Clinical CHP 2 Health Disparities

The registered nurse is teaching the student nurse about the health disparities associated with gender. Which statements from the student nurse indicate effective learning? Select all that apply.

"Health disparities exist between men and women." "Adult women use health care services more than men do." "Women are less likely to receive procedures for cardiovascular diseases than men." Health disparities exist between men and women. Adult women use health care services more than men do and are less likely to receive procedures for cardiovascular diseases than men. Generally, women are less likely to receive care and medical insurance than men.

The nurse is completing a discharge plan for a patient who is being discharged home and will require assistance to complete activities of daily living and dressing changes. The patient is a recent Hispanic immigrant who works at a local factory in a low-paying temporary position. The patient indicates through a translator that he or she did not complete high school, has no health insurance, and lives alone in housing supplied by the employer. When completing the discharge plan, which is important for the nurse to address in efforts to decrease the effect of health disparities? Select all that apply.

Income status, health literacy, education level, ethnicity, and race are all factors or conditions that can contribute to health disparities. Impaired functional status and lack of support systems can also affect the discharge plan, but they are not factors or conditions that lead to health disparities.

A nurse who is developing a teaching plan for a community group concerning healthy lifestyle behavior takes into consideration that "place" can have the most significant effect on which health behavior?

Physical activity and nutrition Physical activity and nutrition can be significantly affected by "place" due to a lack of access to healthy food options and safe areas to exercise. Tobacco and alcohol use, prenatal and maternal-child care, and health screenings for chronic diseases are not as significantly affected by place as physical activity and nutrition are.

Which individual is most likely to experience health care disparities?

A 78-year-old Native-American male living on a reservation Being older, being a minority, living in a rural area, and being of male gender are risk factors for experiencing health care disparities. The 50-year-old female is not at high risk because she is female and middle-class. The 65-year-old Hispanic male is not at risk because he is upper-class and lives in the city. The 72-year-old-African-American male is at risk, but because he lives in a condo and has made a good living, he is not as high risk as the Native American.

Of the following patients, which does the nurse recognize is at the highest risk of experiencing a health disparity?

A 90-year-old Asian American male with no insurance There are many factors and conditions that lead to health disparities. The patient at the highest risk for experiencing a health disparity is the 90-year-old Asian American male with no insurance, because he has three factors that contribute to health disparity: age, minority race, and low income. The 55-year-old white male only has one risk factor, which is low income, since he is on Medicaid. The 60-year-old Asian American has only two risk factors: race and low income. The 48-year-old white female is at the least risk because of her higher education and not being a minority race.

A nurse lobbies the hospital administration for a full-time on-staff interpreter for the large group of Vietnamese immigrants who frequently visit the hospital for care. The nurse is carrying out which nursing role?

Advocate Reduction of health disparities can be achieved via advocacy, such as providing an interpreter to ensure that patients understand the care they are receiving and can provide accurate information. Lobbying is not a nursing role. The nurse is not demonstrating the role of educator or collaborator.

Which nursing intervention establishes a rapport between the patient and the interpreter to reduce health disparities?

Arranging a meeting between the patient and interpreter before starting interpretation Language barriers can contribute to health disparities in patients and an interpreter may be necessary. Arranging a prior meeting between the patient and the interpreter before the interview establishes a rapport between the patient and the interpreter. Merely introducing the interpreter to the patient and using simple words do not establish a rapport with the patient. Talking in a low voice while interpreting ensures a patient's comfort but does establish a rapport with the patient.

In a community-based setting, the nurse finds that a large group of Vietnamese immigrants do not have access to a nearby health care facility. Upon interaction, the nurse finds that the clinic does not provide translators and educational materials. Which factor is responsible for this type of health disparity?

Attitude of the health care provider Certain clinics do not provide translators and educational material to immigrants, and these obstacles might prevent immigrant patients from accessing the facility. In this case, the health care provider's attitude is responsible for this type of health disparity because he or she would be responsible for providing access to these resources. Gender differences, ethnic and racial differences, and the infrastructure of the facility would not affect the access to health care services.

How does the nurse achieve health equity in a specific area?

By allowing the patient to attain his or her health potential Health equity refers to the study of differences in the quality of health and health care across different populations. Health equity can be achieved when everyone has the opportunity to attain his or her health potential and no one is disadvantaged. Folk healing is a cultural factor that affects health. Transcultural nursing involves discovering culturally relevant facts to guide the nurse in providing culturally appropriate care. Understanding the cause of health disparities is not sufficient to achieve health equity.

What is the term for factors related to health of individuals and groups that explain why some people experience poorer health than others?

Determinants of health Determinants of health are factors related to the health of individuals and groups that explain why some people experience poorer health than others. Health status describes the health of a person or a community. Social environment and physical environment are factors that influence the health of an individual or group of people.

The nurse is assessing a female patient who has presented to the emergency department (ED) after fleeing an abusive relationship. For this patient, this abusive relationship would best be described as an aspect of which determinant of health?

Environment An abusive relationship would be an aspect of one's social environment, which includes personal relationships. The determinant education refers to educational level, whereas economic status deals with income. While behavior is a determinant of health, in this situation it is not the patient's behavior but that of her significant other that has affected her social environment and ultimately determined her health.

If a patient cannot afford medical supplies, what responsibility does the nurse have to advocate for this patient?

Ethical obligation When disparities are observed in an individual patient or a family, professional nurses are ethically and legally responsible for patient advocacy. Health equity is achieved when every person has the opportunity to attain his or her health potential, and no one is disadvantaged. Utilitarianism is action for the greater good. A moral obligation is a duty that one owes but is not legally bound to fulfill.

A family arrives at a hospital for a health checkup. During the physical examination, the nurse finds that the daughter is underweight and has symptoms of malnutrition. The other family members are healthy. The daughter states that her brother eats full meals and that she is provided primarily with crackers and water. Which factor has led to health disparity in this case?

Gender The factor leading to health disparity in this case is gender inequality because the son is given preference over the daughter. Education, health literacy, and ethnicity or race are not the factors affecting health in this case.

The registered nurse is teaching the student nurse about health disparities. Which statement of the student nurse indicates the need for further teaching?

Health disparities cannot affect population groups based on socioeconomic status. Health disparities can indeed affect population groups based on socioeconomic status. Health disparities are generally determined by comparing population groups. Health disparities generally occur due to differences in health care access among frontier, rural, and urban settings. Differences in the incidence and burden of diseases that exist among specific population groups can raise health disparities.

An African American parent brings a daughter and a son to a clinic for yearly physical examinations. During the initial assessment, the nurse finds symptoms of measles in one of the children. The nurse learns that neither child has been vaccinated because the parent thinks that it is an unnecessary medical expense. Which factor has led to health disparity in this case?

Health literacy The factor leading to health disparity in this case is health illiteracy, in which the parent is not properly educated about health programs such as vaccination. Location of residency, gender, and ethnicity and race are unlikely to affect health in this case. The access to health care is not affected due to the place where the parent and children live, because health programs are accessible to all. Gender bias is not the cause of health disparity in this case because neither child has been immunized. The race of a patient does not prevent the patient from having access to health care.

Which statement is associated with the concept of health literacy in health disparities?

Health literacy assists the patient in making appropriate health decisions. Health literacy is defined as the degree to which individuals have the capacity to understand basic health information and make appropriate health decisions. Low health literacy is associated with more hospitalization. Health literacy includes the ability to weigh risks and benefits and the ability to analyze health information.

What should the nurse do primarily to reduce health disparities?

Improve interpersonal skills. The first step in reducing health disparities is to improve interpersonal skills, because it is important to provide culturally competent care to patients. The nurse can inform the patient about health care services after improving interpersonal skills. The nurse can advocate for insurance coverage and ask about the financial status of patients after improving interpersonal skills in order to reduce health disparities.

What may be the consequence of failure to advocate for a patient whose care is compromised by health care disparities?

Legal action Failure to advocate for a patient who is experiencing health care disparities can result in legal action. The nurse must advocate on behalf of the patient; taking no action is inappropriate. A moral obligation is a duty one owes, but is not legally held accountable for. Discrimination is based on a patient's race, ethnicity, body size, sexual orientation, or ability to pay and will likely result in less aggressive or negative treatment practices.

A single teenage woman has presented to the local community clinic with presumptive pregnancy. As the nurse completes the assessment, the teen asks the nurse how she can possibly provide for herself and a new child with no job or insurance. Which program that provides assistance with certain medical expenses might help address this disparity?

Medicaid Medicaid is a program that attempts to address disparities by providing assistance with certain medical expenses. Medicare is a national social insurance program for the elderly. Temporary Assistance for Needy Families is a program to help needy families achieve self-efficiency. The Supplemental Security Income Program provides stipends to low-income people who are 65 years of age or older, blind, or disabled

Which action by a nurse in a community-based clinic can help to address potential disparities with a large Hispanic population?

Providing translators and materials in the Spanish language Providing translators and materials in the native language of the population being served can best address potential biases and prejudices and thus increase health care access. Ensuring that childcare services are available may increase ease of access to care but does not necessarily address biases and prejudices. Providers must respect and acknowledge the beliefs and values of the population being served, but it is not necessary that their values align. Providing "English as a second language" classes can assist the population to acclimate and become more literate in the English language but does not necessarily directly affect bias and prejudice.

A patient's overall health is influenced by many determinants. The Affordable Care Act (ACA) impacts which aspect of a patient's health?

The availability of health care The ACA impacted the availability of health care and reduced the number of uninsured Americans by 5.4 million in the first year of implementation. A neighborhood's crime rate is a part of the physical environment and is not addressed by the ACA. A patient's physical environment is not addressed by the ACA; however, it does impact a patient's health status. A patient's educational background is not impacted by the ACA.

A nurse who is caring for a patient who needs emergency surgery is attempting to determine whether the patient has the capacity to consent to the surgery. Which patient abilities should the nurse consider to ensure that the patient's health literacy needs are addressed? Select all that apply

Understand instructions Weigh risks and benefits Make decisions and take action Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information. It includes understanding instructions, weighing risks and benefits, and making decisions and taking action. Internalizing cultural values and describing beliefs, attitudes, and values are not abilities related to health literacy.

Which example of a determinant of health would have the greatest impact on the overall health of an individual?

Use of tobacco and illicit drugs According to research, individual behavior has the largest impact on overall health, comprising 40% of the total influence of all determinants of health. Behaviors such as the use of tobacco and illicit drugs result in diseases such as lung cancer and liver disease in individuals. Health services, such as lack of health care insurance, influence health at 10%. Biology and genetics, such as predisposition to disease, influence health at 28%. Physical determinants, such as workplace injury and industrial injuries, contribute 5% of the total influence.

When is the communication between the patient and the nurse viewed as most effective?

When both the nurse and the patient can understand and exchange the meaning of the communication Communication between the nurse and the patient is the most effective when both parties understand the meaning of that communication, either through gestures or spoken words. Although the nurse and the patient may belong to same culture, there may not be effective communication if either party does not understand the meaning of the exchange. When the patient tries to tell his or her problem, the nurse does not need to exactly understand what the patient is saying. Ineffetive communication can arise when the nurse makes an assumption about the patient's problem.