Chapter 32

Question 1

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 1

ANS: A
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 2

Which 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 than the general population
d. Have worse outcomes with better access to health care than the general population

Answer 2

ANS: A

Vulnerable population groups are more sensitive to risk factors and have worse health outcomes.

Question 3

The differential vulnerability hypothesis 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 3

ANS: B
The differential vulnerability hypothesis refers to the possession of and/or an increased susceptibility to multiple cumulative risk factors in vulnerable groups.

Question 4

Which is an example of a priority population group?

a. People earning more than $100,000/year
b. People earning less than $100,000/year
c. Residents of remote rural areas of Canada
d. African American physicians

Answer 4

ANS: C
Priority population groups are those targeted by national governments for special emphasis in health care goals because they have particularly poor health status.

Question 5

An example of a vulnerable group experiencing multiple risk factors is:

a. Smokers who use chewing tobacco as well as cigarettes
b. Substance abusers who test positive for human immunodeficiency virus (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 5

ANS: B
Multiple risk factors are present in substance abusers, including contracting HIV and hepatitis B virus. Homelessness is another risk factor.

Question 6

A 17-year-old pregnant cocaine addict who is homeless is considered:

a. At risk
b. A special population
c. A Healthy People 2020 target group
d. A vulnerable individual

Answer 6

ANS: D

Vulnerable individuals often have multiple risk factors.

Question 7

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

a. Priority population groups
b. Health disparities
c. Disadvantaged populations
d. Risk markers

Answer 7

ANS: B
The wide variations in health services and health status between certain population groups are called health disparities.

Question 8

What is the primary cause of vulnerability?

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

Answer 8

ANS: C

The primary cause of vulnerability is poverty.

Question 9

Which population is most likely to be affected by poverty?

a. Women
b. Men
c. Two-parent families
d. Adoptive families

Answer 9

ANS: A

Women are more likely to be affected by poverty than other population groups.

Question 10

A nurse operates a school-based clinic in a local school, making it easier for children to access health care. This is an example of:

a. Case finding
b. Wrap-around services
c. Outreach
d. Comprehensive services

Answer 10

ANS: C

Outreach is an approach to making health care more readily available to certain populations.

Question 11

An example of a health disparity is:

a. Childhood immunization rates
b. High dropout rates
c. Unemployment
d. Income below poverty level

Answer 11

ANS: A
High dropout rates, unemployment, and income below poverty level are social conditions that may lead to health disparities.

Question 12

A nurse is developing a one-stop service to meet the needs of a vulnerable group. Which is an example of this type of service?

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 12

ANS: C
Providing multiple services during a single clinic visit makes services more responsive to the combined effects of social and economic stressors.

Question 13

Which vulnerable group 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. Two-year-old boy of underinsured parents
d. Recently unemployed father of five

Answer 13

ANS: B

A poor, older woman with no means of transportation has a combination of risk factors.

Question 14

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 14

ANS: A
This act sought direct payments to eligible individuals to ensure a minimum level of support for people at risk of problems from inadequate financial resources.

Question 15

A client is self-employed as a mechanic and has limited health insurance coverage. This client is considered:

a. Poor
b. Near poor
c. Medically indigent
d. Uninsured

Answer 15

ANS: C

Persons who are self-employed but have inadequate health insurance are considered medically indigent.

Question 16

A mental health nurse working in the 1960s received additional education to provide care for the severely mentally ill in the community because of which legislation?

a. Community Mental Health Centers Act
b. Stewart B. McKinney Homeless Act
c. National Health Planning and Resource Development Act
d. Patient Protection and Affordable Care Act

Answer 16

ANS: A
The Community Mental Health Centers Act funded construction of community mental health centers and training of mental health professionals who provided community-based care for the severely mentally ill individuals who were discharged from state mental hospitals.

Question 17

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

a. Health literacy
b. Ethnicity
c. Medical training
d. Disparity

Answer 17

ANS: A

A measure of a patient’s ability to read, comprehend, and act on medical instructions is health literacy.

Question 18

Which is an example of a social determinant of health?

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

Answer 18

ANS: B
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.

Question 19

A nurse caring for a homeless population recognizes that those who are homeless:

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 19

ANS: C
Homeless and marginally housed people must struggle with heavy demands as they try to manage daily life because their resources are limited.

Question 20

Which demonstrates the removal of a barrier to health care?

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 20

ANS: D
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 21

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

a. Social justice
b. Advocacy
c. Linguistically appropriate health care
d. A waiver

Answer 21

ANS: B

A set of actions one undertakes on behalf of another is advocacy.

Question 22

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

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

Answer 22

ANS: C
Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

Question 23

How can nurses promote social justice?

a. By contacting lawmakers about environmental health issues
b. By assisting at homeless shelters
c. By advocating for policies to improve social conditions
d. By serving on a local coalition to prevent obesity

Answer 23

ANS: C
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 24

Which is the most appropriate action for a nurse when planning and implementing care for vulnerable populations?

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 24

ANS: D

These are some of the multiple roles nurses perform with vulnerable populations.

Question 25

Which trends are occurring among 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

Answer 25

ANS: A, B, D

Elimination of disparities is not a trend related to caring for vulnerable populations.

Question 26

Which interventions are completed as a nurse “sets the stage” when assessing members of vulnerable population groups? 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

Answer 26

ANS: A, B, C
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.