Community Quiz 1
13. There is a tornado alert in the community. What resource would be valuable to the disaster team to ascertain the areas in the community at greatest risk for damage due to the structure of land mass and infrastructure? A) Geographic information systems B) County maps C) Air surveillance D) Geographic analysis
A
multilateral agencies
Agencies that use/receive funding from both governmental and nongovernmental sources (WHO, UN, World Bank)
Way to know Community Health
Community Report Card
Collaborative Model
Community assessment by interdisciplinary team using representative parties of the community (social services, corporations, government officials)
Community as Partner Approach
Community assessment considering expertise of community to understanding health of the community (equity of nurse relationship w community)
Functional Health Status Approach
Community assessment that evaluates health patterns of behaviors of community dwellers that occur across time - how they respond to problems and take action
Community Asset-based Approach
Community assessment that identifies community strengths and resources (used in conjunction w what is needed)
17. When the community collaborates in a plan to create services and education to enhance their health and well being, the plan A) creates an environment that fosters change. B) has an increased rate of success. C) empowers the community, but diminishes the rate of success. D) shifts the focus from dependency to empowerment.
D
The International Council of Nurses is a federation of more than how many national nurses associations? A. 100 B. 110 C. 120 D. 130
D. Rationale: The International Council of Nurses (ICN) is a federation of more than 130 national nurses associations, representing more than 13 million nurses worldwide.
health disparities
Difference in the quality of healthcare delivered or obtainable, often tied to race or ethnicity or socioeconomic status
Millennium Developmental Goals (United Nations)
Eight goals that all 191 UN member states have agreed to try to achieve by the year 2015 to combat poverty, hunger, disease, illiteracy, environmental degradation, and discrimination against women. address major gaps in human development
Dorothea Dix
Improved conditions in jails, poorhouses and insane asylums. Persuaded many states to assume responsibility for the care of the mentally ill Political activist
Communities as Interdependent Systems
Physical environment education safety and Transpo Plitics and govn. Health and social services Communication Economics Recreation
public health intervention wheel
a framework for public health nursing practice that is population-based, contains three levels of practice (individual, community, and system), and defines 17 public health interventions focusing on prevention
function of public health
a national consensus on goals (USDHHS, 2013b); provision of systems of health insurance based on risk, not necessarily on health; and the role of nongovernmental entities in disease prevention and health promotion
who is the client in public health nursing?
community/population
Community Assesment
examination of biological, psychological and sociocultural influences on the environmnet •Physical activity: sidewalks, safe to walk and bike, bike trails •Obesity/Overweight •Substance abuse: is it a problem in this community •Sexual behavior: sex ed, condoms available •Mental health: group homes for mental health in community, whats there •Injury/Violence: state level stats, gun violence •Environment: incinerator in town, green ooze from old factories, any hazards •Immunization: why is it important in that community (people w needs), is this available •Access to healthcare: is there a hospital, clinic, is there primary care available
Identify leading causes of morbidity and mortality in the United States
heart disease, cancer, respiratory issues
aggregate
population group with common characteristics
Define health disparities and identify common disparities in health and health care delivery
"racial or ethnic difference in the quality of healthcare which is not due to access-related factors or clinical needs, preferences, and appropriateness of intervention" (Institute of Medicine, 2002, p. 3). Disparities are found in certain types of illness, such as cardiovascular disease, cancer, HIV, diabetes, end-stage renal disease, and certain surgical procedures. Surgical procedures such as amputations have been found to be more common within minority groups
3. You are completing a community assessment. You note that the computer companies in the community hire a disproportionate amount of their employees from local suburban communities versus the community in which the company is housed. In order to create an accurate assessment you collect data on all of the company's employees, but list those living outside of the community as A) outliers. B) statistically irrelevant. C) an aggregate. D) statistically relevant.
C
4. A significant number of the members of your community have developed cancer. The EPA has discovered a leak of biohazardous waste from a local factory that has leached into the water table. The area is decontaminated and cleaned. The community identifies the need for a local hospice for those with cancer who are dying. Area communities participate in the fund drive. This type of community effort may be considered (a) A) communities of resolution. B) community of concerned citizens. C) community of solution. D) health care-centered community.
C
6. You are conducting a community assessment. The community is large and the members range from affluent executives to poverty-stricken migrant workers. To accurately assess the community, you A) use a questionnaire written on a fifth-grade reading level. B) use multiple methods or perspectives. C) interview a subpopulation of each group represented. D) analyze census data.
B
9. The school nurse notifies you that there have been six confirmed cases of pertussis in the sixth-grade classes. In addition to responding to the cluster of cases you would A) close the school. B) research the vaccine compliance in the school. C) send notes home to the parents regarding a pertussis epidemic. D) consult with the infection control physician at that local hospital.
B
Epidemiological Approach tactics
Community assessment using health trend data to evaluate level of health within the community to address identified healthcare needs (outbreaks, STDs) 1. describing the health of population 2. determine relationships that are predictable 3. developing and testing interventions to empower communities
National Health Expenditure Accounts (NHEA)
Comprised of measures of costs of healthcare goods and services in the United States.
Patient Protection and Affordable Care Act (PPACA) 2010
Provide affordable health insurance coverage -Lower costs -Improve access to primary care (ex. annual physical) -Preventive care and prescription benefits -Cover pre-existing conditions -Extend young adults' coverage
district nurses
Public health nurses in England who provide visiting nurse services; historically, they cared for the people in the poorest parish districts.
bilateral agency
Refers to two agencies that conduct business within one country
Health department structure
US Department of Health & Humans Services CDC State Department of Health Social Services County & City Health Department
Is the following statement true or false? Community assessment includes examination of biologic, psychological, and sociocultural influences of the environment that surrounds a specific group of people
True Rationale: Community assessment includes examination of biologic, psychological, and sociocultural influences of the environment that surrounds a specific group of people.
International Council of Nurses (ICN)
A federation of more than 130 national nurses associations (NNAs), representing the more than 16 million nurses worldwide.
changes in 21st century healthcare
-development of patient/client-centered care -technology [Telehealth, Health information technology (EHR included)] -increased personal responsibility (active participation in own health)
principles of public health nursing (8)
1. The client is the population 2. Primary obligation is greatest good for population as a whole 3. Collaboration with the population as an equal partner 4. Primary prevention is the priority 5. Creates healthy environments (physical, social, and economic) in which populations may thrive 6. Obligation to actively find and reach out to all who can benefit from a service or activity 7. Optimal use of available resources and creation of new evidence-based strategies 8. Collaboration with other professions, populations, organizations, and stakeholder groups is the most effective way to promote and protect the health of people
3 core functions of government in healthcare
1. assess healthcare problems 2. intervenes by developing healthcare policy that provides access to services 3. ensures services are delivered and outcomes achieved
Types of Boundaries in a community
1. geopolitical (town borders) 2. phenomenological (sharing common interests or beliefs, needs - also "communities of solution", 3. underserved populations) societal, national, or international
16. The community you are involved in is concerned regarding public safety and the care of their elders living at home. When you assess the community you find that there is potential to solve their problems within the community setting without outside resources. The plans to meet the community needs are accepted by the members of the community. One method to create a successful environment for assessment is to A) make the assessment process empowering to the community. B) assess the community through interview and share findings in a timely manner. C) involve the community when there is difficulty with the assessment. D) create an environment of change within the community.
A
2. You are conducting a community assessment in a town once supported by multiple paper factories. The factories closed 2 years ago and the majority of the population is now out of work. The school nurse notes that 68% of the students are behind in their physicals and immunizations. On the basis of your community assessment, you will recommend A) the initiation of neighborhood clinics at low or no cost to the community. B) the creation of a taskforce to assess the impact of low income on immunization compliance. C) a formal petition to local government to mandate immunizations or monetary fines to parents. D) a tax relief programs for new companies wishing to settle in the community.
A
7. You are a community health nurse assessing the neighborhood in which your clients live. When observing the physical environment, you note that most of the homes in the neighborhood are well kept and the children playing in the yards are wearing clean clothing. The children appear well nourished. You place the neighborhood on the list as a low priority for a neighborhood well-child clinic. Your assessment is based on A) subjective data. B) objective data. C) cognitive analysis. D) valid data.
A
Healthy People 2020
A U.S. national consensus plan with specific health goals. -designed to reduce certain illnesses and disabilities by reducing disparities in healthcare services. -identifies areas needing plans for improvement based on morbidity and mortality -measures and tracks national health objectives to encourage collaboration, guide people toward making informed health decisions, and assess the impact of prevention activity
Organization for Economic Cooperation and Development
A group that collects data related to healthcare use across a variety of professional and service parameters.
20. You are approach by the health department to investigate and assess the rise in developmental disabilities in an isolated section in the community. In order to begin your assessment you gather objective data from A) client interview—aggregate data. B) Internet—aggregate data. C) Internet—Wikipedia. D) direct observation of the area.
B
1. Community assessment is a critical process for the future because the process may A) identify the need for a community commission. B) identify a method to improve the health of at-risk clients. C) provide a means of grant funding for clinics. D) provide a client base for at-risk neighborhoods.
B
10. There are 12 students in grades 5 to 7 at the local school with confirmed cases of H1N1 flu. The caregivers of the ill children are advised to keep the children home for a minimum of 5 to 7 days. The next step is A) closing the school for 6 weeks. B) education in the school setting regarding respiratory and hand hygiene. C) running a mandatory flu clinic. D) discipline in the school setting for improper hand washing.
B
15. The community that you are assessing is changing. Five years ago, a series of setbacks caused the local foundry to close. Through interview, you discover that generations of families worked at the foundry. Research indicates that no other businesses have grown in the community to provide work for those who worked at the foundry. The research into the communities' history will assist you to A) determine the values evident in the community in the past. B) determine what variables may have detracted from community development. C) create a care plan for the community as a whole, including the need for clinics. D) create a community-based plan for business recruitment.
B
12. There is a statistically high level of obesity and elevated cholesterol levels in the southern section of the community. There is a central area in the neighborhood that makes fast foods easily accessible. The statistics assist you to A) gather support in the community to ban fast foods. B) gather further information regarding trans fats. C) target education and support programs. D) create local exercise and nutrition programs.
C
19. Posthurricane, your disaster team chooses to use a collaborative model to assess the needs of the community. Each of you is given a community analysis and the task to create a tentative plan of action. Why would the use of a collaborative model hamper the progress of the assessment and plan in a disaster? (select all that apply) A) Individual decision making creates bias. B) Assessment is time consuming. C) Approach to problem solving is linear. D) Approaches must be pre-established . E) Collaboration is limited.
B,C
11. You are the community health nurse in a new neighborhood. You introduce yourself to the local minister, and attend various neighborhood meetings. You learn about the ethics, values, and culture of the neighborhood. The community is vocal about the need for public safety and the care of the homeless, especially in the winter. It is important to consider all of the influences in the neighborhood affecting their health and well-being because A) the information can be used to obtain funds to create shelters for the homeless. B) a neighborhood watch may be created with police support. C) the information will help to effectively assess the community. D) it will assist the nurse create a controlled clinical environment.
C
8. As a community health nurse, you are responsible for the general health of the community on multiple levels. The local school nurse identifies that there are an increased number of sick days for children ages 7 to 12 at the local school. On the basis of your research, you note that there is a disparity in the education of the families of the asthmatic children as well as other factors that influence noncompliance with current treatment plans. The next step in your plan of care is to A) conduct a broad-based survey of all families with asthmatic children within several communities. B) determine trends that interfere with family problem-solving techniques. C) develop school-based education programs for both the children and their caregivers. D) submit a proposal to the town for neighborhood asthma clinics.
C
identify utilization of healthcare resources
Changes in payment policies, which are intended to decrease direct and indirect costs, as well as losses from billing fraud/abuse, continue to change healthcare delivery in the United States. There is less use of institutions (i.e., hospitals). Prevention-Oriented approaches.
Clara Barton
Civil War nurse, founder of the American Red Cross, provided aid for natural disasters
14. As a public health nurse, you may participate in individual, family, or community assessments. An organized approach to assessment in the form of an evaluation that is commonly used is A) the scientific method. B) nursing diagnosis. C) evaluation and analysis. D) functional health pattern.
D
18. You are a community health nurse working in a community recently devastated by a tornado. Many of the survivors are cared for in the home. Care is needed for those who are ill, recovering, or in hospice. In order to provide holistic care to the community, you would A) refer the clients to an outreach center. B) consult with the hospice nurse and the social worker. C) provide care according to the physician's orders. D) collaborate between experts and the clients.
D
5. You are part of a nursing consortium conducting community assessments in New England. At a quarterly meeting you note that the preliminary results of your data collection indicates A) each community has distinct needs based on industrialization. B) the communities are diverse and the data unrelated to one another. C) communities have informal and cohesive methodologies for coping with illness. D) the communities have similar goals related to health and safety.
D
What is one of the core functions of the role of government in healthcare? A. Provide affordable health insurance coverage B. Improve access to primary care C. Lower costs D. Assess healthcare problems
D. Rationale: Three core functions are to assess healthcare problems, intervene by developing relevant healthcare policy that provides access to services, and ensure that services are delivered and outcomes are achieved. One of the goals of the Patient Protection and Affordable Care Act (PPACA) is to provide affordable health insurance coverage
challenges for public health nursing
Engaging in evidence-based practice (use evidence from epidemiological research, interviews, and observation) Helping eliminate health disparities in underserved populations (developing community-based programs) Demonstrating cultural competence Planning for community change Contributing to a safe and healthy environment Responding to emergencies, disasters, and terrorism Responding to the global environment (global pandemic, working w global community)
Mary Breckinridge
Established the Frontier Nursing Service to provide family-centered primary health care to rural populations Appalachian population, travel on horseback
Is the following statement true or false? Bilateral agencies and organizations conduct their services in two specific countries.
False Rationale: Bilateral agencies and organizations conduct their services within one specific country.
Is the following statement true or false? The United States has found the most efficient and effective ways to care for all by decreasing health disparities and giving access to care equally.
False Rationale: Despite the economic strength of the United States and other industrialized nations, many countries have found more efficient and effective ways to care for all by decreasing health disparities and giving access to care equally.
Is the following statement true or false? Healthcare disparities are social conditions in which people live and work.
False Rationale: Social determinants of health are social conditions in which people live and work. Healthcare disparities are gaps in healthcare experienced by one population compared with another.
Is the following statement true or false? The functional health status approach uses a retrospective historical approach to understand cultural changes over time to provide information for future initiatives.
False Rationale: The functional health status approach evaluates health patterns in the community. The developmental approaches use a retrospective historical approach to understand cultural changes over time to provide information for future initiatives.
Lillian Wald
Founder of Henry Street Settlement House in NY and Founder of Public Health Nursing - overcrowding and specific infectious diseases (TB, scarlet fever, small pox, typhoid fever)
identify expenditures
Health insurance and appropriate coverage often determine access. Lack of health insurance is related to poverty, and puts residents in a position of vulnerability. The Unites States spends more on healthcare than any industrialized country. Although hospital care accounts for the largest share of healthcare spending, prescription drugs are the fastest growing healthcare expenditure
World Health Organization (WHO)
International center that collects data, advances initiatives, and offers support related to public health
World Bank
International organization that uses funds from developed countries to help initiatives of developing countries.
Lemuel Shattuck
Prepared the first report that set forth the importance of establishing state and local health departments suggested that ill health/disability in American cities are traced directly to unsanitary conditions = sanitation movement
Is the following statement true or false? Nongovernmental organizations use endowed funds or private fund-raising to address the needs of individuals, families, and populations.
True Rationale: A nongovernmental organization (NGO) is an agency that acquires resources from private (vs. public) sources to help others, like foundations. A philanthropic organization is one that uses endowed funds or private fund-raising to address the needs of individuals, families, and populations.
