Introduction to Community Health
You are teaching a new nurse on ways to develop her cultural competency. Which of the following interventions would you recommend for the nurse? Select all that apply.
a. Use the internet to find resources that can help you gain more knowledge about different cultures.
b. Ask patients questions about their cultural traditions and beliefs if you are unfamiliar with that culture.
c. Provide the same type of care and delivery to every patient so you do not project any bias.
d. Be approachable and have an open mind about learning different health beliefs and traditions.
a. Use the internet to find resources that can help you gain more knowledge about different cultures.
b. Ask patients questions about their cultural traditions and beliefs if you are unfamiliar with that culture.
d. Be approachable and have an open mind about learning different health beliefs and traditions.
You are a community health nurse working at the public health department. You are tasked with starting a free exercise class to help motivate residents to work out and lose weight. This program is using what concept to improve community health?
a. Risk reduction
b. Health protection
c. Health promotion
d. Health motivation
c. Health promotion.
Health promotion is defined as the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions. Examples would be related to helping patients make lifestyle changes such as increasing exercise.
LGBTQ+ individuals are at an increased risk of experiencing adverse health outcomes due to discrimination and social isolation. What health disparities are common in this vulnerable population? Select all that apply.
a. Substance use disorders
b. Noncommunicable diseases
c. Suicide
d. HIV/AIDs
e. Injuries from violence
a. Substance use disorders
c. Suicide
d. HIV/AIDs
e. Injuries from violence
LGBTQ+ individuals are at increased risk for communicable diseases such as herpes, gonorrhea, and HIV/AIDs.
You are a home health nurse who has been assigned to take care of a 92-year-old female patient. When you arrive, there is trash everywhere, moldy food on plates, and dirty utensils & cups. She has foul body odor and unkept hair. She tells you her only caretake is her son, but he lives in a different state. Who should the nurse contact in this scenario?
a. A nursing home with availability for the patient
b. A social worker
c. A case manager
d. Adult protective services
e. Elder protection agency
d. Adult protective services (APS).
Reporting suspected elder abuse or neglect cases to APS agencies provides access to services that address the social, medical, and legal needs of older person.
S_______________ is defined as acting in accordance with fair treatment regardless of economic status, race, ethnicity, citizenship, disability, or sexual orientation.
Social justice. Social justice includes the eradication of poverty and illiteracy, the establishment of sound environmental policy, and equality of opportunity for healthy personal and social development.
Explain what an upstream approach is. Give an example of an intervention that would be considered upstream.
Upstream approach focuses on eliminating the factors that increase risk to a population’s health. Example approach: issue of obesity= focusing on agricultural subsidies, transportation policies, creating national standards for meals served to children in childcare settings.
A new health clinic opens up in a rural town. The clinic offers their services based on income. Residents with lower incomes end up paying less for services and those with higher incomes pay more for services. This clinic model demonstrates which of the following?
a. Equality
b. Equity
c. Social determinants of health
d. Economic justice
b. Equity.
This clinic is utilizing a sliding scale payment method which demonstrates equity, providing the most to those who have the least. Equity is the underlying principle behind optimum health as a basic human right.
You are working with a patient recently diagnosed with a rare autoimmune disease and has been given 18 months to live. The patient tells you he wants to be a part of clinical trials in the search for a cure. What type of setting would you recommend to this patient?
a. Outpatient rehabilitation
b. Hospice care
c. Palliative care
d. Skilled nursing facility
c. Palliative care
Palliative care is associated with providing care & symptom relief to patients at any stage of disease while hospice care is associated with provide end of life care to individuals a prognosis of 6 months or less.
_______ refers to having shared geographic origin, language/dialect, religious faith, folklore, food preferences, and culture. _______ categorizes groups of people based on superficial criteria such as physical characteristics.
Ethnicity refers to having shared geographic origin, language/dialect, religious faith, folklore, food preferences, and culture.
Race categorizes groups of people based on superficial criteria such as physical characteristics.
You are assessing a patient who was diagnosed with diabetes type 2 six months ago. He has returned with elevated blood sugar levels and his A1C is 7.2%. What is your first nursing action?
a. Refer him to nutritionist and endocrinologist
b. Provide him health insurance information
c. Give him pharmacy discount coupons he can use for his insulin
d. Assess his health literacy but evaluating his knowledge on diabetes
d. Assess his health literacy but evaluating his knowledge on diabetes.
Priority nursing action is to assess his health literacy by evaluating his knowledge of diabetes. If the patient is knowledgeable on his disease, the other options listed can be explored.
You are an emergency room nurse admitting a new patient. While performing your admission, you find out the patient does not have a permanent residence. He has been moving across the U.S and crashes at different friends and family’s houses. What type of homelessness would this patient be considered?
a. Primary
b. Secondary
c. Tertiary
d. The patient is not considered homeless
b. Secondary- includes those who are staying in a temporary form of housing because they have nowhere else to go—those living with friends or family, or in shelters.
You are a nurse working at a primary care clinic. You are treating a 65-year-old patient. She tells you she has not been updated on her vaccines and asks what immunizations she needs to get. List the 3 vaccines you would suggest to her.
1. Zosters (shingles)
2. Pneumococcal vaccine
3. Annual Influenza
The World Health Organization (WHO) is focused on improving the health of global populations. What are the major functions of the WHO? Select all that apply.
a. Conduct biomedical research
b. Conduct disease surveillance
c. Responder to manmade and natural disasters
d. Oversee various nursing boards
e. Establish evidence-based policies
a. Conduct biomedical research
b. Conduct disease surveillance
c. Responder to manmade and natural disasters
e. Establish evidence-based policies
The WHO is focused on global health, the collaborative transnational research and action for promoting health for all. Their duties include all of the above. They do not oversee nursing boards.
Policy changes and development is key to approaching the issue of incarceration. Which of the following is an upstream approach regarding policy?
a. Provide behavioral health services to those incarcerated
b. Provide alternatives to jail for minor offenses
c. Work with high-risk youth to promote education & provide opportunity for advancement
d. Prescribe medications to individuals who suffer from mental health disorders and are prone to violence
c. Work with high-risk youth to promote education & provide opportunity for advancement
Upstream approaches focuses on eliminating the factors that increase risk to a population’s health. Working with high-risk youth can prevent more individuals from becoming incarcerated.
You are a nurse working at a primary care clinic. You are treating an patient who tells you she moved to the U.S two months ago. She had to flee her country after marrying her husband and converting to Islam. Her status in the US has not yet been definitively determined. How would you classify this patient?
a. Asylee
b. Refugee
c. Immigrant
d. Illegal alien
a. Asylee
A person asking to receive refugee status is outside the United States and seeking to enter, whereas an asylee is a person already residing in the United States when applying for asylum.
Life expectancy is the highest it’s ever been. What are some factors that have contributed to individuals living longer today? Select all that apply.
a. Modern technology
b. Improved sanitation systems
c. More people covered by health insurance
d. Improved maternal and child health services
e. Advances in medicine
f. Diagnostic advances
a. Modern technology
b. Improved sanitation systems
d. Improved maternal and child health services
e. Advances in medicine
f. Diagnostic advances
Although more people are insured under the ACA, insurance is not a major contributor to why people are living longer today.
The public health nurse is responsible for the six standards of practice that describe a competent level of care using the nursing process. What are the 6 standards?
Assessment
Diagnosis
Outcome identification
Planning
Implementation
Evaluation
A school nurse is teaching a group of elementary school children about what happens to their heart rate with exercise. She lets the children experiment with different types of exercise and has them count their pulse rates. What type of learning theory best describes what this school nurse is using?
a. Humanism
b. Cognitive framework
c. Behaviorism
d. Constructivism
d. Constructivism
Constructivism is a learning theory that reflects on our own experiences. A good example is problem solving learning.
Little Italy in Baltimore, Maryland is a neighborhood located east of downtown Baltimore that experienced a number of assaults and robberies. The community already had a longstanding community committee. The committee called a meeting and invited the Baltimore police and their state representative. Because of the relationships this community had built over time with the city of Baltimore and their state representative, they were able to get heightened police presence in the community. Members of the community also banded together and pooled their resources to obtain further security for the community. As a result, the number of assaults and robberies fell. The city strengthened their __________ which helped improve their community.
a. prosperity
b. reputation
c. diversity
d. determinants of health
e. social capital
e. social capital
Social capital usually refers to a person’s or a community’s capacity to obtain support from the social connections available to the person or community. Social capital resides in the quantity and quality of interpersonal ties among people and communities.
You are a home health nurse providing education to a family who has a grandmother with early onset Alzheimer’s. Which of the following is priority for you to teach the family?
a. Obtain caretakers to ensure your grandmother has 24/7 care
b. Notify your neighbors in case of possible elopement
c. Modify the home environment such as removing rugs in high traffic areas
d. Have your grandmother work on activities that stimulate brain health such as puzzles
c. Modify the home environment such as removing rugs in high traffic areas.
Modifying the home environment is priority due to the high risk of falls and injuries during early onset Alzheimer's. 24/7 caretaker and elopement are options that may need to be addressed in later stages of Alzheimer's.