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Public Health, Primary Care, and Primary Health Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 10th Edition,100% CORRECT

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Public Health, Primary Care, and Primary Health Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 10th Edition MULTIPLE CHOICE 1. In the United States, what ar... e most health care dollars spent on? a. Prescription drugs b. Hospital care c. Physician services d. Public health services (PHSs) ANS: B The largest share of health care expenditures goes to pay for hospital care, with physician services the next largest item. The money spent for PHSs is significantly lower than the other categories of expenditures. Other significant drivers of the increasingly high cost of health care include prescription drugs, technology, and chronic and degenerative disease. DIF: Cognitive level: Remembering TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 2. What has caused the number of uninsured Americans to dramatically increase? a. Medicare took over payment of health care costs. b. With a declining population, the costs for health care rose. c. Nursing salaries greatly increased, causing health care costs to rise. d. Health insurance coverNagUe RwSasIdNroGpTpeBd.frComOMemployment-based health plans. ANS: D Although most Americans continue to obtain health insurance from their employer as a benefit, employment does not guarantee insurance. Employer-sponsored health insurance is sensitive to both the general economy and changes in health insurance premiums. As costs for insurance premiums rose, employers either shifted more of these costs to their employees or declined to offer employment-based health coverage at all. Medicare provides coverage only to the elderly and other special populations. The costs for health care are continuing to rise regardless of the size of the population. There has not been a significant change to nursing salaries, and a change in nursing salaries would not impact the number of uninsured Americans. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 3. A nurse is working with a community to decrease the occurrence of influenza. Which of the following U.S. Department of Health and Human Services (USDHHS) or simply HHS) goals is being applied? a. Strengthen Health Care. b. Advance the Health, Safety, and Well-being of the American People. c. Increase Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs. d. Advance Scientific Knowledge and Innovation. ANS: B One of the objectives of Advance the Health, Safety, and Well-being of the American People is to reduce the occurrence of infectious diseases. The goal of Strengthen Health Care focuses on improving health care services, quality, and coverage. The goal of Increase Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs focuses on improving programming and application of found data. The goal of Advance Scientific Knowledge and Innovation focuses on scientific discovery and application of the new knowledge. DIF: Cognitive level: Remembering TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 4. According to the 1999 Institute of Medicine report, as many as 98,000 deaths each year could be attributed to what cause? a. Cardiovascular disease b. Obesity c. Medical error d. Drug overdose ANS: C In 1999 it was thought that our health care system was expensive, and that access and quality were not optimal, but we had not considered this important fact: many people die of preventable medical errors in the United States. This number is not the correct statistic for cardiovascular disease, obesity, or drug overdose. DIF: Cognitive level: ReNmemRbeIringG B.TCOPM: Nursing process: Assessment MSC: NCLEX: Safe and EfUfectSive NCareTEnviroOnment: Management of Care 5. Residents of rural communities report that they must travel for long distances to obtain health care services. As a result, they seek health care only for emergencies and severe illnesses. Which aspect of the health care system in the United States is illustrated in this situation? a. Access to care b. Cost c. Quality d. Advances in technology ANS: A One significant problem is poor access to care. Access can refer to inability to pay for care and inability to access care. Cost refers to the health care expenditures that happen to pay for the services received. Quality refers to the quality of health care that is provided. Advances in technology refer to the medical advancements made to treat diseases. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 6. A nurse is exploring a job opportunity at a community health center. Which expectation would the nurse have about the center? a. Would be situated in a large metropolitan area. b. Provides care only to the economically disadvantaged. c. Offers comprehensive primary care services and supportive services. d. Is used for preventive services such as flu shots. ANS: C Community health centers serve the entire community for primary health care (PHC) services, regardless of income. They are in a high need or medically underserved community, which can be urban or rural. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 7. A nursing program has initiated a recruitment campaign focusing on increasing the minority students in its program. Which of the following best describes the rationale for this program? a. The number of minority versus non-minority nurses should be equal. b. Minority health care professionals who share the same culture with the clients may provide more effective care. c. The profession should be more diverse. d. Minority nurses can mentor other nurses when providing care for diverse populations. ANS: B It is thought that increasing minority representation in the health workforce not only is a commitment to diversity, but also will improve the health care delivery system. Minority health professionals can be expected to practice in underserved areas at a greater rate and health professionals who share the same culture and language with the clients they serve can provide more effective care. UIt haSs bNeen TsuggestOed that the number of minority nurses should be representative of the population served rather than there being equal numbers of minority and non-minority nurses. Minority nurses are able to mentor other nurses; however, is not the main reason that there is a focus on increasing recruitment of minorities. DIF: Cognitive level: Applying TOP: Nursing process: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care 8. A community health nurse is utilizing telehealth. Which factor best describes the rationale for its use? a. Enables clients to get nursing care in their homes. b. Substitutes for health department delivered care. c. Improves access to care in rural areas. d. Replaces face-to-face care for those who cannot afford it. ANS: C Telehealth provides increased access to health care using a computer monitor and telephone line. It is useful for monitoring clients with chronic disease but is not a substitute for health care. Telehealth may or may not be accompanied by home care nursing. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 9. What is one of the goals of the World Health Organization (WHO)? a. Providing public health nurse (PHC) services to everyone b. Preventing outbreaks of disease c. Preventing the transmission of communicable disease among nations of the world d. Providing humanitarian support in times of disaster ANS: A The WHO adopted a resolution in 1977 accepting the goal of attaining a level of health that permitted all citizens of the world to live socially and economically productive lives. This has been adapted to meet the needs of the new century and was deemed “Health for All in the 21st Century.” The focus of this initiative is PHC services. The WHO does not prevent outbreaks of disease, prevention, transmittal of disease, or provide humanitarian support. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 10. A public health agency is considering implementing an electronic health record. Which action best describes one of the benefits the agency will experience? a. Facilitation of interprofessional care b. Improved client compliance with medical regimens c. Cost savings to the agency d. Compliance with the Joint Commission of Accreditation of Healthcare Organizations (JCAHO) standards ANS: A The electronic medical record facilitates interprofessional care in chronic disease management and coordination of referrals; 24-hour availability of records with downloaded laboratory results and up-to-dUateSassNessmTents; inOcorporation of protocol reminders for prevention, screening, and management of chronic disease; improvement of quality measurement and monitoring; and increased client safety and decline in medication errors. There is no data to support that the agency will have improved client compliance or cost savings. Electronic medical records are not a requirement by JCAHO. DIF: Cognitive level: Understanding TOP: Nursing process: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care 11. A nurse interacts with a 25-year-old woman at a community health center who is obtaining a gynecological examination and birth control pills. Which of the following types of care is the client receiving? a. Tertiary health care b. Public health care c. Public health care (PHC) d. Specialized care ANS: C PHC includes basic health care services with the emphasis on prevention. Tertiary health care is highly specialized medical care. Public health care focuses on care for populations. Specialized care focuses on only one aspect of a patient’s health. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 12. A client is receiving public health care (PHC) services. Which of the following expectations would the client have? a. The care would be provided by a physician. b. Private insurance would be necessary to receive care. c. The emphasis of care provided would be on prevention. d. A referral would be made to a specialist after receiving services. ANS: C The focus of PHC is a broad range of services that are designed to be affordable for the recipients of the care and the governments who provide them. The emphasis of care is on prevention and the means of providing the care is based on practical, scientifically sound, culturally appropriate, and socially acceptable methods. All clients can receive PHC services regardless of insurance status. Those receiving primary care services may or may not need referral to a specialist. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 13. A nurse who was working in public health care (PHC) has gotten a new job in primary care. Which of the following differences would be seen by the nurse in this new care setting? a. Focus on individuals. b. Services provided by specialists. c. Autonomy in the practice setting. d. Community focused care is provided. ANS: A NURSINGTB.COM Primary care focuses on individuals. It is also provided by generalists, is dominated by health care professionals, and is not community focused. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 14. What initiative began because of a resolution adopted by the WHO in 1977? a. Declaration of Alma Ata b. Medicare c. Healthy People d. Public Health Care (PHC) movement ANS: D The WHO adopted a resolution accepting the goal of attaining a level of health that permitted all citizens of the world to live socially and economically productive lives. The name of the resolution that was adopted was the Declaration of Alma Ata. Medicare began as part of the Social Security Act. The Healthy People initiative began as part of the 1979 Surgeon General’s Report addressing the health needs of Americans. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 15. What statement is true about public health care (PHC) in the United States? a. It has dramatically improved since the passage of the Declaration of Alma Ata. b. It focuses on the use of government-funded insurance programs. c. It lacks community participation and a multidisciplinary health care delivery team. d. IT utilizes Preferred Provider Organizations to meet needs of the citizens. ANS: C Although PHC has been endorsed by the United States, it faces many challenges. PHC emphasizes broad strategies, community participation, self-reliance, and a multidisciplinary health care delivery team; however, this is not the primary method of health care delivery in the United States. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 16. A community health nurse reviews Healthy People 2020 when considering the health needs that will be addressed in the community. Which goal would the nurse find in this document? a. Promote healthy behaviors for children. b. Cure cancer. c. Eliminate health disparities. d. Provide primary care to all citizens. ANS: C Elimination of preventable disease, disability, injury, premature death; achievement of health equity; elimination of health disparities; and creation of social and physical environments that will promote good health and healthy development and behavior at every stage of life are the four maNjorRgoaIls cGitedBin.HCealMthy People 2020. U S N T O DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance 17. An 80-year-old client comes to the community health center with a large bag of medications. The client tells the nurse these medications are unaffordable on just Social Security. Which statement is the best response by the nurse? a. “Let’s go through these medications and see which ones we can delete.” b. “You can get these medicines at this clinic for free.” c. “I will consult with our social worker to see if Medicare will pay for these medications.” d. “These medications are important. Do your best to pay for them.” ANS: C This elderly patient probably is eligible for benefits through Part C, the Medicare Advantage program, but often a patient needs help negotiating the system. Finding prescriptive coverage through an insurance plan with the help of a social worker is a better choice than eliminating medications, trying to get medications for free (which is only a short-term solution in most cases), and telling the client to find a way to pay for the medications when she does not have the resources. DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 18. A nursing student is researching advanced practice nursing options. Which of the following discoveries would most likely be made by the nursing student? a. Nurse practitioners may work independently depending on the state practice act. b. Certified nurse midwives have limited prescriptive authority. c. Clinical nurse specialists typically provide primary care services. d. The Doctorate in Nursing Practice emphasizes the importance of research. ANS: A Nurse practitioners may work as independent practitioners and can be reimbursed by Medicare or Medicaid for services rendered. Certified nurse midwives have prescriptive authority in some form in all states. Clinical nurse specialists may provide primary care services, but often work in consultation, research, education, and administration. The Doctorate in Nursing Practice role is a clinical role. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 19. Which federal agency included in the public health system is most involved with the health and welfare of United States citizens? a. Centers for Medicaid and Medicare Services b. U. S. Department of Health and Human Services c. U. S. Public Health Service (USPHS; or simply PHS) d. Health Resources and Services Administration ANS: B The U. S. Department of Health and Human Services is charged with regulating health care and overseeing the health staUtus Sof ANmeTricans. TOhe Centers for Medicare and Medicaid Services develops and oversees the rules and regulations specific to these two insurance programs. The PHS is a major component of the Department of Health and Human Services. The PHS consists of eight agencies: (1) Agency for Healthcare Research and Quality, (2) Agency for Toxic Substances and Diseases Registry, (3) Centers for Disease Control and Prevention, (4) Food and Drug Administration, (5) Health Resources and Services Administration, (6) Indian Health Service, (7) National Institutes of Health, and (8) Substance Abuse and Mental Health Services Administration. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 20. A nurse works to promote the passage of a public health law to protect the health of the community. Which activity would the nurse most likely be promoting? a. Requiring all persons to have health insurance coverage b. Administering flu shots in the late fall and early winter c. Mandating immunizations for all children entering kindergarten d. Monitoring and licensing nuclear power plants ANS: C Public health laws protect the community. Required immunizations are an example. Requiring health insurance coverage would not protect the community. Administration of flu shots is not promotion of a law. Monitoring and licensing nuclear power plants are beyond the scope of public health. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 21. A nurse is working in a state health department. Which program would the nurse most likely be working with? a. Senior health b. Dental services c. H1N1 flu education d. Mental health ANS: C Typical programs in a state health department include: communicable disease service, H1N1 flu services, and budget and finance. Senior health, dental health, and mental health are typically found in a local health department. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 22. A nurse is employed by the Department of Homeland Security. Which activity would be expected by this department? a. Prevention and protection against terrorist attacks b. Regulation of licensureNof mRedIicalGperBso.nCnel M c. Inspection of the safety of food and cosmetics d. Regulation of managed care organizations ANS: A The Department of Homeland Security was created after the terrorist attacks of September 11, 2001. Its mission is to prevent and deter terrorist attacks and to protect against and respond to threats and hazards to the nation. Regulating the licensure of medical personnel, inspecting the safety of food and cosmetics, and regulating managed care organizations are not responsibilities of this department. These activities are regulated by other state or federal government agencies. DIF: Cognitive level: Applying TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care MULTIPLE RESPONSE 1. What are some of the untoward events categorized in the Institute of Medicine (IOM) report about medical errors? (Select all that apply.) a. Wrong-site surgery b. Adverse drug events c. Improper transfusions d. Restraint-related deaths e. Poor staffing patterns ANS: A, B, C, D The untoward events of wrong-site surgery, adverse drug events, improper transfusions, and restraint-related deaths are listed in the IOM report. Although poor staffing patterns may result in medical error, this is not one of the untoward events discussed in this report. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 2. A nurse is entering the health care workforce. Which expectation should the nurse have for the workforce? (Select all that apply.) a. There is a shortage of nurses in the United States. b. Schools of nursing turn away qualified applicants due to lack of faculty and limitations of clinical sites. c. By 2026 there are expected to be 438,100 new nursing positions. d. More students are choosing laboratory science, pharmacy technology, and radiology technology over nursing. e. There is a shortage of physician specialists in the United States. ANS: A, B, C The first three options are true. The laboratory science, pharmacy technology, and radiology technology programs have all seen declining enrollments. There is a shortage of primary care physicians as more physicians are choosing to specialize. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and ENffeRctivIe CaGre EBn.vCironMment: Management of Care U S N T O [Show More]

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