Evolve - Health disparities and health equity

The nurse is teaching a group of African American nicotine addicts about the harmful effects of nicotine and ways to quit. Which is the best information the nurse gives to this group of patients to reduce health disparity in them?

"Do it for your loved ones."

The registered nurse is teaching the student nurse about the health disparities associated with gender. Which statements from the student nurse indicate effective learning?

"Health disparities exist between men and women." "Adult women use health care services more than men do." "Women are less likely to receive procedures for cardiovascular diseases than men."

The student nurse is discussing the health disparities associated with age with a colleague. Which correct statements should the student nurse include in the discussion?

"Older adults are associated with rapid cognitive decline." "Older adults generally express aggressiveness toward the treatments used." "Older adults of minority groups are less likely to receive screening for prostate cancer."

The nurse is discussing cultural factors that may affect an individual's health. Which of the following statements is true?

"Persons of lower income and education experience worse health and may die at a younger age than those who are more affluent."

Which of the following patients is most likely to experience a health care disparity?

A 72-year-old African American female

Which individual is most likely to experience health care disparities?

A 78-year-old Native-American male living on a reservation

Of the following patients, which does the nurse recognize is at the highest risk of experiencing a health disparity?

A 90-year-old Asian American male with no insurance

The healthcare provider at the clinic prescribes lisinopril for four patients newly diagnosed with hypertension. The nurse anticipates that which patient may not respond as well to this medication?

A 45-year-old African-American male

While communicating with a patient with glaucoma, the nurse finds that the patient has adequate insurance coverage for the treatment. The nurse then discovers that the patient is not getting proper service from the insurance officer. What should the nurse do in this situation? Multiple choice question

Advocate for the patient's rights

The student nurse is giving nutritional counseling to a patient after receiving instructions from the registered nurse. The nurse finds that the patient does not understand the English language and also that a medical interpreter is unavailable in the facility. Which nursing interventions indicate effective learning?

Behaving politely and formally with the patient Avoiding conjunctions while discussing with the patient Using websites that translate words from one language to another

The nurse is reviewing the history of a patient with multiple health problems. Which of these are considered the top two determinants of an individual's health?

Behavior Genetic predisposition

Which statement is true regarding the health disparities associated with patients of a minority group?

Bias and prejudice can affect health care-seeking behavior in these people.

Why are some parts of the rural United States considered medically underserved?

Decreased numbers of health care providers per population

A patient's family is concerned they cannot afford the patient's hospital admission. For what is this patient at risk?

Discrimination

Which belief contributes to health care disparities?

Fatalism

The senior nurse is teaching the novice nurse about income, education, occupation, and health disparities. Which statement by the novice nurse indicates effective learning?

Health care costs are one of the important factors that contribute to health disparities.

The registered nurse is teaching the student nurse about health disparities. Which statement of the student nurse indicates the need for further teaching?

Health disparities cannot affect population groups based on socioeconomic status.

In a community-based setting, the nurse finds that a group of low-income patients do not have any insurance policies. Which nursing intervention would be most beneficial to this group of patients?

Inform the group about Medicaid.

While caring for an emancipated adolescent patient with a sexual infection, the nurse finds that the patient is a lesbian and is unable to meet health care needs. What is the accurate nursing intervention in this situation?

Inform the patient about "Don't Ask, Don't Tell" Repeal Act.

The nurse is completing a discharge plan for a patient who is being discharged home and will require assistance to complete activities of daily living and dressing changes. The patient is a recent Hispanic immigrant who works at a local factory in a low-paying temporary position. The patient indicates through a translator that he or she did not complete high school, has no health insurance, and lives alone in housing supplied by the employer. When completing the discharge plan, which is important for the nurse to address in efforts to decrease the effect of health disparities?

Low income Ethnicity and race Lack of health insurance Lack of high school education

The nurse identifies a patient at high risk for health care disparities. What should be included as important nursing interventions to reduce health care disparities?

Relationship building Participating in cross-cultural education Using standardized evidence-based guidelines

What barrier for health care does a patient most likely experience when a clinic is located in a high-crime area?

Reluctance to visit a health care provider

A survey was conducted in a small community of people to screen for health problems pertaining to malnutrition. It was found that 90 percent of the children surveyed have protein energy malnutrition (PEM). Which health determinant should the nurse analyze in the community?

Social circumstances

A nurse in the emergency department is caring for a patient complaining of abdominal pain for two weeks. The decision is made by the emergency physician to discharge the patient home. The nurse is preparing the discharge instructions. The nurse knows that the patient is an immigrant from Mexico, speaks only Spanish, and does not have insurance. What resources should the nurse give to the patient with the discharge instructions to increase access to care?

Social services resources Treatment recommendations Discharge paperwork in Spanish Refugee health screening information

Which health factor determinant influences the health of the individuals in the highest level?

Use of tobacco and illicit drugs

What is the term for factors related to health of individuals and groups that explain why some people experience poorer health than others?

determinants of health

A survey about occupation-related health problems was conducted in a small community of people in a suburban area. It was found that 50% of workers suffered from asbestosis. The nurse suspects that which factor is responsible for this condition?

environment

If a patient cannot afford medical supplies, what responsibility does the nurse have to advocate for this patient?

ethical obligation

The nurse has been making home visits to a diabetic patient to assess the patient's ability to manage his diabetes. After two visits the nurse notes that the patient has not been taking the oral antidiabetic agent as prescribed. Further assessment reveals that the patient did not understand the instructions received before hospital discharge. How would this problem best be described?

low health literacy

The World Health Organization (WHO) has organized vaccination programs all over the world for the eradication of diseases. Although these programs reach every part of the world, the nurse recalls that some diseases are found to be prevalent in rural areas. Which factor leads to the health disparity with respect to vaccinations in rural areas?

low literacy skills

A nurse who is developing a teaching plan for a community group concerning healthy lifestyle behavior takes into consideration that "place" can have the most significant effect on which health behavior?

physical activity and nutrition

A community-based nurse plans to reduce health disparities in the state and started working on transportation services and reduced-fee screening programs. Which other professional would be most beneficial to the nurse in this situation?

social worker

A patient's overall health is influenced by many determinants. The Affordable Care Act (ACA) impacts which aspect of a patient's health?

the availability of health care

An illiterate diabetic patient is unable to maintain blood glucose levels in the body because he or she is unable to read the readings on the home glucose monitoring system. Which factor is responsible for this health disparity in the patient?

Health literacy

Which factors and conditions can lead to health disparities?

Health literacy Ethnicity and race Language barriers

Which statement is associated with the concept of health literacy in health disparities?

Health literacy assists the patient in making appropriate health decisions.

Which conditions and health disparities can be seen in people living in rural areas?

Higher median age in population Higher rates of cancer in patients of rural areas Higher rates of obesity and chronic diseases in patients of rural areas

A patient is illiterate and has cancer. What factors will the nurse anticipate to be associated with this patient?

Higher risk of death Greater use of emergency department care Decreased ability to use medications correctly

The nurse is managing hypertension in a patient based on standardized evidence-based care guidelines. Which factors should the nurse consider to reduce health disparity?

History of the patient Symptoms in the patient Laboratory values of the patient

The nurse is caring for a patient undergoing antidepressant therapy. During a follow-up visit, the nurse finds that the patient had developed serotonin syndrome. What statement of the patient indicates what could be responsible for this effect?

"I am taking St. John's wort, because it is our family's traditional remedy to improve appetite."

An emergency nurse is triaging a patient for a chief complaint of back pain. The patient was seen in the emergency department two days ago for the same complaint and was discharged home. Which patient statement is least likely to indicate to the nurse that a health disparity exists? Multiple choice question

"I filled my prescription they gave me when I was discharged two days ago."

A nurse is providing care for patients who attend a local community-based clinic for prenatal care. Which patient would the nurse determine to have the highest risk for infant mortality?

African American, married, second child

Based on which factors can health disparities affect population groups?

Age Gender Sexual orientation Special healthcare needs

Which nursing intervention establishes a rapport between the patient and the interpreter to reduce health disparities?

Arranging a meeting between the patient and interpreter before starting interpretation

The nurse is assessing four patients belonging to different races. Looking at the chart, what does the nurse anticipate regarding health disparities in these patients?

Patient D has a higher incidence of stroke than others.

A community health nurse is making an initial visit to an 83-year-old patient who has been labeled as nonadherent to medications. The patient has never been married, lives alone in a low-income elderly housing community, and only completed the fourth grade. Which action should the nurse initially complete to address a potential health care disparity and improve the patient's medication adherence?

Ask the patient to read the medication labels to the nurse.

As health care leaders, what can nurses do to help reduce health disparities?

Assess their own biases and prejudices and work to eliminate them Ensure that educational resources are available and are culturally appropriate Identify cultural and health care practices that are important to cultural and ethnic identity Ensure that the same standards of care are followed for all patients regardless of ethnicity or culture

Which of these actions by the nurse is considered the first step in providing culturally competent care?

Assessing one's own cultural background, values, and beliefs

In a community-based setting, the nurse finds that a large group of Vietnamese immigrants do not have access to a nearby health care facility. Upon interaction, the nurse finds that the clinic does not provide translators and educational materials. Which factor is responsible for this type of health disparity?

Attitude of the health care provider

A nurse is determining the health status of a community. What tools should the nurse use to calculate the community health status?

Birth rate Death rate Life expectancy

Which statement is true regarding the health issues of African Americans?

Breast cancer rates are higher in African American women.

The nurse is caring for an 18-year old male patient who is a member of the lesbian, gay, bisexual, and transgender (LGBT) club at the local high school. He has bilateral bruising to his upper extremities and a fractured right ulna. He states he received his injury when he tripped down a step in his home. What other possible causes should the nurse consider during the assessment?

Bullying due to sexual orientation Sexual abuse due to sexual orientation

How does the nurse achieve health equity in a specific area?

By allowing the patient to attain his or her health potential

A hospital is conducting a Health Camp in a long-term care facility. The nurse finds that most of the older adult residents are addicted to nicotine. This makes them prone to which diseases?

Chronic bronchitis Cancer of the lungs Thrombo angitis obliterans

During an assessment of a newly admitted patient, the nurse notices that the patient often does not answer questions and remains silent. Which is the best action of the nurse in response to this silence?

Clarify what the patient's silence means.

Older adults who belong to minority groups are less likely than their white counterparts to receive screening for which type of cancer?

Colorectal

Which factor predisposes an individual living in an urban center to health disparities?

Concerns about health safety

The daughters of a 78-year-old nonresponsive patient who had an ischemic stroke two weeks ago have asked the nurse if they can bring a Healing Touch (HT) practitioner to the bedside. How should the nurse best respond?

Consult with the health care team and facilitate the practitioner's visit.

What term best describes the differences in the incidence, prevalence, mortality rate, and burden of disease that exists among specific populations in the United States because of social, economic, or environmental disadvantages?

Health disparity

Which factors that may exist in small rural communities prevent a victim from seeking help with intimate partner violence (IPV)?

Economic factors Patriarchal attitudes Traditional gender roles Fear of lack of confidentiality

Which common nursing interventions reduce health disparities?

Ensuring availability of culturally appropriate patient educational resources Learning about services and programs that focus on specific cultural or ethnic groups Informing patients about health care services available for their specific cultural or ethnic group

The nurse is assessing a female patient who has presented to the emergency department (ED) after fleeing an abusive relationship. For this patient, this abusive relationship would best be described as an aspect of which determinant of health?

Environment

Which statement is true regarding health disparities?

Gay men and lesbian women are at risk for experiencing health disparities more than heterosexuals.

The student nurse is documenting the information about health disparities in ethnic groups associated with medications and genetic differences. Which statements of the student nurse indicate effective documentation?

Genetic variations can affect processing of medication in the body. Some medicines are more effective in certain ethnic groups than in others.

An African American parent brings a daughter and a son to a clinic for yearly physical examinations. During the initial assessment, the nurse finds symptoms of measles in one of the children. The nurse learns that neither child has been vaccinated because the parent thinks that it is an unnecessary medical expense. Which factor has led to health disparity in this case? Multiple choice question

Health literacy

Nurses have the opportunity to reduce health disparities and increase access to care for minority patients. Which nursing intervention would be least helpful in reducing health disparities?

Ignore stereotypical attitudes toward a culture/ethnic group that may interfere with getting appropriate health care

A goal of Healthy People 2020 is to improve the health, safety, and well-being of lesbian, gay, bisexual, and transgender (LGBT) groups. According to Healthy People 2020, which are efforts to improve LGBT health?

Implementing antibullying policies in school systems Decreasing the incidence of sexually transmitted diseases with effective interventions Providing learning experiences for healthcare professional students that increase knowledge regarding LGBT patients

What should the nurse do primarily to reduce health disparities?

Improve interpersonal skills.

What are measures to improve access to health services to reduce health disparities?

Increase the proportion of people with health insurance. Increase the proportion of insured people with coverage for clinical preventive services. Ensure that all people have access to rapidly responding, prehospital emergency medical services.

A single teenage woman has presented to the local community clinic with presumptive pregnancy. As the nurse completes the assessment, the teen asks the nurse how she can possibly provide for herself and a new child with no job or insurance. Which program that provides assistance with certain medical expenses might help address this disparity?

Medicaid

A nurse at an urgent care facility is caring for an 85-year-old patient who moved from India to the United States one month ago. The patient is accompanied by two family members, who are the primary caregivers at home. English is the second language for the patient, and the family members usually interpret for the patient. The patient has a history of diabetes and has not had any supplies to test blood glucose since arriving in the country. The patient's family members state that the patient has had increased abdominal pain, but they didn't know where to go and had trouble finding an urgent care facility. They also state that the patient does not have insurance and they had to save all month for this visit. Based on this information, what action should the nurse take first?

Obtain a trained interpreter in order to perform the initial assessment

The nurse is assessing four different patients. What does the nurse infer from the findings in the chart?

Patient B will be associated with less hospitalization.

The nurse is assessing four different patients. What does the nurse infer from the findings in the chart?

Patient C is more likely to receive medical procedures than Patient B.

A senior nurse is explaining the causes of health disparities to some colleagues. What factors lead to health disparities?

Place Income status Disability status Language barrier

Which is an example of a standardized evidence-based guideline to reduce disparities in diagnosis and treatments?

Prescribed insulin administration based on a patient's blood glucose

Which statements are true regarding the ethical points to be considered regarding health disparities?

Professional nurses are legally and ethically responsible for patient advocacy. In many states, the legal definition of the role of the professional nurse includes patient advocacy. Advocacy provides adequate follow-up care for all patients, especially those who are experiencing health care disparities.

Which action by a nurse in a community-based clinic can help to address potential disparities with a large Hispanic population?

Providing translators and materials in the Spanish language

A 40-year-old Native American male living on a rural reservation is experiencing acute chest pain, and the nearest emergency department is 150 miles away. The patient does not own a car. Which factors could lead to a health disparity for this patient?

Race Place Gender

A patient living in which type of area is least likely to seek help for intimate partner violence (IPV)?

Rural area

During a group discussion on factors related to health disparities, the nurse recalls that "place" refers to geographic location. What health risks do rural populations face compared to urban populations?

Rural people have poor health behaviors. Rural populations have fewer economic resources. Rural populations have fewer health care providers. Rural Americans work for employers who do not provide health insurance.

A nurse is assigned to care for a non-English-speaking Asian patient. Which nursing action would be most effective in communicating with this patient?

Seek assistance of a qualified medical interpreter to facilitate communication.

What disadvantages place lesbian, gay, bisexual, and transgender (LGBT) patients at risk for health disparities?

Social Economic Environmental

When is the communication between the patient and the nurse viewed as most effective?

When both the nurse and the patient can understand and exchange the meaning of the communication

For what health care disparity is the older adult most at risk?

The number of diagnostic tests performed

The nurse is caring for patients in a primary health care facility. Which interventions will help the nurse minimize health disparities among patients?

The nurse treats all the patients equally. The nurse works to eliminate his or her own biases related to different cultural groups. The nurse learns about the services that are available for specific cultural or ethnic groups.

A Native American patient who has been recently diagnosed with hypertension has been prescribed an antihypertensive medication in addition to recommendations for a healthy diet and exercise as recommended by the American Heart Association. The patient is a bit concerned about the changes needed, but the nurse is aware that these approaches reduce disparities in health. Why do they reduce these disparities?

They are based on standardized evidence-based care guidelines.

A nurse provides care for lesbian, gay, bisexual, and transgender (LGBT) patients while working in a medical clinic. What should the nurse consider to plan and provide effective care to these patients?

They are more prone to cardiovascular diseases. They have higher smoking rates than heterosexuals. They have higher risk of developing sexually transmitted diseases (STD).

While people are living longer, the incidence of chronic illness continues to rise. What societal changes that people can alter by adhering to healthier lifestyles have contributed to the increase in chronic illness? .

Tobacco usage Sedentary lifestyles Lack of access to fresh fruits and vegetables

A nurse is caring for a gay patient with HIV. When caring for lesbian, gay, bisexual, and transgender (LGBT) patients, what should the nurse keep in mind in order to prevent health disparities for this group of individuals?

Try to understand their health needs. Avoid discrimination on grounds of sexual orientation.

A nurse who is caring for a patient who needs emergency surgery is attempting to determine whether the patient has the capacity to consent to the surgery. Which patient abilities should the nurse consider to ensure that the patient's health literacy needs are addressed?

Understand instructions Weigh risks and benefits Make decisions and take action

A nurse lobbies the hospital administration for a full-time on-staff interpreter for the large group of Vietnamese immigrants who frequently visit the hospital for care. The nurse is carrying out which nursing role?

advocate

A family arrives at a hospital for a health checkup. During the physical examination, the nurse finds that the daughter is underweight and has symptoms of malnutrition. The other family members are healthy. The daughter states that her brother eats full meals and that she is provided primarily with crackers and water. Which factor has led to health disparity in this case?

gender

Which factor most directly contributes to health care disparities?

health care costs

What may be the consequence of failure to advocate for a patient whose care is compromised by health care disparities?

legal action