Community Health Chapter 7
20. A PHN is looking at creating a plan to address the high rate of uncontrolled hypertension in a community. List the following steps in the order in which the nurse should perform them (1-4). _____ 1. Evaluate the community to see what social determinants of health need to be addressed and what is lacking within the community. _____ 2. Review the program outcomes with evaluations from participants and local care providers to determine the effectiveness of the program. _____ 3. Start planning a community wide health fair with representatives from local primary-care providers, fitness centers, and local produce vendors. _____ 4. Have printed material and educational information available for community participants to take home and use after the fair.
: 1, 4, 2, 3 Feedback: First, the nurse should perform a community assessment to see what social determinants of health need to be addressed and to see what is lacking within the community. Next, the nurse should formulate a nursing diagnosis and create a plan to address the needs of the community. This can be done by planning a community wide health fair with representatives from local primary-care providers, fitness centers, and local produce vendors. Next, the nurse implements the plan and tries to anticipate the needs of the participants after the fair by having printed materials and educational information available for people to take home and use after the fair. Finally, the nurse evaluates the effectiveness of the program and modifies the plan as needed. Objective: 7. Discuss solutions to decreasing health disparity caused by social determinant of health, specifically how nurses can be part of the solution. p. 174 Heading: Nurses Are Part of the Solution Integrated Processes: Nursing Process Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Perfusion
2. Which of the following is the definition of health disparity? A. A difference in health outcomes B. An unequal and unjust difference in health outcomes C. A social factor that impacts health outcomes and contributes to disparity D. Access to health care for everyone without financial hardship
: A Objective: 1. Compare and contrast the concepts of health disparity, inequity, and inequality. pp. 158-160 Heading: Definitions Integrated Processes: N/A Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Comprehension [Understanding] Concept: Promoting Health Difficulty: Moderate Feedback A A health disparity is simply a difference in health outcomes. B A health disparity is simply a difference in health outcomes
11. A nurse is working in a community center and notices a high rate of obesity in its members. The nurse suspects that poor access to fresh fruits and vegetables may be partially responsible. What should the nurse do first when formulating a plan? A. Assess the social determinants in the community. B. Implement a plan to increase access to fresh produce. C. Outline the steps needed to address the disparity. D. Formulate a community diagnosis.
: A Objective: 6. Define and explain the role of social determinants of health in contributing to health disparities. p. 166 Heading: Social Determinants of Health, Health Disparity, and Social Justice Integrated Processes: Nursing Process Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Nutrition
15. During a lecture on health disparities, a student asks the instructor how communities with great access to health care can still have poor health outcomes. How should the instructor respond? A. Social determinants of health determine how people respond to health threats and how they access preventative care. B. The student is incorrect. Communities with good access to care have good health outcomes. C. This phenomenon only occurs in communities where the quality of health care is poor. D. Members of these communities only have access to primary-care providers, which reduces the quality of care they receive.
: A Objective: 7. Discuss solutions to decreasing health disparity caused by social determinant of health, specifically how nurses can be part of the solution. pp. 170-172 Heading: Solutions to Health Disparities > Paradigm Shift Integrated Processes: Teaching/Learning Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Promoting Health
14. A research nurse is looking for funding to study health disparities in a community—an ethnically and economically diverse inner city neighborhood. The nurse is trying to apply evidence from controlled studies to see how they correlate in the real world. What type of study is the nurse designing? A. Translational B. Causation C. Correlation D. Observational
: A Objective: 7. Discuss solutions to decreasing health disparity caused by social determinants of health, specifically how nurses can be part of the solution. pp. 170-172 Heading: Solutions to Health Disparities > Paradigm Shift Integrated Processes: Nursing Process Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Diversity
19. A public health nurse (PHN) is performing a community assessment in order to reduce the childhood obesity rate in a community. What social determinants of health should the PHN examine? Select all that apply. A. Location of primary health providers B. Nutrition and physical education classes in the public schools C. Housing security D. Presence of sidewalks within the community E. Access to fresh produce
: A, B, D, E Objective: 7. Discuss solutions to decreasing health disparity caused by social determinants of health, specifically how nurses can be part of the solution. pp. 166-167 Heading: Social Determinants of Health, Health Disparity, and Social Justice > International Recognition of Social Determinants of Health Integrated Processes: Nursing Process Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Nutrition
1. A nurse is studying the increased infant mortality rate at a local hospital in a largely African American community. The nurse notes that there are very few options for prenatal care in the community and recognizes that this is an example of: A. Health disparity B. Health inequity C. Health injustice D. Social determinant of health
: B A A health disparity is simply a difference in health outcomes
9. Researchers have found that investment in which of the following would have had a greater effect on health disparities than the investment in new medical technology? A. Improving quality of health care B. Increasing access to education for everyone C. Implementing universal health care D. Decreasing crime rate
: B Objective: 5. List reasons why even after 10 years health disparities have not decreased in the United States pp. 165-166 Heading: Magnitude of the Problem > Health Disparities Have Not Been Solved Integrated Processes: N/A Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Comprehension [Understanding] Concept: Evidence-Based Practice
12. A nurse is performing an assessment of a very economically diverse community and realizes that while comparing income to health outcomes, the nurse must be careful to: A. Compare only the outcomes of the richest community members to the outcomes of the poorest community members. B. Recognize that income and outcomes exist on a scale, and look across the entire spectrum. C. Evaluate only the poorest health outcomes and where they land on the income spectrum. D. Evaluate only the poorest community members and their health outcomes.
: B Objective: 6. Define and explain the role of social determinants of health in contributing to health disparities. pp. 166-167 Heading: Social Determinants of Health, Health Disparity, and Social Justice > International Recognition of Social Determinants of Health Integrated Processes: Nursing Process Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Diversity
16. A nurse is counseling a young man with obesity and diabetes. The nurse explains that in addition to direct medical costs, indirect costs will likely include: A. Costs of medication B. Lost wages and loss of employment productivity C. Decreased lifespan D. Increased costs of health insurance
: B Objective: 7. Discuss solutions to decreasing health disparity caused by social determinant of health, specifically how nurses can be part of the solution. pp. 160-161 Heading: Magnitude of the Problem Integrated Processes: Teaching/Learning Client Need: Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Promoting Health
18. A nurse administrator is teaching staff about populations at risk for poor health outcomes in an attempt to decrease health inequities in the hospital. Which of the following groups does the nurse administrator mention are at higher risk for poor health outcomes related to health disparities? Select all that apply. A. People who carry private health insurance B. Families receiving public assistance C. African Americans D. Native Americans E. The middle class
: B, C, D Objective: 2. Discuss the magnitude of health disparities both in the United States and internationally. pp. 157-158 Heading: Introduction Integrated Processes: Teaching/Learning Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Promoting Health
17. A nurse is organizing a round table presentation at a conference. The nurse asks the other participants for suggestions on actions that nurses can take to reduce national health disparities. Which of the following suggestions are known to be effective measures for the reduction of health disparities? Select all that apply. A. Volunteer with an international organization that supports building infrastructure in underdeveloped areas. B. Support initiatives that increase physical education classes and healthy school meals. C. Design and create research studies that address inequities and support vulnerable populations. D. Discuss social and health disparity information with coworkers to promote awareness. E. Act as advocates for patients, families, and communities in reducing inequities.
: B, C, D, E Objective: 7. Discuss solutions to decreasing health disparity caused by social determinant of health, specifically how nurses can be part of the solution. p. 174 Heading: Nurses Are Part of the Solution Integrated Processes: Teaching/Learning Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Critical Thinking
6. Which of the following statements about Healthy People is correct? A. Healthy People 2010 was successful in reaching its goal of ending health disparities. B. Healthy People 2010 focused on climate change as one of the key factors contributing to health inequities. C. The goal of Healthy People 2020 was expanded to include improving the health of all ages and groups, and to eliminate all health disparities and inequities. D. The goal of Healthy People 2010 was to reduce health disparities and inequity.
: C Objective: 3. Describe the role of Healthy People 2010 in eliminating health disparities. p. 161 Heading: Magnitude of the Problem > Goal to Eliminate Health Disparities Integrated Processes: N/A Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Comprehension [Understanding] Concept: Promoting Health
5. Which of the following programs has been designed to work toward optimal health for all Americans? A. Racial and Ethnic Approaches to Health (REACH) B. Universal Health Care C. Healthy People D. EURO Health for All
: C Objective: 3. Describe the role of Healthy People 2010 in eliminating health disparities. p. 161 Heading: Magnitude of the Problem > Goal to Eliminate Health Disparities Integrated Processes: N/A Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Promoting Health
7. A nurse manager has been working in a community health center for many years. In the recent months, the nurse manager has noticed a dramatic increase in the number of Hispanic clients coming in to the center with uncontrolled diabetes. Which of the following is the best way to address the situation? A. Speak with local providers about decreasing the length of time between follow-up visits. B. Involve pharmacists in counseling newly diagnosed patients about their insulin regimen. C. Perform a community assessment to determine why community members aren't properly caring for themselves. D. Develop several educational handouts about managing diabetes and have them translated into Spanish.
: C Objective: 4. Identify different actions nurses can take to alleviate health disparities within the health-care system. p. 174 Heading: A World Without Health Disparities Integrated Processes: Nursing Process Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Nursing Roles
13. A nurse is looking at reasons why members of a community are more likely to die from heart disease. The nurse finds several studies that suggest that social factors, such as ____, are more important than behavioral choices. A. Smoking B. High-fat or high-sugar diets C. Poverty D. Lack of exercise
: C Objective: 6. Define and explain the role of social determinants of health in contributing to health disparities. pp. 166-167 Heading: Social Determinants of Health, Health Disparity, and Social Justice > International Recognition of Social Determinants of Health Integrated Processes: Nursing Process Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Perfusion
4. In a study performed by the Center for Economic and Political Studies, researchers found that between 2003 and 2006 the cost of health inequalities in the United States was approximately: A. $1 million B. $100 million C. $1 billion D. $1 trillion
: D Objective: 2. Discuss the magnitude of health disparities both in the United States and internationally. pp. 160-161 Heading: Magnitude of the Problem Integrated Processes: N/A Client Need: Health Promotion and Maintenance Cognitive Level: Knowledge [Remembering] Concept: Promoting Health
3. In many countries, which factors decrease infant mortality rate? A. Income B. Education level C. Neither 1 nor 2 D. Both 1 and 2
: D Objective: 2. Discuss the magnitude of health disparities both in the United States and internationally. pp. 168-169 Heading: Social Determinants of Health, Health Disparity, and Social Justice > Role of Income and Education Integrated Processes: N/A Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Knowledge [Remembering] Concept: Evidence-Based Practice Difficulty: Moderate Feedback A Both increased income and increased education are known to decrease infant mortality rate. B Both increased income and increased education are known to decrease infant mortality rate. C Both increased income and increased education are known to decrease infant mortality rate. D Both increased income and increased education are known to decrease infant mortality rate. PTS: 1 CON: Evidence-Based Practice
8. A nurse educator is preparing a lesson on the issues surrounding the Affordable Care Act and universal health care. In 2005, which organization passed a resolution that states that every person should be able to access health-care services regardless of economic status? A. The Supreme Court B. The World Health Organization C. The United Nations D. The World Health Assembly
: D Objective: 4. Identify different actions nurses can take to alleviate health disparities within the health-care system. pp. 161-165 Heading: Magnitude of the Problem > Reflection of Health Disparities in Health Outcomes Integrated Processes: Teaching/Learning Client Need: Client Need: Health Promotion and Maintenance Cognitive Level: Comprehension [Understanding] Concept: Promoting Health Difficulty: Easy Feedback A The Supreme Court does not pass regulations. It did, however, uphold that the measures included in the Affordable Care Act (which is not universal health care) are constitutional. B The World Health Assembly, not the World Health Organization, passed a resolution in 2005 that stated that every person should be able to access health-care services regardless of economic status. C The World Health Assembly, not the United Nations, passed a resolution in 2005 that stated that every person should be able to access health-care services regardless of economic status. D The World Health Assembly passed a resolution in 2005 that stated that every person should be able to access health-care services regardless of economic status. PTS: 1 CON: Promoting Health
10. A nurse is teaching an in-service for new nurses on the importance of cultural sensitivity when caring for patients. Which of the following statements is incorrect? A. The ethnic diversity of health-care staff plays little role in the reduction of health-care inequalities. B. Translators should always be used when a patient does not speak English as a primary language. C. Nurses and other health-care workers may often display discriminatory behavior without realizing it. D. Nurses must always work as patient advocates to make sure that the patient is receiving culturally sensitive care.
:A Objective: 4. Identify different actions nurses can take to alleviate health disparities within the health-care system. p. 165 Heading: Magnitude of the Problem > Actions to Reduce Health Disparities Integrated Processes: Teaching/Learning Client Need: Client Need: Psychosocial Integrity Cognitive Level: Application [Applying] Concept: Ethics
