32 - Vulnerability and Vulnerable Populations: An Overview

Question 1

The wide variations in health services and health status between certain population groups are called:

a. ) vulnerable population groups.
b. ) health disparities.
c. ) disadvantaged populations.
d. ) risk markers.

Answer 1

b.) health disparities.

The wide variations in health services and health status between certain population groups are called health disparities. Vulnerable populations are typically considered to be those who are at greater risk for poor health status and who have poor access to health care. Disadvantaged populations have fewer resources for promoting health and treating illness than does the average person in the United States. Risk describes that some people have a higher probability of illness than others.

Question 2

Which of the following is most likely to live in poverty?

a. ) Those who work in high-risk jobs
b. ) Those who have adequate nutrition
c. ) Those who effectively manage stress
d. ) Those who live in single family homes

Answer 2

a.) Those who work in high-risk jobs

People who are poor are more likely to live in hazardous environments that are overcrowded and have inadequate sanitation, work in high-risk jobs, have less nutritious diets, and have multiple stressors.

Question 3

Which federal program created support for older and poor Americans?

a. ) Social Security Act
b. ) Medicare Amendment
c. ) Medicaid Amendment
d. ) Hill-Burton Act

Answer 3

a.) Social Security Act

The Social Security Act sought direct payments to eligible individuals to ensure a minimum level of support for people at risk of problems from inadequate financial resources. The Social Security Act encompasses the Medicare and Medicaid Amendment. The Hill-Burton Act provided funding to assist with building hospitals.

Question 4

A nurse is working with a 17-year-old pregnant cocaine addict who is homeless. Which of the following best describes this client?

a. ) At risk
b. ) A special population
c. ) A Healthy People 2020 target group

d,) A vulnerable individual

Answer 4

d,) A vulnerable individual

Vulnerable individuals often have multiple risk factors. Vulnerable populations of concern to nurses are persons who are poor or homeless, have special needs, pregnant teens, migrant workers and immigrants, individuals with mental health problems, people who abuse addictive substances, persons who have been incarcerated, people with communicable diseases and those who are at risk, and persons who are HIV positive or have hepatitis B virus or STDs. Risk is an epidemiological term meaning that some people have a higher probability of illness than others.

Question 5

A nurse operates a school-based clinic in a local school where multiple providers and disciplines offer care to children, making it easier for children to access health care. Which of the following best describes this approach?

a. ) Advocacy
b. ) Wrap-around services
c. ) Social justice

d,) Comprehensive services

Answer 5

d,) Comprehensive services

Comprehensive services are health care services that focus on more than one health problem or concern. Stationary or mobile clinics that provide a wide array of health promotion, illness prevention, and illness management services in migrant camps, schools, and local communities are examples of this. Wrap-around services describe a system in which comprehensive health services are available and social and economic services are “wrapped around” these services. Advocacy refers to actions taken on behalf of another. Social justice describes justice with respect to the concepts of egalitarianism and equality.

Question 6

Which trends are occurring when providing care for vulnerable populations? (Select all that apply.)

a. ) Community-based care and interorganizational partnerships
b. ) Outreach and case finding
c. ) Elimination of disparities
d. ) Culturally and linguistically appropriate care
e. ) Increased incidence of acute illnesses

Answer 6

a.) Community-based care and interorganizational partnerships

b.) Outreach and case finding

d.) Culturally and linguistically appropriate care

Community-based care and interorganizational partnerships, outreach and case finding, and provision of culturally and linguistically appropriate care are all trends to improve care among vulnerable populations. Elimination of disparities is not a trend related to caring for vulnerable populations. Increased incidence of acute illness is not a trend of care provision for vulnerable populations.

Question 7

A nurse is developing a one-stop service to meet the needs of a vulnerable group. Which of the following would the nurse most likely create?

a. ) Wrap-around services where mental services are linked
b. ) Giving all immunizations on a single clinic visit
c. ) Providing multiple services during a single clinic visit
d. ) Providing free services to the medically indigent

Answer 7

c.) Providing multiple services during a single clinic visit

Providing multiple services during a single clinic visit makes services more responsive to the combined effects of social and economic stressors. Wrap-around services provide comprehensive health as well as social and economic services, so it would include more than the linkage of mental health services. Administering all immunizations or providing free services would not provide a one-stop shop for all needed services.

Question 8

A nurse is caring for a homeless population. Which of the following characteristics should the nurse anticipate as a need of this population?

a. ) Need more nursing care than other vulnerable groups
b. ) Have no desire to seek medical care
c. ) Have even fewer resources than poor people who have adequate housing
d. ) Are living in despair with no hope or resilience

Answer 8

c.) Have even fewer resources than poor people who have adequate housing

Those who are homeless have even fewer resources than poor people who have adequate housing. Homeless and marginally housed people must struggle with heavy demands as they try to manage daily life because their resources are limited. These individuals must cope with finding a place to sleep at night and a place to stay during the day or moving frequently from one residence to another, as well as finding food, before even thinking about health care.

Question 9

A nurse is planning and implementing care for vulnerable populations. Which of the following would be the most appropriate action for the nurse to take?

a. ) Setting up multiple clinics in a wide geographic area
b. ) Advising legal consultants on a variety of issues
c. ) Making laws to protect the homeless
d. ) Teaching vulnerable individuals strategies to prevent illness and promote health

Answer 9

d.) Teaching vulnerable individuals strategies to prevent illness and promote health

Teaching vulnerable individuals, families, and groups strategies to prevent illness and promote health is one of the ways nurses provide care for these populations. Setting up clinics, advising legal consultants, and making laws do not address the direct care provision role of the nurse.

Question 10

A nurse is promoting social justice. Which of the following actions would the nurse most likely take?

a. ) Contacting lawmakers about environmental health issues
b. ) Assisting at homeless shelters
c. ) Advocating for policies to improve social conditions
d. ) Serving on a local coalition to prevent obesity

Answer 10

c.) Advocating for policies to improve social conditions

Social justice refers to providing equitable care and social supports for the most disadvantaged members of society. Nurses can function as advocates for policy changes to improve social, economic, and environmental factors that predispose vulnerable populations to poor health.

Question 11

A nurse is working with multiple vulnerable groups. Which of the following would be most sensitive to adverse effects?

a. ) Pregnant teenager living with her parents for financial support
b. ) Poor, older woman with no means of transportation
c. ) 2-year-old boy of underinsured parents
d. ) Recently unemployed father of five

Answer 11

b.) Poor, older woman with no means of transportation

A poor, older woman with no means of transportation has a combination of risk factors. A pregnant teenager, 2-year-old boy, and recently unemployed father are only displaying one risk factor, not multiple risk factors as the older woman displays.

Question 12

A set of actions one undertakes on behalf of another is:

a. ) social justice.
b. ) advocacy.
c. ) resilience.
d. ) risk.

Answer 12

b.) advocacy.

A set of actions one undertakes on behalf of another is advocacy. Social justice describes justice with respect to the concepts of egalitarianism and equality. Resilience refers to how vulnerable populations are able to resist or overcome the effects of the vulnerability. Risk describes that some people have a higher probability of illness than others.

Question 13

A client is self-employed as a mechanic and has no health insurance coverage. Which of the following best describes the legislation that will assist this client in obtaining health insurance?

a. ) Balanced Budget Act
b. ) Health Insurance Portability and Accountability Act (HIPAA)
c. ) Patient Protection and Affordable Care Act (ACA)
d. ) Social Security Act

Answer 13

c.) Patient Protection and Affordable Care Act (ACA)

The ACA of 2010 provides the opportunity for all to purchase health insurance. The Balanced Budget Act shifted payment in home health care. The HIPAA was intended to help people keep their health insurance when moving from one place to another. The Social Security Act created the largest federal support program for elderly and poor Americans.

Question 14

A nurse “sets the stage” when assessing members of vulnerable population groups. Which of the following interventions would be completed? (Select all that apply.)

a. ) Creating a comfortable, non-threatening environment
b. ) Providing culturally and linguistically competent assessment
c. ) Collaborating with others as appropriate
d. ) Providing financial and legal advice
e. ) Developing a free clinic in a low-income neighborhood

Answer 14

a.) Creating a comfortable, non-threatening environment

b.) Providing culturally and linguistically competent assessment

c.) Collaborating with others as appropriate

Nurses set the stage by creating a comfortable, non-threatening environment, providing culturally and linguistically competent assessment, and collaborating with others as appropriate. A nurse should not provide financial or legal advice. Developing a free clinic does not “set the stage.”

Question 15

A nurse is examining social determinants of health. Which of the following is the nurse looking at?

a. ) Ethnicity
b. ) Income
c. ) Gender
d. ) Marital status

Answer 15

b.) Income

Social determinants of health are such factors as economic status, education, environmental factors, nutrition, stress, and prejudice that lead to resource constraints, poor health, and health risk.

Ethnicity, gender, and marital status are not considered social determinants of health.

Question 16

Resilience refers to the:

a. ) resistance of certain groups to risk factors.
b. ) increased susceptibility to cumulative risk factors among vulnerable groups.
c. ) variability in the effects of stressors according to socioeconomic status.
d. ) increased sensitivity of the very young and the very old to risk factors.

Answer 16

a.) resistance of certain groups to risk factors.

Resilience refers to how vulnerable populations are able to resist or overcome the effects of the vulnerability. These populations do not succumb to the health risks that impinge on them.

Question 17

A nurse is working with a vulnerable group experiencing multiple risk factors. Which of the following best describes this group?

a. ) Smokers who use chewing tobacco as well as cigarettes
b. ) Substance abusers who test positive for HIV
c. ) Persons with limited access to care because they live in a rural area
d. ) New mothers needing information about baby and child care

Answer 17

b.) Substance abusers who test positive for HIV

Multiple risk factors are present in substance abusers, including contracting HIV and hepatitis B virus. Homelessness is another risk factor. Vulnerable populations of concern to nurses are persons who are poor or homeless, have special needs, pregnant teens, migrant workers and immigrants, individuals with mental health problems, people who abuse addictive substances, persons who have been incarcerated, people with communicable diseases and those who are at risk, and persons who are HIV positive or have hepatitis B virus or STDs.

Question 18

A nurse works with a group of abused women to enhance their levels of self-esteem. Which of the following levels of prevention is being performed?

a. Primary level of prevention
b. Secondary level of prevention
c. Tertiary level of prevention
d. Health promotion

Answer 18

c. Tertiary level of prevention

Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Primary prevention aims to prevent disease and illness before it occurs. Secondary prevention focuses on screening and early detection. Health promotion is not a level of prevention.

Question 19

A nurse considers an audience’s ability to read, comprehend, and act on medical instructions while preparing health education materials. Which of the following factors is the nurse considering?

a. ) Health literacy
b. ) Resilience
c. ) Social justice
d. ) Health disparity

Answer 19

a.) Health literacy

A measure of a patient’s ability to read, comprehend, and act on medical instructions is health literacy. Resilience has to do with the factors that allow people to resist the effects of vulnerability. Social justice describes justice with respect to the concepts of egalitarianism and equality. Health disparity refers to the wide variations in health services and health status among certain population groups.

Question 20

A nurse is working with a vulnerable population. Which of the following is the nurse most likely working with?

a. ) Families earning more than $50,000/year
b. ) Families earning less than $15,000/year
c. ) Residents of urban areas
d. ) African American physicians

Answer 20

b.) Families earning less than $15,000/year

Vulnerable populations of concern to nurses are persons who are poor or homeless (families earning less than $15,000 per year would be considered poor), persons who have special needs, pregnant teens, migrant workers and immigrants, individuals with mental health problems, people who abuse addictive substances, persons who have been incarcerated, people with communicable diseases and those who are at risk, and persons who are human immunodeficiency virus (HIV) positive or have hepatitis B virus or sexually transmitted diseases (STDs).

Question 21

What is the primary cause of vulnerability?

a. ) Race
b. ) Age
c. ) Poverty
d. ) Illness

Answer 21

c.) Poverty

The primary cause of vulnerability is poverty. Race, age, and illness may cause populations to be vulnerable, but these factors are not the primary cause.

Question 22

A nurse is working to remove barriers to receiving health care. Which of the following actions is the nurse most likely to support?

a. ) Discrimination against certain groups
b. ) Treatment of pets at the same facility
c. ) Provision of free food at a food bank
d. ) Providing services for a rural population by using a mobile clinic

Answer 22

d.) Providing services for a rural population by using a mobile clinic

Barriers to access are policies and financial, geographic, or cultural features of health care that make services difficult to obtain or so unappealing that people do not want to seek care. Examples of removing barriers include providing extended clinic hours, low-cost or free health services for people who are uninsured or underinsured, transportation, mobile vans, and professional interpreters, which can help improve access to care.

Question 23

What is implied by the web of causation model?

a. ) Variables interact resulting in higher probability of illness.
b. ) One disease causes another, especially in vulnerable populations.
c. ) The greater the poverty, the more likely people are to have diseases.
d. ) Immunizations are necessary because vulnerable populations spread disease.

Answer 23

a.) Variables interact resulting in higher probability of illness.

The web of causation model implies that not only are there more variables, but the variables interact, resulting in higher probability of illness. The relative risk for poor health is greater for vulnerable populations.

Question 24

A nurse is working with a family who is unable to find adequate health care coverage for the children in the family. Which of the following pieces of legislation will assist in provision of health care coverage for these children?

a. ) Social Security Act
b. ) Balanced Budget Act
c. ) HIPAA
d. ) ACA

Answer 24

a.) Social Security Act

The Social Security Act provides funds to insure currently uninsured children. The Balanced Budget Act shifted payment in home health care. The HIPAA was intended to help people keep their health insurance when moving from one place to another. The ACA of 2010 provides the opportunity for all to purchase health insurance.

Question 25

Which of the following is a characteristic of a vulnerable population?

a. ) Have worse health outcomes and an increased sensitivity to risk factors than the general population
b. ) Have a single risk factor but experience worse health outcomes than the general population
c. ) Have multiple risk factors but equal health outcomes to the general population
d. ) Have worse outcomes with better access to health care than the general population

Answer 25

a.) Have worse health outcomes and an increased sensitivity to risk factors than the general population

Vulnerable population groups are more sensitive to risk factors and have worse health outcomes. Vulnerable populations experience multiple risk factors. Vulnerable populations have worse health outcomes than the general population. Vulnerable populations have more problems accessing health care than the general population.

Question 26

A nurse is caring for a population that has experienced a health disparity. Which of the following best describes a health disparity?

a. ) Low childhood immunization rates
b. ) High dropout rates
c. ) Unemployment
d. ) Income below poverty level

Answer 26

a.) Low childhood immunization rates

Low childhood immunization rates signify a health disparity. High dropout rates, unemployment, and income below poverty level are social conditions that may lead to health disparities.