401: Community In-Class Questions

What is an epidemiologic transition? A. High fertility and high mortality, resulting in slow population growth B. Improvement in hygiene and nutrition, leading to a decreased burden of infectious disease C. Decline in mortality and later decline in fertility D. High and fluctuating mortality, due to poor health, epidemics, and famine

D. High and fluctuating mortality, due to poor health, epidemics, and famine Rationale: Epidemiologic transition includes high and fluctuating mortality, due to poor health, epidemics, and famine. Demographic transitions include high fertility and high mortality, resulting in slow population growth; improvement in hygiene and nutrition, leading to a decreased burden of infectious disease; decline in mortality and later decline in fertility.

TYPES OF COMMUNITIES: Geopolitical vs Phenomenologic vs Communities of Solution

Geopolitical community: Group of people who live within identified boundaries and governing systems. EX: A city, town, locale Phenomenologic community: Group of people who have interpersonal and intrapersonal connections. EX: homeless or persons with disabilities. Communities of solution: Formed by a group of people to address common interests, beliefs, or needs

Epidemiologic triad

HOST, AGENT, ENVIRONMENT Epidemiologic triad is the classic model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment, not by any single factor. Wheel of causation de-emphasizes the agent as the sole cause of disease while emphasizing the interplay of physical, biologic, and social environments.

THEORY: Lewin's Model of Change

Unfreezing: Staus quo is a necessary precursor to change Changing: a dynamic process that may be more successful when it is actively managed rather than allowed to happen haphazardly. Refreezing: process of stabilizing once a change has occurred with the goal of sustaining the change in the community's systems, policies and customs.

Vulnerable vs Underserved populations

Vulnerable: greater disproportionate risk of poor health Underserved: greater exposure to health risk

Communicable or not? -Chicken pox -Norovirus -Tetanus

•Chicken Pox (Varicella Zoster)- Airborne or direct contact with blisters - YES •Norovirus- Fecal-oral route - YES •Tetanus- Non communicable from person to person from soil, contaminated objects, enters through puncture wounds - NO

FROM MIDTERM: 45. The home health nurse 1s working with an older adult client and the family caregiver. Which resources can the nurse point out, which are available to assist this family in the care of this client? (Select all that apply.) A) Adult day care respite program to prevent caregiver burden B) Personal care services for the client C) Caregiver support group D) Pet sitting services E) Social services if needed

A) Adult day care respite program to prevent caregiver burden B) Personal care services for the client C) Caregiver support group E) Social services if needed

A client presents with severe diarrhea. The client tells the nurse that she went to a chicken roast at church the previous weekend. The nurse suspects a foodborne illness. Which cause of bacterial foodborne illness should the nurse most suspect in this case? A) Campylobacter B) Listeria monocytogenes C) Salmonella D) Escherichia coli O157:H7

A) Campylobacter Campylobacter infection, consumption of contaminated poultry is the most common source, although undercooked meats, ground beef, pork, cheese, eggs, shellfish, unpasteurized milk, and direct exposure to pets and farm animals

CH 25 The occupational nurse is concerned some hazards may be present at a local playground. Which best exemplifies biologic hazards? (Select all that apply.) A) Contaminated body fluids B) Poisonous plants C) Diesel exhaust D) Venomous snakes E) Aerosols

A) Contaminated body fluids B) Poisonous plants D) Venomous snakes Contaminated body fluids, poisonous plants, and venomous snakes are examples of biologic hazards. Diesel exhaust and aerosols are examples of chemical exposure.

***Which epidemiologic model prioritizes how people infected with West Nile virus, the mosquitoes, and the environment they share contribute to outbreaks of this disease? A) Epidemiologic triad B) Wheel of causation C) Web of causation D) Natural history

A) Epidemiologic triad

Nongovernmental Organization (NGO) VS. Philanthropic Organization

A nongovernmental organization (NGO) is an agency that acquires resources from private (vs. public) sources to help others. A philanthropic organization is one that uses endowed funds or private fund-raising to address the needs of individuals, families, and populations

A 70-year-old client is seeking a fourth refill on a prescription for an opioid medication. The nurse is concerned that the client may be developing a tolerance for the drug. Which comment by the client would most confirm this concern? A) "Lately I've had to double up on my dose just for it to be effective." B) "I ran out of pills a week ago and have felt sweaty and agitated ever since." C) "I feel like I just can't function without the medicine." D) "The medicine has been wonderful. I think one more refill should do it for me."

A) "Lately I've had to double up on my dose just for it to be effective."

CH 25 The occupational health nurse is a member of the emergency planning committee in the workplace. The nurse is helping to formulate an emergency plan for the facility. Which goals should the nurse ensure are met while developing the plan? (Select all that apply.) A) Establish clear reporting instructions for employees B) Provide instructions on safe lifting techniques C) Identify hazardous substances that workers are exposed to in their daily work D) Name key personnel who will assume necessary tasks E) Establish emergency escape routes

A) Establish clear reporting instructions for employees D) Name key personnel who will assume necessary tasks E) Establish emergency escape routes The goals of an emergency plan are to anticipate emergencies and to establish clear reporting instructions for employees. The plan names key personnel who will assume necessary tasks. It establishes emergency escape routes and procedures to identify workers and visitors with and without disabilities. The plan ensures that predesignated areas have been arranged and employees have participated in actual drills. An emergency plan would not include providing instructions on safe lifting techniques or identifying hazardous substances, as these are normal work concerns, not emergencies.

CH 20 A nurse is part of the disaster recovery team after a major community flood. Epidemiologic analysis of this town includes factors that influence the health status of this community. Which data may be included in the epidemiologic analysis report? (Select all that apply.) A) Continuing death B) Population shift C) Contamination of water supplies D) Limited access to places of worship E) Collapse of access to healthcare

Ans: A, B, C, E An epidemiologic analysis of adverse health effects after any kind of disaster identifies factors that influence the health status of the community on a long-term basis. Some of these factors include continuing death, chronic illness, and/or disability; population shift if recovery is prolonged; contamination of food and water supplies, with an increased risk of infectious diseases; and collapse of local and regional healthcare access. Limited access to places of worship would not be included in the report, as it does not directly affect the health status of the community.

CH 20 The national weather service warns of an impending ice storm that may have crippling effects on the community. Widespread electrical outages are predicted as well as freezing temperatures. The community health nurses are mobilized to establish emergency living quarters and clinics for those without heat. In which phase of this disaster are the nurses' actions occurring? A) Impact B) Postimpact C) Preimpact D) Preparedness

Ans: C) Preimpact Disasters have a timeline, often referred to as a life cycle or phases. These include the preimpact phase (before), the impact phase (during), and the postimpact phase (after). Actions taken during these phases affect the illness, injury, and death that occur following the incident. Although disasters vary significantly, the response to each is similar. Preparedness is not a phase of the disaster itself but of the emergency management response to the disaster.

***At Mount Sinai, the nurses provide client-centered care. Which action best exemplifies this? A.) Reading the After Visit Summary to a client B.) Having a client complete a self-reported functional status indicator and then reviewing it with the client C.) Documenting a client's vital signs D) Scheduling a follow up appointment for a client

Answer: B The Agency for Healthcare Research and Quality (AHRQ) has developed a series of tools that empower clients and assist providers in achieving desired outcomes, including client-reported functional status indicators

A client presents with several ulcerative sores on his penis that are firm, round, and painless. He also has rough, reddish brown spots on his palms and the bottoms of his feet. He acknowledges that he is sexually active with multiple partners and is inconsistent in his use of a condom. Which sexually transmitted infection should the nurse most suspect in this client? A) Gonorrhea B) Chlamydia C) Syphilis D) Human papillomavirus

C) Syphilis

What is the "gold standard" for research design?

randomized, control group design

CH 24 The nurse cares for many clients who have serious illnesses. Which client is the best candidate for hospice care? A) Brain cancer who is expected to live 3 months and who is not pursuing aggressive treatment B) Congestive heart failure who is expected to live 9 months and who is not pursuing aggressive treatment C) Lung cancer who is expected to live 1 month and who is pursuing radiation therapy D) Stroke who is expected to live only a few more hours unless emergency brain surgery can remove a clot

A) Brain cancer who is expected to live 3 months and who is not pursuing aggressive treatment In the early 1980s, Congress added a hospice benefit to the Medicare program that was designed to support dying clients with an expected prognosis of less than 6 months to live if the disease ran its usual course. When two healthcare providers determine that a seriously ill client has 6 months or less to live, and the dying person and family agree to provide care and comfort as opposed to aggressive medical intervention, loved ones often seek hospice.

CH 19 The nurse visits the home of client in a low-income community and notices that paint is flaking off the walls and forming a dust in the corners of some rooms. The nurse asks the client when the house was built, and she responds that it was built in 1959. Which contaminant should the nurse expect to find in this home? A) Lead B) Radon C) Asbestos D) Pesticide

A) Lead

FROM MIDTERM: A group of public health nurses are providing maternal care to various members of the community. Which actions by the nurses have a positive effect on the families and should improve the outcomes of these visits? (Select all that apply.) A) Remain friendly and approachable B) Encourage the mothers(clients) to guide the visit C) Dictate what the mother should be doing D) Ensure each visit follows the prescribed standards E) Remain flexible and let the families needs dictate the visit

A) Remain friendly and approachable B) Encourage the mothers(clients) to guide the visit E) Remain flexible and let the families needs dictate the visit

***A community health nurse forms and widely advertises a daily walk in the park to promote better health. The nurse informs the clients in the clinic that walking will improve their overall health and well-being. Two older adults show up the first night and none the second. Which information should the nurse gather to explain the failure of the program? (Select all that apply.) A) The severity of the physical challenge related to the client population B) What stands in the way of taking action toward the goal of health promotion C) The presence or absence of cues needed for the program to achieve success D) The presence or absence of a strong team leader among the participants E) The need to increase persuasion when implementing the program

A, B, C The health belief model, developed by Hochbaum (1956) and Rosenstock (1974), specifies that individual, family, or community health-related behavior depends on: (1) the severity of the potential illness or physical challenge; (2) the level of conceivable susceptibility; (3) the benefits of taking preventive action; and (4) what stands in the way of taking action toward the goal of health promotion. A strong team leader and persuasion are not integral parts of the health belief model.

***A nursing student visiting an underserved community is concerned about the lack of healthcare for some community members. Which aspects of Lewin's change theory should the student suggest to healthcare team to implement to encourage them to make the desired changes to improve the availability of healthcare? (Select all that apply.) A) Unfreezing the status quo B) Changing or moving to a new state C) Enforcing the status quo D) Refreezing to sustain the change or changes made E) Increasing restraining forces

A, B, D

***A U.S. healthcare team is working in a third world country. Which risk factors for poor health should the healthcare team be prepared to deal with as they implement their program? (Select all that apply.) A) Burning of wood and dung for cooking and heat B) Low status of women C) Sedentary lifestyle D) Not wrapping an infant immediately after birth E) Overconsumption of fatty foods

A, B, D These are the driving forces behind increased mortality. The continuous smoke from the burning of air-polluting solid fuels affects the population's health and in turn affects economic prospects. The continued low status of women, despite years of policy development, increases the risk of disease and disability. Interventions to improve neonatal care at birth in lower-income countries.

What is the time frame that nurses have to complete a focused family interview? A. 15 minutes B. 30 minutes C. 45 minutes D. 60 minutes

A. 15 minutes Rationale: Focused family interviews of 15 minutes or less can yield a wealth of information.

CH 22 The school nurse is prepared to assist with health education as appropriate. The school nurse is likely to perform all of the following health education EXCEPT? A) Teaching faculty members how to assess their students for upper respiratory illnesses B) Teaching a student how and when to use her EpiPen C) Teaching a sixth grade class about the consequences of cyber bullying D) Counseling a student about tobacco use E) Teaching a group of students with eating disorders about a healthy view of food

ANS: A) Teaching faculty members how to assess their students for upper respiratory illnesses The school nurse must seek to accomplish health teaching in encounters with students and families, in the classroom, in individual counseling sessions (e.g., teaching a child how and when to use his or her EpiPen), and in group meetings. It is recommended that the focus of health education be health promotion based on concerns addressed in the National Health Objectives of Healthy People 2020. These issues include use of drugs and alcohol, sexual behavior, tobacco use, nutrition, physical activity, and violence prevention. It would not be appropriate for the nurse to teach faculty members how to assess their students for upper respiratory illnesses, as this is the nurse's responsibility.

CH 22 The school nurse was informed by the public school administration, that there is a noticeable increase in students smoking. Which interventions are most appropriate for the nurse to implement to correct this issue? (Select all that apply.) A) Starting an after-school tobacco cessation program with the assistance of local representatives of the American Cancer Society B) Having a local clinical oncologist speak at a PTA meeting about the hazards of tobacco use among children C) Confronting groups of students while they are smoking with information regarding the school's smoking policy and the dangers of smoking D) Promoting the community's "great smoke-out" smoking cessation event each year E) Encouraging the school's administration to designate a single smoking area outside to limit nonsmokers' exposure to the smoke

ANS: A, B, D A) Starting an after-school tobacco cessation program with the assistance of local representatives of the American Cancer Society B) Having a local clinical oncologist speak at a PTA meeting about the hazards of tobacco use among children D) Promoting the community's "great smoke-out" smoking cessation event each year The Whole School, Whole Community, Whole Child Model, as one possible solution to counter the minimal effect provided by using a single-focused approach to prevention based only on education. This model is a collaborative design that uses the resources of a community (including health educators, counseling, psychological services, nutrition, the environment, and the family) to provide structured preventive services such as after-school programs, parent outreach, and crisis intervention. These preventive services are designed to promote changes throughout the school environment.

CH 20 The nurse assesses clients during a community disaster in a systematic fashion, concentrating on their ability to breathe. Which action should the nurse prioritize before conducting the physical assessments? A) Don PPE B) Interview the client C) Report to the hot zone D) Request a HAZMAT expert to witness the client assessment

Ans: A) Don PPE Donning PPE must be the first priority. Then assessment of the victim's ability to breathe is also necessary.

CH 20 The public health nurse is aware the weather predictions are including a massive rain storm related to a recent hurricane along the Mexican coast. The nurse is concerned that many of the inhabitants of the community, especially the newer ones, are ill-prepared for the possible damage which can occur. Which factor should the nurse expect to most hinder the efforts to help the community to prepare and provide assistance as needed after the storm? A) Community does not like the designated shelters B) Lack of family support system to assist with evacuation C) Nonbelief in the seriousness of the weather prediction D) Fear of deportation by recent immigrants

Ans: D) Fear of deportation by recent immigrants Social and economic inequality plays a large part in all areas of life; however, special attention to minority and disadvantaged neighborhoods must be given when planning for disasters. Public health nurses recognize that many immigrant populations are not only unfamiliar with existing community resources but are reluctant to disclose their immigration status for fear of deportation.

***The case manager is working with a patient who has asthma. Because the patient has trouble affording inhalers, the case manager researches client assistance programs through which the patient could receive free medications. Which aspect of case management is this nurse portraying with this action? A) Care management B) Advocacy C) Disease management D) Interdisciplinary collaboration

B) Advocacy

CH 18 The public health nurse is relocating to an area that is currently classified as a medically underserved region. Which situation will the nurse most likely encounter in this new position? A) A geographic area, population group, or medical facility with shortages of healthcare professionals to the degree that a full complement of healthcare services is not possible B) An area with a lack of medical care services as determined by the number of primary medical care healthcare providers per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population 65 years or older C) A U.S. federal designation for those populations that face economic, cultural, or linguistic barriers to accessing primary medical care services D) A subgroup of the population that has a higher risk of developing health problems because of marginalization

B) An area with a lack of medical care services as determined by the number of primary medical care healthcare providers per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population 65 years or older

CH 23 The faith community nurse works in a hospital that serves several local congregations. Which tasks would the nurse most likely perform in this role? (Select all that apply.) A) Administer flu shots B) Coordinate the discharge and transition of congregation members from the hospital to home C) Recommend services that the hospital provides D) Serve as a health advisor to members of the congregation E) Assess congregation members for possible upper respiratory illnesses

B) Coordinate the discharge and transition of congregation members from the hospital to home C) Recommend services that the hospital provides D) Serve as a health advisor to members of the congregation In a paid institution-based model, the faith community nurse can serve as an ambassador and referral agent for the institution. For example, a religiously affiliated hospital can support the services of faith community nurses in key feeder congregations so that clients discharged from the hospital have coordinated transition to the home congregation setting. The faith community nurse does not provide direct nursing care services (such as flu shots or assessment of upper respiratory illnesses), but supports the client and family members in assuming self-care and in engaging the healthcare system appropriately. The faith community nurse serves as a health advisor, and he or she can recommend services that the hospital or health system provides.

***Mr. Jones is admitted to the coronary care unit with congestive heart failure. The client's inability to adhere to his diet and medication regimen is the reason for his frequent admissions. The Community Health nurse sees the patient once he is at home. Which would be most appropriate for the nurse to include in this client's plan of care? A) Insisting that the client adhere to his diet B) Developing culturally relevant and gender-sensitive interventions C) Teaching the family to adapt their cultural dietary plans to the client's diagnosis D) Assessing the client's financial needs and obtaining financial assistance as needed

B) Developing culturally relevant and gender-sensitive interventions The development of culturally relevant and gender-sensitive interventions that demonstrate positive outcomes in health and well-being is the focus of prevention efforts. Approaching individuals and groups about behavior change must incorporate knowledge of diverse client perspectives and include the use of counseling skills and motivational interviewing.

CH 18 A nurse has relocated from a rural hospital to a larger urban hospital and is noting some differences in the care being provided to the clients. Which most accurately characterizes the difference the Medicare clients with acute myocardial infarctions (AMIs) who were treated in rural hospital where the nurse used to work? (Select all that apply.) A) Less likely to experience an opportunistic infection than those in urban hospitals B) Less likely to receive recommended treatments than those in urban hospitals C) More likely to have a second AMI within a month of the first than those in urban hospitals D) Have significantly higher adjusted 30-day post-AMI death rates from all causes than those in urban hospitals E) Experience faster recovery times than those in urban hospitals

B) Less likely to receive recommended treatments than those in urban hospitals D) Have significantly higher adjusted 30-day post-AMI death rates from all causes than those in urban hospitals

***A student nurse is observing a client in the community, who is from a culture for which neither the student or the Case management nurse have a limited knowledge base. The student suggests that the Case management nurse perform the admission interview using cultural humility. Which should the nurse ask in the interview? (Select all that apply.) A) Yes or no questions B) About traditions C) Open-ended questions D) How the client has addressed the illness E) If the cause of the illness is spiritual

B, C, D

CH 23 The nurse is planning several primary prevention activities for the local community. Which activities would the nurse prioritize to meet this goal? (Select all that apply.) A) A program helping military veterans with amputations adapt to their new circumstances B) HIV screening open to the whole faith community C) A weight-lifting program for seniors to maintain strong bones D) A community vegetable garden to promote healthy eating E) Leg exercises to help people recovering from hip fractures to walk again

C) A weight-lifting program for seniors to maintain strong bones D) A community vegetable garden to promote healthy eating Primary prevention activities include programs on exercising to maintain health, smoking cessation programs, and heart-healthy eating programs. Secondary prevention includes screening for hypertension and setting up screenings such as mammogram vans or other tests to diagnose problems early. Tertiary prevention involves minimizing the effect of health problems and maximizing function for people with such conditions such as diabetes, stroke, or injury.

The nurse works with a female client who recently developed an infection of Staphylococcus aureus while in the hospital. The nurse would determine that S. aureus is which component in the chain of infection? A) Host B) Environmental reservoir C) Agent D) Portal

C) Agent The Agent, or the microbe that causes the disease, is the "what" of the epidemiologic triangle. The host, or the organism that is harboring the infectious agent, is the "who" of the triangle. The environment, which includes those external factors that cause or allow disease transmission, is the "where" of the triangle. Other necessary elements include a portal of exit from the host, environmental reservoirs, transmission, and a portal of entry to a new host.

***The nurse conducts a class on the basics of nutrition to a group of obese adults. The nurse counsels the audience, telling them that they need to change their behaviors. By the end of the class, the nurse has lost the audience. Which action should the nurse prioritize to enhance audience participation and learning in the next class? A) Use consistent methods of persuasion B) Offer advice while the participants are passive C) Encourage the group to participate in the decision making D) Encourage the group to continue ambivalent behaviors

C) Encourage the group to participate in the decision making Motivational interviewing, which was developed by Rollnick and Miller (1995), is defined as a "directive, client-centered communication style for eliciting behavior change by helping clients/[groups] to explore and resolve ambivalence." To address behavior change using this method, the motivation comes from the client and is not imposed by a clinician

Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention: primary, secondary, and tertiary. Which best represents a secondary prevention strategy? A) Creating and broadcasting a public service announcement that raises awareness about IPV B) Putting up posters around the health provider's office that give tips on what to do if one is in an abusive relationship C) Screening a client for evidence of abuse who has several risk factors for IPV D) Providing a client who is being abused by the spouse the number to an abuse hotline to get help leaving the spouse

C) Screening a client for evidence of abuse who has several risk factors for IPV -Primary prevention includes screening and prevention efforts that target the general population. -Secondary prevention occurs through generalized screening and inquiry with high-risk populations. -Tertiary prevention involves caring for victims affected by or currently experiencing violence.

What is bioavailability? A. Study of the adverse effects of chemical, physical, or biologic agents on people, animals, and the environment B. An estimate that determines a person's level of exposure to a contaminant C. Amount of a contaminant that actually ends up in the systemic circulation D. Process of using medical tests such as blood or urine collection to determine if a person has been exposed to a contaminant and how much exposure he or she has received

C. Amount of a contaminant that actually ends up in the systemic circulation Rationale: Bioavailability is the amount of a contaminant that actually ends up in the systemic circulation. Toxicology is the study of the adverse effects of chemical, physical, or biologic agents on people, animals, and the environment. An exposure estimate determines a person's level of exposure to a contaminant. Biomonitoring is the process of using medical tests such as blood or urine collection to determine if a person has been exposed to a contaminant and how much exposure he or she has received.

Who is perhaps the best known epidemiologist of the 19th century? A. John Graunt B. William Farr C. John Snow D. Florence Nightingale

C. John Snow Rationale: Perhaps the best known epidemiologist of the 19th century was John Snow, a contemporary of William Farr. One of the first people to study patterns of disease in populations was a London haberdasher, John Graunt. Farr set up a system for consistent collection of the numbers and the causes of deaths. Florence Nightingale, the daughter of a wealthy Englishman, was also a contemporary of William Farr and John Snow. She devoted her life to the prevention of needless illness and death.

The client is diagnosed with Lyme disease. He states that he is not a hiker and does not remember being bitten by a tick. Which is the best response from the nurse? A) "You must have been bitten by a tick and didn't recognize it as such." B) "Did you spend time in a brushy or grassy area in the last 90 days?" C) "Conduct a full-body tick check once a week during the summer." D) "A history of a tick bite is not required."

D) "A history of a tick bite is not required." A history of tick bite is not required. A county in which the disease is endemic is one in which at least two confirmed cases have been previously acquired or in which established populations of a known tick vector are infected with Borrelia burgdorferi.

The nurse is evaluating a young mother who believes she may be pregnant again. Which relationship factor discovered by the nurse should raise suspicions that this family is at risk for intimate partner violence? A) Emotional dependence and insecurity B) Belief in strict gender roles C) Desire for power and control D) Unhealthy family interactions

D) Unhealthy family interactions Individual risk factors for intimate partner violence include emotional dependence and insecurity, belief in strict gender roles, and desire for power and control. Relationship risk factors include unhealthy family relationships and interactions.

The student nurse is creating a poster for a class project which will illustrate the chain of infection. Which item should the student nurse point out as a vehicle in this chain? A) Animals B) Insects C) Reptiles D) Water

D-Water Indirect contact involves contact of a susceptible host with a contaminated intermediate inanimate object, called a vehicle, such as a contaminated surgical instrument, needle, toy, soiled clothing, or bed linen. Vehicles also include food, water, and contaminated hands that are not washed. Indirect contact also includes vector transmission. Vectors are animal or insect carriers of infectious agents.

vThe International Council of Nurses is a federation of more than how many national nurses associations? A. 100 B. 110 C. 120 D. 130

D. 130 Rationale: The International Council of Nurses (ICN) is a federation of more than 130 national nurses associations, representing more than 13 million nurses worldwide.

Which of the following are included in the notion of social injustice? A. Belief of those in power that others are inferior B. Denial of human rights to certain populations C. Disparities in access to services, such as healthcare D. All of the above

D. All of the above Rationale: Social injustice involves the denial of economic, sociocultural, political, civil, or human rights of certain populations or groups based on the belief of those with power that others are inferior. In healthcare, it manifests as disparity in access.

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. Assess healthcare problems 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.

Ecomap vs Genogram

Ecomap—a diagram used to identify the direction and intensity of family relationships between members and/or community institutions of importance to the family. Genogram—a diagram of family relationships between blood relatives that can span two or more generations. Life events such as marriages, divorces, births, and deaths are included in the diagram; it is used to identify relationships as well as possible patterns of disease.

Health Belief Model

Health belief model—a behavior change model that considers the severity of the potential illness or physical challenge, the level of conceivable susceptibility, the benefits of taking preventive action, and the challenges that may be faced in taking action toward the goal of health promotion. Learning model—a behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose

Population aggregate vs Coalitions vs Stakeholders

Population aggregate: a subset of the population such as people with or at risk for a specific health problem or having specific social or demographic characteristics. -An example would be people over 50 at risk for colon cancer. Coalitions: Group of consumers, health professionals, policy-makers, and others working together to improve community health status or to solve a specific community health problem. Stakeholders: an individual, organization or group that has an interest (stake) in a specific community health issue or outcome of the community-level intervention and opinion leaders

Levels of Prevention & EXAMPLES

Primary prevention—maximizing health and wellness through strategies that are set in place before illness or injury is present *Examples: Immunizations, Driver's safety classes Secondary prevention—maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury *Examples: Screening procedures Tertiary prevention—maximizing health and wellness through strategies that are set in place at the palliation and end stage of disease and injury trajectories *Examples: Rehabilitation, Palliative care

The community health clinic is noting a rise in the number of individuals with H1N1 virus and is concerned that an epidemic is occurring. Which agency would be most appropriate to become involved with this situation? A) Department of Health and Human Services B) Centers for Disease Control and Prevention C) World Health Organization D) Department of Defense

The Department of Defense (DoD) has an electronic surveillance system for the early notification of community-based epidemics (ESSENCE), which has been in operation since 2001 to detect infectious disease outbreaks

Is the following statement true or false? Case management is the development and coordination of care for a selected client and family.

True Rationale: Case management—development and coordination of care for a selected client and family. Care management—coordination of a plan or process to bring health services together as a common whole in a cost-effective way.

Multilevel Interventions

Upstream: at the societal, environmental, or policy level Mainstream: at the population or community level Downstream: at the individual level