Community - Week 2 (Ch 3 7 8) - Evolve Questions Flashcards
The federal agency most responsible for improving the health status of the American people is the:
A. Office of Health Preparedness.
B. Office of Global Affairs.
C. Food and Drug Administration.
D. U.S. Department of Health and Human Services.
D. U.S. Department of Health and Human Services.
The U.S. Department of Health and Human Services (USDHHS) is the federal agency most heavily involved with the health and welfare concerns of U.S. citizens. The department includes the Office of the Secretary, 11 agencies, and a program support center. It is charged with regulating health care and overseeing the health status of America. Newer areas in the HHS are the Office of Public Health Preparedness, the Center for Faith-Based and Community Initiatives, and the Office of Global Affairs. The Office of Public Health Preparedness was added to assist the nation and states to prepare for bioterrorism after September 11, 2001.
DIF: Cognitive Level: Knowledge
REF: Page 40
A nurse works in a free clinic for uninsured low-wage employees in the community. The free clinic setting operates in a primary health care (PHC) strategy. The nurse would most likely focus on: A. Incidence of the disease. B. Physician orders for the individual. C. Pathophysiology of the disease. D. Self-care/management.
D. Self-care/management.
Primary health care (PHC) is generally defined more broadly than is primary care. It includes a comprehensive range of services including public health; prevention; and diagnostic, therapeutic, and rehabilitative services. PHC is essential care made universally accessible to individuals and families in a community. Health care is made available to them with their full participation and is provided at a cost that the community and county can afford. PHC encourages self-care and self-management in health and the social welfare of daily life. PHC does not provide a focus on incidence of disease, pathophysiology of disease, or individual orders for care.
DIF: Cognitive Level: Application
REF: Page 39
Parents can expect their children to be immunized for communicable diseases before entering kindergarten in the local school system because:
A. primary care clinics focus on prevention.
B. primary care clinics maintain adequate supplies of immunization.
C. the public health system has mandates for immunization.
D. the public health system provides good access to immunization clinics.
C. the public health system has mandates for immunization.
Although the goal of the public health system is to ensure that the health of the community is protected, promoted, and ensured, overlap exists between this system and the primary care system. The overlap comes from the primary care system, which provides health promotion and disease prevention, and through the public health system, which provides personal primary care services for those who cannot afford to receive care elsewhere. The public health system is mandated through laws that are developed at the national, state, and local levels. Examples of public health laws instituted to protect the community are laws mandating immunization for all children entering kindergarten or laws requiring the constant monitoring of the local water supply to make sure that it meets set standards.
DIF: Cognitive Level: Application
REF: Page 40
A nurse who questions whether a particular activity in her job description is within her scope of practice would look to which government jurisdiction or agency to seek the clarification?
A. Federal system
B. State system
C. Department of Labor
D. U.S. Department of Health and Human Services
B. State system
Every state has a board of examiners of nurses. The board may be in the department of licensing board of the health department or in an administrative agency of the governor’s office. Created by legislation known as a state practice act, the examiners’ board is made up of nurses and consumers and, in a few states, other providers and/or administrators. The functions of the board are described in the practice act of each state and generally include licensing and examination of registered nurses and licensed practical nurses; approval of schools of nursing in the state; revocation, suspension, and denial of licenses; and writing of regulations about nursing practice and education. The Department of Labor, the Department of Health and Human Services, and other federal agencies are not responsible for licensure at the state level.
DIF: Cognitive Level: Application
REF: Page 44
A nurse in community health that administers a local WIC program for women, infants, and children is participating in a federal-state collaborative program that receives oversight from the:
A. Department of Agriculture (DOA).
B. Department of Defense (DOD).
C. Department of Health and Human Services (DHHS).
D. Department of Labor (DOL).
A. Department of Agriculture (DOA).
The Department of Agriculture is involved in health care primarily through administering the Food and Nutrition Service, which oversees a variety of food assistance activities in collaboration with state and local government welfare agencies to provide food stamps to needy persons to increase their food purchasing power, as well as school breakfast and lunch programs, grants to states for nutrition education training, and WIC, a supplemental food program for women, infants, and children. The Department of Defense provides health care for members of the military and their dependents. The Department of Health and Human Services maintains primary responsibility for the health of the American people. Agencies within the Department of Labor develop safety and health standards and ensure compliance.
DIF: Cognitive Level: Application
REF: Pages 43-44
Implementing a community-level program, such as walking for exercise, to assist citizens in improving health behaviors is an example of which level of prevention? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Disease promotion
A. Primary prevention
Implementation of a community level program like walking for exercise to assist citizens in improving health behaviors related to lifestyle is an example of primary prevention at the public health level. Implementation of a family-planning program to prevent unintended pregnancies for young couples who attend the local community health center is a secondary prevention activity. An example of tertiary prevention at the public health level is the self-management asthma program for children with chronic asthma to reduce their need for hospitalization. These examples are not disease promotion measures.
DIF: Cognitive Level: Application
REF: Page 44
What are some examples of programs which may be provided at the local health department level? (Select all that apply.)
A. Immunization clinics
B. Health education
C. Family planning services
D. Licensing of health care professionals
E. Quality and safety data
A. Immunization clinics
B. Health education
C. Family planning services
Some examples of programs that may be offered by local health departments include immunization clinics, health education, and family planning. The range of services varies considerably depending on the size of the area served and the resources available to fund programs. Licensing of health care professionals is conducted at the state level and quality and safety data is typically provided by federal entities.
DIF: Cognitive Level: Application
REF: Page 45 (Box 3-5)
What are some of the effects of technology in the area of home health care? (Select all that apply.)
A. High technology equipment increases expense.
B. Technology decreases legal liability.
C. Technology has the potential for increased privacy.
D. Technology quickly becomes outdated when newer developments occur.
E. There is inconsistent quality of resources available on the Internet.
A. High technology equipment increases expense.
D. Technology quickly becomes outdated when newer developments occur.
E. There is inconsistent quality of resources available on the Internet.
Cost is the most significant negative aspect of advanced health care technology. The more high-technology equipment and computer programs become available, the more they are used. High-technology equipment is expensive, quickly becomes outdated when newer developments occur, and often requires highly trained personnel. There are other drawbacks to new technology, particularly in the area of home health care. These include increased legal liability, the potential for decreased privacy, too much reliance on technological advances, and the inconsistent quality of resources available on the Internet and other places.
DIF: Cognitive Level: Knowledge
REF: Page 36
What are some of the benefits of an electronic medical record in the public health setting? (Select all that apply.)
A. Timely billing and financial reimbursement for services provided
B. Improved public reporting of medication errors
C. Coordination of referrals and facilitation of chronic disease management
D. Improvement of quality measurement and monitoring
E. Incorporation of protocol reminders for prevention, screening, and management of chronic disease
The electronic medical record (EMR), a form of electronic health record, helps with ensuring patient safety and quality care. The availability of an EMR system allows the embedding of reminders so that the clinician can have access to practice guidelines at the very point of care for patients. Some additional benefits in public health, and these are some of the uses health centers make of such records, include the following:
· 24-hour availability of records with downloaded laboratory results and up-to-date assessments
· Coordination of referrals and facilitation of interprofessional care in chronic disease management
· Incorporation of protocol reminders for prevention, screening, and management of chronic disease
· Improvement of quality measurement and monitoring
· Increased client safety and decline in medication errors
DIF: Cognitive Level: Knowledge
REF: Page 37
Primary care refers to personal health care for the most common needs of members of a community. Which of the following statements also differentiates primary care from primary health care? (Select all that apply.)
A. Primary care consists of a multidisciplinary team.
B. Primary care is provided within the context of family and community.
C. Primary care encourages self-care and self-management.
D. Primary care provides first-contact, continuous, comprehensive, and coordinated care.
E. Primary care provides preventive, curative, and rehabilitative services.
B. Primary care is provided within the context of family and community.
D. Primary care provides first-contact, continuous, comprehensive, and coordinated care.
Primary care refers to personal health care that provides first-contact and continuous, comprehensive, and coordinated care. The providing of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with clients, and practicing in the context of family and community. Primary health care is defined more broadly than is primary care. Primary health care is “essential care” made universally accessible to individuals and families in a community with the full participation of the community and provided at a cost that the community/county can afford. The primary health care workforce is a multidisciplinary team that includes providers from multiple disciplines, community outreach workers, allied health professionals, translators, and community members themselves.
DIF: Cognitive Level: Knowledge
REF: Page 48; Box 3-1 on page 34
A public health nurse has identified the need to make amendments in an existing law concerning the TB health assessment of individuals sentenced to serve jail terms on weekends only, based on the current criminal justice system practices and potential health risk to the free-living community. To raise this concern, the nurse has several paths to follow, but the amendment of any existing laws would ultimately be decided by:
A. the executive branch of the government.
B. the legislative branch of the government.
C. local representatives.
D. senate hearings.
B. the legislative branch of the government.
Each of the government branches at the federal, state, and local levels plays an important role in developing and implementing health law and public policy. Concerned citizens have many avenues to address issues related to required laws and regulations as well as existing laws and regulations. However, each branch of government has separate and important functions. The legislative branch identifies problems, proposes debates, and passes and modifies laws to address identified problems.
DIF: Cognitive Level: Comprehension
REF: Page 110
Several community-oriented nurses want to explore the problem of obesity in school-age children and assess their community school district health status related to that problem. When gathering information at a national level, they would begin with the:
A. Centers for Disease Control and Prevention (CDC).
B. Centers for Medicare and Medicaid Services (CMS).
C. Health Resources and Services Administration (HRSA).
D. National Institute of Nursing Research (NINR).
A. Centers for Disease Control and Prevention (CDC).
The Centers for Disease Control and Prevention (CDC) serves as the national focus for developing and applying disease prevention and control, environmental health, and health promotion and education activities designed to improve the health of the people of the United States. The Centers for Medicare and Medicaid Services (CMS) administer Medicare and Medicaid accounts and guide payment policy and delivery rules for services for the poor, elderly, disabled, and unemployed. HRSA has been a long-standing contributor to the improved health status of Americans through the programs of services and health professions education that it funds. The NINR is the focal point of the nation’s nursing research activities.
DIF: Cognitive Level: Application
REF: Page 115
A mother brings her child to the nurse’s office a few days before the first day of class for the new school year. The mother wants the child to begin school but says, “I’m going to take care of the immunizations tomorrow.” The most important action the nurse should take is to:
A. conduct a physical exam to determine whether the child is healthy.
B. explain to the parent that all required immunizations must be given before the child will be allowed to enter school.
C. let the child begin school but ensure that the school keeps the child separated from the other children.
D. make sure the child does have an appointment for tomorrow.
B. explain to the parent that all required immunizations must be given before the child will be allowed to enter school.
Community-oriented nursing practice interacts with many legal aspects of nursing in community health. Nurses employed by health departments or boards of education may deliver school and family health nursing, a specialty area of practice with its own legal aspects. School health legislation establishes a minimum of services that must be provided to children in public and private schools. Children must have immunizations against certain communicable diseases before entering school.
DIF: Cognitive Level: Application
REF: Pages 120-121
A public health nurse employed by the Department of Health is working on a team developing local health policy. The nurse recognizes which of the following about policy development?
A. It is based on Socratic method.
B. It is important that the policy has been approved by the American Nurses Association.
C. It is primarily up to politicians to plan for health care.
D. It is very similar to the nursing process.
D. It is very similar to the nursing process.
Health policy is simply the process of turning health problems into workable action solutions. Thus, the policy process is very similar to the nursing process, but the focus is on the level of the larger society, and the adoption strategies require political action. The policy process includes the following:
· Statement of a health care problem
· Statement of policy options to address the health problem
· Adoption of a particular policy option
· Implementation of the policy product
· Evaluation of the policy’s intended and unintended consequences in solving the original health problem
DIF: Cognitive Level: Application
REF: Page 121
Politics is simply described as:
A. the ability to fund a special project.
B. the art of influencing others.
C. business conducted in the senate.
D. interaction between the policymakers and the public.
B. the art of influencing others.
Politics is the art of influencing others to accept a specific course of action. Therefore, political activities are used to arrive at a course of action (the policy). Law is a system of privileges and processes by which people solve problems based on a set of established rules. Policies are made not only by governments but also by institutions such as a health department or other health care agency, a family, or a professional organization. Politics are associated with funding, business conducted in the senate, and interaction between policymakers and the public but these are not the correct definition of the term.
DIF: Cognitive Level: Knowledge
REF: Page 110
