Wellness Across Adult Lifespan ch. 3 & 25

A nurse working on a postpartum unit of a large urban hospital has received a grant to begin a "Baby-friendly Hospital Initiative" developed by WHO. When explaining the major premises of the initiative to her unit manager, the nurse should stress which of the following?

"Improving nutrition by promoting breast feeding of newborns through age four months is what this program is all about."

The nurse working at a crisis hotline center assesses that which of the following callers is most at risk for suicide?

A 16-year-old girl who broke up with her boyfriend An 80-year-old male in constant pain from metastatic cancer

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA)

A Staphylococcus bacterium resistant to many antibiotics.

Smallpox (Variola major)

A biological agent with symptoms that usually resemble influenza symptoms, which include fever and myalgias, followed by a rash.

Anthrax (Bacillus anthracis)

A category agent that poses a high risk to national security.

Medicare

A federal health insurance program that finances medical care for people over 65, disabled individuals who are entitled to Social Security benefits, and people with end-stage renal disease requiring dialysis or a kidney transplant.

Accountable Care Organizations (ACO's)

A health care organization characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients.

Point-of-service (POS)

A health care plan in which members decide how to receive services at the time of service; it combines HMO and indemnity features. As with HMOs, providers are paid through a capitation or risk-based system and, as with preferred provider organizations, individuals can choose a non-plan provider by paying extra.

High-Deductible Health Insurance Plans (HDHP's)

A health insurance plan with lower premiums and higher deductibles than a traditional health plan.

Preferred Provider Organizations (PPO's)

A network of providers who agree to deliver services for a discounted fee. The provider generally incurs no financial risk; the financial burden is on the client rather than the provider.

Nursing Centers are nurse-managed health centers, often situated in medically underserved rural and urban areas, which primarily serve vulnerable populations in the provision of primary care to individuals and families. What are the key components of a nursing center?

A nurse as chief manager A nursing staff that is accountable and responsible for care and professional practice Nurses as the primary providers of care

Gatekeeper

A physician or APN who provides primary care and who makes referrals for emergency services or specialty care.

Hospitalist

A physician whose professional focus is caring for the hospitalized individual.

Botulism

A rare but serious paralytic illness caused by a nerve toxin that is produced by the bacterium Clostridium botulinum.

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)

A retrovirus that causes AIDS. AIDS is the progression of the virus.

Health Insurance Exchanges

A set of state-regulated and standardized health care plans in the United States, from which individuals may purchase health insurance eligible for federal subsidies.

Managed Care

A system that seeks to manage the cost of health care, the quality of that health care, and access to care. It is based on the belief that health care costs can be controlled by "managing" the way in which health care is delivered.

Indemnity Insurance Plan

A type of medical plan that reimburses the patient and/or provider as expenses are incurred.

Concierge Care

A type of primary care medical practice in which physicians charge individual clients a membership fee (on average of $1500 to $1900 per year; range reported as $60 to $15,000 per year) in return for enhanced health care services or amenities.

Which of the following statements are true regarding Advanced Practice Nurses (APNs)?

APNs serve economically disadvantaged and vulnerable populations. APNs have specialized clinical knowledge and skills at the masters or doctoral level. APNs typically practice in the roles of nurse practitioners, clinical nurse specialists, nurse midwives, or nurse anesthetists.

Violence

According to the World Health Organization, violence is defined as the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.

Which of the following patients seen in a clinic has an increased risk of experiencing interpersonal violence?

An 8-year-old male who has witnessed his mother being verbally abused by her boyfriend A 14-year-old female whose parents are problem drinkers A 10-year-old boy who has difficulty making friends A 16-year-old girl who is 70 pounds overweight and concerned about her weight

Plague

An infectious disease of animals and humans caused by a bacterium named Yersinia pestis.

World Health Organization (WHO)

An international agency founded after World War II to promote health around the world.

Which information about anthrax is correct?

Anthrax can cause skin lesions or pneumonia.

Malnutrition

Bad nourishment that can be associated with either too much or too little food intake and is not limited to the wrong types of food. Malnutrition is characterized by inadequate or excess intake of protein, energy, and micronutrients such as vitamins

What is the role of the gatekeeper in a managed care health plan?

Coordinate and oversee an individual's care

In the private sector, which organization provides health care insurance that includes independent prepayment plans?

Health Maintenance Organizations (HMO)

Primary Care Provider (PCP)

Health care providers who provide care in the managed care arena. They can be physicians or midlevel practitioners (physicians' assistants, nurse practitioners, or nurse midwives) who provide basic health care services.

Health Savings Accounts (HSA's)

Health care reimbursement accounts established for the employee.

Fee-for-service

Individual health care payment arrangement in which the person pays for each visit.

Insurance

Individual payment to a fund to provide protection for each contributor against financial losses resulting from an unlikely, but possible, occurrence.

Which of the following indicators is one of the most important determinants of the health of a nation?

Infant mortality rates

Why do infants in developed countries have better outcomes in natural disasters?

Most infants in developed countries are breastfed.

Self-abuse

Negative and often dangerous behavior done to yourself.

According to the Institute of Medicine, nurses can play a key role in helping realize the objectives set forth in the 2010 Affordable Care Act. What are the key roles?

Nurses should practice to the full extent of their education and training Effective workforce planning and policy making require better data collection and an improved information infrastructure. Improved education systems should promote seamless academic progression.

Advanced Practice Nurses (APN's)

Nurses with advanced education beyond the baccalaureate degree who are prepared to manage and deliver health care services to individuals, families, groups, communities, and populations; includes clinical nurse specialists, nurse practitioners, nurse midwives, nurse anesthetists, and others.

Which of the following interventions will be most helpful in preventing premature death in children under the age of 5?

Nutritional supplements

Which of the following components are included in the World Health Organization's (WHO) definition of malnutrition?

Obesity Inadequate intake of vitamins/minerals Inadequate protein intake

Advocate

One who pleads the cause of another.

According to the IOM report Keeping Patients Safe: Transforming the Work Environment of Nurses, what are the four main problem areas in nurses' work environments?

Organizational management Workforce management Work design Organizational culture

Independent Practice Associations (IPA's)

Organizations composed of independent physicians in solo or group practices who provide health care services to members of an HMO in their private offices, eliminating the expense of the staff model HMO, which furnished and owned the facility in which care was provided.

Nursing Centers

Organizations that give an individual access to professional nursing services. The key components of a community nursing center include a nurse as chief manager, nursing staff who are accountable and responsible for care and professional practice, and nurses as the primary providers of care.

Which statement about smallpox is correct?

People who received the smallpox vaccine 50 years ago may still be protected from the disease.

The Patient Self-Determination Act requires health care facilities to have which of the following?

Policies and procedures for advance directives Documentation of individual decisions about life-sustaining treatment Available education about advance directives

The Institute of Medicine has made recommendations for promoting safety within the health care system. Which of the following are accurate reflections of the recommended practices?

Promote health literacy. Improve transparency in the reporting of health information technology. Nurses demonstrate an understanding of the environment they work in.

Capitation Rate

Rate paid to a physician or group of physicians that is a set amount for each enrolled person assigned to them, per period of time, whether or not that person seeks care.

Which of the following projects fall under the guidance of WHO collaborating nutrition centers?

Research related to preserving the freshness of foods Educational seminars related to nutritional requirements Comparison of the effectiveness of vitamin pills versus fresh fruit and vegetables Research related to BMI and cardiovascular disease

Centers for Disease Control and Prevention (CDC)

The US agency designated to investigate the nation's health.

Suicide

The action of killing oneself intentionally

Affordable Care Act (ACA)

The comprehensive health care reform law enacted in March 2010. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 and was amended by the Health Care and Education Reconciliation Act on March 30, 2010. The name "Affordable Care Act" is used to refer to the final, amended version of the law.

Bio Terrorism

The intentional use of a pathogen or biological product to cause harm to a human, animal, plant, or other living organism in order to influence the conduct of government or to intimidate or coerce a civilian population.

Health Maintenance Organizations (HMO's)

The prototypical managed care structure that encompasses two possibilities: (1) a health plan in which providers assume some of the financial risk and (2) a health plan that uses primary care providers as gatekeepers.

Terrorism

The use of violence and intimidation in the pursuit of political aims.

Medicaid

Title XIX Social Security Amendment (1965), a combined federal and state program. The program provides access to care for the poor and medically needy of all ages.

The primary federal agency charged with providing health services to the public is the

United States Department of Health and Human Services (USDHHS).

The school nurse has been asked to present a workshop on community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) for high school teachers. The nurse should stress that CA-MRSA is a:

potentially fatal skin infection that is difficult to treat.