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Community Health Nursing Final Exam
Questions and Answers.
The conditions and circumstances in which people are born, grow, live, work, and age that are shaped by a set of forces beyond the control of the individual: economics and the distribution of money, power, social policies, and politics at the global, national, state, and local levels - Correct answer Social Determinants Of Health Provides science-based, 10-year national objectives for improving the health of all Americans - Correct answer Healthy People 2020 Measures that actively promote health, prevent illness and provide protection - Correct answer Primary Prevention Who is the target of primary prevention? - Correct answer essentially well population What are some examples of primary prevention in PH? - Correct answer - annual vaccination
- health education at high schools Early diagnosis and prompt interventions that limit disability - identifies risks or hazards and modifies, removes or treats them before a problem becomes more serious - Correct answer Secondary Prevention Who is the target of secondary prevention? - Correct answer populations that have risk factors in common What are some examples of secondary prevention in PH? - Correct answer screening / testing -BP
-Cholesterol -Blood glucose -STD -pregnancy test Which LOP reduces impairments and disabilities, minimize suffering, promote adjustment to immediate condition and rehab - Correct answer Tertiary Prevention Who is the target of tertiary prevention? - Correct answer population in which a disease or injury has occurred What are some examples of tertiary prevention - Correct answer teaching a diabetic patient to: -exercise -diet -foot care Core Functions of Public Health - Correct answer Assessment, Policy Development, Assurance Systemic data collection about a population including monitoring population's health status and provide / disseminating info about the health of community - Correct answer assessment Create policies that support health of the population through leadership and research - Correct answer policy development Making sure that essential community-oriented health services are available - Correct answer assurance Collection of individuals who have one or more personal or environmental characteristics in common - Correct answer populations
-identifies factors/strengths/weaknesses influencing the problem or risk Levels of practice - Correct answer 1. Individuals/ families
- Community
- System How is the intervention wheel used? - Correct answer - identifies core PHN function levels: individuas/families, communities, systems
- identifies 17 interventions -adopted worldwide Assumption 1 of the intervention wheel defines PHN practice: - Correct answer -promoting and protecting the health of populations using nursing, social and public health sciences -education in both PH and nursing -primary focus: health and disease prevention for entire population groups Assumption 2 of the intervention wheel: PHN practice focuses on populations. What populations are they focused on? - Correct answer -populations at risk -populations of interest A population with a common identified risk factor or risk exposure that poses a threat to health - Correct answer population at risk A population that is essentially healthy but that could improve factors that promote or protect health - Correct answer population of interest Assumption 3 of the intervention wheel: PHN practice considers the determinants of health. What are determinants of health? - Correct answer -health inequities such as unaffordable insurance,
limited health care resources in particular areas, lack of opportunities to be health -US inequities: race, gender, age, socioeconomic status Factors that influence health status across life cycle - Correct answer determinants of health In assumption 4 of the intervention wheel: priorities identified through community assessment. What is a community assessment and what is the result? - Correct answer -community assessment: ongoing collection and analysis -result: list of community issues - identify gaps btwn needs and services Assumption 5 of intervention wheel: emphasis on prevention. What are the levels of prevention? - Correct answer -primary (well population) -secondary (early stages of disease) -tertiary (seeks to prevent worsening of crisis)
- although not every event is preventable, every event has a preventable component Anticipatory action taken to prevent the occurrence of an event or to minimize its effect after it has occurred - Correct answer prevention Assumption 6 of the intervention wheel: phns intervene at 3 levels of practice. What are the 3 levels? - Correct answer - community level: change community norms, attitudes, awareness, practices and behaviors
- system: change organizations, law, policies and power structures -individual/families: change behaviors, knowledge, attitudes, practices and beliefs
Social marketing Policy development & enforcement - Correct answer yellow wedge Advocacy is often viewed as a precusor to ______ ________ - Correct answer policy development Social marketing is seen by some as a method of carrying out _____________ - Correct answer advocacy Which of the 17 interventions is often preceded by outreach activities and frequently follows surveillance? A. Community organizing B. Case management C. Counseling D. Screening - Correct answer Answer: D Screening frequently follows either surveillance or disease and health event investigation & is often proceeded by outreach Assumptions of the intervention wheel, what is assumption 9? - Correct answer Assumption 9: PHN Practice Contributes to the Achievement of the 10 Essential Services -10 essential services = what PHN does
protect and promote health
- interventions = how it gets done
the means; the implementation Assumptions of the intervention wheel, what is assumption 10? - Correct answer Assumption 10: PHN Practice Is Grounded in a Set of Values and Beliefs -cornerstones of PHN synthesize values & beliefs from both PH and nursing -the intervention wheel = what and how -cornerstone = why
Best available evidence from a variety of sources including research studies, nursing experience and expertise, and community leaders. - Correct answer evidence based practice Why do we use the intervention wheel? - Correct answer common language Framework, way of thinking about PHN practice Identifying and documenting interventions performed by PHN What are the 3 components on the intervention wheel? - Correct answer 1. Population-based
- 3 practice levels
- 17 interventions Which of the 17 interventions is often seen as a precursor to policy development? A. Advocacy B. Counseling C. Case finding D. Health teaching - Correct answer Answer: A Advocacy Interventions found on the intervention wheel - Correct answer 1. Surveillance
- Disease and other health investigations
- Outreach
- Screening
- Case finding
- Referral and follow-up
- Case management
- Delegated functions
- Health teaching
- Consultation
- Counseling
- Collaboration
- PH agencies could shift from direct clinical services
- PH agencies could refocus on community, population-focused promotion and prevention The Affordable Care Act addresses population health in what 4 ways? - Correct answer 1. Provisions to expand insurance coverage
- Provisions aimed at improving the quality of care offered
- Provisions which seek to enhance prevention & health promotion measures within health care delivery system
- Provisions aimed at promoting community & population-based activities What is the role of nurses at local levels - Correct answer responsible for monitoring health status & enforcing laws and regulations that protect & improve the public's health responsibilities vary depending on the locality & are responsible for implementing / enforcing local, state, and federal public health codes What is the roles of nurses at state levels - Correct answer responsible for monitoring health status and enforcing laws and regulations that protect and improve the public's health What is the role of nurses at federal levels - Correct answer develop regulations that implement policies formulated by Congress & provide significant funding to state & territorial health agencies What are the different levels of prevention at local, state and federal levels? - Correct answer What does the triangle of epidemiology consist of? - Correct answer host, agent, environment
The study of the occurrence and distribution of health-related states or events in specified populations, including the study of the determinants influencing such states, and the application of this knowledge to control the health problems - Correct answer epidemiology Indicates the proportion of the population who newly experience the event over some period of time - Correct answer incidence Example of incidence - Correct answer A measure of in a population at a particular time - Correct answer prevalence Example of prevalence - Correct answer all students with the flu during fall 2016 Prevalence: measure of all individuals affected by the disease at a particular time What is a disease spectrum? - Correct answer How is a disease spread? - Correct answer What are the steps of investigation - Correct answer 1. Confirm existence of outbreak
- Verify diagnosis / define case
- Estimate number of cases
- Orient data collected to person, place and time
- Develop and evaluate hypothesis
- Institute control measures & share findings What is included in the surveillance process? - Correct answer assess public health status Define public health priorities Evaluate programs
What are the 4 important concepts of environmental protection? - Correct answer Permitting - government places limits on amount of pollution emitted into air or water Environmental Standards - standards set for polluters Compliance - ensuring that permits and standards are met Monitoring - making sure there is compliance What 4 phases are included in the environmental risk assessment? - Correct answer 1. Determine whether chemical is associated with negative health effects (in animals or humans)
- Determine whether chemical has been released into environment: air, water, soil or food
- Estimate how much and by which route of entry the chemical might enter human body
- Characterize risk assessment process - taking into account all 3 previous steps Screenings for older adult - Correct answer Health risks for men include: - Correct answer Leading cause of death in women and prevention? - Correct answer Kids LOP - Correct answer What are health risks in kids? - Correct answer acute illnesses Chronic health conditions Mental health Environmental health What are the 3 domains of learning? - Correct answer 1. Cognitive
- Affective - feeling
- Psychomotor - acting
Domain of learning that includes memory, recognition, reasoning, understanding, application and problem-solving - Correct answer cognitive learning What are the 6 components of the cognitive domain - Correct answer 1. Knowledge
- Comprehension
- Application
- Analysis
- Synthesis
- Evaluation Domain of learning that include attitude changes and development of value - Correct answer affective learning Domain of learning that includes neuromuscular coordination and motor skills - Correct answer psychomotor learning What are the 3 conditions that influence psychomotor learning - Correct answer - necessary ability
- sensory image
- opportunities to practice When teaching a patient who is a psychomotor learner, you should first ______ then ______ - Correct answer first demonstrate Then practice Considerations when planning a health program - Correct answer - clear message
- nondistracting environment
- use clear language
- tailor a learning format
Programs where Congress authorizes spending by determining particular eligibility criteria rather than a particular amount of spending - Correct answer entitlement programs Ways of paying health care providers - Correct answer Medicare is a health insurance program for: - Correct answer age 65 or older Under age 65 with certain disabilities People of all ages with End-Stage Renal Disease Replaces TN original Medicaid program - Correct answer tenncare What is Part A, Part B, Part C and Part D of medicare coverage? - Correct answer Part A: Hospital Insurance
- in patient care Part B: Medical Insurance
- doctors services and outpatient care Part C: Medicare Advantage Plan Part D: Prescription Drug Coverage Policy process - Correct answer What are health related functions of government? - Correct answer Laws that are used in public health commonly - Correct answer
- Correct answer ethical dilemma Food-borne bacterial disease that causes headache, abdominal pain, diarrhea, N/V and fever - Correct answer salmonella When is onset of salmonellosis? - Correct answer within 48 hrs after eating contaminated food
Where do outbreaks of salmonellosis commonly occur? - Correct answer restaurants Hospitals Nursing homes Children's institutions What is the route of transmission of salmonellosis? - Correct answer -eating inadequately cooked food that comes from infected animal -eating food contaminated with feces of infected animal or person Strain of bacteria that produces powerful toxins causing bloody diarrhea, abdominal cramps and some times fever - Correct answer e. Coli O157:H What is the route of transmission of e. Coli? - Correct answer eating meat, esp beef that has been cooked insufficiently to kill e coli What are the 2 types of food-born disease - Correct answer - food infection Ex: Salmonellosis, Gastroenteritis
- Food Intoxication Ex: Botulism Occurs when a person ingests pre-formed toxin that leads to illness within a few hours to days - Correct answer food-borne botulism Why is food-borne botulism a public health emergency? - Correct answer contaminated food might still be available for others What are the measures of protection from food-borne disease? - Correct answer -keep clean
NOT illegible if more than intermittent or part-time care is needed What are some hospice client focus? - Correct answer 1. Attention to body, mind, and spirit
- Death is not a taboo topic
- Health care technology used with discretion
- Clients have a right to truthful discussion and participation in treatment decisions What are some hospice client considerations? - Correct answer Respond to health and wellness needs of populations of faith communities and are partners with the church in fulfilling the mission of health ministry - Correct answer parish nursing What are the 2 types of parish nursing? - Correct answer congregation based Institution based Occupational health and the epidemiology triangle - Correct answer host, agent, environment All employed individuals and groups are at risk of being exposed to occupational hazards - Correct answer host Occupational exposures that are classified as biological, chemical, enviromechanical, physical, or psychosocial - Correct answer agent Workplace conditions, such as temperature extremes, crowding, shift work, and inflexible management styles - Correct answer environment Activities of school nurses - Correct answer health education Family/community involvement
Physical education Health services Nutrition services Counseling, psych and social services Healthy school environment Health promotion for staff Approach to family nursing that places individual family member first and family second - Correct answer family as context / structure Approach to family nursing that places family first and individuals are second Focus on how individual members affect whole family - Correct answer family as client Approach to family nursing that views family as interacting system
- whole is more than the sum of its parts Family seems as interactions and relationships - Correct answer family as system Approach to family nursing that views family as primary unit of society and part of a larger system - Correct answer family as component of society How to reduce family health risks? - Correct answer home visits - identify barriers, identify supports for reaching family health promotion goals Contracting Empowering families Working agreement that is continuously renegotiable and may or may not be written - Correct answer contracting with families Steps of disaster triage - Correct answer Breathing?
