Community Health 1.5, 1.9, 3.5, 3.6

A public health nurse is developing an educational brochure on diabetes for the community clinic. Which group has a higher propensity toward health disparities related to cancer and diabetes?

African Americans

During an intake assessment at the local health department, the nurse asks a Spanish-speaking client where in Mexico they were born. The client becomes angry and says they are from Colombia. What is the best action for the nurse to take?

Apologize for the cultural insensitivity, and make a mental note to be more careful in the future.

A new client is scheduled at the clinic. During the assessment, the nurse notes a circular, dark pink indentation on the client's abdomen. The nurse is aware the client is not originally from the United States. What is the nurse's next best action in assessing this client?

Ask the client to describe usual health beliefs and practices when the client becomes sick

Which of the following are included in the 10 essential services of public health? (Select all that apply.)

Assessing and monitoring population health, Communicating effectively to inform and educate, Utilizing legal and regulatory actions, Enabling equitable access, Building a diverse and skilled workforce

The public health nurse is offering nutrition classes and developing a walking program for community residents. Which of the 10 essential public services is the nurse demonstrating?

Communicating effectively to inform and educate

While providing in-home wound care, the nurse notes the client is frequently vocal and screams at relatives when in pain. In performing a cultural assessment, in what area would the nurse document the frequent outburst and vocalizations?

Communication

When considering health views, which statement is the basis for discussions concerning the effect of culture?

Cultural world views can influence different beliefs regarding the causes of illness.

A community health nurse is working with the nearby Native American reservation to develop a program to reduce the health disparities this population faces. What is a known health disparity among these individuals that the nurse will want to address?

Diabetes

What is the goal of a community health assessment (CHA)? Select all that apply.

Effective assessment of existing community health problems, Prioritization of community-focused health interventions, Identification of community health resources, Associating health needs with possible community resources

What is the initial nursing intervention when conducting a cultural assessment?

Establishing an accepting environment

A public health nurse is developing a program based on the goals of the government initiative Healthy People. Which are health indicators the nurse may use as a part of the program? (Select all that apply.)

Exercise frequency, Tobacco usage, Substance abuse

What is the source for established national objectives and health outcomes that guide health promotion in the United States?

Healthy People

A community nurse who routinely works in the immunization clinic notes an influx of new patients from Russia. The nurse wants to improve their knowledge of this new population. What steps can the nurse take to cultivate cultural sensitivity toward this new client population? (Select all that apply.)

Interview some of the new members and inquire about cultural values., Demonstrate a genuine interest in the lives and culture of the new clients.

While taking a walk around the school at lunch, the school nurse notices the cafeteria dumpsters are next to the playground. The nurse goes over to the dumpster to investigate and finds them leaking and attracting bees. Which of the 10 essentials is the nurse demonstrating?

Investigating and diagnosing

While working in the free clinic, the public health nurse is assessing a migrant farm worker who has an infection on their right hand. The nurse cleans the wound, applies antibiotic cream, and wraps the area to keep it clean. The nurse is conducting an assessment to determine if the client has any contributing factors related to health disparities. Which of these are considered contributing factors to health disparities? (Select all that apply.)

Language barriers, No means of transportation, A diagnosis of schizophrenia

Which factor is considered when determining social determinants of health? Select all that apply.

Place of birth, Childhood experiences, Employment history, Age

A client who is employed at a local, large manufacturing plant has an appointment at the clinic. What type of insurance plan would the intake nurse expect the client to have?

Privately funded insurance Rationale:Large companies with more than 50 employees must offer health insurance to their employees. This health insurance is privately funded.

A community nurse is working with clients in a communicable disease clinic. A client seeking treatment confides to the nurse that they have sex for money sometimes to pay rent. The nurse provides the client with education on how to protect themselves from further infection and offers them free condoms. Which of the elements of the American Nurses Association Code of Ethics is the nurse practicing while taking care of this client? (Select all that apply.)

Respect, regardless of social status, Compassion, regardless of the health problem, Dignity, regardless of personal attributes

Which groups are susceptible to health disparities? (Select all that apply.)

Runaway teenagers, Unemployed individuals, People who belong to ethnic or racial underrepresented groups, People who did not finish high school, Individuals partaking in drug treatment programs

In preparing a health and wellness care plan for the local senior citizen center, the nurse ensures the consideration of the three universal needs. Which are universal human needs of the community? (Select all that apply.)

Safety and security, Sense of belonging

Self-reflection about cultural assumptions and biases is a practical step the nurse can take to cultivate cultural sensitivity and humility.

TRUE

A client has asked the nurse who qualifies to receive an income-based subsidy from the government to help with healthcare coverage. What should the nurse tell the client?

The subsidies are given based on incomes within the 100% to 400% poverty level. Rationale:The Affordable Care Act includes subsidies for low-income individuals and families to help obtain private insurance.

Which are examples of publicly funded healthcare in the United States? Select all that apply.

Your Response: Medicare, Medicaid Rationale:Medicare and Medicaid are publicly funded healthcare plans in the United States.

Which examples of inequities may interfere with health? Select all that apply.

Your Response: Social, Economic, Political Rationale:Inequities that may interfere with health include economic, social, and political.

A recently hired clinic nurse is providing intake on a new client at the clinic. The client says they do not have insurance. When the client leaves, the nurse says, 'I thought all people had insurance since the Affordable Care Act.' What would be the nursing supervisor's best response to this comment?

Your Response:'Even though there is coverage available, many people in the United States cannot afford healthcare coverage.' Rationale:With the Affordable Care Act, more people than ever are able to obtain health insurance. However, the number of those without insurance has recently increased. This increase is believed to be among those who are working but have low incomes. These individuals without insurance usually fall into one of three categories: those who have only one wage earner and cannot afford the insurance offered; those who cannot afford the co-payments for care even if insurance is offered; and those who are not offered insurance by their employer and must seek and pay for it by themselves.

In the United States, what percentage of healthcare services is paid for with public funds?

Your Response:45% Rationale:Of healthcare services in the United States, 45% are paid for with public funds.

The home health nurse is developing a treatment care plan for an older retired client with Medicare insurance. What factor will the nurse take into consideration as the plan is developed?

Your Response:If ordered by the provider, treatments are usually covered by publicly funded healthcare plans. Rationale:Medicare covers inpatient hospitals, time-limited skilled nursing homes, and home health services.

Evaluation, research, and quality improvement are important parts of the 10 essentials of public health services. When used for community problems, what purpose do they serve?

Your Response:Improve and innovate public health functions Rationale:Evaluation, research, and quality improvement improve and innovate public health functions.

Which type of funding is the payer for the majority of health expenditures in the United States?

Your Response:Private coverage Rationale:The majority of payment for healthcare in the United States comes from private coverage.

Which value is central to nursing and public health?

Your Response:Social justice Rationale:The value that is central to both nursing and public health is social justice.

Social justice is the fair and equitable distribution of social benefits and burdens and is tied to issues of human rights.

Your Response:TRUE Rationale:Social justice is the fair and equitable distribution of social benefits and burdens and is tied to issues of human rights.

A client is considering the options available for their child's health insurance coverage in the marketplace provided by the Affordable Care Act, but the client is worried because the child has a preexisting diagnosis of diabetes. What should the nurse tell the client about preexisting conditions and the Affordable Care Act?

Your Response:The Affordable Care Act requires insurance companies to cover an individual regardless of preexisting conditions. Rationale:Beginning in 2010, the Affordable Care Act prohibited lifetime limits on coverage and preexisting conditions for children.