Chapter 3 Community-Based Nursing Practice

Question 1

Community-based health care is a?

Answer 1

Collaborative, evidence-based model designed to meet the health care needs of a community

Question 2

Community-based health care is a model of care that reaches?

Answer 2

Everyone in a community (including the poor and underinsured), focuses on primary rather than institutional or acute care, and provides knowledge about health and health promotion and models of care to the community

Question 3

Public health services aim at achieving a?

Answer 3

Healthy environment for all individuals

Question 4

Our health is also determined in part by access to?

Answer 4

Social and economic opportunities; the resources and support systems available in our homes, neighborhoods, and communities; the quality of our schooling; the safety of our workplaces; the cleanliness of our water, food, and air; the nature of our social interactions and relationships

Question 5

Soical determinants of health are factors that?

Answer 5

Contribute to a person’s current state of health

-factors may be: biological socioeconomic, psychosocial, behavioral, or social in nature

Question 6

Scientists generally recognize 5 determinants of health:

Answer 6

1) biology & genetics (sex & age)
2) individual behavior (such as alcohol, injection drug use, unprotected sex, and smoking)
3) Social environment (such as discrimination, income, & gender)
4) physical environment (where a person lives or crowding condition
5) health services (such as access to quality health care and having health insurance)

Question 7

Health disparities negatively affect groups of people who have systematically experienced social or economic obstacles to health. These obstacles stem from characteristics historically linked to?

Answer 7

Discrimination or exclusion such as race or ethnicity, religion, socioeconomic status, gender, mental health, sexual orientation, or geographic location
-other characteristics include cognitive, sensory, or physical disability

Question 8

Health disparities are?

Answer 8

Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations

Question 9

Populations can be defined by factors such as?

Answer 9

Race or ethnicity, gender, education or income, disability, geographic location (rural or urban), or sexual orientation

Question 10

Health disparities are inquitable and are directly related to the historical and current?

Answer 10

Unequal distribution of social, political, economic, and environmental resources
-they result from multiple factors including poverty, environmental threats, inadequate access to health care, individual and behavioral factors, & educational inequalities

Question 11

A public health nursing focus requires?

Answer 11

Understanding the needs of a population or a collection of individuals who have one or more personal or environmental characteristics in common
-population examples: high risk infants, older adults, or an ethnic group such as Native Americans

Question 12

A public health nurse understands factors that influence?

Answer 12

Health promotion and health maintenance, the trends and patterns influencing the incidence of disease w/in populations, environmental factors contributing to health & illness, & the political processes used to affect public policy
-example: a nurse uses data on increased incidence of playground injuries to lobby for a policy to use shock absorbed material rather than concrete

Question 13

Public health nursing requires

Answer 13

Preparation at the basic entry level and sometimes a BSN that included educational preparation and clinical practice in public health nursing
-a specialist in public health has a graduate level education with a focus in the public health sciences

Question 14

Community health nursing

Answer 14

Nursing practice in the community, with primary focus on the health care of individuals, families, and groups w/in the community

• provides direct care services to subpopulations w/in community
• example: a case manager follows older adults recovering from stroke and sees the need for community rehabilitation services, or a nurse practitioner gives immunizations to pt’s with the objective of managing communicable disease w/in community

Question 15

Goal of community health nursing

Answer 15

Preserve, protect, promote, or maintain health

- the emphasis of such nursing care is to improve the quality of health and life within that community

Question 16

Community health nursing requirements

Answer 16

Not as clear as public health, not all agencies require advanced degree
-nurses w/graduate degree in nursing who practice in community settings are considered community health nurse specialists, regardless of public health experience

Question 17

Care takes place in a community settings such as a home or clinic, where nurses focus on the needs of an individual or family

Answer 17

Community-based nursing

Question 18

With the individual and family as the patients, the context of community-based nursing is?

Answer 18

Family-centered care within the comunity
-this focus requires a strong knowledge base in family theory, principles of communication, group dynamics, and cultural diversity

Question 19

Groups of patients who are more likely to develop health problems as a result of excess health risks, who are limited to access to health care services, or who depend on others for care

Answer 19

Vulnerable populations

Question 20

Immigrant populations often have higher rates of?

Answer 20

HTN, diabetes mellitus, and infectious diseases; decreased outcomes of care; and shorter life expectancies

Question 21

The immigrant population practices?

Answer 21

Non traditional healing practices

Question 22

Risk factors for abusive relationships include

Answer 22

Mental health problems, substance abuse, socioeconomic stressors, and dysfunctional family relationships

Question 23

A community nurse in a diverse community is working with health care professionals to provide for prenatal care for under employed and under insured South African women. Which overall goal of Healthy People 2020 does this represent?

Answer 23

Increase life expectancy and quality of life and to eliminate health disparities

By providing prenatal care to this group of women, the nurse improves the birth outcomes for their children and in turn the child’s quality of life. Underinsured represent a health disparity, and Healthy People 2020 aims to decrease this inequity.

Question 24

Vulnerable populations of patients are those who are more likely to develop health problems as a result of:

Answer 24

Excess risks, limits in access to health care services, and dependency on others for care

It is the excess of risks and combination of risk factors that make this population more vulnerable. These vulnerabilities can be associated with the individual’s/community’s social determinants of health or individual health disparities.

Question 25

Following a community assessment that focused on adolescent health behaviors, the nurse determines that a large number of adolescents smoke and designs a smoking cessation at the youth community center. This is an example of which nursing role:

Answer 25

Counselor

To engage a patient to participate in a smoking cessation program or any program that requires changing a behavior requires the nurse to act as a counselor to support the patient in changing that behavior (e.g., in this case a smoking habit). The nurse does not educate the patient about the dangers of smoking but first must actively counsel him or her to decide to change the behavior. Without support and counseling, the smoking cessation education may not be used effectively by the patient.

Question 26

The nurse in a new community based clinic is requested to complete a community assessment. What is the order for completing this assessment?
1. Structure or locale 2. Social systems3. Population

Answer 26

1, 3, 2

To begin a community assessment, the structure and geographic boundaries of the community are identified. Look at the structures in the community (e.g., schools, churches, types of residences). Next obtain data about the population and the demographics of the community. Who are the residents of the community, what is the age range, which types of ethnicity are represented? Last, review the social systems in the community.

Question 27

Which of the following are major public health problems commonly affecting older adults? (Select all that apply.)

Answer 27

Substance abuse
Confusional states
Financial limitations
Acute and chronic physical illnesses
The older-adult population frequently has restricted or fixed income levels and a higher percentage of chronic and physical illnesses. The management of these illnesses further depletes the financial resources of the older-adult population, further increasing their risks for health problems.