PH ch 3

Which statement can be applied to the majority of services provided by the public health nurse at the local level? a. "The primary aspect of my role is supervisory." b. "I will primarily care for the population in the community." c. "I am most frequently acting as a consultant in the community." d. "The greater part of my time in the community will focus on research."

b. "I will primarily care for the population in the community." Rationale More often than at other levels of government, public health nurses at the local level provide population level or direct services. Public health nurses at the state level are more likely to provide services such as research, consulting, and supervising.

Which would the nurse characterize as a key component of the primary care system? a. The primary care system offers partial individual care. b. The primary care system is the entry point to focus on health issues. c. Primary care is delivered solely by government-funded institutions. d. The primary care system is legally bound to work with the whole community.

b. The primary care system is the entry point to focus on health issues. Rationale The primary care system serves as the initial point of contact for individuals to address health problems. The primary care system provides comprehensive care. Primary care is delivered by a public or private entity. The primary care system is composed of private entities that are not legally bound to work with the whole community.

Which nursing concern correlates with an underinsured client suspected of having melanoma? a. The client will not seek care. b. There is a lack of treatment options. c. Noncompliance with prescribed treatment will occur. d. The client will not be able to afford health care treatment offered.

b. There is a lack of treatment options. Rationale Uninsured or underinsured clients are typically diagnosed at more advanced disease states. Once diagnosed, these clients often receive less therapeutic care because they have fewer surgery and treatment options. Clients are likely to seek and adhere to treatment, but the options they have are limited. A client who is underinsured cannot be denied health care but will not have many options for treatment.

Which agency has a mission to prevent and deter terrorist attacks while protecting against and responding to threats and hazards to the nation? a. U.S. Preventive Services Task Force b. U.S. Department of Homeland Security c. The National Incident Management System d. The Centers for Disease Control and Prevention

b. U.S. Department of Homeland Security

Which statement would the nurse include when explaining the public health system to a client? a. "Public health can only be delivered through public entities." b. "Health departments are accountable to private stakeholders." c. "Public health departments must address all public health issues." d. "Health departments are not always legally bound to provide essential health services."

c. "Public health departments must address all public health issues." Rationale Public health departments must address all public health issues. Public health can be delivered through private and public entities. Health departments are accountable to multiple stakeholders, not just those that are private. Public health departments are legally bound to provide essential public health services.

Which factor would the nurse recognize as contributing to the projected growth of employment for registered nurses? a. Increased life expectancy b. Projected population growth c. Attention on preventative care d. Population's declining access to health care

c. Attention on preventative care Rationale The projected growth of employment for the registered nurse is attributable to the aging population, increased focus on preventative care, and growing rates of chronic conditions. Increased life expectancy, projected population growth, and decline in access to health care are not contributing factors.

Which statement describes primary care in the community? a. Health care available at no cost b. Care required to maintain health c. Essential care made universally accessible d. Government-funded care available to everyone

c. Essential care made universally accessible Rationale Primary care is essential care made universally accessible to individuals and families in the community. Primary care in the community is health care provided at a cost that the community and country can afford. Primary health care in the community is not care required to maintain health. The government does not solely fund primary health care.

Which clinical situation can be interpreted as a preventable complication for which Medicaid and Medicare will not reimburse? a. Pneumonia b. Uncontrolled hypertension c. Hospital-acquired infection d. Reaction to a blood transfusion

c. Hospital-acquired infection Rationale Medicare and Medicaid will no longer reimburse hospitals for preventable complications such as hospital-acquired infections. Care for pneumonia, uncontrolled hypertension, and a reaction to a blood transfusion have not been identified as preventable conditions for which hospitals will not be reimbursed by Medicaid and Medicare.

Which indicator correlates with the strengthening of the public health infrastructure on a national level? a. The objectives on a state level have been reduced. b. On a local level the objectives have been increased. c. Nationally the number of objectives regularly tracked have been increased. d. Nationally the proportion of population-based objectives have been reduced.

c. Nationally the number of objectives regularly tracked have been increased Rationale Increasing the objectives to be tracked on a national level is an indicator that correlates with the strengthening of the public health infrastructure. Reducing the objectives at the state level, increasing the objectives at the local level, and reducing the proportion of population-based objectives are not indicators to help strengthen the public health infrastructure. Population objectives are not tracked on a national level.

Which would the nurse characterize as a key feature of the Affordable Care Act's (ACA's) aim of "improving quality and lowering costs"? a. Decreasing health care premiums b. Integrating new health care technology c. Offering tax incentives to small business providing insurance d. Providing new, voluntary options for long-term care insurance

c. Offering tax incentives to small business providing insurance Rationale ACA's aim of improving quality and lowering health care costs includes offering small business health insurance tax credits. Decreasing health care premiums, integrating new health care technology, and providing new, voluntary options for long-term care insurance are not key features of the ACA's aim of "improving quality and lowering costs."

Which statement characterizes a new consumer protection developed from the Affordable Care Act (ACA)? a. Implementing annual limits on insurance coverage b. Regulating rates for privately purchased insurance c. Preventing bias of clients with pre-existing conditions d. Offering money to individuals participating in clinical trials

c. Preventing bias of clients with pre-existing conditions Rationale New consumer protections provided by the ACA include the prevention of bias for clients with pre-existing conditions. Implementing annual limits on insurance coverage, regulating private insurance rates, and offering money to individuals participating in clinical trials are not protections developed from the ACA.

Which statement identifies the goal of Healthy People 2020 that provides a framework for measurable health indicators? Select all that apply. One, some, or all may be correct. a. Create social and physical environments that promote good health for all. b. Achieve health equity, eliminate disparities, and improve the health of all groups. c. Promote quality of life, healthy development, and healthy behaviors across all life stages. d. Attain high-quality and longer lives free of preventable disease, disability, injury, and premature death. e. Promote health improvements in agriculture, industry, education, housing, communications, and health care.

a, b, c, d

Which source would the nurse select as a contribution to funding for the public health department? Select all that apply. One, some, or all may be correct. a. Tax dollars b. State grants c. Federal grants d. Private insurance e. Individual client payments

a, b, c, d Rationale Funding for the public health department comes from tax dollars, state and federal grants, and private insurance such as Medicare and Medicaid. Funding for the public health department does not come from individual client payments

The nurse has been asked to research technological advances and how they can be used within the health department. After examining telehealth the nurse determines this to be a viable option based on which benefit? Select all that apply. One, some, or all may be correct. a. Accuracy in information transmitted to providers b. Efficiency in administering care due to decreasing paperwork c. Coordination of care across various departments and specialties d. Availability of quick and accurate health records between health care agencies e. Accessibility to health care for patients in remote areas without health care providers

a, b, c, d, e Rationale Telehealth allows for direct access to records between health care agencies, as well as decreasing paperwork, increasing accuracy in transmission of accurate information, ability to coordinate care across specialties and departments, and improving accessibility of health care for those in remote rural areas.

What are the goals of the U.S. Department of Homeland Security? Select all that apply. One, some, or all may be correct. a. Response b. Recovery c. Protection d. Prevention e. Awareness f. Compensation

a, b, c, d, e, Rationale Response, recovery, protection, prevention, and awareness are goals of the U.S. Department of Homeland Security. Compensation is not a goal of the U.S. Department of Homeland Security.

Which would the nurse determine as a major goal of the Affordable Care Act (ACA)? Select all that apply. One, some, or all may be correct. a. Lower cost of health care b. Provide consumer protection c. Increase health care coverage d. Improve the health care quality e. Decrease the use of tertiary care

a, b, d Rationale The major focus of the ACA is to lower the cost of health care, provide consumer protection, increase health care coverage, and improve health care quality. The major goals of the ACA do not include increasing health care coverage or decreasing the use of tertiary care.

Which can be applied to the domains of improving the involvement of registered nurses (RNs) in primary care? Select all that apply. One, some, or all may be correct. a. Promoting career development for primary care nurses b. Developing primary care expertise in nursing school faculty c. Redesigning nursing practice to make full use of primary care d. Increasing opportunities for interprofessional education and teamwork development in both academics and practice e. Changing the culture in nursing schools and practices to place greater value on primary care and the role of nurses

a, b, d, e Rationale The domains to improve the involvement of RNs in primary care include developing primary care expertise in nursing school faculty, promoting career development of nurses in primary care, increasing opportunities for interprofessional education and teamwork development in both education and practice, and changing the cultures in both nursing schools and practice to place greater value on primary care and the role of nurses. Redesigning nursing practice to make full use of primary care is not a domain of improving the involvement of RNs in primary care.

To which area of the hospital would the risk manager plan to provide additional nursing patient safety education and monitoring? a. Surgical area b. Labor and delivery c. Medical surgical unit d. Post-anesthesia care unit

a. Surgical area Rationale Areas of the hospital prone to high rates of errors with serious consequences include surgical areas. Labor and delivery, medical surgical units, and the post-anesthesia care unit do not have the highest rates of errors with serious complications.

Which would the nurse determine is a function of state health departments? Select all that apply. One, some, or all may be correct. a. Establishing health codes b. Licensing facilities and personnel c. Training community first responders d. Financing and administration of programs e. Providing mental health and professional education

a, b, d, e Rationale The functions of state health departments include establishing health codes, licensing facilities and personnel, financing and administration of programs such as Medicaid, and providing mental health and professional education. The Department of Homeland Security is a federal program that works with first responders through programs such as the Community Emergency Response Team. This program trains people to be better prepared to respond to emergency situations in their communities.

Which strategic goal has been identified by the U.S. Department of Health and Human Services (HHS)? Select all that apply. One, some, or all may be correct. a. Advance scientific knowledge and innovation. b. Strengthen the infrastructure of the nation's health care system. c. Advance the health, safety, and well-being of the American people. d. Strengthen the nation's health and human services infrastructure and workplace. e. Increase the efficiency, transparency, accountability, and effectiveness of HHS programs.

a, c, d, e Rationale Strategic goals identified by the HHS include to advance scientific knowledge and innovation; advance the health, safety, and well-being of the American people; strengthen the nation's health and human services infrastructure and workplace; and increase the efficiency, transparency, accountability, and effectiveness of HHS programs. Strengthening the infrastructure of the nation's health care system has not been identified as a specific strategic goal by the HHS.

Which action demonstrates the expectations of the local and state health departments during an environmental disaster? Select all that apply. One, some, or all may be correct. a. Assembling, communicating, and documenting data b. Ensuring residents have access to quality health care c. Promoting the safety of the residents in the immediate area d. Responding to emergencies in an efficient and appropriate manner e. Maintaining the safety of those immediately outside the danger zone

a, c, d, e Rationale The expectations of the local and state health departments in an emergency include collecting and reporting data, protecting those outside the danger zone, appropriately responding to an emergency, and ensuring the safety of the residents in the immediate area. Ensuring residents have access to quality health care is not an expectation of local and state health departments affected by a disaster.

Which agencies are under the U.S. Public Health Service (part of the Department of Health and Human Services)? Select all that apply. One, some, or all may be correct. a. Food and Drug Administration b. Mental Health Global Action Program c. National Incident Management System d. Agency for Healthcare Research and Quality e. Health Resources and Services Administration f. Agency for Toxic Substances and Diseases Registry

a, d, e, f Rationale The Food and Drug Administration, Agency for Healthcare Research and Quality, Health Resources and Services Administration, and Agency for Toxic Substances and Disease Registry are agencies under the U.S. Public Health Service, which is under the Department of Health and Human Services. The Mental Health Global Action Program was launched by the World Health Organization. The National Incident Management System is the national platform for disaster response, and it includes universal protocols and language.

Which statement by the public health nurse demonstrates an understanding of health care expenditures? a. "Acute care is the largest health care expenditure." b. "Uninsured clients account for the least health care expenditures." c. "The largest health care expenditure goes to primary health care provider services." d. "Money paid out for Medicare enrollment is the least amount of health care expenditure."

a. "Acute care is the largest health care expenditure." Rationale The largest expenditure of health care is for acute care services. Primary health care provider services are the second most costly. Uninsured clients or those enrolled in Medicaid do not account for the least amount of health care expenditure.

Which workforce trend can be selected as affecting the role of the nurse? a. Expanded hospital services b. Greater need for tertiary care c. Decreased demand for nurses d. Increased number of hospital beds

a. Expanded hospital services Rationale Expanding hospital services (including mental health, substance abuse, and long-term care facilities) affect nurses. Nursing employment is projected to grow, rather than decrease. There is an increased focus on primary care, not tertiary care. As care has become more community based, tertiary care hospitals have reduced, rather than increased, the number of hospital beds.

After analyzing the factors that have contributed to increased health care costs, which should the manager plan to discuss with the nursing staff? a. Increase in use of technology b. Decline in seeking out primary care c. Integration of alternative therapies d. Increased use of public health services

a. Increase in use of technology Rationale Significant drivers of increased health care costs include technology. A decline in seeking out primary care and integration of alternative therapies are not directly associated with increased health care costs. Public health services account for much less than other categories of health care expenditures.

To achieve the specific goals of Healthy People 2020, which cooperative components must be established within a community to provide community-based care? a. Primary care and public health b. Private funding and primary care c. Private funding and public health d. Public health and privatized insurance

a. Primary care and public health

Which describes the aim of an accredited public health district? a. Promotes community health b. Provides affordable community care c. Monitors community health outcomes d. Provides access to primary care prevention

a. Promotes community health

Which is an example of a targeted competency the nurse performs when using information management tools to monitor the outcomes of the intervention processes? a. Skills b. Attitudes c. Knowledge d. Assessment

a. Skills Rationale The nurse using informatics to monitor the outcomes of the intervention process is demonstrating the competency of a skill. The nurse is not using attitudes or knowledge. Assessment is not a targeted competency.

Which statement would the nurse correlate with the stimulation for change in the health care workforce? a. The distribution of the age of the population has significantly changed. b. The increase in technology has decreased the need for primary providers. c. The growth of the inner city population has increased the need for more clinics. d. There has been an increase in the bed capacity of the hospitals to meet the current demands.

a. The distribution of the age of the population has significantly changed. Rationale The distribution of the age of the population has resulted in a significant increase in the size of an aging population, which has stimulated the need for increased health care professionals. The increase in technology has not decreased the need for primary providers. The inner cities have not experienced growth stimulating a change in the health care workforce. The hospitals have expanded services that have resulted in a decrease in the bed capacity of the hospitals.

Which statement would the nurse use when discussing the contrast between the public and private health care systems? a. The systems operate autonomously. b. The systems partially operate together. c. The systems collaborate on specific efforts. d. The systems are dependent upon each other.

a. The systems operate autonomously. Rationale Historically, the public and private health care systems have operated autonomously of one another. The systems do not partially operate together, do not collaborate on specific efforts, and are not dependent upon one another.

Which statement would the nurse relate to the overall objective for both the public and the primary health care systems? a. The systems support the health and well-being of all people. b. The systems concentrate on the curative aspect of individualized care. c. The systems develop policies to address community-level health issues. d. The systems' overall goal is to become integrated to provide a greater impact on health.

a. The systems support the health and well-being of all people. Rationale The overall objective for both the public and the primary care systems is to promote the health and well-being of all people. Primary care is focused on the health and well-being of individuals. Public health is tasked with participating in the development of policies to address community-level health issues. Integration of the two systems is not an overall goal.

Which government department has established programs to prepare nurses and other health care providers for emergency response? Select all that apply. One, some, or all may be correct. a. National Institutes of Health b. Food and Drug Administration c. Department of Homeland Security d. Centers for Disease Control and Prevention e. Health Resources and Services Administration

b, c, d, Rationale The Centers for Disease Control and Prevention, Food and Drug Administration, and Department of Homeland Security are government departments involved in developing programs to prepare health care providers for emergencies. The National Institutes of Health and the Health Resources and Services Administration are not involved in developing these programs.

Which special service will the public health nurse select to deliver at a local health department? Select all that apply. One, some, or all may be correct. a. Provide treatment for tuberculosis. b. Offer childhood immunization clinics. c. Conduct health education for the public. d. Engage in training for disaster preparedness. e. Provide follow-up care for sexually transmitted infections.

b, c, d, e Rationale In some communities, the public health nurse may offer childhood immunization clinics, provide public health education, participate in disaster preparedness, and provide follow-up care for sexually transmitted infections. The public health nurse may follow up with a client receiving treatment for tuberculosis but is not responsible for providing treatment.

Which statement made by a client would the nurse correlate with the greatest risk for receiving low-quality care? a. "I am a private pay client." b. "I have government insurance." c. "I am covered by my parent's insurance." d. "I have limited insurance through my employer."

b. "I have government insurance." Rationale Clients likely to receive low-quality care are receiving public funds such as Medicaid benefits. An employed client with limited health insurance, a private pay client, or a client covered by a parent's insurance is not necessarily at risk for receiving low-quality care.

Which statement correlates with the adoption of a culture of quality improvement and the effect it has had on client safety outcomes? a. There has been a significant decline in errors and untoward events. b. Action has been taken to help increase consumer awareness of health care quality. c. Clients can access reported preventable complications on health care consumer websites. d. All health care facilities must make their quality measures of health available to consumers.

b. Action has been taken to help increase consumer awareness of health care quality. Rationale Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care in areas such as heart attack, heart failure, and pneumonia. Errors and untoward events continue to occur. Clients do not have access to reported preventable complications on health care consumer websites. The only quality measures published in a database accessible to the consumers come from health care agencies receiving Medicaid and Medicare reimbursements.

Which area has been identified by the national health plan for the United States as an area of most concern? a. Aging population b. Disease prevention c. Access to health care d. Affordable health care

b. Disease prevention Rationale Disease prevention and health promotion have been identified as the areas of most concern.

Which describes the outline of the American Nurses Association (ANA) Principles for Health System Transformation after the implementation of the Affordable Care Act? a. Public health care system b. Equitable health care system c. Universal health care system d. Private insurance health care system

b. Equitable health care system Rationale The outline of the ANA Principles for Health System Transformation is based on an equitable health care system, not a public, universal, or private health care system.

Which can be identified as a public health law that was developed and carried out at the local level to protect the health of the community? a. Proper labeling of food b. Food service inspection c. Regulation of tobacco products d. Monitoring the safety of approved prescriptions

b. Food service inspection Rationale Food service inspection is an example of a public health law that has been developed and carried out at the local level. Ensuring food is labeled correctly, regulating tobacco products, and monitoring the safety of approved prescriptions are laws that have been developed and carried out at a national level.

Which social and economic trends correlate to the stimulation in the demand for health care? a. Decline in the overall size of a family b. Increased interest in health and self-care c. Declining quality of life due to lack of resources d. Fluidity of living arrangements and job placement

b. Increased interest in health and self-care Rationale An interest in health and self-care, which includes nutrition, fitness, and complimentary therapy, is correlated with the stimulation in the demand for health care. An improved, rather than declining, quality of health has also affected health care. A change in the composition of families and living patterns have contributed to the stimulation in the demand for health care. This change is not specifically attributed to fluctuating living arrangements or a decline in the size of a family.

Which income distribution trend is related to the effect on health care consumers? a. The average income is in the lowest quintile. b. Individual (per-person) income has increased. c. The per-family average income has decreased. d. Incomes are becoming more evenly distributed.

b. Individual (per-person) income has increased. Rationale The average per-person income has increased. The average income per family has increased, which affects health care consumers. The average income is in the highest, not the lowest, quintile. Average incomes have become unevenly distributed.

Which part of Medicare would the nurse identify as incorporating private insurance? a. Medicare Part B b. Medicare Part C c. Medicare Parts A and B d. Medicare Parts A, B, and D

b. Medicare Part C Rationale Medicare Part C, the Medicare Advantage program, incorporates private insurance plans into the Medicare program. Medicare Parts A and B are the traditional Medicare programs. Medicare Part D is the prescription drug program.

Which force is related to the stimulated change in the demand for health care in the United States? a. Population growth b. More older adults with degenerative illness c. Increased mortality rate from infectious disease d. Increase in chronic disease among younger adults

b. More older adults with degenerative illness Rationale The increased rate of chronic and degenerative illness in older adults has contributed to an increased demand for health care in the United States. The population has declined, not grown, in the United States. New treatments for infectious disease have resulted in decreased rather than increased mortality. An increased rate of chronic disease in younger adults is not considered to be a factor affecting the change in demand for health care in the United States.

Which social and economic trend correlates with the changes that are occurring in the health care system? a. There has been a significant increase in the use of tertiary care. b. Nutrition and fitness are associated with increased consumer spending. c. Traditional medicine has been affected by a decrease in consumer spending. d. The focus on preventative health has resulted in a decline of chronic disease.

b. Nutrition and fitness are associated with increased consumer spending. Rationale Increased spending on nutrition and fitness is connected to the changes that are occurring in the health care system. Increased use of tertiary health care is not identified as a current trend. Traditional medicine and complementary therapies are increasingly sought out by the public. There has been an increase, not a decrease, in the number of people with chronic disease.

Which demonstrates the movement of Healthy People 2020 from the traditional disease-specific focus to a more holistic view of health consistent with a public health frame of reference? Select all that apply. One, some, or all may be correct. a. Preventative care b. Social environment c. Access to health care d. Physical environment e. Health care economics

b. Social environment d. Physical environment Rationale Emphases on social and physical environments move Healthy People 2020 from the traditional disease-specific focus to a more holistic view of health consistent with a public health frame of reference. Emphases on preventative care, access to health care, and health care economics do not move Healthy People 2020 from a more traditional to a holistic framework.

Which definition describes the role of the Public Health Services Commissioned Corps? a Provides direct assistance to local health departments b. Regulates health care and oversees the health status of Americans c. Protects, promotes, and advances the health and safety of the United States d. Ensures the homeland is safe, secure, and resilient against terrorism and other hazards

c. Protects, promotes, and advances the health and safety of the United States Rationale The role of the Public Health Services Commissioned Corps is to protect, promote, and advance the health and safety of the United States. The state health department is responsible for providing direct local assistance to the local health departments. The U.S. Department of Health and Human Services is responsible for the regulating health care and overseeing the health status of Americans. The U.S. Department of Homeland Security's mission is to ensure the homeland is safe, secure, and resilient against terrorism and other hazards.

Which can be identified as a primary benefit of Healthy People 2020's main goals? a. Identifies current needs for primary health b. Reflects health of the majority of the U.S. population c. Provides a framework for measuring and tracking indicators d. Considers health indicators that are applicable to all communities

c. Provides a framework for measuring and tracking indicators Rationale The primary benefit of the main goals of Healthy People 2020 is the provision of health indicators that can be measured and tracked. The goals do not specifically identify needs for primary health, reflect the health of the majority of the U.S. population, or reflect indicators that apply to all communities.

Which would the nurse identify as the role of the primary care system? a. Is charged with creating a healthy community b. Addresses community-level health concerns c. Serves the individual who presents to the practice d. Focuses on the prevention of population health problems

c. Serves the individual who presents to the practice Rationale The primary care system serves the individual who presents to the practice. The public health system addresses community-level health concerns, is charged with creating a healthy community, and focuses on the prevention of population health problems.

Which type of payer mechanism has been established as the most desirable option for financing a reformed health care system? a. Public b. Mixed c. Single d. Private

c. Single Rationale A single-payer mechanism has been identified as the most desirable option for financing a reformed health care system. Public, mixed, or private payer mechanisms have not been identified as the most desirable options for financing a reformed health care system.

Which statement supports the correlation between the indicators of Healthy People 2020 related to the strengthening of the public infrastructure and the effect they have on the practice of nursing? a. The data gathered can be used as an evidence-based resource for practice. b. The information gathered about the health trends will support changing practice. c. Statistics will demonstrate the correlation between nursing care and changing practice. d. Statistical information that is gathered will help provide strategies for promoting community-based wellness.

c. Statistics will demonstrate the correlation between nursing care and changing practice. Rationale These indicators of the Healthy People 2020 related to the strengthening of the public infrastructure will assist nurses in having data to show that their assessments and interventions are changing practice. The data gathered are not specifically used as an evidence-based resource for practice. The information gathered for the strengthening of the public infrastructure is not focused on a specific health trend. The information gathered is not intended to provide strategies for promoting community-based wellness.

Which action will the nurse plan to take to continue to contribute to the implementation of the Patient Protection and Affordable Care Act (ACA)? a. Conduct research on population health. b. Maintain focus on the private health sector. c. Strengthen the existing access to public health. d. Promote economic growth of health care services.

c. Strengthen the existing access to public health. Rationale Contributions by nurses to the implementation of the ACA include strengthening access to primary care. Conducting population health research, maintaining focus solely on the private health sector, and promoting economic growth of health care services are not nursing contributions to the implementation of the ACA.

Which incident would the manager plan to include when discussing an event categorized as an error? a. A client who experienced an adverse reaction to a drug b. A surgical procedure that was performed on the wrong site c. The nurse did not communicate the declining state of a client d. The nurse did not verify the consent before a client's surgical procedure

c. The nurse did not communicate the declining state of a client Rationale Failure to communicate is a category of an error. Other categories of error include diagnostic, treatment, and prevention errors; equipment failure; and other system failures. Adverse drug reactions, wrong-site surgery, and failure to verify consent are not categories of error.

Which statement about health care access can be interpreted as correct? a. Clients without insurance are unable to obtain health care. b. The uninsured receive less tertiary care than insured clients. c. Third-party payers determine where clients can receive care. d. Clients in northern and eastern states are more likely to be uninsured.

c. Third-party payers determine where clients can receive care. Rationale Third-party payers such as insurance companies determine where clients can receive care, as well as how much care they can obtain and which types of care will be covered. Clients who do not have insurance can obtain health care, but their choices are limited. The uninsured receive less primary care, not tertiary care, compared to those who are insured. Clients in the southern and western states, rather than northern and eastern states, are more likely to be uninsured.

Which statement made by the nurse characterizes full community participation? a. "The individuals in the community will support community-based and public health agencies." b. "The community will seek to be proactive in seeking primary care at a local health care facility." c. "The people in the community will work toward creating the availability of affordable health care in the community." d. "People who live in the community participate with local government in developing programs to help resolve health problems."

d. "People who live in the community participate with local government in developing programs to help resolve health problems." Rationale Full community participation means that individuals within the community will assist in the development of approaches to help resolve health problems. Full community participation does not mean that the community will be proactive in seeking primary care at a local health care facility or support community-based and public health agencies. Full community participation does not imply that the people in the community will work toward creating the availability of affordable health care in the community.

Which describes a key factor of managed care? a. Limits use of health care services b. Primary level of private health care c. Mandated through law at the national level d. Health care facilities provide care at decreased cost

d. Health care facilities provide care at decreased cost Rationale A key factor in managed care is the decreased cost to the consumer when using the health facilities that have contracts with the insurance company. The key factor for managed care is not to limit the use of health care services but to decrease overuse. Managed care is not a level of health care; it is a system in which care is delivered by a specific network of providers who provide care using a case management approach. Managed care is not mandated through law at a national level.

Which client would the nurse correlate with receiving tertiary preventative care? a. The client newly diagnosed with bipolar disorder b. The client who requires screening for periodontal disease c. The client with a history of a heart attack who is prescribed aspirin d. The client with diabetes who is referred to a self-management program

d. The client with diabetes who is referred to a self-management program Rationale A client who is referred to a diabetes self-management program is receiving tertiary prevention. The clients who are newly diagnosed with bipolar disorder, require screening for periodontal diseases, and have a history of a heart attack and are prescribed aspirin are receiving secondary preventative care.

Which statement can be applied to the relationship between primary care and public health systems? a. The systems' primary focus is on secondary care. b. The systems offer comprehensive coordinated care. c. The systems are organized to provide duplicated services. d. The primary and public systems are elements of primary health care.

d. The primary and public systems are elements of primary health care. Rationale The primary and public health systems are part of primary health care. The primary care and public health systems are not organized to provide duplicated services. The focus of primary care is to offer comprehensive coordinated care, whereas the focus of the public health systems is designed to prevent disease and offer primary care. The public health system is organized to prevent disease and promote the health of the population