Community Health Nursing Chapter 26 MC
When explaining the concept of disability to a local community group, which of the following descriptions would be most appropriate for the nurse to include? A)A disability is a condition someone has, not something one is. B)The plan of care for two persons with the same disability would be the same. C)A disability refers to a person's inability to do something. D)Handicap and disability are two terms that go hand in hand.
A Feedback: Long-held negative views of disabilities are being replaced with new and more positive approaches that view individuals and their challenges from a more holistic standpoint. Thus, a disability is something that a person has, not something one is. Even persons with the same disability but their plan of care can be quite different. Earlier terminology equated disability with an inability or incapacity or handicap that presents a more negative view of the condition.
When describing the importance of the World Health Report to a group of students, the instructor would emphasize which of the following? A) It challenged the world community to focus more attention on unhealthy behaviors that lead ultimately to chronic disease, disability, and early mortality. B) Lifestyle choices are not one of the key contributors to morbidity and mortality levels in either affluent or poor countries. C)Infectious disease is the major threat. D)Malnutrition is the only threat.
A Feedback: The World Health Report challenged the world community to focus more attention on unhealthy behaviors that lead ultimately to chronic disease, disability, and early mortality. It recognized that although infectious disease and malnutrition require ongoing vigilance because they continue to plague many parts of the world, they are not the only threat. Lifestyle choices are also one of the key contributors to morbidity and mortality levels in both affluent and poor countries.
In Healthy People 2020, what is the emphasis of the categories of objectives that relate to the goal of "Disability and Health to promote the health and well-being of people with disabilities?" A)A growing emphasis on a holistic approach that recognizes life satisfaction is just as important to health and well-being as preventative services B)A growing realization that healthy-life years for persons with disabilities do not equate to decreased health costs at local, state, and national levels, unlike they do for persons without disabilities C)Focus on personal responsibility for healthy lifestyle by persons with disabilities D)Concept that persons with disabilities are always dependent on others
A Feedback: In Healthy People 2020, the emphasis of the categories of objectives that relate to the goal of "Disability and Health to promote the health and well-being of people with disabilities" is a growing emphasis on a holistic approach that recognizes life satisfaction is just as important to health and well-being as preventative services. It also indicates a growing realization that healthy life years for persons with disabilities equate to decreased costs at local, state, and national levels, just as they do for persons without disabilities. There is not a focus on personal responsibility for healthy lifestyle by persons with disabilities or a concept that persons with disabilities are always dependent on others.
Which of the following are the three areas has Healthy People identified for public health action for the year 2020 using the International Classification of Functioning, Disability, and Health? Select all that apply. A)Improve the conditions of life for persons with disabilities B)Address the inequitable distribution of resources among people with disabilities and those without disabilities C)Expand the knowledge base and raise awareness about determinants of health for people with disabilities D)Ensure the health of people with disabilities by influencing many social and physical factors E)Public health activities need to focus only on preventing disability
A, B, C Feedback: The three areas that Healthy People has identified for public health action for the year 2020 using the International Classification of Functioning, Disability, and Health include improve the conditions of life for persons with disabilities; address the inequitable distribution of resources among people with disabilities and those without disabilities; and expand the knowledge base and raise awareness about determinants of health for people with disabilities. The plan to ensure the health of people with disabilities by influencing many social and physical factors is too broad. Public health activities need to focus only on preventing disability is a misconception.
A community health nurse is preparing for a presentation on disabilities and is planning to include information about Healthy People 2020 goals. When addressing these goals, the nurse identifies differences from the goals addressed by Healthy People 2000. Which of the following would the nurse identify as different? Select all that apply. A)Rather than individuals with disabilities and/ or chronic illnesses being defined by their limiting conditions, they are viewed as having the potential to meet and exceed health promotion and disease prevention goals set for the nation's population as a whole. B)The approach to disability now emphasizes the principles of health promotion and disease prevention for those currently experiencing disabilities and/or chronic illness. C)The goals for Healthy People 2000 have an entire section on disability and secondary conditions. A growing realization that healthy life-years for persons with disabilities equate to D) decreased health costs at local, state, and national levels, just as they do for persons without disabilities.
A, B, D Feedback: A comparison among Healthy People plans over the last decades underscores the emergence of new approaches to identifying priority areas and planning to improve the health of individuals with disabilities and chronic illness. In Healthy People 2000, only one priority was devoted to disability and chronic illness. Over the past two decades, interest in disability has accelerated. Areas that are focused on with Healthy People 2020 include rather than individuals with disabilities and/or chronic illnesses being defined by their limiting conditions, they are viewed as having the potential to meet and exceed health promotion and disease prevention goals set for the nation's population as a whole; the approach to disability now emphasizes the principles of health promotion and disease prevention for those currently experiencing disabilities and/ or chronic illness; and a growing realization that healthy life-years for persons with disabilities equate to decreased health costs at local, state, and national levels, just as they do for persons without disabilities.
Which one of the following statements about the benefits of universal design for all persons is the most accurate? A) It is the right thing to do to allow access to the built environment for all persons including persons with disabilities. B)A healthier population may be achieved with attention to the environmental barriers that impede healthy lifestyles for all persons, including those with chronic or disabling conditions. C)The built environment refers to the naturally occurring features of the planet. D)Access implies universal design.
B Feedback: A healthier population may be achieved with attention to the environmental barriers that impede healthy lifestyles for all persons, including those with chronic or disabling conditions. Universal design is the right thing to do for persons with disabilities but is not the most accurate or best reason to ensure universal design. The built environment refers to the physical parts of where we live and work (e.g., homes, buildings, streets, open spaces, and infrastructure). Universal design incorporates access, but access does not necessarily imply universal design.
A community health nurse is reviewing the effects of the Americans with Disabilities Act of 1990. Which of the following would the nurse identify as a major result of this legislation? A)Employers with five or more employees must abide by the American with Disabilities Act. B)Architectural barriers must be removed from pathways so that they are accessible by wheelchair. C)The disabled are eligible to receive telephone services in their home at no cost to them. D) Individuals with disabilities who wish to vote must be provided transportation to polling places to vote.
B Feedback: A major accomplishment of this law was the removal of architectural barriers; curbs, stairs, handicap toilets, etc. so that the disabled in wheelchairs can freely move about. Employers with 15 or more employees must follow this law. Adapted telephone services are provided for those who are hearing or physically impaired, but the telephone service is not free. Polling places must be accessible to the disabled and absentee ballots and voter registration can be done from home.
A community health nurse is planning to apply the International Classification of Functioning, Disability, and Health to clinical care in the community. The nurse could use this document as a basis for which of the following? A)Curriculum design B)Needs assessment C)Quality of life measures D)Policy design
B Feedback: In clinical care, the ICF document would be helpful with a needs assessment. Using the ICF document for curriculum design would reflect education; using it for quality of life measures would reflect research; using it for policy design would reflect social policy.
A community health nurse is compiling a list of organizations that serve the needs of persons with disabilities. Which of the following would the nurse categorize as a federal agency? A)National Organization on Disability B)National Council on Disability C)National Association of the Deaf D)American Foundation for the Blind
B Feedback: The National Council on Disability is an independent federal agency. The National Organization on Disability, National Association of the Deaf, and American Foundation for the Blind are private organizations.
Which of the following is a major difference between Healthy People 2010 and Healthy People 2020 with respect to people with disabilities? A)Healthy People 2010 emphasized the disparities that persons with disabilities experience. B)The emphasis on "secondary conditions" in Healthy People 2010 has been replaced in Healthy People 2020 with a concern for health disparities for people with disabilities. C)People with disabilities do not experience health disparities any more than people in the general population. D)Healthy People 2020 continues to emphasize secondary conditions.
B Feedback: The emphasis on "secondary conditions" in Healthy People 2010 has been replaced in Healthy People 2020 with a concern for health disparities for people with disabilities. Key to addressing the barriers is for people with disabilities to "(1) be included in public health activities; (2) receive well-timed interventions and services; (3) interact with their environment without barriers; and (4) participate in everyday life activities. Without these opportunities, people with disabilities will continue to experience health disparities, compared to the general population."
When developing programs to assist individuals with disability and chronic illness, which of the following would be most important? A)Narrow focus B)Holistic practice C)Orientation to the present D)Episodic care
B Feedback: The role of the community health nurse with respect to disabilities and chronic illness requires a holistic practice and broad focus. Strong and sustained efforts are needed to achieve results. The community health nurse addresses current needs and plans for the future.
A community health nurse is making a home visit to a family. The family has a son with a disability who requires a motorized wheelchair. The family asks for the nurse's assistance. Which response by the nurse would be most appropriate? A)"His disability should automatically cover the cost of the chair." B)"We'll need to check with the insurance company about coverage." C)"You'll probably be able to get it if you pay for half the cost." D)"You might be able to get a regular wheelchair, but a motorized one is impossible."
B Feedback: One major obstacle for families with a disabled or chronically ill member may be obtaining needed assistive devices and technology. Just because the technology exists does not mean that it can be obtained. Often the insurance carrier, whether private or governmental, sets limits on which products can be obtained or which brands are acceptable. Thus the nurse working with the family would need to check with the insurance company first and determine what if anything is covered and then determine how to go about obtaining what the son needs.
The community health nurse is invited to speak to a group of students about clients with disabilities. As part of the class, the nurse intends to describe The International Classification of Functioning, Disabilities, and Health (ICF) and its attempts at standardized language. Which of the following would the nurse include as terminology that was standardized? Select all that apply. A)Disability impairment issues B)Body functions C)Handicapping conditions D)Activities E)Environmental factors F)Personal Factors
B, D, E, F Feedback: The ICF included definitions for body functions and structures, activities, and environmental and personal factors. Terms such as disability, impairment, and handicap have been removed from the definition and replaced with functioning, which is more holistic and positive.
When working with the community to develop effective plans to meet the needs of people with disabilities, the community health nurse reviews the statistics involving individuals with disabilities. Which of the following would the nurse identify as accurately reflecting the number of persons with ongoing disability? A)10 million people—less than 5% of the US population B)27 million people—about 10% of the US population C)36 million people—about 12% of the US population D)150 million people—almost 50% of the US population
C Feedback: An estimated 36 million people or 12% of the population is living with some ongoing level of disability. The other statistics of 10 million, 27 million, and 150 million are inaccurate
After teaching a group of students about leading health risks, the instructor determines that the teaching was successful when the students identify which of the following as the #1 leading health risk? A)Unsafe sex B)High blood pressure C)Underweight D)Tobacco consumption
C Feedback: The ten leading health risks are (1) underweight; (2) unsafe sex; (3) high blood pressure; (4) tobacco consumption; (5) alcohol consumption; (6) unsafe water, sanitation, and hygiene; (7) iron deficiency; (8) indoor smoke from solid fuels; (9) high cholesterol; and (10) obesity.
When reviewing the concept of universal design with a group of community developers, the community health nurse recognizes that the emphasis is on which of the following as the underlying theme? A)Disability needs B)Adaptation C)Access D)Safety
C Feedback: The underlying theme of universal design is ensuring access. Universal design is the design of products and environments to be usable by all people, including those with disability needs as well as chronic illness. The concept incorporated issues of adaptive design and safety measures such as reinforcement in bathroom walls to allow for installation of grab bars, but the key issue is accessibility.
After teaching a class about the International Classification of Functioning, Disability, and Health (ICF), the instructor determines that the teaching was successful when the students identify which of the following as a personal factor? A)Problems with ambulation B)Working C)Coping styles D)Amputation
C Feedback: Personal factors are the features of an individual's background, life, and living that are not part of a health condition or health status, such as gender, race, age, other health conditions, fitness, lifestyle habits, upbringing, coping styles, social background, education, profession, past and current experience, overall behavior pattern and character style, individual psychological assets, and other characteristics. Problems with ambulation would be considered an activity limitation. Working would be an activity. Amputation would be an impairment.
An instructor is reviewing the principles that resulted from the 2011 reassessment of global progress on addressing disability with a class. Which of the following would the nurse include? A)The government must focus solely on seeking improvement in the lives of individuals and families living with disability. B)Government must play the only role in addressing disability. C)It is unimportant for service providers, academic institutions, the private sector, communities, and people with disabilities and their families to address disability. D)The importance of all persons, including those with disabilities to participate in their country's development.
D Feedback: In 2011, the World Health Organization and the World Bank reassessed global progress on addressing disability in light of the 2006 Convention on the Rights of Persons with Disabilities. It was determined that not only must governments seek improvements in the lives of individuals and families living with disability, but every citizen needs to participate in their country's development. Government at every level may play a most significant role, but there are important roles for service providers, academic institutions, the private sector, communities, and especially people with disabilities and their families.
A community health nurse is providing information handouts that describe the need for annual gynecologic exams to local health clinics that provide care for individuals with disabilities. The nurse is fulfilling which role? A)Advocate B)Coordinator C)Researcher D)Educator
D Feedback: Providing information handouts is a method for teaching. Therefore, the nurse is assuming the role of an educator at the community level. In the advocate role, the nurse would assist in arranging for the population to receive the appropriate screening, ensuring that any special modifications or adaptations would be available. In the coordinator role, the nurse might arrange for screening to be performed during a routine visit made by a client to a facility or make arrangements for transporting the clients to a facility for the screening. In the researcher role, the nurse might contact other community health nurses about their experience in ensuring screening for this population to discover if they have similar needs or problems.
A community health nurse is working with a group of visually impaired individuals and is developing a program to promote self- confidence and self-respect. Which of the following organizations would be a valuable resource for the nurse? A)American Foundation for the Blind B)American Council of the Blind C)Guide Dogs for the Blind D) National Federation of the Blind
D Feedback: The nurse would contact the National Federation of the Blind whose focus is on helping blind individuals achieve self- confidence and self-respect. The American Foundation for the Blind advocates for the visually impaired through increased state and federal funding. The American Council of the Blind provides services such as information and referral, scholarship assistance, public education, and industry consultation, governmental monitoring, consultation, and advocacy. The Guide Dogs for the Blind makes guide dogs available for the visually impaired.
A community health nurse is developing a plan of care for a family who is providing round-the-clock care in their home for a daughter who is chronically ill. Which of the following would be most important for the nurse to integrate into the plan? A)Insurance limitations B)Skill teaching C)Flexible visiting D)Respite care
D Feedback: Respite care is another area of great importance for families of the disabled and the chronically ill. It can be emotionally draining to meet the daily needs of a member who cannot perform self-care. This often leads to caregiver fatigue and increased stress. It is also important to recognize the effect of the situation on noncaregivers in the family, particularly nondisabled siblings of a disabled child. Respite care offers some needed relief to the family and allows for uninterrupted attention to the nondisabled children. Whatever the source, some type of respite care is often vital to the family's health and should be a priority in the overall treatment plan of the family. Although insurance considerations, teaching, and flexible visiting would be issues to be addressed, respite care is a priority.