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NUR 388 Midterm Exam Modules 4-6.
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NUR 388 Midterm Exam Modules 4-6.
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NUR 388 Midterm Exam Modules 4-6Which of the following is the primary cause of vulnerability to health problems?
a. Breakdown of family structures
b. Poverty
c. Prejudice
d. Social isolation - ANS-b. Poverty
People with lower incomes and less education tend to be at higher risk for health
problems. Poverty is a primary cause of vulnerability.
Which of the following terms is used to describe aggregates who are at high risk for
having poor health outcomes because of limited resources?
a. Disadvantaged families
b. Multi-problem families
c. Resilient populations
d. Vulnerable populations - ANS-d. Vulnerable populations
Vulnerable populations are groups (aggregates) with an increased risk to develop
adverse health outcomes. Families are a subgroup of populations and do not
appropriately fit the definition of "aggregates." Resilience refers to the ability to resist
poor health outcomes, not to succumb to them.
A community health nurse would like to implement an intervention to increase lasting
resilience among new immigrants. Which of the following actions should be taken by the
nurse?
a. Direct clients to English-as-second-language courses.
b. Give immigrant clients money to help them get settled.
c. Identify areas in the city where housing is less expensive.
d. Solicit donations for food, clothing, and other needs. - ANS-a. Direct clients to
English-as-second-language courses.
Vulnerability can be reversed by obtaining resources to increase resilience. Learning the
basic language of the country of residence will give immigrants the ability to
communicate and navigate through systems and thus remove barriers that promote
disenfranchisement and disadvantaged status.
,Which of the following factors predisposes many migrant farm workers to
disenfranchisement?
a. Being a minority group member
b. Inability to attend religious services because of work requirements
c. Previous experiences of physical abuse
d. Short length of time in the community - ANS-d. Short length of time in the community
Disenfranchisement refers to a feeling of separation from mainstream society. The
person does not seem to have an emotional connection with any group in particular or
the larger society. For migrant workers who are frequently moving, the short length of
time they stay in the community does not allow for the development of social ties. Being
a minority group member would not by itself cause disenfranchisement if the minority
group member lived in a community with persons from similar ethnic and cultural
backgrounds. A person's inability to attend religious services or to have had
experienced previous physical abuse are not specifically related to disenfranchisement
of the population of migrant farmworkers.
A large financial grant was being offered to whichever health facility wanted to accept
the responsibility for giving care to local vulnerable populations. Which of the following
actions would most likely be taken by the local medical centers?
a. Agree to collaboratively apply for the funds in a cooperative proposal.
b. Individually compete eagerly for the additional funds now available.
c. Reach out enthusiastically to this previously underserved population group.
d. Strongly consider not applying, because this population will be expensive to treat. -
ANS-d. Strongly consider not applying, because this population will be expensive to
treat.
Many agencies do not wish to provide services to vulnerable populations. Vulnerable
populations are more expensive to treat because they have multiple, cumulative risks
and require special service delivery considerations (e.g., to help overcome
transportation problems or provide culturally competent care). Because of the major
costs associated with providing care to this population and risks related to
reimbursement, it would not be in the best interest of the agency to want to eagerly
apply to provide care to this group.
Which individual has the greatest risk for becoming a member of the vulnerable
population of the local community?
,a. A male diagnosed with a cardiac issue who recently moved in with his adult child
b. A single mother who is studying for a law degree at the local university
c. A 50-year-old married female who has worked as a server in local restaurants for her
entire adult life
d. A single male who has a history that includes a learning disability and a parent
diagnosed with type 2 diabetes - ANS-d. A single male who has a history that includes a
learning disability and a parent diagnosed with type 2 diabetes
The WHO, consistent with Healthy People 2030, describes three overall determinants of
health to be (1) the social and economic environment, (2) the physical environment, and
(3) the person's individual characteristics and behaviors. The WHO also notes that
individuals are unlikely to be able to directly control many of the determinants of health,
and this is directly related to vulnerability. The seven WHO factors are as follows (WHO,
2015, pp. 1-2):1. Income and social status: Higher income and social status are
associated with better health.2. Education: Low education is linked with poor health,
more stress, and lower self-confidence.3. Physical environment: Safe water and clean
air; healthy workplaces; safer homes, communities, and roads; and good employment
and working conditions, especially when the person has more control, all contribute to
good health.4. Social support networks: Family, friends, and community as well as
culture, customs, traditions, and beliefs affect health.5. Genetics, as well as personal
behavior and coping skills, affect health.6. Health services: Access and use of services
affect health.7. Gender: Men and women suffer from different types of diseases at
different agesThe single male with a history of learning disabilities and a family history
of type 2 diabetes has several potential risk factors including those related to his social
support network (being single); learning disabilities (effecting education and possible
low self-esteem); and a first degree family history of a chronic disease (type 2 diabetes).
While the life stories in the remaining options present the individual with risks, none
have multiple risks like the male depicted in the correct option.
A homeless family brought their father to the public health clinic after he reported
bleeding when he went to the bathroom. Which of the following nursing actions would
be most appropriate?
a. Begin tests to determine the cause of the bleeding while asking about other family
concerns from nutrition to shelter for the night.
b. Refer the man to a urologist to address the urinary bleeding.
c. Suggest that the family take him to an urgent care center immediately.
, d. Treat the urinary infection and give the man medication to take to prevent the
recurrence of infection. - ANS-a. Begin tests to determine the cause of the bleeding
while asking about other family concerns from nutrition to shelter for the night.
It is important to provide comprehensive, family-centered, "one-stop" services. Providing
multiple services during a single clinic visit is an example of one-stop services. If social
assistance and economic assistance are provided and included in interdisciplinary
treatment plans, services can be more responsive to the combined effects of social and
economic stressors on the health of special population groups. If the family is referred to
a different provider or agency, it is likely that this follow-up will never occur. Only
addressing the urinary infection, and not the homeless status of this family, does not
provide the comprehensive services that are expected from a public health clinic.
Nursing students have been assigned to set up a health fair for the homeless population
in a large urban setting. Without any funds to pay for space, where should the health fair
be located, assuming that all of the following sites are available at no cost?
a. At the city's homeless shelter, which is, by policy, vacant during the day
b. At a large medical center, where the students could get permission to use an empty
clinic in the evening
c. At the largest inner city police station, where there was a large empty space available
d. At the local community college, where there are plenty of tables and chairs - ANS-a.
At the city's homeless shelter, which is, by policy, vacant during the day
The most convenient place for the clients would be the homeless shelter, where
transportation and lack of comfort in an unfamiliar place would not be issues. It is helpful
to provide comprehensive services in locations where people live and work, including
schools, churches, neighborhoods, and workplaces. Thus, for the homeless population,
the homeless shelter would be an appropriate location. Homeless persons would
probably avoid the police station, and many may not wish to go to the medical
center—also, there would be transportation issues. Depending on the location of the
community college, there may also be transportation issues.
Which of the following bills would the nurse lobbyist, who believes strongly in social
justice, encourage legislators to support?
a. A bill that establishes policies requiring all persons to pay the same cost for services
regardless of income
b. A bill that promotes universal health insurance coverage
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