community week 5 Health Disparities

Which represent barriers to mental health treatment in ethnic populations? Select all that apply.

**Language barriers **Lack of diversity among health care providers ​ **Lack of cultural understanding by health care providers

Which two assessment findings require priority follow-up?

**Median income below state poverty level **No mental healthcare providers

The nurse should act on which two community priorities first?

**Partner with a mental healthcare provider for telehealth evaluation and ongoing care. **Partner with community organizations to reduce food insecurity and increase job stability.

In a veteran, which condition may be the primary cause of mental health issues?

**Post-traumatic stress syndrome

Which statement is true when determining if a geographic area is rural or urban?

**Rural and urban areas, by relative nature, occur on a continuum.

Which statement best describes a mental illness requiring further follow-up?

**Symptoms significantly impact functions of daily life.

The nurse is completing a cultural assessment. Match the assessment question with the coordinating component of the cultural assessment.

What does your sickness mean to you?===Attitude What is important for me to know about your faith or spiritual needs===Beliefs What has your experience been since coming to the United States?===Context How are decisions about healthcare made in your family?===Decision-making style

Review the case information and highlight the findings that are concerning to the nurse.

**The client did not want to see the healthcare provider **told him to "lay off the fried foods **told he did not meet the criteria and was at low risk **the client did not disclose information **The wife was told to wait for the prescribed medicationto begin to work

Which actions promote social justice? Select all that apply.

****ALL***** -training nurses to advocate for client rights​ -increasing diversity of healthcare staff​ -increasing access to care through virtual healthcare​ -employing healthcare staff who speak multiple languages​ -health policies that support equal access to healthcare

Which approach is the most common model currently used for the treatment of mental illness?

***Community-based treatment

When caring for an older adult, the nurse educates the client and family about home safety because the client is at highest risk for which problem?

***Falls

Which statement by a young victim of violence indicates possible emotional trauma?​

"My friends say I'm different since the shooting."​

Match each of the following nursing ethics provisions (in the left column) with the best nursing example (in the right column)

***The Nurse practices compassion=== nurse allows dying client's.. ***The nurse promotes, advocates=== the nurse turns the bedside.... ***The nurse collaborates with === the nurse serves... ***the profession of nursing=== the nurse advocates for legislation...

Based on Frank's answers, the nurse determines that he is at most risk of

***harm self or others ***substance use **homelessness ***self care deficit

The nurse is caring for an American Indian woman who reports having intermittent acid reflux. The client tells the nurse that some medications provided by the tribal healer have been helpful. Which is the best response made by the nurse?

**"Tell me more about the medications and how you take them."

Which questions should the nurse ask to obtain priority information? Select all that apply.

**"Where are you able to wash up and get a change of clothes?" **"Have you used any drugs?" **"Can you describe in more detail the things you see, and where and when you see them?" **"Did your uncle see or hear things that weren't there?" **"Do you feel the need to hurt yourself or someone else?"

Click to highlight the assessment findings that require additional follow-up.​

**"seeing things." **disheveled and he has a foul odor ** treated for a "mental health" issue **unable to get a job

ighlight the findings that place this family at risk for homelessness.​ The nurse is caring for a family whose income is from one parent. One parent works while the other parent cares for the children ages 2, 4, and 5. The parent working outside the home, works

**$10 an hour **rent is $650 **The working parent is an alcoholic and is unable to afford treatment

The nurse is caring for a homeless teenage female at a Federally Qualified Health Center (FQHC). The teenager reports engaging in survival sex. The nurse has completed an assessment and the teenager is not pregnant, does not have any sexually transmitted infections, and her physical health is adequate. The teenager has symptoms of depression. What actions should the nurse take? Select all that apply.

****ALL**** Refer to a food bank Refer to mental health counseling Refer to homeless youth services Provide condoms Provide oral contraceptives

Which are the examples of community violence? Select all that apply.​

**A church group demonstrating and shouting derogatory slurs during a diversity pride event **Illicit drug users conducting home invasions to steal items to sell in order to buy more illicit drugs​ **A fight between two 3rd grade student​s **An incident of road rage involving a parent who chased down someone speeding through their neighborhood​

Which statement is the definition of mental illness?

**A condition that may disrupt activities of daily function

The nurse working in a clinic in a small community has heard of several incidents of youth violence and feels someone needs to take action. Which community issues below are potential community risk factors for violence? Select all that apply.​

**A local lumber mill just shut down.​ **A new low-income housing area just opened.​

The nurse leader of a healthcare clinic is trying to promote culturally responsive healthcare services to the community. Which actions should the nurse leader take? Select all that apply.

**ALL** **Participate in community events to promote the services available. **Compare the diversity of individuals served at the clinic to the diversity of the community. **Develop a healthcare advisory board that includes community members. **Ensure client education materials are prepared in multiple languages. **Provide staff with cultural professional development opportunities.

The nurse is caring for a veteran who served in the military for 25 years and had several deployments. Which is the most likely barrier to this client to seeking needed care?

**Acclimation to military culture

Review the client case. The client is at risk for which top 3 complications?

**Amputation **Suicide **Continued homelessness

Match each example with one of the challenges associated with mental illness

**Andrea is on risperidone. ==Comorbidity **Josiah is unable to get counselling== Lack of resources Edward notices that when he applies==Stigma of mental illness​ Last time Ali was in a mental health unit,==Facility inadequacy

The nurse is caring for an 80-year-old female. The client lives alone, has no family nearby, and has a caregiver who comes regularly to the client's home to take care of her. The client has bruising on both arms and reports she cannot remember how it happened. The client has lost weight since the last visit and appears unkempt. Which action should the nurse take first?

**Ask the client abuse assessment questions.

Review the client case. The nurse is making a home visit to the client's transitional housing. Which actions should the nurse take? Select all that apply.

**Assess foot wound **Assess blood sugar **Assess medication adherence **Refer to local clinic that provides free foot care

Which of the following issues are family risk factors for the perpetration of violence? Select all that apply.​

**Census data showing a large number of adults who did not finish high school **High numbers of adults being arrested for illicit drug possession **Noticing a large number of small children playing in the street during a 10 pm windshield survey

Which are the assessment findings that should concern the nurse? Select all that apply

**Client smokes **Client is homeless **Client has uncontrolled diabetes **Client has post-traumatic stress disorder

A district health nurse is assigned to two rural counties in the state. To achieve the best outcomes possible in reducing the health disparities for the large number of frail older clients in the two counties, the nurse should consider using which community-oriented nursing skills? Select all that apply.

**Community-oriented primary healthcare **Case management

Place the prevention steps in order, starting with the first step.​

**Define the problem​ **Identify risk and protective factors​ **Develop and test prevention strategies​ **Adoption of successful strategies​

Which relationships can increase the risk of experiencing violence? Select all that apply.​

**Family members **Peers **Partners

An undocumented migrant farmworker has been diagnosed with tuberculosis (TB). The local health department initiates treatment by dispensing the first month's supply of medication aterm-89nd educates the client on the need to continue treatment for 6 to 12 months. What challenge(s) may this individual face when seeking follow-up care? Select all that apply.

**Fragmented services *Reduced availability of services *Language barriers *Discrimination

Rural residents appear to have a more persistent, endemic level of depression. The nurse understands that to improve residents' mental health, which barriers must be overcome? Select all that apply.

**Gaps in continuum of mental health services **Number of mental health services **Tolerance for destructive coping behaviors

Use the drop-down menu to indicate if the client's mental health was most impacted by biological, genetic, or social factors.

**Genetic - "My mom had major depressive disorder, and now I do too." **Social - "I was sexually assaulted at a young age, and now I have nightmares and insomnia." ***Biological- "I have hyperthyroidism and was diagnosed with panic attacks." **Biological- "These steroids are causing me to be depressed."

Which are risk factors for the act of violence? Select all that apply.​

**High level of transiency **Low parental involvement​ **Association with delinquent peers​

When planning primary prevention education for a rural community, the nurse should consider interventions based on which facts about rural American health? Select all that apply.

**Higher rates of diabetes mellitus **Higher infant and maternal morbidity rates **Higher rates of obesity **Less likely to meet physical activity recommendations **Higher rates of suicide

What are societal factors that contribute to homelessness? Select all that apply.

**Insufficient income **Shortage of affordable housing **Lack of support services

The assumptions and biases of the healthcare provider contributed to which outcomes? Select all that apply.

**Lack of treatment for cholesterol **Delay in needed care **Critical information not communicated **Mistrust of healthcare providers **Delay in seeking treatment

The nurse challenged the care team to consider and educate the client's wife about all treatment options. The client's treatment plan was changed to integrate the most recent evidence and he eventually recovered. Which action contributed the most to the client's health outcome?

**The nurse speaking up about the difference in the care provided for the client

Which legislative act acknowledged mental illness as a disease?

**U.S. Surgeon General's Report on Mental Health in 1999

Review the case. The nurse should address the client's loneliness by recommending the client move to

**an assisted living facility

The task force should address

**increased wait times **delayed transfer for mental healthcare

The client has a terminal diagnosis and the family has not told the client the diagnosis yet. At this point, the nurse should

**not tell the client

Violence disrupts the

**safety **higher-level

The client is most at risk for

**sexually transmitted infections **unintended pregnancy

The nurse is caring for a client in an acute care unit. The healthcare provider rounds on all the clients in the unit except one because the healthcare provider runs out of time. The nurse calls the healthcare provider back to the unit to round on that client. The nurse is demonstrating

**social justice

Review the case. Highlight the assessment findings that are concerning to the nurse and require follow up.

**spoiled food in the refrigerator **worsening dementia **macular degeneration **rugs throughout the apartment **reports being lonely

Which disabilities will have clinical manifestations that are present at birth? Select all that apply.

*Down syndrome​ *Spina bifida​ *Cystic fibrosis​

What are risk factors for the act of violence? Select all that apply.​

*Exposure to violence​ *History of aggressive behavior​ *Learning disorder​

A school nurse is asked to assess a 13-year-old child because of excessive drowsiness and inattention in class. The nurse determines that this is a child of migrant workers on a local produce farm. Based on the nurse's knowledge of migrant worker families, which activity should the nurse ask about?

*Field work

Fill in the blank with the proper usage of each definition:​

*Impairment *Disability​ *Handicap

The nurse reached out to the mayor's office to discuss the issue of violence in the community. The mayor asks the nurse to lead a committee to address the issue of violence. What should the nurse do next?​

*Obtain data on reported incidents and arrests from the police chief.​

Which conditions are more likely to result in complications and death more frequently in children with intellectual or developmental disabilities?​

*Reflux *Constipation​ *Seizures

Which referrals would reduce the family's risk of becoming homeless? Select all that apply.

*Resources to supplement their food supply *Alcohol addiction treatment *Resources for housing assistance

A nurse in a community health clinic located in Virginia is conducting an assessment on a Hispanic worker currently working in a local apple orchard for the season. The nurse determines that the worker originates from Florida and is living in temporary housing with other orchard workers. Based on this information, the nurse should integrate the special needs of what vulnerable population?

*migrant farmworkers

Which assessment questions should the nurse ask a client who identified themselves as a veteran? Select all that apply.

----ALL When did you serve? Did you serve in combat? What was your job in the military?​ Did you have any injuries related to your military service? Were you exposed to noise, chemicals, gasses, or other hazardous substances?

Which groups are considered vulnerable populations? Select all that apply.

---ALL

The school nurse is working to support the lesbian, gay, bisexual, transgender, and queer students in the school. What action(s) should the nurse take? Select all that apply.

---Start a lesbian, gay, bisexual, transgender, and queer extracurricular organization. --Assess school policies and curriculum for inclusivity. --Engage teachers to designate their classroom as a "safe space" --Maintain confidentiality of students who identify as lesbian, gay, bisexual, transgender, or queer

The lesbian, gay, bisexual, transgender, and queer populations are at higher risk for which problems? Select all that apply.

--ALL Chronic diseases Drug abuse Human immunodeficiency virus (HIV) Suicide Bullying

Which of the following are health disparity outcomes for minorities? Select all that apply.

-Increased healthcare costs -Higher mortality rates -Poorer health outcomes -Higher prevalence of chronic conditions​

Which are federal programs to improve the health of minority groups? Select all that apply.

-National Breast and Cervical Cancer Early Detection Program -Ryan White Comprehensive AIDS Resources Emergency -National Institute on Minority Health and Health Disparities -Racial and Ethnic Approaches to Community Health

For each identified community assessment factor, click to specify if the factor impacts the mental health, physical health, or the county's ability to provide support to residents. Select one or more answers per row.

Check ALL

A year has passed since actions were taken to reduce the wait time for mental health treatment. For each data point, click to specify if the finding indicates that the community health has improved, not changed, or declined.​

Improved​: Two nurse practitioners are providing mental telehealth visits Transfer to inpatient facility mental health treatments have decreased Not Changed: 22 inpatient beds at a local hospital Declined: Unemployment rates increased

Review the client case. The nurse is discharging the client from the Veteran's Affairs hospital to transitional housing. Indicate whether each teaching point is indicated or nonessential.

Essential: Educate client about wound care Education client about smoking cessation Educate client about medication prescriptions Educate client about potential health complications related to not adhering to treatment regimen for diabetes Nonessential: ***Educate client about food resources

What percentage of homicides in the United States involve a firearm?​

75%

The community health nurse is meeting with the leaders of rural towns to discuss barriers to healthcare. The nurse should inquire about which situations? Select all that apply.

ALL

Which groups of people are at risk for being homeless? Select all that apply.

ALL

Which resources are available through the Substance Abuse and Mental Health Services Administration (SAMHSA)? Select all that apply.

All

For each nursing action in the left column, drag and match the most appropriate diagnosis.

Arrange for a bed at a shelter with showers available **Self-care deficit Request an assessment for possible housing assistance ***Impaired home maintenance Refer to a mental health professional **Impaired cognition Notify crisis team to further evaluate risk for violence **Risk for harm to self or others

The nurse is caring for a veteran with suicidal ideations. The nurse is implementing a crisis response plan. Indicate whether each nursing action is indicated or contraindicated.

Contraindicated: **Recommend inpatient hospitalization Indicated: **Interview client about recent suicide ideation **Assess recent stressors **Identify with the client skills to self-manage stress **Address barriers to care

​The nurse is caring for a homeless teenage female at a Federally Qualified Health Center (FQHC). The teenager reports engaging in survival sex. Indicate whether each nursing assessment is essential or nonessential.

Essential: Assess results of pregnancy test Assess mental health Assess overall physical health Assess results of sexually transmitted infections testing Nonessential: ***Assess level of education

Review the case. Indicate whether each outcome is expected or unexpected. Select only one answer for each row.

Expected: **Unable to take in adequate nutrition **Decline in health **Family honoring advanced directives **Placement in hospice care Unexpected: **Broken hip​

Indicate whether each individual is considered homeless, runaway youth, homeless youth, or not homeless.

Homeless: **Adult staying at a shelter **Adult living on the streets **Adult with no home address admitted to a psychiatric facility **Adult living in their vehicle **Adult who moves between friends and family homes Not Homeless: **Adult who lives in a community group home for developmentally disabled adults Homeless Youth: **14-year-old staying at a shelter Runaway Youth: **16-year-old staying with friends without parent's knowledge

The local hospital emergency department has recently experienced an increase in gastroenteritis cases among migrant farmworkers. After being informed of the rise in cases, the local public health nurse should schedule a case mapping of which locations?

Housing for migrant workers

Review the client case. The nurse is assessing the client 3 months after wound debridement. Select whether each assessment finding indicates the client's condition has improved, has not changed, or has declined.

Improved: **Client has enrolled in housing assistance program **Client has enrolled in additional mental health services assistance Unchanged: **A1C level is 10 Declined: **Wound is swollen, reddened, and has a foul odor

In the table below, the outcomes are listed in the rows and the goals are in the columns. For each outcome, click to specify which program goal it has addressed. Select only one answer in each row.

Increase options for healthy nutrition across the lifespan. ​ **Created farmers' markets .. Promote community planning and transportation plans that create places for safe and accessible physical activity. **Created safer places for physical activity for.. Support tobacco-free living. **Increased the number of commercial shopping plazas... Connect clinics to community programs so people can manage chronic diseases, such as heart disease and diabetes. **Trained community health workers to serve in the Navajo Nation

Select whether each nursing action is indicated or contraindicated. Select only one answer in each row.

Indicated: **Advocate for all clients' beliefs even when care is not based on evidence. **Take time to educate the client and family about all the treatment options. **Be mindful and understanding of medical mistrust. **Acknowledge the client's potential fears or concerns. Contraindicated: **Always implement healthcare provider orders without question.

Review the case. Select whether each nursing action is indicated or contraindicated.

Indicated: **Complete medication reconciliation. **Assess if client has advanced directives​. **Suggest the family move familiar items to the living facility. **Engage the client in decision making. Contraindicated: **If the client repeatedly states they want to go home once they arrive at the new facility,

For each potential nursing intervention, indicate whether the intervention is indicated or contraindicated. Select only one answer in each row.

Indicated: **Stay up-to-date on evidence-based practices and guidelines **Ask questions about all treatment options for all clients **Notice patterns of clients who are and are not receiving the same treatment for similar conditions **Reflect on own biases Contraindicated: **File a civil rights complaint on behalf of the client

Review the case. For each potential nursing intervention, indicate whether the intervention is indicated or contraindicated. Select only one answer for each row.

Indicated: **​Assess if worsening symptoms are related to Alzheimer's disease or normal signs of aging. **Assess client's ability to perform basic activities of daily living. **Provide family with resources about facility options. **Assist family in determining eligibility for insurance coverage for other facilities. Contraindicated: **Visit potential facilities with the family.

The nurse is planning several interventions for Frank's next visit. Click to specify if the potential interventions are indicated, nonessential, or contraindicated for Frank's condition.

Indicated: Focus on reality and not the hallucination experience Remove dangerous objects from the room Refer the client to a mental health professional Document details of the hallucination Nonessential: **Review the clinic's hours of operation Contraindicated: **Put the client in soft restraints **Reschedule the appointment for tomorrow

For each potential community intervention proposed by the community task-force in the left column, click to specify if the intervention is indicated, nonessential, or contraindicated for the mental health of this community and its residents. Select one option for each row.

Indicated: Partner with a mental healthcare provider for telehealth evaluation and ongoing care. Partner with community organizations to reduce food insecurity and increase job stability. Improve the shared community parks to provide safe environments for residents to gather, socialize, and get physical exercise. Nonessential: **Recruit a mental healthcare specialist to open an office in the county. Contraindicated: **Limit the number of referrals for inpatient mental healthcare​.

Click to specify the number of individuals who live in the areas listed in the left column. Each row may include one or more responses.

Less than 6 per square mile: *Frontier Less than 20,000: *Rural 20,000 to 49,999: *Urban 1 million or more: *Urban

For each measured outcome, click to specify if the outcome indicates a lowered risk for the potential perpetration of violence, an increased risk, or no change in the risk.​ Select only one answer in each row.

Lowered Risk: **Thirty adults graduated from the new, free GED® program.​ **An expanding lumber mill in a neighboring town agreed to hire workers from the closed mill. Increased Risk: **A local gas station closed permanently. No Change in Risk: **A large manufacturing company is in negotiations to buy the property on the edge of town. **The city released funding for opening a new park.

For each nursing action below, specify whether it is an example of maintenance, negotiation, or restructuring under the Sunrise Model. Select only one answer in each row.

Maintenance: **The nurse administers normal saline Negotiation: **The nurse administers a transfusion of clotting factor Restructuring: **The nurse administers a blood transfusion

Review the expected outcomes below and indicate whether they were met or not met.

Met Met Not Met Met

Which services can make a positive impact on the life of a person with a disability? Select all that apply.​

Opportunities for training programs in the workforce​ Grants for housing modifications Caregiver services to assist with activities of daily living​ Accessible public transportation​

For each potential prevention activity below, click to specify if it is a primary, secondary, or tertiary prevention.​ Select only one answer in each row.

Primary Prevention​: Starting an adult GED® (general educational development) program, free for all residents. Secondary Prevention​: Passage of bullying law so that students who bully others are placed in a special classroom program.​ Tertiary Prevention​: Hiring an advanced practice nurse to work with victims of violence to keep them from turning to violence.​

Review the case. For each finding, indicate if the finding is consistent with the client being at risk for falls, depression, or nutritional deficit. Select only one answer for each row.

Risk for Falls: **Rugs in the home **Macular degeneration Risk for Depression: **Reports being lonely **Lives alone Risk for Nutritional Deficit: **Spoiled food found in refrigerator

Match each condition with the expected symptoms.

Schizophrenia: Symptoms include verbal or auditory hallucinations, paranoia, insomnia, and psychosis. Bipolar disorder: Symptoms include significant mood swings causing erratic behavior and severe depression. Post traumatic stress syndrome: Symptoms include recurrent nightmares, insomnia, severe anxiety, and depression that continues after an event. Substance use disorder: Symptoms include loss of control over a substance, the continued use despite injury, and obsession with obtaining more.

Indicate whether each situation represents a social justice model or a market justice model.

Social Justice: **Nurses should be trained to be culturally competent **Everyone should have access to high-quality healthcare **Everyone should have access to quality education **Safe housing is a basic human right Market Justice​: **A healthcare model without government involvement

Which two prevention activities should be trialed first?

Start an adult GED® (general educational development) program, free for all residents.​ Work with state economic development professionals to bring in a manufacturing plant to replace jobs lost due to the closure of the lumber mill.​

Review the client case. For each assessment finding, indicate if the finding is primarily caused by system factors or individual factors.

System Factors: ***Client suffers from severe post-traumatic stress disorder ***Client cannot find affordable permanent housing Individual Factors: ***Client has uncontrolled diabetes ***Client smokes

Which level of prevention is focused on treating the long-term consequences of violence?​

Tertiary prevention

When caring for a vulnerable population, it is important for the nurse to understand the

Unique disparities

Using the concept of upstream thinking, indicate whether each intervention to prevent homelessness is an upstream or downstream intervention.

Upstream: **Create a voucher program for rental assistance **Create new affordable housing inventory **Support legislation that increases minimum wage Downstream: **Refer clients to a shelter **Refer clients to a soup kitchen

The client continued to decline, so his wife took him to the hospital. He was admitted with pneumonia. The client coded, was intubated, and transferred to the intensive care unit. The client was diagnosed with coronavirus. One nurse noticed that the client was not receiving the same treatment as other coronavirus clients. The client is at highest risk for

poor outcomes bias and discrimination

Using the community violencepreventionsocial-ecologicalsocioeconomic model can help people understand how factors that influence community violence interact. According to the model, which level are the following factors related to?​ creating safe neighborhoods— individualrelationshipcommunitysocietal​ strengthening parent-child communication—individualrelationshipcommunitysocietal promoting social norms that protect against violence—individualrelationshipcommunitysocietal​ increasing conflict resolution skills—individualrelationshipcommunitysocietal

social-ecological community relationship societal individual