Chapter 15 Flashcards
What designation is given to group as high risk of having poor health outcomes?
a. Cumulative risk groups
b. Health disparity groups
c. Resilient populations
d. Vulnerable populations
d. Vulnerable populations
Vulnerable populations are defined as groups who are at higher risk for poor health outcomes due to things like:
• Low income
• Limited access to healthcare
• Chronic illness
• Homelessness
• Age (very young or very old)
• Racial/ethnic minority status
• Immigration status, etc.
Basically, if life has stacked the odds against you like a rigged Jenga tower, public health puts you in the “vulnerable” category.
What is the best intervention a CHN can initiate to increase lasting resilience among new immigrants?
a. Directing clients to English-as-a-second-language courses
b. Giving immigrant clients money to help them get settled
c. Identifying areas in the city where housing is less expensive
d. Soliciting donations for food, clothing, and other needs.
a. Directing clients to English-as-a-second-language courses
What CHN intervention would best serve as a vulnerable population?
a. Addressing multiple health concerns, including preventative education, when clients present for treatment of an illness.
b. Establishing a system of networks so that clients may be referred to different services such as preventative care, acute illness care, and chronic treatment.
c. Providing acute care services that focus on the client’s main health concern and setting up appointments at discharge for other concerns.
d. Referring clients to specialists to address specific health concerns.
a. Addressing multiple health concerns, including preventative education, when clients present for treatment of an illness.
What definition accurately reflects the meaning of the term health inequities?
a. Health inequities are the accumulation of multiple factors that lead to poor health.
b. Health inequities occur when people are more inclined to become ill and usually do not seek appropriate care.
c. Health inequities are unfair differences in health that could be avoided with reasonable action.
d. Health inequities are wide variations in health status and services among certain population groups.
c. Health inequities are unfair differences in health that could be avoided with reasonable action.
What is a primary cause of vulnerability?
a. Breakdown of family structure
b. Poverty
c. Prejudice
d. Social isolation
b. Poverty
The lack of financial resources may cause some people to not seek preventative health services. This leaves them vulnerable and with increased risk of experiencing the effects of preventable illness.
Which level of prevention is a CHN practising when she offers homeless clients yearly tuberculosis (TB) screening and free treatment for those who test positive.
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Secondary and tertiary prevention
b. Secondary prevention
A CHN is orienting a new recruit to a health clinic that primarily serves vulnerable populations. Which statement by the CHN indicates a need for additional information?
a. “If a client who does not speak English comes in, you must obtain an interpreter right away.”
b. “We try to take care of as many problems as possible in on visit, so when you check the client in, ask about additional concerns.”
c. “You will like working with Filipino immigrants because they have close knit family structures.”
d. “You will need to assist the client by scheduling any referral of follow-up appointments.”
c. “You will like working with Filipino immigrants because they have close knit family structures.”
While screening for diabetes at a community clinic, a CHN found out that a new client had type 2 diabetes. The CHN then provided counselling, referred the client to an endocrinologist for initial assessment and treatment, helped with arrangements for financial assistance, arranged transportation, and booked a follow-up appointment. What role does this type of service exemplify?
a. Case management
b. Client advocacy
c. Holistic care
d. Wrap-around services
a. Case management
Why? Because the CHN is coordinating multiple services—counseling, referrals, transportation, financial help, follow-ups. That’s classic case management: making sure all the puzzle pieces fit so the client doesn’t fall through the bureaucratic cracks.
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Why Not C. Holistic care?
Holistic care is more of a philosophy—seeing the client as a whole person: body, mind, spirit, vibes, emotional baggage, etc.
It’s a mindset, not a specific role or action.
Case management, on the other hand, is a job description with receipts.
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The Others:
B. Client advocacy – That’s more about standing up for the client’s rights, removing barriers, or yelling at the system on their behalf.
D. Wrap-around services – Sounds close, but usually refers to interdisciplinary, long-term services—often for youth, mental health, or chronic needs with heavy social service involvement.
CHNs at a clinic for homeless people are concerned that clients rarely return for follow-up after their TB skin tests. What policy would be the most appropriate on for addressing this situation?
a. Call all homeless clients 48 hours after testing to remind them to return to the clinic for follow-up.
b. Have the homeless persons read the test result themselves and then mail in the results on a postage-paid card coded to protect privacy.
c. re-administer the test if the client returns later than scheduled for follow-up.
d. Routinely refer all homeless clients for chest X-rays.
b. Have the homeless persons read the test result themselves and then mail in the results on a postage-paid card coded to protect privacy.
Why? Because the CHN is coordinating multiple services—counseling, referrals, transportation, financial help, follow-ups. That’s classic case management: making sure all the puzzle pieces fit so the client doesn’t fall through the bureaucratic cracks.
⸻
Why Not C. Holistic care?
Holistic care is more of a philosophy—seeing the client as a whole person: body, mind, spirit, vibes, emotional baggage, etc.
It’s a mindset, not a specific role or action.
Case management, on the other hand, is a job description with receipts.
⸻
The Others:
B. Client advocacy – That’s more about standing up for the client’s rights, removing barriers, or yelling at the system on their behalf.
D. Wrap-around services – Sounds close, but usually refers to interdisciplinary, long-term services—often for youth, mental health, or chronic needs with heavy social service involvement.
What action should a CHN take when using the case management approach with vulnerable populations?
a. Be willing to enter into a long-term relationship with families.
b. Direct and control the client’s care because the CHN knows what is most needed.
c. Encourage families to become self-sufficient and less dependent on nursing personnel for advice and referrals.
d. Rotate assignments periodically, to prevent attachment and codependency.
a. Be willing to enter into a long-term relationship with families.
Which of the following is an example of tertiary prevention by a CHN?
a. Administering the Mantoux test to identify persons with TB.
b. Assessing for signs and symptoms of active TB
c. Directly observing clients with active TB as they take their antituberculosis medications.
d. Interpreting TB skin test results.
c. Directly observing clients with active TB as they take their antituberculosis medications.
What is the cause of the greatest overall costs to the community for providing health care to people who are homeless?
a. The need for increased preventive services to address the health conditions of the homeless population.
b. The need for more frequent clinic visits by homeless clients for multiple health problems.
c. The spread of contagious diseases by people who are homeless to those they pass on the street.
d. The fact that most of the care for people who are homeless take place in hospital emergency departments.
d. The fact that most of the care for people who are homeless take place in hospital emergency departments.
A CHN Presents a proposal for a program for preventing teen pregnancy to a group of parents. In the discussion that follows the presentation, which statement by a parent indicates the need for additional teaching by the CHN?
a. “I do not know if my son is sexually active; however, I have decided that I am going to talk to him about birth control, just in case.”
b. “I have found that being very strict and checking on my daughter whenever she is out are the best ways to prevent trouble.”
c. “I plan to sit down with my daughter and have an honest talk about sexuality and potential risks.”
d. “I will start spending more time with my teen when i get home from work.”
b. “I have found that being very strict and checking on my daughter whenever she is out are the best ways to prevent trouble.”
What CHN action would best ensure long-term positive outcomes in pregnant teens from low-income groups and their children?
a. Help teen mothers learn about body changes during pregnancy.
b. Develop programs that enable teen mothers to complete their education.
c. Offer courses in proper care of babies.
d. Monitor pregnant teens for early detection of problems in pregnancy.
b. Develop programs that enable teen mothers to complete their education.
A CHN who works at a clinic for homeless persons wants to institute a more efficient treatment for chronic wounds. What CHN action offers the best way to improve outcomes for these clients?
a. Administer antibiotics to all homeless persons with chronic, non healing wounds.
b. Facilitate daily access to a room with soap, water, and bandages.
c. Provide free bandaging supplies to clients at each clinic visit.
d. Regularly monitor the wound condition of clients.
b. Facilitate daily access to a room with soap, water, and bandages.
What information is most important to keep in mind when care for a pregnant teen?
a. All teen pregnancies are considered high risk.
b. Limited knowledge can lead to pregnancy complications.
c. Pregnant teens are less likely to focus on proper prenatal nutrition.
d. Pregnant teens who are poor are more likely to have poorer health conditions.
c. Pregnant teens are less likely to focus on proper prenatal nutrition.
What CHN action can help prevent depression in older adults who are at high risk for it?
a. Encourage them to move to a nursing home where they will have the company of others in the same age group.
b. Monitor for signs and symptoms of depression.
c. Organize a health promotion program for older adults at the local centre.
d. Encourage older adult clients to focus on their strengths rather than their weaknesses.
c. Organize a health promotion program for older adults at the local centre.
A CHN is concerned about caregiver stress in the children of older clients with health concerns. What secondary prevention strategy can the CHN implement to limit caregiver stress?
a. Asking caregivers how they are coping with their role.
b. Encouraging caregivers to periodically take. a few hours away from their duties.
c. Establishing support groups for caregivers of older adult parents.
d. Referring some caregiving responsibilities to home health nurses or professional caregivers.
a. Asking caregivers how they are coping with their role.
What CHN action could potentially increase accessibility to healthcare services for clients experiencing mental illness and housing instability?
a. Apply for a grant to fund a mobile clinic to take health care to clients.
b. Distribute flyers to homeless persons that detail the location of various health care services.
c. Refer homeless clients to temporary housing facilities.
d. Solicit donations for food and clothing to be distributed to the homeless.
a. Apply for a grant to fund a mobile clinic to take health care to clients.
A CHN suspects that an elementary school student is being physically abused. Which action would be the most appropriate one for the CHN to take?
a. Ask the student about the abuse.
b. Document findings in the student’s school record.
c. Discuss the suspicions of abuse with the student’s teachers of the family’s spiritual leader.
d. Notify legal authorities.
d. Notify legal authorities.
Which action by a case manager would be classified as primary prevention?
a. Advocating for the client whose values conflict with those of the medical service provider?
b. Collaborating between nursing and occupational health personnel.
c. Educating a group regarding community services that are available if they are ever needed.
d. Resolving conflict between a primary care clinic and tertiary care facility.
c. Educating a group regarding community services that are available if they are ever needed.
A client reports that the narcotic she tok for pain on a regular basis made her feel bad and that when she tried alternative alagesic, she experienced withdrawal symptoms. What is this client suffering from?
a. Drug abuse
b. Drug addiction
c. Drug dependence
d. Substance abuse
c. Drug dependence
A CHN is asked by a parent group to explain the risk factors for alcoholism. What statement should the CHN include in the explanation?
a. Alcoholism is determined solely by environment.
b. Alcoholism is determined partly by genes.
c. Alcoholism is higher in women.
d. Persons born with fetal alcohol syndrome are alcoholics form birth.
b. Alcoholism is determined partly by genes.
At a district board meeting, the CHN requests funding for an after-school recreation program that promotes healthy, fun activities in an effort to decrease substance abuse. Which level of prevention does this exemplify?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Primary and secondary prevention
a. Primary prevention
