NURSING 3458 Chapter 03: Public Health, Primary Care, and Primary Health

NURSING 3458 Chapter 03: Public Health, Primary Care, and Primary Health Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 10th Edition MULTIPLE CHOICE 1. In the United States, what are most health care dollars spent on? a. Prescription drugs b. Hospital care c. Physician services d. Public health services (PHSs) ANS: B The largest share of health care expenditures goes to pay for hospital care, with physician services the next largest item. The money spent for PHSs is significantly lower than the other categories of expenditures. Other significant drivers of the increasingly high cost of health care include prescription drugs, technology, and chronic and degenerative disease. DIF: Cognitive level: Remembering TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 2. What has caused the number of uninsured Americans to dramatically increase? a. Medicare took over payment of health care costs. b. With a declining population, the costs for health care rose. c. Nursing salaries greatly increased, causing health care costs to rise. d. Health insurance coverNagUe RwSasIdNroGpTpeBComOMemployment-based health plans. ANS: D Although most Americans continue to obtain health insurance from their employer as a benefit, employment does not guarantee insurance. Employer-sponsored health insurance is sensitive to both the general economy and changes in health insurance premiums. As costs for insurance premiums rose, employers either shifted more of these costs to their employees or declined to offer employment-based health coverage at all. Medicare provides coverage only to the elderly and other special populations. The costs for health care are continuing to rise regardless of the size of the population. There has not been a significant change to nursing salaries, and a change in nursing salaries would not impact the number of uninsured Americans. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 3. A nurse is working with a community to decrease the occurrence of influenza. Which of the following U.S. Department of Health and Human Services (USDHHS) or simply HHS) goals is being applied? a. Strengthen Health Care. b. Advance the Health, Safety, and Well-being of the American People. c. Increase Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs. d. Advance Scientific Knowledge and Innovation. ANS: B One of the objectives of Advance the Health, Safety, and Well-being of the American People is to reduce the occurrence of infectious diseases. The goal of Strengthen Health Care focuses on improving health care services, quality, and coverage. The goal of Increase Efficiency, Transparency, Accountability, and Effectiveness of HHS Programs focuses on improving programming and application of found data. The goal of Advance Scientific Knowledge and Innovation focuses on scientific discovery and application of the new knowledge. DIF: Cognitive level: Remembering TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 4. According to the 1999 Institute of Medicine report, as many as 98,000 deaths each year could be attributed to what cause? a. Cardiovascular disease b. Obesity c. Medical error d. Drug overdose ANS: C In 1999 it was thought that our health care system was expensive, and that access and quality were not optimal, but we had not considered this important fact: many people die of preventable medical errors in the United States. This number is not the correct statistic for cardiovascular disease, obesity, or drug overdose. DIF: Cognitive level: ReNmemRbeIringG B.TCOPM: Nursing process: Assessment MSC: NCLEX: Safe and EfUfectSive NCareTEnviroOnment: Management of Care 5. Residents of rural communities report that they must travel for long distances to obtain health care services. As a result, they seek health care only for emergencies and severe illnesses. Which aspect of the health care system in the United States is illustrated in this situation? a. Access to care b. Cost c. Quality d. Advances in technology ANS: A One significant problem is poor access to care. Access can refer to inability to pay for care and inability to access care. Cost refers to the health care expenditures that happen to pay for the services received. Quality refers to the quality of health care that is provided. Advances in technology refer to the medical advancements made to treat diseases. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 6. A nurse is exploring a job opportunity at a community health center. Which expectation would the nurse have about the center? a. Would be situated in a large metropolitan area. b. Provides care only to the economically disadvantaged. c. Offers comprehensive primary care services and supportive services. d. Is used for preventive services such as flu shots. ANS: C Community health centers serve the entire community for primary health care (PHC) services, regardless of income. They are in a high need or medically underserved community, which can be urban or rural. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 7. A nursing program has initiated a recruitment campaign focusing on increasing the minority students in its program. Which of the following best describes the rationale for this program? a. The number of minority versus non-minority nurses should be equal. b. Minority health care professionals who share the same culture with the clients may provide more effective care. c. The profession should be more diverse. d. Minority nurses can mentor other nurses when providing care for diverse populations. ANS: B It is thought that increasing minority representation in the health workforce not only is a commitment to diversity, but also will improve the health care delivery system. Minority health professionals can be expected to practice in underserved areas at a greater rate and health professionals who share the same culture and language with the clients they serve can provide more effective care. UIt haSs bNeen TsuggestOed that the number of minority nurses should be representative of the population served rather than there being equal numbers of minority and non-minority nurses. Minority nurses are able to mentor other nurses; however, is not the main reason that there is a focus on increasing recruitment of minorities. DIF: Cognitive level: Applying TOP: Nursing process: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care 8. A community health nurse is utilizing telehealth. Which factor best describes the rationale for its use? a. Enables clients to get nursing care in their homes. b. Substitutes for health department delivered care. c. Improves access to care in rural areas. d. Replaces face-to-face care for those who cannot afford it. ANS: C Telehealth provides increased access to health care using a computer monitor and telephone line. It is useful for monitoring clients with chronic disease but is not a substitute for health care. Telehealth may or may not be accompanied by home care nursing. DIF: Cognitive level: Understanding TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 9. What is one of the goals of the World Health Organization (WHO)? a. Providing public health nurse (PHC) services to everyone b. Preventing outbreaks of disease c. Preventing the transmission of communicable disease among nations of the world d. Providing humanitarian support in times of disaster ANS: A The WHO adopted a resolution in 1977 accepting the goal of attaining a level of health that permitted all citizens of the world to live socially and economically productive lives. This has been adapted to meet the needs of the new century and was deemed “Health for All in the 21st Century.” The focus of this initiative is PHC services. The WHO does not prevent outbreaks of disease, prevention, transmittal of disease, or provide humanitarian support. DIF: Cognitive level: Understanding TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care 10. A public health agency is considering implementing an electronic health record. Which action best describes one of the benefits the agency will experience? a. Facilitation of interprofessional care b. Improved client compliance with medical regimens c. Cost savings to the agency d. Compliance with the Joint Commission of Accreditation of Healthcare Organizations (JCAHO) standards ANS: A The electronic medical record facilitates interprofessional care in chronic disease management and coordination of referrals; 24-hour availability of records with downloaded laboratory results and up-to-dUateSassNessmTents; inOcorporation of protocol reminders for prevention, screening, and management of chronic disease; improvement of quality measurement and monitoring; and increased client safety and decline in medication errors. There is no data to support that the agency will have improved client compliance or cost savings. Electronic medical records are not a requirement by JCAHO. DIF: Cognitive level: Understanding TOP: Nursing process: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care 11. A nurse interacts with a 25-year-old woman at a community health center who is obtaining a gynecological examination and birth control pills. Which of the following types of care is the client receiving? a. Tertiary health care b. Public health care c. Public health care (PHC) d. Specialized care ANS: C