Chapter 04: Perspectives in Global Health Care (Stanhope: Public Health Nursing, 8th Ed)

The introduction of health care technology into lesser-developed countries has led to less-than-satisfactory results because: a. People do not want to use newer technology. b. The cost is so high that they cannot afford to use new technology. c. Other health needs may be more important than using complex technology. d. Technology is too complex for people in lesser-developed countries.

ANS: C It is not generally a lack of desire that is a barrier to use of the new technological systems, but the lack of knowledge about them. It is essential to conduct needs assessments to learn what a community has, what a community wants, and what it can sustain. Well-intended projects have failed because the most basic needs were not met, nor was recognition given to what resources and services the country could sustain.

A woman living in a lesser-developed country is likely: a. At risk for a Vitamin E deficiency b. To have several children c. At risk for death during pregnancy and childbirth d. Viewed as the leader of the family unit

ANS: C Most deaths to women worldwide are related to pregnancy and childbirth. Most of these deaths occur in lesser-developed countries. Common nutritional deficiencies in this population are zinc, iodine, vitamin A, folic acid, and calcium. One of the reasons this problem exists is because women are not seen as valued members of society.

Which statement about tuberculosis (TB) is true? a. Meningitis is the leading cause of death from tuberculosis. b. Chemotherapy, if made widely available, could eradicate the disease. c. Many TB cases are associated with HIV. d. The TB bacillus is difficult to isolate.

ANS: C The rise in HIV has lead to an increase in TB because the disease depresses the immune system. Chemotherapy is not always effective, especially in the new drug-resistant strains.

When working with colonias, it is important to remember: a. They have developed roads, transportation, and electrical services. b. They are frequently driven off, only to return to the same area. c. Their settlements have led to an increase in several disease conditions. d. Their contributions have improved the local economy.

ANS: C These settlements have led to an increase in numerous disease conditions associated with poverty, poor sanitation, and overcrowded conditions such as respiratory and diarrheal illnesses.

Which religious organization would be contacted to provide food to starving people in a lesser-developed country? a. International Red Cross b. Church World Service c. Maryknoll Missionaries d. Catholic Relief Services

ANS: D Catholic Relief Services alleviates suffering and provides assistance to people in need affected by war, starvation, famine, drought, and national disasters without regard to race, religion, or nationality. The Red Cross is not a religious organization, and the Church World Service and Maryknoll Missionaries do other things besides providing food.

Income level and social networks are examples of: a. Culture b. Development c. Community d. Determinants

ANS: D Determinants are conditions and factors that are important considerations in population health.

An example of a successful campaign against which of the following communicable diseases was carried out during the 1960s and 1970s? a. Tetanus b. Measles c. Pertussis d. Smallpox

ANS: D Smallpox was virtually eliminated throughout the world as a result of immunization.

The key to achieving the goals of Health for All in the 21st Century (HEALTH21) is the worldwide: a. Cure of communicable disease b. Technological development of all nations c. Availability of health care insurance d. Implementation of primary health care

ANS: D The major key to attaining Health for All by the Year 2000 was the worldwide implementation of primary health care; this has extended into the next century with the document HEALTH21. The World Health Assembly in 1977 stated that all citizens of the world should enjoy a level of health that would permit them to lead a socially and economically productive life.

Worldwide, the most frequent cause of death from a single agent is: a. AIDS b. Malaria c. Hepatitis d. Tuberculosis

ANS: D Tuberculosis strikes nearly 3 million people each year. One third of the worlds population harbors the pathogen.

An example of a multilateral organization is: a. United Nations (UN) b. United States Agency for International Development (USAID) c. Project Hope d. Catholic Relief Services

ANS: A A multilateral organization is one that receives funding from multiple governments and nongovernmental sources, which describes the UN. Project Hope and Catholic Relief Services are private voluntary organizations. USAID is funded by one country, the United States.

Which event would be considered the result of bioterrorism? a. Outbreak of smallpox b. Bombed historic buildings c. Explosion of land mines d. Threats of war

ANS: A Bioterrorism is a term used to describe the deliberate release of viruses, bacteria, or other germs (agents) used to cause illness or death in people, animals, or plants.

Which of these statements is true about the disability-adjusted life years (DALYs) in lesser-developed countries? a. Communicable diseases account for the greatest percentage. b. Diarrheal disease and respiratory infections are rampant despite technology. c. Injuries account for most disability. d. Birth control methods are often lacking.

ANS: A Communicable diseases account for the greatest percentage of calculated DALYs in lesser-developed countries.

Which medication would a nurse administer to a client diagnosed with tuberculosis? a. Isoniazid b. Nevirapine c. Amodiaquine d. Bacille Calmette-Gurin (BCG)

ANS: A Isoniazid is one of several chemotherapeutic medications used to treat tuberculosis. Nevirapine is used to decrease the likelihood of maternal transmission of HIV-AIDS. Amodiaquine is one of several medications used to treat malaria. Bacille Calmette-Gurin is a vaccine that has been promoted as effective in inducing active immunity against tuberculosis.

Which health problem is in need of control in developed countries? a. Hepatitis b. Malaria c. Polio d. Smallpox

ANS: A Malaria, polio, and smallpox are more commonly found in lesser-developed countries.

Multilateral organizations: a. Receive funding from multiple sources b. Control the spread of disease c. Feed the people of the world d. Use nurses as their main source of information

ANS: A Multilateral organizations are those that receive funding from multiple government and nongovernment sources. The other items are specific to the agencies listed, but do not include all of the organizations.

Which is a disease that was once isolated and rare but is now widespread throughout the world? a. Acquired immunodeficiency syndrome (AIDS) b. Smallpox c. Malaria d. Measles

ANS: A Smallpox has been eradicated; malaria and measles were not isolated and rare throughout the world. AIDS was once isolated and rare, but is now worldwide.

The intergovernmental organization that focuses its efforts on assisting countries in Latin America is the: a. Pan American Health Organization b. World Bank c. World Health Organization d. United Nations Childrens Fund

ANS: A The Pan American Health Organization serves as a regional field office in Latin America for the World Health Organization.

Which project would most likely receive funding from the World Bank? a. Development of a sanitation system b. Improvement of roads and bridges c. Creation of a national health insurance plan d. Recovery efforts following a hurricane

ANS: A The World Bank lends money to lesser-developed countries so that they might use it to improve the health status of their people. Projects include control and eradication of disease, providing safe drinking water and affordable housing, developing sanitation systems, and encouraging family planning and childhood immunizations.

To manage the public health aspects of a bioterrorist event, nurses need to understand (select all that apply): a. Medical management and public health measures b. The names and descriptions of the agent/disease c. The chemical features of the pathogens d. How to address mental health concerns

ANS: A, B, D Nurses need to understand the names of the pathogens and the disease they cause, the medical management and public health measures (so that accurate information can be disseminated), and how to help people cope with their feelings.

The Millennium Development Goals address (select all that apply): a. Reduction of child mortality b. Eradication of communicable diseases c. Promotion of gender equality and empowerment of women d. Achievement of universal health care access/AIDS, malaria, and other diseases; ensuring environmental sustainability; and developing a global partnership for development.

ANS: A, C The Millennium Development Goals address reduction of child mortality and promotion of gender equality and empower women. Other goals include eradicating extreme poverty and hunger; achieving universal primary education; improving maternal health; combating HIV

The health priorities in HEALTH21 are based on the concept of: a. Eradication of communicable disease worldwide b. Equality and solidarity with an emphasis on the responsibility for health c. World trade and knowledge sharing about health concerns d. Provisions for the creation of UNICEF

ANS: B HEALTH21 goals are equity and solidarity with an emphasis on the individual's, family's, and community's responsibility for health.

One intervention that has been shown to be effective in improving the health status of a population is: a. Decreasing the number of people who need outside resources b. Increasing in the number of children who can attend school c. Increasing the monetary resources that can be used to treat disease and illness d. Improving the ability to pay debt to more developed countries

ANS: B Health status improvement in children can lead to better education that eventually helps the countrys economic growth.

Population health is an approach and perspective that focuses on: a. Control of the spread of the HIV virus worldwide b. The broad range of factors and conditions that influence health c. Community-based care for all citizens d. Prevention and diagnosis of disease worldwide

ANS: B Population health is a holistic approach that considers the total health system.

An example of a philanthropic organization is: a. International Red Cross b. Carnegie Foundation c. Nestl d. Johnson & Johnson

ANS: B The Carnegie Foundation is a philanthropic organization, receiving funding from private endowment funds. The Red Cross is a nongovernmental agency, and Nestl and Johnson & Johnson are private voluntary organizations.

A community health nurse would use the global burden of disease (GBD) to track: a. The number of cases of HIV/AIDS in a country b. Losses from premature death and losses of healthy life that result from disability c. The economic impact of disability on lesser-developed countries d. The rate of disability in industrialized nations

ANS: B The GBD combines losses from premature death and losses of healthy life that result from disability.

When utilizing the health care system in the United Kingdom, it is expected that the community health nurse will experience: a. An equal employer-citizen share in cost of health care b. Ownership and operation of the system by the government c. Nurse practitioners as the primary providers of care in the system d. Primary care provided in hospitals

ANS: B The United Kingdom has a tax-supported health system. Services are available to all without cost or for a small fee.

A nurse would anticipate finding signs and symptoms of which disease/disorder when assessing a refugee who fled the genocide in Darfur? a. Tuberculosis b. Post-traumatic stress disorder c. Chronic obstructive pulmonary disorder d. Malnutrition

ANS: B The biopsychological changes seen following genocide include physical stress reactions (cardiovascular, neurological) and mental stress responses, especially post-traumatic stress disorders and depression.

An international agency is most likely to use its funds for: a. Development and installation of technology b. Food relief, worker training, and disaster relief c. Support of dictatorships and corrupt governments d. Funding of local private organizations

ANS: B The lesser-developed countries still receive the greatest amount of financial support from the more developed countries, but most of it goes toward food relief, worker training, and disaster relief instead of health care.

Roles for nurses related to global health include providing (select all that apply): a. Medications and vaccines for worldwide use b. Direct patient care and facilitating education and health promotional needs of the community c. Knowledge and skill in countries where nursing is an organized profession d. Consultation to auxiliary personnel

ANS: B, C, D Nurses perform many roles related to global health, including providing direct patient care, facilitating education and health promotional needs of the community, providing knowledge and skill in countries where nursing is an organized profession, and providing consultation to auxiliary personnel.

Which is referred to as a lesser-developed country? a. France b. Japan c. Indonesia d. Sweden

ANS: C A country that is not yet stable with respect to its economy and technological development is lesser developed, which describes Indonesia. France, Japan, and Sweden are considered developed countries.

Which is an example of one of the components of a unit of disability-adjusted life years (DALYs)? a. A woman who lives to be 100 years old b. A woman who contracts HIV after working as a prostitute c. A father with 5 children who dies at the age of 50 from malaria d. A woman who gives birth to a premature infant

ANS: C A male who dies from malaria at age 50 would represent 30 DALYs. Measurement is based on the potential limit for life, which has been set at 82.5 years for women and 80 years for men.

Which antimalarial intervention would be appropriate for client teaching when educating those living in an area of the world where malaria is endemic? a. Receive a dose of IV quinine. b. Avoid direct contact with individuals who have malaria. c. Use insecticide-treated bed nets. d. Apply dichlorodiphenyltrichloroethane (DDT) spray.

ANS: C An effective antimalarial intervention is the use of insecticide-treated bed nets. Malaria is contracted by being bit by an infected mosquito; it cannot be passed by direct person-to-person contact. IV quinine is the drug of choice for treating malaria, not preventing it. Some mosquitoes are resistant to DDT, so this may not be effective.

What would be the best strategy for a government to use to prepare for bioterrorism? a. Threaten lesser-developed countries so they dont develop biological weapons. b. Ban biological weapons worldwide. c. Effectively detect pathogens and manage services. d. Develop antidotes for biological agents.

ANS: C Health care professionals and public health officials need to be able to effectively detect pathogens, manage services, and communicate during a bioterrorism threat.