Midterm Community
occupational and environmental health nurse
preventive health care and health restoration within the context of a safe and healthy environment
district nursing
principles of nursing emerged, differentiated "sick nursing" from "health nursing"
home health & hospice nursing
provision of health care for home based clients and terminally ill
faith- community nursing
provision of health services and health education within faith communities
school nurse
provision of health services and health education within school districts on a local, state, and national level
What are the common types of environmental hazards?
Chemical, physical, mechanical, biological, socialcultural
local level of participation in health
City and county health departments
Change agent nurses
Communicate with elected officials, belong to professional organizations, serve on advisory boards
Carrier
Person who sheds infectious agent without any symptoms of the disease
Why is epidemiology important?
Plans and evaluate strategies to prevent illness and as a guide to management of patients and whom disease has already developed
Lavinia dock
1st nursing textbook
Lillian Wald
1st public health nurse
Utilization review
A formal prospective, concurrent, or retrospective assessment of the medical necessity, efficiency, and appropriateness of healthcare services
Medicare
A health insurance program for people who are older than 65 years of age, are disabled, or end-stage renal disease
Managed care plan
A health plan that uses financial and sensitives to encourage enroll to use selected providers who have a contract with the plan
Flexible spending account (FSA) or health savings account (HSA)
A mechanism by which an employee may pay for uncovered health expenses through payroll deductions, using pretax dollars
Vector
A mode of transmission for a disease
Pandemic
A occurrence of a disease or an endemic, that covers a large geographical area, or is even worldwide (COVID)
A nurse manager in a community clinic is planning an in-service to increase staff nurses' knowledge on cultural diversity in health care. Which of the following information should the nurse manager include in the presentation. SATA A. clients from different cultures can vary in how they seek health care services B. power imbalances between providers and clients assists in bridging cultural differences C. in some cultures, health care decisions can be made by more then just the individual client D. a client's culture may influence their willingness to follow health recommendations E. cultural groups can have different perceptions of health conditions
A, C, D, E A. clients from different cultures can vary in how they seek health care services C. in some cultures, health care decisions can be made by more then just the individual client D. a client's culture may influence their willingness to follow health recommendations E. cultural groups can have different perceptions of health conditions
Mechanical environmental hazards
Pressure, ergonomics, confined space, repetitive motion
A nurse is discussing major health organizations with a group of newly hired nurses. Which of the following organizations should the nurse describe as widely recognized for managing the US Blood supply? A. American Red Cross B. US Public Health Service commissioned corps C. occupational health and safety administration D. agency for healthcare research and quality
A. American Red Cross
A public health nurse is a member of a committee tasked with planning health policy. In which areas should the nurse become involved to affect health policy planning on a local level? SATA A. Community Homeowners Association B. City Council Meetings C. Workplaces D. interest Groups E. Social Media Sites
A. Community Homeowners Association B. City Council Meetings C. Workplaces D. interest Groups E. Social Media Sites
A team of public health nurses is collaborating with other health providers to deliver primary care services to vulnerable populations. Which professionals are necessary to deliver public health care services to individuals? SATA A. Nurses B. Ancillary Staff C. Primary Care Providers D. Unlicensed Assistive Personnel E. Government Officials
A. Nurses B. Ancillary Staff C. Primary Care Providers D. Unlicensed Assistive Personnel
A nurse is discussing individual client factors that influence developing a communicable or infectious disease with a peer. Which of the following factors could increase a client's risk for contracting a communicable or infectious disease? SATA A. Older Age B. Living in a Nursing Home C. Immunosuppressant Medications D. Poor Nutrition
A. Older Age B. Living in a Nursing Home C. Immunosuppressant Medications D. Poor Nutrition
a nurse in a community-based clinic is reviewing health care reforms with a newly licensed nurse. which of the following should the nurse identify as having the greatest impact on the ability of obtaining health insurance? A. The Affordable Care Act (ACT) B. Medicaid C. The Children's Health Insurance Program (CHIP) D. medicare prescription, drug, improvement, and modernization act (MMA)
A. The Affordable Care Act (ACT)
A nurse manager in a community clinic is explaining the concept of culture to a newly licensed nurse. Which of the following statements should the nurse manager use to describe a subculture? A. a subculture is a variation within an ethnic group or cultural group B. a subculture is an ability to practice openness to new ways of thinking C. a subculture is a collective of differences that occur in color and national origin D. a subculture is a collective of differences that occur in race and ethnicity
A. a subculture is a variation within an ethnic group or cultural group
a group of school nurses is preparing a presentation to stakeholders to assist with implementing a program for the preventing of injuries in school aged children. which of the following information should the group discuss in the presentation? A. allocation of funding through grants B. allocation of resources by collecting co-pay C. allocation of funds through a health savings account D. allocation of resources by selecting a deductible
A. allocation of funding through grants
A community health nurse is researching social determinants of health in the differing populations they serve. The nurse should identify that which of the following factors place populations at the highest risk for negative health outcomes? A. poverty B. language barriers C. transportation access D. genetics
A. poverty
Environmental human risk
Air, water, food, vulnerable groups, toxic waste, radiation
Environment
All the external factors surrounding the host that might influence vulnerability or resistance
Cultural humility
Appreciating, understanding, and partnering with clients from culture is different than nurses culture
How do you advocate policy change on the local level?
Attend: council meetings, workplace committee meetings, connect with local interest groups, become involved with community homeowner associations
a team of school nurses of school nurses is planning to advocate for students who will be affected by a proposed law. when should the school nurses plan to analyze the law to advocate for the students? SATA A. when the passed bill is being featured negatively on the multiple news outlets B. when the bill is proposed to the legislature C. when parent and teacher organizations post about the law on social media sites D. when the executive branch signs the bill into law E. when a percentage of students has been affected by the law
B & D B. when the bill is proposed to the legislature D. when the executive branch signs the bill into law
A community health nurse is reviewing a new county Rotavirus with a newly hired nurse. There are 75 new cases that were reported yesterday in a population of 4000, with 250 existing cases. What is the incidence rate? A. 20.5 per 1000 B. 20 per 1000 C. 21 per 1000 D. 19.5 per 1000
B. 20 per 1000
A nurse should recognize that which of the following factors contributes to sexually transmitted infections (STIs) becoming a significant public health problem? A. Increased communicability B. Antibiotic resistance C. Lack of primary prevention methods D. Unknown mechanism of transmission
B. Antibiotic resistance
A nurse is discussing the epidemiology framework with a newly licensed nurse. Which of the following terms should the nurse include in the discussion? A. Culture B. Environment, Host, and Agent C. Mindset D. Container
B. Environment, Host, and Agent
a nurse has been found guilty of medication mismanagement at the community clinic. The nurse was fired and the nurse managed was obligated to report the event. which organization has the legal obligation to enforce the laws and rules found in the nurse practice act? A. the local judicial system B. The State Board of Nursing C. government agencies for health D. administrative law judges for the government
B. The State Board of Nursing
a nurse is planning to engage in health policy advocacy activities. which of the following actions in the most direct application of health policy advocacy? A. preforming community assessments B. interacting with decision makers C. maintaining client confidentially D. watching the news to understand politics
B. interacting with decision makers
a community health nurse is a part of a team that plans to propose a policy that improves access to primary care. which of the following is the first step in becoming as a policy making advocate? A. calling legislators B. locating the correct level and jurisdiction where an idea can be introduced C. developing a proposal for the policy D. posting about the issue on social media
B. locating the correct level and jurisdiction where an idea can be introduced
A nurse manager at a public health clinic is working to expand diversity of the clinic's nursing staff. The manager knows that which of the following factors is a barrier to creating a diverse workforce? SATA A. decrease in diverse populations B. stigma facing male nurses in the work force C. male nurses make up only 12% of the national workforce D. distrust of the health care system
B. stigma facing male nurses in the work force C. male nurses make up only 12% of the national workforce
A school nurse is preparing a lesson for for a high school health class about the prevention of sexually transmitted infections (STIs). Which of the following interventions should the nurse include that aims to block transmission of STIs at the portal of exit? A. Prophylactic antivirals B. Immunizations C. Condom use D. Antibiotics
C. Condom use
An occupational health nurse is discussing social determinants of health with staff member in the clinic. Which of the following does the nurse suggest the team use when searching for non-profit resource to provide information about social-economic factors in the local community? A. National Institutes for Health (NIH) Office of Disease Prevention (ODP) B. Centers for Disease Control C. County Health Rankings D. the local health department
C. County Health Rankings
A public health nurse is workign with local health care providers on programs to improve the growth and development of children in their community. Which of the following describes a secondary prevention intervention for autism spectrum disorder (ASD)? A. Environmental policies to determine the amount of air pollution in the area B. Free healthy pregnancy classes for expectant parents C. Early intervention program screening children for developmental delays D. Well-child preventive health visits
C. Early intervention program screening children for developmental delays
A nurse in a public clinic is planning a health fair for clients in the community who are at risk for developing type 2 diabetes mellitus. Which of the following activities should the nurse include for secondary prevention? A. Providing a cooking lesson using sugar alternatives B. Demonstrating a 15-minute exercise routine C. Screening for blood sugar levels D. Educating about stress management strategies
C. Screening for blood sugar levels
A school nurse receives a telephone call from a parent who suspects their school-age child may have coronavirus-2 (SARS-C0V-2). Which of the following instructions should the nurse give as secondary prevention? A. The child should be taken to the hospital if they develop labored respirations. B. The child should wear a mask to school. C. The child should be tested to determine the cause of their illness. D. The child should be immunized prior to coming to school.
C. The child should be tested to determine the cause of their illness.
A nurse educating nursing students about social factors that influence the health of children. The nurse should recognize that the teaching has been effective when the student correctly identify which of the following as social determinant of health? A. the child has been diagnosed with an allergy to peanuts B. the child has hereditary heart defect C. the child lives in a rural, isolated community D. the child play soccer with a community league
C. the child lives in a rural, isolated community
A nurse is providing care to a client who is from a different culture. Which of the following statements is true regarding the cultural theory? A. The nurse should know everything about the client's culture B. it is possible for the nurse to separate the client's culture from their care C. the nurse should aim to provide culturally competent & congruent care D. the nurse should be fair and treat everyone the same
C. the nurse should aim to provide culturally competent & congruent care
tertiary prevention
COMPLICATIONS- prevent complications within the disease (care plan)
A community health nurse is investigating the number of existing cases of Rotavirus in a population of 4000. There are currently 250 existing cases. What is the prevalence rate? A. 60 per 1000 B. 63 per 1000 C. 63.5 per 1000 D. 62.5 per 1000
D. 62.5 per 1000
A nurse is preparing a workshop on preventing common communicable and infectious diseases in the community. Which of the following prevention methods should the nurse include to target diseases that are transmitted through direct contact? A. Pest control B. Proper sanitation C. Clean drinking water D. Isolation
D. Isolation
A home health nurse cares for a neighborhood of diverse clients. Which of the following aspects of cultural diversity should the nurse remember when caring for the clients? A. there should be no variation in the delivery of care among diverse clients B. individuals who live in the same neighborhood will accept the same level of care C. the nurse shaped determine the plan of care regardless of client diversity D. caring for diverse clients will require balancing differences and needs
D. caring for diverse clients will require balancing differences and needs
A community health nurse is reflecting on unconscious feelings they may have toward some of the clients they care for. The nurse should identify this as which of the following concepts of cultural competence? A. color discrimination B. stereotyping C. explicit bias D. implicit bias
D. implicit bias
A nurse is reviewing the effects of the Affordable Care Act (ACA) on the community with a new licensed nurse. Which of the following describes the major effect the ACA has on health funding inequities? A. changed the way hospitals are paid based on quality performance measures B- improved the quality and safety in local health care facilities C. reduced medicare payments to local hospitals for preventable readmissions D. increased ability of everyone in the community to obtain health insurance
D. increased ability of everyone in the community to obtain health insurance
A nurse is providing care to a client from a different culture during a health fair. Which action by the nurse indicates cultural competence? A. developed communication skills B. speaks a different language C. assess client for chronic illness D. interacts effectively in a multicultural context
D. interacts effectively in a multicultural context
Bill to Law
Draft the bill, introduction, and committee review, committee markup, floor consideration, chamber approval, conference committee, approval by both chambers, presidential action, becomes law
Florence Nightingale epidemiology
During the Crimean War, use epidemiological measures of rates of illness per 1000 soldiers to justify the need to improve environmental conditions
Federal department of health and human services role
Enhance the health and well-being of all Americans by providing effective health and humans services by fostering sound, sustained advances in the sciences, underlying medicine, public health, and social services
Theory of culture care diversity
Explores the relationships between health of people from different cultures, nurses cannot separate cultural beliefs, and practices.
who came up with the idea of district nursing?
Florence nightingale- introduced German District nursing
What three things does an epidemiological triad include?
Host, agent, environment
Nurses and political action committees
How to promote the election of candidates that share similar interest
Culture assessment
Identify the patient's cultural understanding of the health problem, and how cultural norms may affect the plan of care
Infection control
Identify the source and stop the spread
Acquired immunity
Immunity developed from an actual exposure, choice, specific infectious agent, or appropriate vaccine
IPREPARE mnemonic
Investigate, present work, residence, environmental concerns, past work, activities, referrals and resources
Medicaid
Joint federal and state funded programs that provide health services for low income people
Diversity and nursing
Male nurses only make up to percent of the national workforce and are often stigmatized, minorities, or generally underrepresented
Health maintenance organization (HMO)
Managed care, plan that acts as an insurer, prepaid premium. HMO is usually employs physicians.
Cultural competence
Meaningful and useful care strategies, based on knowledge of the cultural heritage, beliefs, attitudes, and behaviors of those whom they render
chemical environmental hazards
Medication, illegal drugs, pesticides, volatile organic compound, industrial chemicals
What is the difference between morbility and mortality?
Morbidity is the state of being unhealthy for a particular disease or situation. Mortality is a number of deaths that occurred within the population.
Endemic
Occurring at a consistent, expected level and geographic location (STIs, TB)
Indirect transmission
Occurs when there is no direct human to human contact. Contact occurs for a reservoir to contaminated surfaces.
What are the four basic modes for paying for healthcare in the US?
Out-of-pocket, individual private insurance, employment based group private insurance, government financing
primary prevention
PREVENT- aims to stop behaviors that cause disease throughout education, legislation, vaccination on a population level
What is a communicable disease?
Pathological response of the host to infectious agent, manifesting as an illness
Cultural groups and healthcare
People react differently to disease based on their unique cultural perspective, culture effects how individual defines the meaning of illness, the patient may not be the one to make their health decision
Case
Person diagnosed with disease
ACA (affordable care act)
Provides coverage a preventative services without co-pays, health insurance companies cannot refuse coverage or charge more just because you have a pre-existing condition, coverage until age 26
Physical environmental hazards
Radiation, weather, sound, vibration, impact
What is the general role of board of registered nursing?
Regulates the practice of registered nurses, sets education standards for nursing programs, protect the public, and enforces the laws and roles contained in the nursing act
secondary prevention
SCREENING- involves individual screening to catch a disease early as possible (catch it early)
Nurses and coalitions
Working with other groups to maximize resources, increased influence, and move towards a common goal
Host
Susceptible, human, or animal that harbors in nourishes is a disease causing agent
Diagnosis-related groups (DRGs)
System of payment classification for inpatient hospital services based on the principal diagnosis, procedure, age and gender of the patient, and complications
Direct transmission
The immediate transfer of an infectious agent from an, infected host or reservoir to an appropriate portal of entry in the human host through physical contact
Prevalence
The number of all cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time
Incidence
The occurrence of new cases of a disease or condition, in a given community over a given period relative to the size of the population at risk
Latent period (latency.)
The period of replication before shedding
Cultural awareness
The self-examination and in-depth exploration of one's own biases, stereotypes, and prejudices that influence behavior
Epidemiology
The study of health related trends and populations for the purposes of disease prevention, health maintenance, and health protection
incubation period
The time from invasion to the time when the first symptoms appear
Implicit bias
The unconscious attitudes that precipitate unintentional discriminatory behavior
Reducing implicit bias in nursing
Understand the cultures of patients, avoids stereotyping, understand and respect the power of unconscious bias
Epidemic
Unexpected increase in occurrence of an infectious disease in geographical area over an extended period of time (smallpox, measles)
sociocultural environmental hazards
Violence and war, interpersonal abuse, and internalized racism
Communicable period
With shedding the infectious agent
Nurses as lobbyist
Working to influence lawmakers to pass, effective legislation via professional organizations
Population at risk
Young children, older adults, people with poor nutrition, immunosuppressed clients, individuals living in nursing homes, client who have a high risk lifestyle, international travelers, healthcare workers
health
a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
health promotion
activities that enhance resources directed at improving well being
Where are the sources of contamination?
agrochemicals, waste disposal, mining activities, industries
Under which act was Medicare and Medicaid passed?
amended in 1965
public health nurse
assessment of population status on a population level
Health Belief Model
predicts/explains health behaviors, emphasizes change at the individual level, avoiding disease
Biological environmental hazards
bacteria, viruses, parasites, mold, allergens, pet dander
Agent
causes or contributes to a health problem or condition
public health nursing
community-based, population-focused nursing practice.
What is the goal of upstream thinking?
prevent problems from developing in the first place
What is the assurance part of the public health intervention wheel?
enforce laws, link to services, assure competent workforce, evaluate
Florence Nightingale
established "modern nursing" during the crimean war. identified sanitation, screening, and prevention as the hallmarks of health promotion
How do nurses use epidemiology?
examine factors that affect individual, family, and population group, because it is more difficult to control these factors in the community than it is in the hospital
early home care
female family members, reduced suffering & promoted healing
Nightingale Environmental Theory
focus on the relationship between the individuals health and their environment, preventive care
health prevention
focuses on avoiding disease and the effects of disease
upstream thinking
focuses on interventions that promote health or prevent illness
Mary Breckinridge (1881-1965)
frontier nursing, predecessor to VNA
What is the policy development part of the public health intervention wheel?
inform, educate, empower; mobilize community partnerships, develop policies
Branches of government in law making
legislative branch makes a law, then goes to the executive branch for passing, the judicial branches enforces the new laws
IPREPARE
mnemonic on how public health nurses assess exposure and determine risk. Used to help determine current and passing environmental exposure.
What are the 10 essential functions of public health?
monitor health, diagnose & investigate, inform, educate, empower; mobilize community partnerships, develop policies, enforce laws, link to care, assure competent workforce, evaluate
What is the assessment part of the public health intervention wheel?
monitor health, diagnose and investigate
What are the social determinants of health?
neighborhood and built environment, health and quality, social and community context, education access and quality, economic stability
What are the sustainable development goals? (17)
no poverty, zero hunger, good health and well being, quality education, gender equality, clean water and sanitation, affordable and clean energy, decent work and economic growth; industry, innovation, and infrastructure; reduced inequalities, sustainable cities and communities, responsible consumption and production, climate action, life below water, life on land, peace, justice, strong institutions, partnerships for the goals
social determinate of health
non medical factors that influence health. conditions in which people are born, grow, live, work, and age
federal level of participation in health
overseen by the US department of Health and Human Services (DHHS)
principles of nursing emerged
person, health environment
state level of participation in health
regulate facilities and organizations that influence health and health services
What does upstream thinking consider?
social, economic, and environmental origins of health problems that affect populations
public health
the art and science of health promotion, disease prevention, and injury protection, through organized community effort
Culture
the enduring behaviors, ideas, attitudes, and traditions shared by a large group of people and transmitted from one generation to the next
Risk
the probability that an event will occur (ex; an individual will become ill or die within a stated period of time or age)