health Care Research and Quality (AHRQ)
3.Healthy People
What is cultural humility?
Cultural humility: an understanding that awareness about ones own culture is an ongoing process and an acknowledgment that we must approach others as equals with respect for their prevailing beliefs and cultural norms
A nurse received funding to start a mobile health unit to serve the health needs of the homeless population. In addition to a having a good understanding of noncommunicable diseases, what other specialty areas would be helpful in caring for this population?
1.Treatment of substance use disorders
2.Treatment of communicable diseases
3.Treatment of mental health disorders
4.All of the above
4.All of the above
When conducting a community survey in a larger urban community, two PHNs, Mark and Jane, know that there is great diversity based on socioeconomic status. They know it is important to determine which respondents do not meet the poverty threshold. They understand that this indicator reflects: (Select all that apply.)
1.The Census Bureau adjusts it based on family size and other demographics.
2.A lack of goods and services commonly taken for granted by mainstream society.
3.The method for doing the calculations over the past 40 years has included the increasing cost of medications.
4.The method for doing the calculations over the past 40 years has included increasing the percentage spent on food.
1.The Census Bureau adjusts it based on family size and other demographics.
2.A lack of goods and services commonly taken for granted by mainstream society.
4.The method for doing the calculations over the past 40 years has included increasing the percentage spent on food.
What is secondary prevention? Name some examples:
Secondary prevention is early detection of disease Examples: SCREENINGS
A nurse working in an urban nurse-managed health clinic located in a neighborhood with a high poverty rate notices that the patients she is seeing with type 2 diabetes are having difficulty controlling their A1C levels. She suspects that they may be having difficulty accessing their medications due to cost. What would be her first step in addressing the problem?
1.Conduct a focused assessment that includes a patient survey and an evaluation of factors associated with access to medication.
2.Counsel patients on how to obtain health insurance to help with the cost of pharmaceuticals.
3.Develop a patient education information pamphlet related to controlling A1C that is culturally relevant and addresses health literacy levels of the population.
4.Formulate a community diagnosis and enlist stakeholders to help increase assess to diabetic medications.
1.Conduct a focused assessment that includes a patient survey and an evaluation of factors associated with access to medication.
A nurse is assessing a young mother who lost her job. She has no way to support her family and has found herself living on the streets because she doesn’t have any other family in the area. Which of the following should she do first?
1.Look at the broader picture and see if there are any opportunities for policy change.
2.Help her find shelter at the community shelter for women and children.
3.Provide her with information on resources to help her with financial support while she seeks a new job.
4.Ask her to come back in 6 months for a re-evaluation.
2.Help her find shelter at the community shelter for women and children.
A nurse is working at a primary care clinic on the Mexican-Californian border. The nurse frequently takes care of refugee families when they first arrive in the United States. When meeting with a new family, the nurse makes sure to inform them that they are eligible for which of the following services?
1.Medicaid
2.Free health insurance for 1 year
3.Housing and food support
4.Free English classes
3.Housing and food support
A nurse is organizing a round table presentation at a conference. The nurse asks the other participants for suggestions on actions that nurses can take to reduce health disparities in their country. Which of the following suggestions are known to be effective measures nurses can take that focus on the reduction of health disparities? (Select all that apply.)
1.Volunteer with an international organization that supports building infrastructure in underdeveloped areas.
2.Support initiatives that increase physical education classes and healthy school meals.
3.Design and create research studies that address inequities and support vulnerable populations.
4.Discuss social and health disparity information with coworkers to promote awareness.
5.Act as advocates for patients, families, and communities in reducing inequities.
2.Support initiatives that increase physical education classes and healthy school meals.
3.Design and create research studies that address inequities and support vulnerable populations.
4.Discuss social and health disparity information with coworkers to promote awareness.
5.Act as advocates for patients, families, and communities in reducing inequities.
What is tertiary prevention? Name examples:
Tertiary prevention treats the established disease to prevent it from getting worse Examples:REHAB
Upstream vs Downstream?
Upstream: focus on eliminating the factors that increase risk to health
Downstream: actions taken after disease or injury has occurred
A community nurse-managed clinic has seen an increase in the number of patients who have immigrated to the U.S. from Central America who are experiencing poorer outcomes than other patients. A nurse working in the clinic decides to take a multiple determinants of vulnerability approach to help understand possible underlying factors for this population. Using that approach, she would take into account all but which of the following as primary factors?
1.Stigma
2.Racism
3.Discrimination
4.Health literacy
4.Health literacy
The maternal-child nurse who is fluent in Spanish is working at the public health department located in a “sanctuary city”. She is conducting a home visit with a young mother from Northern Triangle of Central America who arrived in the U.S. in 2017 and is now staying with her brother who is a U.S. citizen. The mother is very frightened and states that she fled her country because of the violence she and her children has experienced. She fears that they will not survive if they go back. The mother is eligible to apply for what status?
1.Asylee
2.Refugee
3.Immigrant
4.Permanent resident
1.Asylee
A public health nurse (PHN) is performing a community assessment to better understand the underlying factors associated with the increase in the childhood obesity in the community. What social determinants of health should the PHN include in the assessment? (Select all that apply.)
1.Location of primary health providers
2.Nutrition and physical education classes in the public schools
3.Housing security
4.Presence of sidewalks and green space within the community
5.Access to fresh produce
1.Location of primary health providers
2.Nutrition and physical education classes in the public schools
4.Presence of sidewalks and green space within the community
5.Access to fresh produce
What is palliative care?
Focuses on getting rid of the pain
comfort
A nurse is looking at reasons why members of a community are more likely to die from heart disease. The nurse finds several studies that suggest that social factors, such as ____, are more important than behavioral choices.
1.Smoking
2.High-fat or high-sugar diets
3.Poverty
4.Lack of exercise
3.Poverty
A public health nurse (PHN) is starting a study of different populations in the community to see which groups have faced marginalization and to what degree. The PHN is looking for evidence that:
1.A group has been discriminated against based on their race or ethnicity.
2.A group has been treated as if they are not important or of little consequence to the rest of society.
3.A group has been labeled by society as possessing a particular characteristic that is not valued, leading to a loss of status.
4.A group has been assigned a negative or positive belief that is believed to apply to the entire group.
2.A group has been treated as if they are not important or of little consequence to the rest of society.
What is diversity?
What is culture?
What is ethnicity?
Diversity: groups and individuals are not all the same but differ in relation to cultures, ethnicity, and race
Culture: the customary beliefs, social forms, and material traits of a racial, religious, or social group
characteristics featured of everyday experiences (diversions or a way of life) shared by people in a place or time
Ethnicity: includes shared geographical origin, language, or dialect, faith, folklore, food preferences, and culture
A nurse is training for a new job at a community clinic after moving to Central California, an area rich in agriculture and where a large number of migrant workers are employed. The nurse asks about specific social and health issues that the migrant worker population faces, and the nurse supervisor replies: (Select all that apply.)
1.They have difficulty establishing residency in a single location, making them ineligible for government benefits.
2.Most of them lack access to worker’s compensation or disability insurance.
3.Frequent travel and location changes make it difficult for them to establish continuity of care with a single provider.
4.Illegal immigration status is a problem for almost all of them.
5.Language is often a barrier.
1.They have difficulty establishing residency in a single location, making them ineligible for government benefits.
2.Most of them lack access to worker’s compensation or disability insurance.
3.Frequent travel and location changes make it difficult for them to establish continuity of care with a single provider.
5.Language is often a barrier.
What is aggregate?
Collection of people who share one or more personal or environmental characteristics: geography or special interests