Historical Influences on Community and Public Health Nursing

Question 1

POPULATION FOCUSES NURSING

Answer 1

Problems are defined (assessments/diagnoses) and solutions (interventions), such as policy development or providing a given preventive service, are implemented for or with a defined population or subpopulation as opposed to diagnoses, interventions, and treatment carried out at the individual level.

Question 2

EQUITY

Answer 2

The state in which everyone has the opportunity to reach their full potential and no one is disadvantaged from achieving this potential due to social position or any other socially defined circumstance.

Long-standing inequity
violence
systemic racism
both called public health crises
challenges for nurses and health care systems.

Question 3

major health organizations in community and public health settings

Answer 3

(WHO, OSHA, CDC)

Question 4

Quotation from Pearl S. Buck
“If you want to understand today, you have to

Answer 4

search yesterday.”

Question 5

first hospital in the United States was established

Answer 5

in Philadelphia, Pennsylvania, in 1751 by Dr. Thomas Bond and Benjamin Franklin.

Question 6

Florence Nightingale

Answer 6

founder of modern nursing
best known for her work to improve care on the battlefield and in the hospital
‘LADY WITH THE LAMP’

Question 7

Shattuck report of 1850,

Answer 7

connected sanitation to disease in Massachusetts and laid the groundwork for public health as a discipline

Question 8

Lillian Wald (1867-1940),
SHE COINED THE TERM

Answer 8

-The first public health nurse
-considered the founder of public health nursing
-FIRST TO WORK WITH INSURANCE COMPANY - MET LIFE - TO PROVIDER COVERAGE FOR WORKERS
-established the Henry Street Settlement House in 1893 (CARED FOR AND PROVIDED EDUCATION ON HEALTH/ HYGIENE/ CHILD CARE),
- ESTABLISHED VISITING NURSE SERVICE OF NEW YORK CITY
“PUBLIC HEALTH NURSE”

Question 9

Jesse Sleet Scales,(1865-1956)

Answer 9

the first Black public health nurse in the U.S

INITIALLY WORKED WITH BLACK FAMILIES WITH TB

ESTABLISHED STILLMAN HOUSE (PART OF HENRY STREET SETTLEMENT TO CARE FOR BLACK FAMILIES)

Question 10

D’Antonio maintains that it was nursing care, not medical care, that

Answer 10

made the difference in whether people lived or died during the flu epidemic of 1918

D’Antonio states that the skilled care of the nurses in helping families manage fever and dehydration was life-sustaining

Question 11

In 1921, the importance of public health nurses in providing maternal and child health care was recognized by the passage of

Answer 11

The Sheppard Towner Act, which provided funding for such care

Question 12

President Harry Truman to call public health nurses

Answer 12

“one of the most important groups of health care workers in the country”.

Question 13

The Nurse Training Act of 1943 established the

Answer 13

Nurse Cadet Corps and prohibited discrimination.
This opened the door for Black nurses who, prior to this time, were not allowed to join the Red Cross, the military, or the major professional nursing organizations

Question 14

Nurses Were First Called

Answer 14

“Public Health Nurses

Question 15

Clara Barton (1821-1912)

Answer 15

nurse in the patent office during the U.S. Civil War

“Angel of the Battlefield”

create the American Red Cross. Her dream was realized, and she served as director there for 23 years

Question 16

Mary Breckinridge (1881-1965)

Answer 16

creating the Frontier Nursing Service (FNS)
caring for victims of the 1918 influenza pandemic
rural Kentucky, visited their clients on horseback.
ESTABLISHED Frontier Graduate School of Midwifery in 1939.

Question 17

Margaret Sanger (1879-1966)

Answer 17

advocating for women’s reproductive rights.
credited with coining the phrase “birth control”
opened the first birth control clinic in 1916
advocacy was instrumental in establishing Planned Parenthood
Sanger hired Gregory Pincus to develop a birth control pill, which was ultimately approved by the FDA in 1960

Question 18

Which of the following people were known for their work with wounded soldiers?

A Lillian Wald

B Mary Breckinridge

C Dorothea Dix

D Clara Barton

Answer 18

D Clara Barton

Question 19

CDC List of Top Public Health Achievements in the 21st Century

Answer 19

Vaccine-preventable diseases
Prevention and control of infectious diseases
Tobacco control
Maternal and infant health
Motor vehicle safety
Cardiovascular disease prevention
Occupational safety
Cancer prevention
Childhood lead poisoning prevention
Public health preparedness and response

Question 20

WORKING CLASS

Answer 20

People who, when they go to work or when they act as citizens, have comparatively little power or authority. They are the people who do their jobs under more or less close supervision, who have little control over the pace or the content of their work, and who are not the boss of anyone.

Question 21

1700s and early 1800s were overcrowded and lacked proper housing, clean water, adequate sewage, and waste removal. People were dying from

Answer 21

cholera, typhus, tuberculosis, and dysentery

Question 22

Edwin Chadwick - commissioned report- the living conditions of working class in England.
Influenced by Chadwick’s findings, Lemuel Shattuck conducted a similar study in the U.S. in Massachusetts. His report concluded

Answer 22

-diseases occurring in the U.S. were related to a lack of sanitation.
-provided framework for many public health initiatives and are credited with advancing life expectancy.

Question 23

Dr. John Snow

Answer 23

-data collection and mapping activities, he discovered that CHOLERA epidemic in the area was the result of contaminated water

• early efforts in contact tracing led to the development of epidemiology as a discipline

FATHER OF EPIDEMIOLOGY

Question 24

Vaccines are consistently recognized as

use of vaccines began with the work of

Answer 24

major public health achievements by the CDC

Dr. Edward Jenner, who is credited with developing the vaccine for smallpox (global disease that killed about 30% of those who contracted it)

-milkmaids who had contracted a less serious disease called cowpox seemed to be immune to smallpox

Question 25

Major Vaccines Timeline

Answer 25

1700s - SMALLPOX 1800s - RABIES/POLIO 1900s - PERTUSSIS/DIPTHERIA/TETANUS/INFLUENZA/MUMPS/MEASLES/RUBELLA/HEP B/PNEUMONIA/TB/VARICELLA/ HEP A 2000s- HPV/MENINGOCOCCUS/ROTAVIRUS/COVID 19

Question 26

Penicillin was discovered by ALONG WITH ________ a few years earlier, changed the way medicine was practiced forever.

Answer 26

Dr. Alexander Fleming in 1928 sulfonamides Fleming, Howard Florey, and Ernst Chain were awarded the Nobel Prize for GETTING PNC INTO A USABLE FORM

Question 27

Dorothea Dix,

Answer 27

advocate for prison reform and care of the mentally ill. She, like Nightingale, understood how the environment affected health. Her efforts led to the establishment of state-operated mental health hospitals and reforms in the care of prisoners Dix was not a nurse, but her national reputation as an organizer and advocate for the ill led to her appointment as director of the Union Army nurses in the Civil War

Question 28

The first federal public health law was enacted in

Answer 28

1798 President John Adams created a hospital for sick sailors. Became what is now known as the U.S. Public Health Service,

Question 29

What are some of the public health accomplishments of the 21st century? (Enter your response and submit to compare to an expert’s response.)

Answer 29

2000s- HPV/MENINGOCOCCUS/ROTAVIRUS/COVID 19

Question 30

direct delivery of health care services is managed at the federal government plays a primary role in

Answer 30

-state and local levels, -maintaining and improving the health of the country

Question 31

WHO Sustainable Goals

Answer 31

End poverty and hunger Ensure good health and well-being Achieve gender equality Ensure clean water and sanitation Ensure affordable and clean energy Promote decent work and economic growth Build industry innovation and infrastructure Reduce inequalities Make cities and communities sustainable Ensure sustainable consumption and production Take action on climate change Preserve oceans Protect ecosystems Promote peaceful societies Strengthen global partnerships

Question 32

WHO is the expanded definition of health found in their 1948 constitution, which states,

Answer 32

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

Question 33

UNICEF

Answer 33

established in 1946. Focus is on children protecting the rights of children emergency relief provide clean water, sanitation, nutrition, education, and gender equality for children claims to provide more vaccinations worldwide than any other agency.

Question 34

POLICY

Answer 34

Guidance to determine action followed by government or an organization to obtain a specific outcome.

Question 35

HHS

Answer 35

Formerly known as the Department of Health Education and Welfare, tasked with safeguarding the health of those living within its boundaries, both its citizens and refugees. DONE THROUGH 11 agencies that collaborate with state and local governments to gather data and set health policy

Question 36

Administration for children and families (ACF)

Answer 36

ACF promotes the economic and social well-being of families, children, individuals, and communities.

Question 37

Administration for Community Living (ACL)

Answer 37

ACL maximizes the independence, well-being, and health of older adults, people with disabilities across the lifespan, and their families and caregivers.

Question 38

Agency for Healthcare Research and Quality (AHRQ)

Answer 38

AHRQ’s mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used.

Question 39

Agency for Toxic Substances and Disease Registry (ATSDR)

Answer 39

ATSDR performs public health assessments of waste sites, health consultations concerning specific hazardous substances, health surveillance and registries, response to emergency releases of hazardous substances, applied research, information development and dissemination, and education and training concerning hazardous substances.

Question 40

Food and Drug Administration (FDA)

Answer 40

The FDA is responsible for protecting public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices and by ensuring the safety of our nation's food supply, cosmetics, and products that emit radiation. FDA also has responsibility for regulating the manufacturing, marketing, and distribution of tobacco products

Question 41

Indian Health Service (IHS)

Answer 41

IHS is responsible for providing federal health services to Indigenous Peoples and Alaska Natives.

Question 42

Substance Abuse and Mental Health Services Administration (SAMHSA)

Answer 42

SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.

Question 43

CDC

Answer 43

country’s foremost “science-based, data-driven, service organization” charged with protecting the public’s health.

Question 44

MAJOR DIVISIONS OF CDC

Answer 44

National Institute for Occupational Safety and Health (NIOSH) Public Health Service and Implementation Science, Public Health Science and Surveillance, Noninfectious diseases, Infectious Diseases

Question 45

HRSA

Answer 45

-Improving health care for people who are "geographically isolated, economically or medically vulnerable”. -programs FOR high-quality primary care, particularly those who need prenatal care and people with HIV/AIDS. -Training health professionals, including nurses, and distributing those providers to areas where they are most needed. -Overseeing organ donations / bone marrow cord blood. -compensation for anyone who may have been harmed by vaccination. established in 1982 when the Health Resources Administration and Health Services Administration were combined

Question 46

NIH

Answer 46

1887 as a one-room laboratory National Cancer Institute (NCI) and the National Heart, Lung, and Blood Institute (NHLBI). instrumental in setting national parameters for managing hypertension, a condition amenable to population-focused care strategies mission of NIH is to expand knowledge of living systems to enhance life

Question 47

CMS

Answer 47

oversees Medicare and Medicaid

Question 48

MEDICARE

Answer 48

Medicare -people 65 years/ people with disabilities, esrd -managed by the federal government -benefits and eligibility are same across U.S. Part A, - hospitalization, Part B, - doctors’ visits and some durable medical equipment. Part D - prescription drug coverage (Part D). Medicare is not free.

Question 49

MEDICAID

Answer 49

-state-managed -people younger than 65 and pregnant individuals who meet specific poverty levels. -Eligibility / benefits vary from state to state. -cover pregnant people, people with disabilities, -those who need long-term care. In 1997, -coverage to children whose families did not qualify for Medicaid but were too poor to afford health care for their children. SCHIP. -Standalone plans are overseen by state agencies and not CMS.

Question 50

What agency should Carlos contact and what information does he need to help his client? (Enter your response and submit to compare to an expert’s response.) Because the client needs help paying for health care, Carlos should start with CMS. The client is only 63 years old, so they are too young for Medicare unless the client has a disability or ESRD. Because Medicaid is a program managed by the state, Carlos would need to be sure of which state the client resides in and then determine what those state requirements are. Income and age are usually determining factors, but Carlos would need to know if the client’s income is used to support the client alone or a family. Learning more about the client’s family might also help with eligibility.

Answer 50

Because the client needs help paying for health care, Carlos should start with CMS. The client is only 63 years old, so they are too young for Medicare unless the client has a disability or ESRD. Because Medicaid is a program managed by the state, Carlos would need to be sure of which state the client resides in and then determine what those state requirements are. Income and age are usually determining factors, but Carlos would need to know if the client’s income is used to support the client alone or a family. Learning more about the client’s family might also help with eligibility.

Question 51

What are some of the public health accomplishments of the 21st century? (Enter your response and submit to compare to an expert’s response.)

Answer 51

vaccines of the last century - find that card

Question 52

Public Health Service Commissioned Corps (PHSCC)

Answer 52

-uniformed service branch of the HHS -members wear uniforms and are expected to serve for a set period of years. -founded as dedicated to the care of sailors. Therefore, - uniforms worn and the ranks and titles given are those of the U.S. Navy. began as a corps of physicians, expanded - include nurses, scientists, researchers, and other providers. -overseen by the surgeon general. providing direct care.

Question 53

Office of Disease Prevention and Health Promotion (ODPHP) four initiatives:

Answer 53

ODPHP sets and supports national health objectives. Healthy People, Healthy Aging, Health Literacy, and Health Care Quality.

Question 54

Healthy People

Answer 54

provides a framework for addressing the health of the nation -decreasing mortality and improving life for the elderly -health disparities and health behaviors

Question 55

Healthy People 2030 Overarching Goals

Answer 55

-Attain thriving lives / well-being/ free of preventable disease, disability, injury, and premature death. Eliminate health disparities, / health literacy . Create environments promote attaining the full potential for health and well-being for all. Promote healthy development, healthy behaviors, and well-being across all life stages. Engage leadership, key constituents, and the public across multiple sectors to act and design policies that improve the health and well-being of all.

Question 56

Some of the leading health indicators are age-specific, while others cross all age groups. Place each LHI in its appropriate category. (Drag the options to the desired category.)

Answer 56

all ages LHI food insecurity homicides calories from added sugars flu vaccination age specific LHI's are colorectal screenings diabetes diagnoses obesity

Question 57

Occupational Safety and Health Administration (OSHA)

Answer 57

address the high numbers of workplace injuries and deaths charged with maintaining safe workplaces housed within the Department of Labor

Question 58

OSHA was one of the first agencies to address the need for

Answer 58

Personal Protective Equipment (PPE) for industrial and construction workers, w . OSHA also protects whistleblowers and aids community-based agencies involved in disaster response and recovery.

Question 59

Non-Government Organizations (NGO)

Answer 59

work to improve social, environmental, health, and economic issues in the U.S. and abroad humanitarian charities work outside of, but in cooperation with, local governments. may receive governmental grants, - accountable to the granting organization. - funding most - from donations from private individuals, private for-profit companies, and other philanthropic foundations.

Question 60

Examples of NGO's

Answer 60

Doctors without Borders (medical care), Feeding America (hunger relief), Habitat for Humanity (helping people build homes), Special Olympics (helping people with special needs), Greenpeace (care for the environment).

Question 61

American Red Cross

Answer 61

nonprofit humanitarian organization. not considered an NGO because it was chartered by the U.S. Congress must fulfill the provisions of this charter. considered an auxiliary organization and has the legal status of “federal instrumentality” also widely recognized for managing the nation’s blood supply and collects almost half of the blood and blood products in the U.S

Question 62

HIT PHI - deals primarily with

Answer 62

Health information technology PUBLIC HEALTH INFORMATICS -unlike clinical informatics, PHI deals with primary and secondary prevention measures For these data sets to yield useful information, - must be interoperability, analytic software, and providers able to perform and understand the analytics produced.

Question 63

One of the competence areas for Quality and Safety Education for Nurses (QSEN) is informatics, defined as

Answer 63

the ability to use information and technology to communicate, manage knowledge, mitigate error, and support decision making. Examples include navigating electronic health records and using data to improve outcomes.

Question 64

QSEN Competencies

Answer 64

Patient-centered care Teamwork & collaboration Evidence-based practice Quality improvement Safety Informatics

Question 65

Telehealth

Answer 65

use of technology in care delivery, health information, and remote health education generally involves encounters on the internet, such as streaming and video conferences and visits use of telephones, faxes, and email are not included

Question 66

Telemedicine

Answer 66

providers see clients and provide care remotely

Question 67

Both technologies have the potential to address inequity across populations, particularly around access, and decrease costs

Answer 67

telehealth and telemedicine

Question 68

The American Health Information Management Association code of ethics provides guidance related to the use and storage of

Answer 68

data in a safe and secure manner, preventing access and use of the data in an inappropriate manner.

Question 69

health care spending for individuals older than 65 is _____times that of the general population, accounting for almost _____ of health care expenditures. the shift to an aging population creates a shift in focus from

Answer 69

three to five 1/3 morbidity and mortality to issues of life quality, disability, and frailty.

Question 70

older adults who need or prefer to stay in their homes could do so, in many cases, with

Answer 70

affordable personal care and minor home repairs or structural modifications, such as ramps and safety bars in bathrooms.

Question 71

Widening protocols means

Answer 71

adding more people to “medication vs. lifestyle change,” adding more cost burden to the individuals and the system.

Question 72

Nurses can influence individual behaviors like

Answer 72

diet and exercise through educational programs in schools and clinics.

Question 73

The aging of the population and the use of advanced technologies have resulted . The U.S. spent approximately ________ on health care in 2019, accounting for almost 18% of the gross domestic product (GDP), more than all other developed countries

Answer 73

in increasing the cost of health care across the developed world $4 trillion

Question 74

Population health,

Answer 74

moves the focus of health care and health promotion away from individual virtues and frailties to the attitudes and behaviors of the collective A system of using large data sets to analyze care needs and provide care to groups of individuals with the goals of improving health outcomes for the group.

Question 75

Climate Change

Answer 75

Extreme weather / temperatures exacerbating heart / respiratory conditions, increasing mosquito population, placing the homeless and those living in poverty at risk for exposure. Droughts / floods affect access to clean water and food production Extreme heat affects labor patterns /mental health /promotes aggression and violence

Question 76

food insecurity

Answer 76

The lack of sufficient food to sustain a healthy life for all persons living in the household.

Question 77

food deserts

Answer 77

Geographic areas that lack sufficient access to grocery stores, especially in low-income communities.

Question 78

As Carlos continues to work with his 63-year-old client, he learns that the client lives with their daughter, who is pregnant, her husband, and their two small children. The son-in-law works as a day laborer. Carlos is concerned that the family may be experiencing food insecurity. What resources are available for this family? (Enter your response and submit to compare to an expert’s response.)

Answer 78

Supplemental Nutrition Assistance Program (SNAP) provides food for low-income families. Women, Infants, Children (WIC) provides food, education, and referrals for pregnant clients and clients who recently gave birth, nursing clients, and children up to 5 years old. The school lunch program provides free or reduced-price school lunches, and possibly breakfasts, to children from low-income families.

Question 79

Core Competencies for Public Health Professionals

Answer 79

Analytical/assessment skills Policy development/program planning skills Communication skills Cultural competency skills Community dimensions of practice skills Public health sciences skills Financial planning and management skills Leadership and systems thinking skills

Question 80

racism

Answer 80

A system of structuring opportunities in a way that unfairly disadvantages some individuals and communities and unfairly advantages other individuals and communities on the basis of race.

Question 81

systemic racism

Answer 81

Racism that operates through laws and regulations designed to disadvantage some groups and advantage others.

Question 82

intersectionality

Answer 82

A framework for understanding how social identities, such as gender, race, ethnicity, social class, religion, sexual orientation, ability, and gender identity, overlap with one another and with systems of power that oppress and advantage people in the workplace and broader community.

Question 83

cultural humility

Answer 83

Awareness that all clients are unique and can only be known and understood through encountering each client with an open mind and a desire to know and understand that patient’s needs and desires.