Pop 1 Exam

Behavioral beliefs

attitude toward the expected consequences/outcome of the behavior

Dorothea Dix

reformer of conditions in mental health institutions

Fatalism

"belief that one's fate is fixed and that personal efforts can do little to affect that fate"

ANA standards of Practice

(17) 1-6 > ADOPIE 7-17> Professional performance, research, leadership, environment, ethics

10) The nurse is caring for a specific population within a community. Which nursing action should the nurse use to exemplify the population health nurse's case finding role? 1. Assess a client's need for education. 2. Advocate for a mother who is being seen in a clinic. 3. Carry out an investigation of meningitis cases. 4. Develop an educational plan for a group of adolescents.

. Case finding has been described as basic to population health nursing. Case finding involves identifying individual cases or occurrences of specific diseases or other health-related conditions requiring services. In the educator role, the population health nurse provides clients and others with information and insights that allow them to make informed decisions on health matters. As an advocate, the population health nurse engages in a number of activities or functions including determining the need for advocacy, determining the point at which advocacy will be most effective, collecting facts related to the problem, and presenting the case to the appropriate decision makers.

1) The population health nurse is reviewing the recommendations within the Report of the Massachusetts Sanitary Commission drafted by Lemuel Shattuck. What should the nurse identify as being the most important effect of this document? 1. Establishing state boards of health. 2. Establishing workhouses for the sick poor. 3. Mobilizing social reform to sanitary engineering. 4. Refuting that poverty was the result of deficiencies in moral character.

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13) The population health nurse is comparing the provisions of the Patient Protection and Affordable Health Care Act with the National Health Service approach used in the United Kingdom. What feature of both health care coverage approaches has been identified as a need? 1. Promote efficiency. 2. Implement research. 3. Reduce chronic illnesses. 4. Limit caregiver autonomy.

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Population Health Care Sector Includes

1 public and 2 private organizations

Health Promotion 3 factors

1) Advocacy 2) Health Environment 3) Information & Skills

The process of education

1) Assess ability to learn and needs to learn. 2) Plan an implementing (prioritize) (Goals and objectives) 3) Select Content and teaching strategies > relavent to your population and available resources. 4) Evaluating

Tiers

1) Nurse RN in hospital 2) Nurse admin 3) Public Health Nurses

7) The "Tour for Cure" is an annual bike relay sponsored by the Multiple Sclerosis (MS) Society. Entrants are sponsored for each mile by voluntary donations, which go to the MS Society to fund research activities and provide services to those diagnosed with MS. The Tour highlights awareness and public education of the disease. As a voluntary health agency, which additional functions can the MS Society accomplish? (Select all that apply.) 1. Promote legislation through lobbying. 2. Health planning and organization. 3. Ensure sufficient health professionals to care for those with MS. 4. Enforce laws and regulations that help to diagnose and treat those with MS. 5. Hire individuals with chronic diseases to assist with fund-raising efforts.

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7) The nurse is preparing a seminar on population health for a group of staff nurses in a community health clinic. Which events that demonstrated the effectiveness of population health nursing in the United States should the nurse emphasize? (Select all that apply.) 1. Formation of the Red Cross. 2. School nursing program in New York City. 3. Improvement of sanitary conditions in slum areas. 4. Formation of benevolent societies to care for the sick poor. 5. Visiting nurse services of Metropolitan Life Insurance Company.

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3) In preparation for a health fair the nurse wants to explain the role of ancient civilizations on water purification. Which civilizations should the nurse highlight as being advocates for clean water supplies? (Select all that apply.) 1. Aztecs. 2. Greeks. 3. Romans. 4. Germans. 5. Egyptians.

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While reviewing the indicators of healthy life the population health nurse decides that additional attention is needed on individuals in the community with specific health problems. On which community members should the nurse focus to help improve these indicators? (Select all that apply.) 1. Persons being treated for cancer. 2. Families with members identified with obesity. 3. Individuals who have had myocardial infarctions and strokes. 4. Individuals who continue to smoke after being advised to stop. 5. Individuals with arthritis who have received joint replacements.

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The population nurse is participating on a committee to improve the way health care is provided to individuals who live in the state. What characteristic of the population should the nurse identify to improve the organization and effectiveness of health care delivery? (Select all that apply.) 1. Technological advances. 2. Changes in delivery systems. 3. Changing population demographics. 4. More uninsured members in the state. 5. Reduced numbers of healthcare providers.

1-4 The numbers of healthcare providers is not a characteristic of the population that impacts the organization and effectiveness of health care delivery.

The nurse is functioning as a liaison within a local clinic. What action is the nurse performing in this role?

1. Serving as initial point of contact between client and agency. 2. Coordinating and directing the use of health care services. 3. Organizing and integrating services. 4. Creating alliances of individuals or groups to achieve a specific purpose. Answer: 1 Explanation: 1. The liaison role is one of serving as the initial point of contact between the client and agency. The case manager role is one of coordinating and directing the selection and use of health care services. As a coordinator the nurse organizes and integrates services to best meet client needs in the most efficient manner possible.

- John Snow

1854 - John Snow used disease tracing methods to identify the Broad Street Pump as the source of the cholera outbreak in London; "Father of Public Health and Epidemiology"

The March of Dimes has instituted a public awareness campaign to decrease premature births. It has also conducted media campaigns to raise public awareness of this health problem in addition to research about prematurity and government lobbying efforts. Official government efforts to address prematurity include research and public awareness. As a voluntary agency the primary emphasis of the March of Dimes campaign is on: 1. Funding, research, and education. 2. Research, education, and policy development. 3. Education, policy development, and funding. 4. Policy development, research, and public health practice.

2 NO EDUCATION FOR VOLUNTARY INSTITUTIONS

The clinical trainer for a group of population health nurses is planning to present the historical events that shaped and formed the development of population nursing in the United States. Which events should the trainer include? (Select all that apply.) 1. Creation of district nursing. 2. Settlement house movement. 3. Passage of immigration limiting legislation. 4. Standardization of community nursing practice. 5. Passage of legislation specific to community nursing.

2-4-5 1=England

13) The population nurse becomes aware of a treatment plant that is depositing waste materials into the drinking water. Efforts to have this plant change its behavior have failed and the nurse has been asked by community members to intervene. Which action should the nurse perform when advocating for the community members? 1. Provide a list of community members who are employees of the treatment plant. 2. Analyze other community approaches used to address similar water treatment issues. 3. Collect information about the waste materials being introduced into the water supply. 4. Examine community members for health problems believed to be caused by the contaminated water.

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A graduate nurse has scheduled an appointment with the director of the Center for Nursing Research within the National Institutes of Health. What types of research should the graduate nurse prepare to discuss during this meeting? 1. Medication compliance. 2. Reduction in sentinel events. 3. Health promotion and illness prevention. 4. Elimination of hospital-acquired infections.

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The population health nurse is helping a client identify alternative solutions for a health problem. In which focus and role is the nurse functioning in this situation? 1. Client-oriented and educator. 2. Delivery-oriented and case manager. 3. Client-oriented and counselor. 4. Population-oriented and counselor.

3. Client-oriented and counselor.

1) The client is experiencing nasal congestion from a cold. The client self-administers an over-the-counter cold product to alleviate symptoms. The best description of the health care system the client is using is: 1. Complementary health care. 2. Scientific health care. 3. Personal health care. 4. Popular health care.

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12) The nurse case manager is explaining to a group of health care providers how insurance expenditures for health spending led to the development of diagnosis-related groups (DRGs) in efforts to control spending. What should the case manager emphasize as the driving force for directing health efforts with DRGs? 1. Organize services to be more cost-effective. 2. Decreasing length of stays for hospitalizations. 3. Placing the emphasis on the community to improve population health status. 4. Emphasizing health promotion to decrease hospitalizations and medical costs.

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15) The nurse is identifying events that can shape the future of population health nursing practice for a group of nursing students. Which event should the nurse emphasize? 1. International effort to eradicate smallpox. 2. Prospective payment for nursing services. 3. Surveillance of the CDC on population health. 4. Threat of terrorism to harm the public's health.

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How did The National Health Planning and Resources Development Act of 1974 attempt to address the demand for health care services? 1. Increasing funds to improve the health status of the indigent poor. 2. Recognizing that increased hospitals improved the public health status. 3. Increasing funds for more health services to improve public health status. 4. Recognizing the contribution of health practitioners to the public health status

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Promotion? 1. Provide fresh fruit for morning and afternoon snacks. 2. Schedule scoliosis screening for all female students aged 12 through 16. 3. Examine the quality of repairs made to the school pool after a recent landslide. 4. Ensure safety equipment is available for all student use during sports activities.

: 1. Health promotion entails activities designed to foster a healthy lifestyle and develop a state of good health in the population. This includes advocacy for access to healthy foods, designed to foster good nutrition as a health promoting strategy. The resolution level of health care is eliminating an existing health problem.

Horizontal Health Promotion

Address the policies and environmental conditions that improve health

Anna Maxwell

American Florence Nightingale"

Nonprofit Examples

American Lung Society American Cancer Society American Public Health Association

Clara Barton

Angel of the Battlefield" With one other nurses, she cared for 3,000 injured after the battle of Bull Run; began the American Chapter of the Red Cross in 1882

During a meeting held at the county health department the population health nurse learns that to change the culture of health care from one of disease treatment to health promotion three aims must be achieved. What actions should the nurse take to help achieve these aims? (Select all that apply.) . Teach the population ways to improve health. 2. Structure care delivery so that the patient experience is enhanced. 3. Critically analyze the utilization of resources when providing care. 4. Support the delivery of population health services at the state level. 5. Negotiate with voluntary agencies for grant moneys to help provide care.

Answer: 1, 2, 3 Explanation: 1. The "Triple Aim" identified by the Institute for Healthcare Improvement is to improve population health, enhance patient experience of care, and reduce or control costs

) While working with a local community on an immunization program, the nurse is developing an evaluation tool that incorporates the standards of care for population health nursing practice. What standards should the nurse include in this tool? (Select all that apply.) 1. Advocacy. 2. Research. 3. Collegiality. 4. Autonomy. 5. Leadership.

Answer: 1, 2, 3, 5

12) After completing a community assessment the nurse is preparing a plan to address behavioral determinants of health. Which topics should the nurse include in this plan? (Select all that apply.) 1. Use of park and bicycle trails. 2. Intake of fresh fruits and vegetables. 3. Ease of obtaining marijuana and cocaine. 4. Hours that the community health clinic is open. 5. Use of protective gear when bicycling.

Answer: 1, 2, 3, 5

11) The nurse is creating a program to address cigarette smoking by community members. Which Healthy People 2020 topical areas are relevant to this program? (Select all that apply.) 1. Tobacco. 2. Oral health. 3. Substance abuse. 4. Environmental quality. 5. Clinical preventive services.

Answer: 1, 4 Explanation: 1. For the topical area of Tobacco, objectives include reducing tobacco use by adults and adolescents. 4. For the topical area of Environmental Quality, a leading health indicator objective is to reduce tobacco use by adults. Tobacco is not a leading health indicator objective for the topical area of Oral Health.

2) The nurse is reviewing the evolution of national health care systems in countries throughout Europe and the United States for a school project. In which century should the nurse emphasize that national health insurance in the United States was first proposed? 1. Late 20th century. 2. Mid-20th century. 3. Early 20th century. 4. Mid-19th century.

Answer: 3

The nurse is designing a health education program for the community. In what order should these actions take place? Prioritize learning needs Write specific outcomes Assess the community Select teaching strategies

Assess Prioritize Write Outcomes Select Teaching Strats

Core public Health Functions

Assessment > Identify need of population Policy > develop local state and national policies Assurance > Reflects responsibility of the public heath system to make sure needs are met. Educate

After an outbreak of measles at a local high school the nurse encourages students who are susceptible to have the measles immunization because of the serious consequences from the disease. After educating the students on the benefits of the immunization, most students decide the benefits outweigh the barriers. What model was used to guide health promotion in this situation? Precaution Adoption Process model Health Belief model Pender's Health Promotion model Theory of Reasoned Action model

B

Branding vs tailoring

Beanding is broad

Social marketing competition vs commercial marketing

Competition is unhealthful behavior in social marketing.

Case Management

Coordinating and selecting health care service to meet identified client needs

1978 - The Declaration of Alma-Ata

Developed at an international conference of Primary Care Called for the access to primary health care for all

1982 - The Tax Equity and Fiscal Responsibility Act

Developed diagnosis-related groups (DRG's) where hospitals would receive payment in advance for client's according to their diagnosis Led to discharge of sicker patients and increased demands on PHNs

Insurance came from

During WWII, the dearth of skilled laborers led industries to offer health insurance benefits for competent workers Led to the national emphasis on curative rather than preventive care Present emphasis on cost containment has led to a shift away from institutional care and more toward home community-based care

Bloom's Taxonomy for Learning

ESA ACK eval synthesis analysis application comprehension recall

The nurse meets with members of the community in open forums to help determine ways to improve health. The nurse identifies health problems in the community based on the community input and the nurse's community assessment. In this situation, the nurse is practicing: 1. Public-health nursing. 2. Community-driven care. 3. Community-focused care. 4. Community-oriented care.

Explanation: 3. Community-focused care brings nursing knowledge and expertise to the community. Public health nursing has a perceived focus of environmental sanitation and controlling communicable diseases. Community-driven care focuses on the needs of the community as a whole, but can be limited to only addressing needs identified by community members. Community-oriented care is limited and focuses program development on small aggregates while potentially ignoring health issues affecting larger population groups.

Established hospice

Florence Wald

Affective

Focus of learning is on attitudes and values; the degree to which the attitude or value has been internalized by the learner

Florence Nightingale

Founder of modern hospital nursing Instrumental in the development of district nursing

How do we know if we have been successful in achieving Healthy People 2020 goals?

General health status -(Physical) Health-related quality of life and well-being -satisfaction, participation in activities Determinants of health -various person social and environmental, acess to health care Disparities -differences in health care access or status

Lalonde Report of Canada

Identified the importance of biological, environmental, and lifestyle risks as determinants of health and the need for greater attention toward the elimination of risks Marked a shift away from treatment paradigm to health promotion focus at a national level

Level oh Health Care legislative helmet Health Promotion Illness and injury prevention Resolution Restoration

Illness and injury prevention

Vertical Health Promotion

Illness prevention personal behavior modification

Mary Breckenridge

Initiated the Frontier Nursing Service (FNS) Provided midwifery services to the remote areas of rural Appalachia

Cognitive

Intellectual skills related to factual information and its application

Credit to nursing school

Lillian Wald

The Henry Street Settlement

Lillian Wald and Mary Brewster Considered the first American public health agency Wald cared for the sick in their homes but also focused on improving societal conditions that affected health in the whole community Wald coined the term public health nurse and was a political activist

Goldmark Report 1923

Need for advanced preparation for public health nursing Nursing education to take place in institutions of higher learning

AD(O)PIE

Outcome Identification

Healthy People 2020 Goals

Over Reaching

Pender's Health Promotion moel

Pender's model describes **behavior** being influenced by attitudes and behavior-specific cognitions and affect that result in a commitment to action.

Four Ps of social market

Place (where thing is available) Price(possibly weight gain) Product (not smoking) Promotion (media)

Prevention

Primary Prevention

Promotion

Primary Prevention

Public/Population Health Nursing

Promote health and preserve health prevent disease

Upstream

Promote health strats at root cause

The Brown Report of 1948, Nursing for the Future

Reemphasized the need for nurses to be educated in institutions of higher learning

5) The organizational structure of the United States health care delivery system can best be described by three subsystems:

Scientific health system, complementary health system, and popular health system.

Resolution

Secondary identification (how to fix)

SMART

Specific Measurable Achievable Realistic Time Bound

Local Level Responsibilities

Statistics Disease control Screening Education School Health Population Health

Summative vs formative evaluation

Summative > assigning a grade Formative > Sentences, submit an outline for a paper, midterm evaluations

Restoration

Tert - fixing the problem

Pender's Health Promotion Model

The commitment to action results in actual behavior but may be modified by competing demands and preferences

Elizabeth Frye

Trained lower-class women to provide care to the sick poor Involved in attempts to improve conditions in British prisons

Nursing Outcomes Classification (NOC)

allows nurses to document the effectiveness of interventions

Reason Action and Planned Behavior

attitudes are the product of subjective norms influenced by others

Lemuel Shattuck

beginning of public health practice Report of the Massachusetts Sanitary Commission

The Metropolitan Life Insurance company

company saw how community health nursing reduced mortality and would limit the death benefits paid by the company

Community based nursing practice

delivery of health-care services outside of the typical clinical setting

Precaution Adoption Process

describes the stages that occur in decisions to adopt or not adopt a health-related behavior

William Rathbone

district nursing services

Health Promotion

fosters people's ability to improve their own health by increasing their control of its determining factors

1876 - Louis Pasteur and Robert Koch

identify bacteria Development of vaccines emerges; early efforts at vaccination were called variolation

The Health Belief model

individual perceptions of susceptibility and seriousness, modifying factors, perceptions of benefits and barriers to actions, and cues to action.

Community - Approach

interventions for the entire community population driven

Community-Care

interventions specific to supopulation

Us healthcare considered type of system

nonsystem

Normative beliefs

one's perceptions of others' attitudes toward the behavior and the value that person places on other peoples judgment

Theory of Planned Behavio

one's perceptions of their ability to control the behavior

Coordination management

organizing and intergrating health care delivery service to best meet population health care needs

Jacob Henle

postulated microorganisms as the cause of disease rather than vapors or humors

Nonprofit organizations

provide adjuncts to services provided by government agencies Funded primarily by donations Research Education Policy development

Florence Lee

published a report recommending the employment of educated women for district nursing services TRAIN NURSES

Nursing Intervention Classification

system categorizing nursing services and facilitate their direct reimbursement

Health Determinants

the range of personal, social, economic, and environmental factors that influence health status

Precaution Adoption Process Model

the stages that occur in decisions to adopt or not adopt a health-related behavior