Chapter 34 Migrant Health issues (stanhope)

A nurse plans to collect data about morbidity and mortality among migrant workers in a community. Which of the following barriers is the nurse most likely to encounter? a. Difficulty securing a stable population b. Lack of resources c. Unwilling participants d. Fear of deportation

ANS: A Accurate morbidity and mortality data are difficult to obtain due to farm workers leaving when no longer working, going back to their home to receive medical services, and decreases in infectious diseases that are easier to record. p 753

A nurse is caring for a migrant farm worker who has been working in the agricultural industry for the past 10 years. When questioned about environmental hazards, the client reports regular exposure to pesticides. Which of the following is the client at increased risk of developing? a. Cancer b. Memory loss c. Skin rashes d. Headaches

ANS: A Chronic exposure to pesticides may lead to cancer. Acute exposure to pesticides may cause memory loss, skin rashes, and headaches. p756

Which of the following health problems ranks as one of the top five problems for farm workers aged 5 to -19 years? a. Dental problems b. Communicable diseases c. Gastrointestinal problems d. Stress

ANS: A Farm workers of all ages consistently have more dental disease than the general population. p 757

A nurse is partnering with an organization to improve affordable housing in rural areas of the country. Which of the following best describes who the nurse is collaborating with? a. Housing Assistance Council (HAC) b. Local housing authority c. Temporary Assistance for Needy Families (TANF) d. Public Housing Development for Families

ANS: A HAC is a nonprofit organization whose mission is to improve affordable housing in rural areas. TANF is a program that assists families in need. The local housing authority provides public housing assistance. Public Housing Development for Families promotes the development of local strategies for affordable public housing. p 753

A nurse is assessing a client who has had an acute exposure to a pesticide. Which of the following symptoms is the client most likely to display? a. Memory loss b. Musculoskeletal problems c. Cancer d. Infertility

ANS: A Memory loss is a symptom that is displayed following an acute exposure to a pesticide. Musculoskeletal problems, cancer, and infertility are from chronic exposure. p 756 How to box

The nurse is caring for a migrant family. During the interview, the mother tells the nurse that the family follows an Eastern migratory stream originating in southern Florida. Which of the following statements is accurate? a. This is one of the migratory streams that migrant farm workers traditionally follow. b. This is a unique migratory pattern. c. This is a traditional family-generated migratory pattern. d. This is an unpredictable pattern that may lead the family through southern California.

ANS: A Migrant workers traditionally have followed one of three migratory streams: (1) Eastern, originating in Florida; (2) Midwestern, originating in Texas; and (3) Western, originating in California. pp751-752

A nurse is implementing a secondary prevention strategy. Which of the following activities would the nurse most likely implement? a. Monitoring for prenatal care b. Treatment for anemia c. HIV prevention d. Tetanus immunization

ANS: A Monitoring for prenatal care is an example of a secondary prevention strategy. Treatment for anemia is tertiary prevention, and HIV prevention and tetanus immunization are primary prevention strategies. p 761

A nurse is polite and non-confrontational when working with the family of a migrant worker. Which of the following concepts is the nurse demonstrating? a. Simpatía b. Respeto c. Dignidad d. Personalismo

ANS: A Simpatía means having polite, non-confrontational relationships with others. Respeto means respect, dignidad means dignity, and personalismo is relating to the individual. p760

A nurse is providing care for a Mexican client who has sustained a farm injury. If a major decision about the client's treatment needs to be made, who would most likely make that decision? a. The male head of the family b. The wife/mother c. The person needing services d. The crew leader

ANS: A The male is considered to be the major decision maker in the family, whereas the female is considered the caretaker. p 760

A nurse is working from a client who is part of the Mexican culture and is experiencing a folk illness. Which of the following actions by the client should the nurse anticipate? a. Prefer to seek care with a folk healer b. Consult the female leader of the family c. Rely on Western medicine to cure the ailment d. Become isolated and not seek care

ANS: A There are four common folk illnesses that a nurse may encounter with the Mexican client: (1) mal de ojo (evil eye), (2) susto (fright), (3) empacho (indigestion), and (4) caida de mollera (fallen fontanel). When faced with one of these illnesses, the traditional Mexican individual would prefer to seek care with a folk healer. Healers known as curanderos, herbalistas, and espiritualistas are often sources of health care for folk illnesses. pp760-761

Which factors are challenges of the migrant lifestyle? (Select all that apply.) a. Leaving one's home every year b. Traveling c. Experiencing uncertainty regarding work and housing d. Lack of resources e. Middle income wages

ANS: A, B, C, D Leaving one's home every year, traveling, experiencing uncertainty regarding work and housing, and lack of resources are some of the challenges of the migrant lifestyle. The specifics for payment differ depending on the location and type of work. Reports of average income for farmworkers have varied p752

A nurse is working with a client whose principal employment is in agriculture on a seasonal basis and has established temporary housing in the area while employed. Which of the following terms best describes this laborer? a. Seasonal farm worker b. Migrant farm worker c. Transient worker d. Share cropper

ANS: B A migrant farm worker is a laborer whose principal employment is in agriculture on a seasonal basis and, for the purposes of such employment, establishes a temporary abode. A seasonal farmworker returns to his permanent residence, works in agriculture for at least 25 days or parts of days, and does not work year round only in agriculture. A transient worker moves from place to place to find work. A share cropper is a tenant farmer who uses part of the crop to pay for rent. p751

Which factor may limit access to care for migrant farm workers? a. Unwillingness to seek affordable health care b. Lack of knowledge regarding services c. Availability of 24-hour health care services d. Adequate transportation

ANS: B Because of isolation, migrant farm workers lack usual sources of information regarding available services. Migrant workers typically are unable to afford health care, have limited services available, and may not have adequate transportation to get to health care services. pp 754-755

A nurse is educating migrant women to serve as links between the existing health care agencies and the migrant farm worker family. Which of the following best describes the role of these women? a. Migrant head start workers b. Outreach care workers c. Physician assistants d. Nurse aides

ANS: B Because these outreach workers are members of the migrant community, they are trusted and know the culture and the language. Physician assistants and nurse aides do not serve in this lay person role in the community. p761

Which statement is true about health care services for migrant workers? a. Clinics are usually found within walking distance from work. b. Undocumented workers fear deportation when using clinics. c. Health care records are kept by workers to allow for continuation of services. d. Clinics are most often open on weekends and keep evening hours.

ANS: B Clinics are usually a great distance from work and offer health services only during work hours. Health records do not typically follow the client. p 754

A nurse is implementing a tertiary prevention strategy. Which of the following activities would the nurse most likely implement? a. Diabetes screening b. Rehabilitation for musculoskeletal injury c. Birth control d. Pregnancy testing

ANS: B Rehabilitation for musculoskeletal injury is an example of tertiary prevention. Diabetes screening and pregnancy testing are secondary prevention strategies, and birth control is a primary prevention. p761

Which statement about migrant and seasonal farm workers is true? a. There are more than 10 million working in the United States. b. The majority are Mexican. c. Most are employed in the Northeastern states. d. Thirty-five percent are undocumented workers.

ANS: B The majority of migrant farm workers are foreign-born (72%) and predominantly Mexican (68%). Estimates suggest there are approximately 1.0 to 1.8 million hired farmworkers. Five states account for 65% of all farm workers: (1) California, (2) Florida, (3) Washington, (4) Oregon, and (5) North Carolina. Of the migrant and seasonal farmworkers, 52% have legal authorization to work in the United States. p751

What effect does alcohol consumption have on migrant farm workers? a. Provides relaxation and is important for migrant workers' well-being b. Adds additional risks to pesticide exposure c. Poses safety hazards for farm workers d. Allows migrant workers to sleep better, thus improving daytime productivity

ANS: C Alcohol can contribute to farm-related injuries. Drug and alcohol use has been identified as a significant source of stress. Alcohol can also contribute to health problems, greater risk for human immunodeficiency virus (HIV), violence in camps/home sites, domestic violence, and decreased funds for personal and family needs. p 758

A nurse is assessing the occupational health risks of a migrant farm worker. Which health risk is the nurse most likely to find? a. Denial of care when going to the emergency room b. Difficulty obtaining affordable health insurance c. Increased exposure to chemicals and work-related injuries d. Episodic violence from farm owners and employers

ANS: C Occupational health risks for migrant farm workers include working conditions, exposure to chemicals, and using machinery. Denial of care and difficulty obtaining health insurance are not occupational health risks. Episodic violence from farm owners is not a known occupational health risk p755

A nurse is a political advocate for the migrant population. Which of the following best describes the action being taken by the nurse? a. Upholding immigration laws and deporting illegal aliens b. Passing laws to improve the living conditions of migrant farm workers c. Educating communities about the health problems of migrant farm workers d. Learning to speak Spanish for better communication with migrant farm workers

ANS: C Political advocacy can include educating communities about these individuals. This education helps to provide legislators and policy makers at local, state, and national levels with the information needed to make policy decisions. p762

Which legislation changed the availability of federal services accessible to certain immigrants to the United States? a. Migrant Health Act of 1962 b. Supplemental Security Income (SSI) c. Welfare reform legislation of 1996 d. Food stamps

ANS: C The Welfare reform legislation of 1996 changed the availability of federal services accessible to certain immigrants in the United States. The Migrant Health Act provides funds for primary and supplemental health services to migrant workers and their families. Because of the welfare reform legislation of 1996, many legal immigrants and unauthorized immigrants are ineligible for services such as SSI and food stamps. p754

Which of the following disorders has been identified as an occupational health risk for agricultural workers? a. Stroke b. Heart disease c. Diabetes d. Cancer

ANS: D Cancer is an identified but not well-documented health problem for migrant farm workers associated with their exposure to chemicals. Other identified health risks are musculoskeletal injuries, traumatic injuries, respiratory problems, dermatitis, infectious diseases, and eye problems. p 756

A nurse is planning to provide culturally effective care to Mexican migrant farm workers. Which of the following strategies should be used by the nurse? a. Learn how to speak Spanish to improve communication b. Understand that traditional beliefs and practices are more common among the well-educated population c. Consult the female head of household about health care matters d. Recognize that cultural backgrounds of the workers will vary depending on their place of origin

ANS: D It would be incorrect to assume that all Mexicans have the same cultural beliefs. The nurse must remember that beliefs and practices differ between regions and localities of a country, and among individuals. Mexico is a multicultural country; therefore, the cultural backgrounds of Mexican immigrants vary depending on their place of origin. pp759-760

A nurse is implementing a primary prevention strategy. Which of the following activities would the nurse most likely implement? a. Urine screening for pesticide exposure b. Tuberculosis (TB) skin testing c. Treatment of lead poisoning d. Reduction of pesticide exposure

ANS: D Reduction of pesticide exposure is an example of primary prevention. Urine screening and TB skin testing are secondary prevention, and treatment of lead poisoning is tertiary prevention. p761

A nurse is implementing a primary prevention strategy for migrant workers. Which of the following activities would the nurse most likely implement? a. Caring for persons afflicted with pesticide exposure b. Setting up clinics for persons with HIV c. Doing research in the field related to heat stress d. Educating about prevention of such illnesses as HIV and infectious diseases

ANS: D The primary level of prevention often includes education for the prevention of diseases, measures to reduce pesticide exposure, and immunizations. Caring for persons afflicted with pesticide exposure, setting up clinics for persons with HIV, and doing research in the field related to heat stress are examples of tertiary prevention. p 761

Which statement about migrant and seasonal farm workers is true? a. The economic status of migrant workers has improved over the last decade. b. This is a transient population that does not need nursing care. c. Most migrant workers are eager to accept health care services. d. Availability of food in the United States depends on these individuals.

ANS: D Availability and affordability of food in the United States depends on these individuals, yet their economic and social status has not changed significantly over the past decades. Most migrant workers do not seek out health care services. p751