Exam #2 Community Flashcards
A nurse reviewed some handouts before meeting the community residents attending a program on healthful living. What is this nurse’s behavior called?
b. Health promotion
What is it called when a 50-year-old woman comes to the clinic for her first screening mammogram?
c. Health protection
Which is the best definition of health?
a. A goal and a resource for living
A nurse was becoming frustrated. She had given her client extensive information on his health problem, but the client continued to be noncompliant in making needed changes. What had the nurse forgotten?
b. Information, while necessary, will not motivate people to change.
The nurse working with a client to change behavior to maximize health asked the client to bring his family to the next visit. Why would the nurse want the family to come with the client?
d. To evaluate whether the family members approve of the proposed changes
Under the Theory of Reasoned Action, what is the easiest way to determine whether a person will change his or her behavior?
a. One’s intention to perform a behavior
In addition to working with a client to change behavior to improve health, what else must be kept in mind according to the Theory of Planned Behavior?
c. The client’s belief about factors that may facilitate or impede the behavior
Why would some people believe the air within a particular building carries a risk and makes them ill?
a. They consistently feel worse on workdays and weeks without holidays.
Individual responsibility can be assumed for modifiable risk factors, but what risk factors are least subject to modification?
b. Environmental exposure
Individual responsibility can be assumed for modifiable risk factors, but what risk factors are least subject to modification?
b. Environmental exposure
What is the primary reason risk reduction is of such importance in the United States today?
c. The leading causes of death are all related to lifestyle choices
What is the cause of most preventable deaths in the United States?
d. Tobacco
Which question is the most important to be included in each client’s health history?
d. What kinds of tobacco do you use daily?
During a health history, the client looked confused and said, “But everybody drinks, like at parties and such. How much drinking do you think is too much?” How should the nurse respond?
c. Per day, no more than one drink for women and two drinks for men.
What is the primary reason that so many Americans are obese?
b. For many people, caloric intake is more than needed for their physical activity.
Based on statistics, which group is probably more physically active?
d. A group of highly paid college graduates
Which neighborhood would probably be best for someone interested in retaining his or her health?
c. One with high walkability
Which factors have a profound, if sometimes unrecognized, impact on one’s health? Select all that apply.
a. Adequate resources to allow easy access to health services
b. Interpersonal relationships with family and friends
c. Local, state, and national policies
e. Physical neighborhood where one works and lives
A, B, C, E
Which factors are included in Pender’s model explaining what influences individuals to pursue health promotion activities? Select all that apply.
a. A belief that one can change one’s behaviors
b. Environmental choices possible
d. The rewards one believes will result if action is taken
f. What one’s family and peers believe should be done
A, B, D, F
What interventions might a nurse choose based on the Health Belief Model to help a client improve his or her lifestyle choices? Select all that apply.
c. Examine the individual’s perceptions of his or her health in relation to current lifestyle behavior choices
d. Review how lifestyle changes can reduce risk and improve the client’s life
e. Share statistics regarding the probability of health problems and their seriousness if action is not taken
f. Use communication channels to send reminders of action currently needed
C, D, E, F
A nurse was becoming frustrated. It had been 2 weeks, and although the client had verbalized that the best time of day to take a 15-minute walk was early in the morning, the client had not begun to exercise. What had the nurse forgotten? Select all that apply.
a. A decision to act always occurs before action begins.
b. Behavior change is difficult and takes time.
A, B
Why do nurses often ask clients how they are sleeping? Select all that apply.
c. Many adults report sleep problems or occasional lack of sleep.
d. Many important functions occur during sleep.
C, D
What is it called when an epidemiologist writes a summary of a food poisoning outbreak, from cause to plans, for prevention in the future?
b. Descriptive epidemiology
B
Two brothers played with their cousin. One brother later became quite ill, whereas the other did not. How can this be explained?
c. Difference in genetic inheritance between the two brothers
C
When would the wheel model of epidemiology be more helpful than the epidemiological triangle model?
b. When there are multiple causes for a chronic disease
B
Why is it so important to discover all the variables that may be involved in creating a disease state in some persons?
c. To find variables susceptible to prevention or early intervention.
C
What is the advantage of the web of causation model in comparison with the epidemiological triangle model?
d. The web of causation model shows the relationships among variables.
D
The textbook summarizes a research study of sexually transmitted infections among young adults. What was determined to be a major variable in exposure to infection?
c. The environment in which the young adults lived
C
A community health nurse determined exactly how many cases of a particular disease were current in the community. What should the nurse do before determining what interventions should be planned?
b. Compare the current rate with the previous rate of disease
B
People were very concerned about another outbreak of swine flu. All care providers were asked to report, without individual names, any new cases to the public health department for tracking. What would be most helpful for local media to report to keep citizens informed?
a. The ongoing incidence rate
A
In trying to determine whether the swine flu outbreak was getting worse, what rate should be carefully observed?
c. The swine flu incidence rate
c
A newspaper published an article about the athletic banquet at the local high school that had approximately 1000 family members in attendance. Exactly 650 persons became ill within 24 hours, complaining of severe diarrhea, vomiting, and cramping. What is the attack rate?
c. 650:1000
c
In a particular community, the rate of new cases of diabetes and the rate of new cases of flu during the month of January were precisely the same. Which disease would have the higher prevalence rate?
b. As a chronic condition, diabetes would have the higher prevalence rate.
b
Why do we not know the incidence or prevalence of gonorrhea?
a. Gonorrhea is not a reportable condition.
a
Which group should be used for determining the community’s pregnancy rate?
d. Women between 15 and 45 years old in the community
d
Which research study would determine the attributable risk of a sedentary lifestyle in cardiac disease?
c. Subtracting the rate of cardiac disease among athletes from the rate of cardiac disease among nonathletes
c
A nurse did a study of two skin lotions: an inexpensive one and an expensive one. The nurse found that there was a risk factor of 0.7 for skin sores using the inexpensive one and a risk factor of 1.2 using the expensive one. Which one should the nurse use?
d. The inexpensive lotion
What is the name for the model that demonstrates the progression of disease from prepathogenesis through disease outcome?
c. Natural history model
What level of prevention does a screening examination, required for each school athlete before being active in school sports, represent?
c. Secondary prevention
What disease would be the best choice for screening if any of the following were possible?
b. Disease B, which can be controlled if caught early in the disease process
One hundred women received notification that their screening tests suggested that they might have a serious health problem. How can you reassure these scared women so they will come in for follow-up testing and treatment?
c. Point out that screening is only suggestive and that not all positive screenings mean they actually have the health problem.
What is the best way to increase the positive predictive value of a screening test?
b. Test a group at high risk for the health problem
Healthy People 2020 establishes goals for improving the health of all Americans. What is most necessary to determine whether Americans’ health is improving?
b. Comprehensive and systematically collected surveillance data on the health status of various population groups
Which kind of study would be most helpful in examining potential risk factors in comparison with disease at a specific time through collecting data regarding current exercise, sleep patterns, and current health status among 12-year-olds?
a. Cross-sectional study
A researcher, interested in the onset of early menses, compared the life experiences and history of 1000 14-year-old girls, half of whom had monthly periods and half of whom did not, to determine what variables might be observed. How would this study be categorized?
c. Retrospective study
One famous study followed a cohort of nurses over their lives, collecting data and health histories as they aged. What kind of study is this?
b. Prospective study
A researcher wanted to engage in the best possible research design to obtain reliable information about the possible cause(s) of a disease. Which design would the researcher choose?
c. Prospective study
Which research design would a researcher with limited time and funds probably choose?
d. Retrospective study
On the basis of findings related to elevated blood levels of cholesterol, a researcher wanted to determine whether a new drug would notably lower the blood levels of cholesterol in otherwise healthy persons. What kind of study would the researcher probably choose?
b. Experimental study
The lack of certain B vitamins can result in pellagra. Where would a nutritional deficiency fit in the agent-host-environment model?
b. Agent factor
What is the Tuskegee Syphilis Study best known for today?
d. Unethical and racist treatment of uninformed subjects
What types of data do epidemiologists gather to try to determine which factors may lead to disease? Select all that apply.
a. Demographic characteristics
c. Geographic data
f. When disease struck the area
What is the advantage of the ecosocial epidemiology model over both the web of causation model and the epidemiological triangle model? Select all that apply.
a. It decreases the focus on the individual person.
c. It emphasizes the role of complex political and economic context.
f. Its use suggests possible public policy interventions.
Which factors are necessary to assume there might be a cause-effect relationship between a particular variable A and a specific illness? Select all that apply.
a. It is easy to understand how the variable A could lead to the illness.
b. Research studies consistently demonstrate a relationship between variable A and the illness.
d. The more of variable A present, the sicker the person becomes.
A nurse wanted a screening test that was very sensitive in determining who might have a particular illness. What might be a problem with using such a sensitive test? Select all that apply.
c. Persons who do not have the illness are told that they might, which leads to anxiety, as well as time and cost of follow-up diagnostic tests.
d. Such a test may have lower specificity, so some persons with the disease are told they are disease free and hence do not receive care.
Why would a patient not do what the nurse instructs after being told several times what needs to be done to get better?
A. Barriers prevent action.
What did Florence Nightingale suggest is one of the most fundamental nursing principles?
B.Constantly engage in health teaching.
Why might health education in the community be more effective than health education in a professional setting such as a hospital or clinic?
C. The setting is familiar and comfortable to participants.
What must the nurse do before implementing a comprehensive and entertaining educational program?
B.Develop an open and trusting relationship with participants.
Why is there such a community health emphasis on heath education programs?
A. Behavioral change must be voluntary.
What is the chief determinant of whether a health education program will create change?
A. Amount of input and participation by learners
What is the best way to choose the goals for a particular educational program?
D. The target audience must determine their needs and priorities.
What factor is crucial to plan an effective health education program?
C. The sociopolitical cultural context of the community’s environment
How does one know if learning has occurred?
D. There is a long-term change in knowledge and behavior.
What led to the creation of the Health Belief Model (HBM)?
D. Attempting to understand why people did not flock to free health care
Which factor is the main determinant of behavior within the Health Belief Model?
B. Perceived benefits of engaging in healthy behaviors
What is a factor found in the Health Belief Model (HBM) that is not a factor in Pender’s Health Promotion Model (HPM)?
C. Personal threat as motivator
What is the primary purpose of both the HBM and HPM models?
c.
To help explain why individuals do or do not engage in health actions
d.
To help professionals know how to intervene in client decisions
C. To help explain why individuals do or do not engage in health actions
Which method is most consistent with Freire’s approach to empowerment?
A. Encouraging active participation and dialogue in critical reflection
What is the most crucial skill for a nurse teaching diabetic self-care in a small group?
D. Listening carefully to understand participants’ issues
What is the most likely reason that a nurse responsible for teaching spends more time being quiet than giving information?
D. The nurse is listening to the group’s dialogue to identify problems.
What is the goal of participatory action research?
Social change resulting from stakeholders’ strategies
D. Social change resulting from stakeholders’ strategies
What would be an appropriate response if a nurse were asked, “Why are you so rarely in the department office?”
A. “I have to be where the people are.”
A very busy day was planned at a community health fair. Why would a nurse spend time greeting and meeting each new person who walked in?
B. To immediately establish a friendly relationship and a level of trust
What nurse behavior would be most effective at creating a base for providing culturally effective care?
C. Exhibiting sensitivity to individual differences resulting from culture and experiences
What is the first and most crucial step according to the Framework for Developing Health Communications?
D.Target the program to meet the audience’s learning needs as they perceive them
What is the best way for the nurse to be sure that the teaching material and communication channels will be effective?
D. Pretest the materials with members of the target group to obtain feedback about their acceptability and understandability
How is “health literacy” operationally defined in the United States?
C. Knowing how to access and use information to make health decisions
When handed the consent form to sign before treatment could be given, a patient looked at the nurse and said, “I’m sorry; I forgot my glasses today.” What should the nurse do?
D, Wonder if the patient might have difficulty with reading and therefore summarize the content of the form for the client
How can a nurse determine a patient’s reading level?
A. Ask, “Do you find it useful to have someone help when you receive written material from your doctor or pharmacy?”
Why would the nurse continue to ask questions and encourage attendees to contribute examples from their own lives relevant to the discussion?
C. Because persons learn by doing through active participation
What may help the nurse be effective in helping clients change their behavior?
A. Counseling through the Ask, Advise, Assess, Assist, and Arrange approach
What does Knowles say is especially typical of adult learners? Select all that apply.
c.
Learning draws on the learner’s previous life experiences.
e.
Sharing experiences with others enriches and motivates learning.
f.
They want information related to current developmental tasks.
CEF
Which of these can be found in both the Health Belief Model and Pender’s Health Promotion Model? Select all that apply. a. Cues to action b. Demographics c. Perceived barriers d. Perceived benefits
ABCD
What variables are missing from both the HBM and HPM models? Select all that apply.
a.
Ignoring the impact of being socially and politically disenfranchised
b.
Inaccessibility of health services
d.
Omitting the influence of social, structural, and physical environmental factors
ABD
A nurse involved with a community group told peers that the group was learning networking, negotiating, lobbying, and information seeking. Why isn’t the nurse working toward a noticeable improvement in health status for the group? Select all that apply.
b.
Networking, negotiating, lobbying, and information seeking will continue to be useful throughout the participants’ life span.
d.
There are no immediate solutions to the current health problems in most communities.
BD
Which suggestions would be helpful for effective teaching? Select all that apply.
a. Be encouraging and give positive feedback for helpful comments
d. Review and summarize the key points at periodic intervals
e. Incorporate demonstrations, illustrations, and real-life examples
ADE
What might be the result if a health care provider charged more than the managed care organization typically paid for a procedure?
C. Provider would get the typical payment instead of what was charged.
What would be the easiest way to explain case management to a client?
d. “With your input we will coordinate your care for the best outcome.”
D. “With your input we will coordinate your care for the best outcome.”
A hospital was going to start a care management program. Which group of clients may be selected to first receive such services?
c. Clients with potentially better outcomes if their care was more carefully coordinated
Who first created the idea of a continuum of care, which later evolved into the term “case management”?
d. Those who coordinated services for discharged psychiatric patients after World War II (WWII).
What was the aftermath of the deinstitutionalization of mentally ill patients into the community during the 1970s?
d. Without follow-up care, many clients were readmitted to care.
d. Without follow-up care, many clients were readmitted to care.
Which elderly persons are often the targets of case management?
b. Those who live alone without close relatives
What is the purpose of case management from the client’s perspective?
a. To help clients navigate a complex, fragmented, confusing health care system to obtain appropriate care
For hospitalized patients, when is case management implemented?
A. Immediately on admission
Why are utilization review departments becoming case management units?
b. Monitoring service use alone does not improve patient outcomes.
Why are health care institutions unhappy beyond the fact that they are not receiving the previous high reimbursement for procedures from Medicaid or Medicare?
b. Because insurance companies and other third-party payers copy Medicaid’s approach to holding down costs
Why are nurses increasingly becoming case managers when social workers have historically been so successful in the role?
a. Because of the need for ongoing patient assessment.
a. Because of the need for ongoing patient assessment.
A very skilled baccalaureate-prepared clinical nurse was asked to assume a case manager role. What will initially be the most difficult for the new case manager?
c. Gaining knowledge of reimbursement structures and financial strategies
What is the biggest influence on the case manager’s role?
d. The specific program that employs the case manager
How may a client continue to receive care management services after the existing program services expire?
b. Pay for such services via contract
The case manager gave the client a list of eight possible sources for the equipment needed for care after discharge. Why did the nurse not just tell the client the best source for the equipment?
a. The client has a right to select providers of needed resources.
What are the goals of nursing case management regardless of setting? Select all that apply.
b. Contain costs and control use of services
c. Decrease duplication and fragmentation
d. Enhance client’s quality of life
BCD
Which clients may be eligible for hospital-based, disease-specific case management support? Select all that apply.
a. A large group of patients who have high-cost conditions
c. Those who may be maintained in a stable condition in their home environment
AC
What are considered core functions of a case manager? Select all that apply.
a. Assessment and diagnosis of needs
b. Coordination and collaboration with others
d. Monitoring and evaluating patient status
ABD
How does the case manager identify people who would benefit from case management services? Select all that apply.
a. Evidence-based criteria
d. Referrals from health care providers or agencies
e. Risk identification from data management
f. Use of health risk screening tools
ADEF
Under the New England model of case management, how does the nurse determine the appropriate financial cost of care? Select all that apply.
b. Discharge of the patient within the allotted number of allowed hospital days
f. Use of a diagnosis-appropriate critical pathway
BF
