- After the oil spill of 2010 in the Gulf of Mexico, which occurred following a hurricane in that same area four years previously, public health officials became particularly concerned about the economic health of the area. What caused this economic concern?
| A. | Illnesses due to the quality of the air |
| B. | Illnesses due to the quality of the water |
| C. | The habitats of the fishing industry being destroyed |
| D. | The closing of the recreational industry |
ANS: C
Objective: 1. Describe the role of nursing in environmental health.
- 130-131
Heading: Introduction
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Trauma; Economics
Difficulty: Easy
| Feedback |
| A | The illnesses due to the quality of the air hampered the health of the residents, but was not the main blow to the economy. |
| B | The illnesses due to the quality of the water hampered the health of the residents, but was not the main blow to the economy. |
| C | The destruction of the habitats of the fishing industry was the major problem for the economy as this had been the main industry for the area. |
| D | The closing of the recreational industry was a temporary problem and affected only a small portion of the economy. |
PTS: 1 CON: Trauma | Economics
- The health effects of the 2010 oil spill in the Gulf of Mexico on the workers and residents, the food supply, and the fishing industry demonstrates the relationship between environmental health and personal health. According to the World Health Organization (WHO), the factors that are addressed in environmental health are:
| A. | Water, air, and waste |
| B. | Economics and governmental structure |
| C. | Areas that we live, work, and play |
| D. | Physical, chemical, and biological |
ANS: D
Objective: 1. Describe the role of nursing in environmental health.
- 130-131
Heading: Introduction
Integrated Processes: N/A
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Knowledge [Remembering]
Concept: Trauma; Safety
Difficulty: Moderate
| Feedback |
| A | Illnesses affecting environmental health could be biologically transmitted through water, air, and waste, but there are broader environmental factors indicated by WHO. |
| B | Economics and governmental structure are factors that might limit the health problem or make it worse, but these are not the broader environmental factors indicated by WHO. |
| C | Areas in which we live, work, and play are the settings where environmental problems could take place, but these categories are not the broader environmental factors indicated by WHO. |
| D | Environmental health addresses the physical, chemical, and biological factors that are external to a person and all the related factors impacting behaviors. |
PTS: 1 CON: Trauma | Safety
- A public health nurse (PHN) uses the epidemiological triangle to understand
| A. | The environment that brings an agent and host together |
| B. | The role environment plays in the health of individuals, families, and communities |
| C. | The role of water, air, and waste in environmental health |
| D. | Both 1 and 2 |
ANS: D
Objective: 1. Describe the role of nursing in environmental health.
- 132-134
Heading: The Role of Nursing in Environmental Health > Approaches to Environmental Health
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Analysis [Analyzing]
Concept: Promoting Health; Safety
Difficulty: Moderate
| Feedback |
| A | The epidemiological triangle describes the relationship between an agent, host, and environment. |
| B | The epidemiological triangle is a framework used to examine human-environment interactions and their potential impact on the health of individuals, families, and communities. |
| C | The role of water, air, and waste in environmental health addresses only one point of the epidemiological triangle. |
| D | This is correct. The epidemiological triangle helps the PHN understand the environment that brings an agent and host together, as well as the human-environment interactions that impact the health of individuals, families, and communities. |
PTS: 1 CON: Promoting Health | Safety
- A PHN is evaluating a community’s pollution, accessible transportation, and outside activities and the maintenance of its neighborhood buildings. The nurse is evaluating the:
| A. | Environmental stability |
| B. | Built environment |
| C. | Ecological approach |
| D. | Environmental health |
ANS: B
Objective: 2. Describe the impact of the built environment on health.
- 132-134
Heading: The Role of Nursing in Environmental Health > Approaches to Environmental Health
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Assessment; Promoting Health; Safety
Difficulty: Easy
| Feedback |
| A | Environmental stability is how well a community is able to maintain the health of a population. This question is referring to the built environment. |
| B | The built environment, the human-made surroundings created for the daily activities of humans, reflects the range of physical and social elements that make up a community. This question is referring to the built environment. |
| C | The ecological approach requires an understanding that individuals and populations interact with their environment. This question is referring to the built environment. |
| D | Environmental health is all the physical, chemical, and biological factors that are external to a person and all the related factors impacting behaviors. This question is referring to the built environment. |
PTS: 1 CON: Assessment | Promoting Health | Safety
- The PHN realizes that the mere presence of an agent, even if it is known to have toxic properties, does not necessarily mean there is a risk to health. However, the three routes of entry for chemical exposure include all of the following, except:
| A. | Ingestion |
| B. | Inhalation |
| C. | Dermal absorption |
| D. | IV |
ANS: D
Objective: 3. Utilize an environmental health assessment to identify health risk factors.
- 135-136
Heading: Hazardous Substances > Types of Exposures
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Safety
Difficulty: Easy
| Feedback |
| A | Ingestion, or swallowing, can be accidental, or the person can be unaware of swallowing a toxic substance. |
| B | Inhalation, or breathing in an agent, can be accidental, or the person can be unaware of the toxicity in the air. |
| C | Dermal absorption can be accidental, or the person can be unaware of an agent being absorbed through the skin. |
| D | IV means being administered into a vein or veins, and it is not considered to be one of the routes of entry for chemical exposure. |
PTS: 1 CON: Safety
- A hospital admits a patient who is having breathing problems after mixing household cleaning products. The nurse recognizes that this patient is suffering from exposure to which type of environmental hazard?
| A. | Biological |
| B. | Mixed |
| C. | Physical |
| D. | Chemical |
ANS: B
Objective: 3. Utilize an environmental health assessment to identify health risk factors.
- 135-136
Heading: Hazardous Substances > Types of Exposures
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Oxygenation; Safety
Difficulty: Moderate
| Feedback |
| A | Biological exposure can be caused by bacteria, viruses, plant or animal contact, or toxic plants or fungi. |
| B | Mixed exposure refers to a mixture of two types of exposures, such as cigarette smoking and asbestos. It can also be caused by mixing two toxic chemicals. |
| C | Physical exposure can be caused by heat and cold, radiation, noise, and vibration. It can also be caused by bodily injury. |
| D | Chemical exposure can be caused by agents such as pesticides, lead, or cigarette smoke. |
PTS: 1 CON: Oxygenation | Safety
- A family survived a dangerous weather event, but now they are suffering through another part of environmental risk: stress, pain, and anxiety. The nurse recognizes that this is the:
| A. | Physical agent |
| B. | Mixed exposure |
| C. | Psychosocial factor |
| D. | Biological agent |
ANS: C
Objective: 3. Utilize an environmental health assessment to identify health risk factors.
- 135-136
Heading: Hazardous Substances > Types of Exposures
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Trauma; Promoting Health; Safety
Difficulty: Easy
| Feedback |
| A | A physical agent causes an injurious exchange of energy and physical damage to a person. |
| B | A mixed exposure is the mixture of two environmental hazards, such as physical and chemical. |
| C | The psychosocial factor is less commonly acknowledged. However, it is important to recognize that communities and individuals that live in fear or experience stress, panic, and anxiety associated with real or perceived threats are subject to psychosocial conditions that affect not only health and safety but overall well-being. |
| D | A biological agent can be a bacteria, virus, animal, or toxic plant or fungi that causes a medical reaction. |
PTS: 1 CON: Trauma | Promoting Health | Safety
- A PHN is learning about exposure risk assessments, which are used by policy makers and other regulators to evaluate the health effects from an environmental exposure. In these assessments, the final step in the process involves making a judgment about the risk of the health problems to those who are exposed. The nurse learns that this is referred to as a:
| A. | Dose-response assessment |
| B. | Risk characterization |
| C. | Hazard identification |
| D. | Exposure assessment |
ANS: B
Objective: 3. Utilize an environmental health assessment to identify health risk factors.
- 135
Heading: Hazardous Substances > Exposure Risk Assessment
Integrated Processes: Teaching/Learning
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Nursing Roles; Assessment; Safety
Difficulty: Moderate
| Feedback |
| A | A dose-response assessment, the second step, is based on experiments and looks for the correlation between an increase in harmful effects and the increase in the quantity of a substance. |
| B | A risk characterization, the last step, pulls together the information gathered in the previous steps to determine the health risk of those affected.
|
| C | A hazard identification, the first step of an exposure risk assessment, seeks details to input from government information portals about the exposure. |
| D | An exposure assessment, the third step, is the consideration of the level, timing, and extent of the exposure. |
PTS: 1 CON: Nursing Roles | Assessment | Safety
- Older adults have higher body burdens of chemicals that have been absorbed over their lifetimes, and these chemicals collect in the adipose tissue or bone, and can later result in poor health outcomes, such as cancer or organ damage. The PHN recognizes that this substance collection is called:
| A. | Half-life |
| B. | Bioaccumulation |
| C. | Latency period |
| D. | Environmental exposure |
ANS: B
Objective: 5. List social, behavioral, and physical characteristics that increase susceptibility to health effects associated with environmental exposure.
- 144-146
Heading: Environmental Health and Susceptible Populations > Older Adults
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Nursing; Safety
Difficulty: Moderate
| Feedback |
| A | This is the time in which half the amount of a certain chemical is excreted out of the body. |
| B | Over time, chemicals accumulate in the tissues and cause irreparable damage to the body. |
| C | A latency period is the period between exposure to a substance and the actual onset of disease. |
| D | Environmental exposure is when a living organism comes into contact with a harmful substance. |
PTS: 1 CON: Nursing | Safety
- A PHN notices that the Air Quality Index measures 120 for an area. The PHN knows that this means that:
| A. | The air quality is good. |
| B. | The air quality is unhealthy. |
| C. | The air quality is hazardous. |
| D. | The air quality is moderate affecting the most sensitive individuals. |
ANS: D
Objective: 7. Describe issues related to air and water quality.
- 147-149
Heading: Air > Ambient Air
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Oxygenation; Safety
Difficulty: Moderate
| Feedback |
| A | Air quality is considered good at a value of 50 or less. |
| B | Air quality is unhealthy for everyone at values of 150 and above. |
| C | Air quality is considered hazardous at values 300 or higher. |
| D | Air quality at values of 101 to 150 are considered moderate and would affect the most sensitive individuals. |
PTS: 1 CON: Oxygenation | Safety
- A nursing instructor is holding a lecture on environmental health and explains that gene environment interaction:
| A. | Can directly cause diabetes, pulmonary disease, and breast cancer |
| B. | Can change the expression of a genetic trait and alter physical aspects |
| C. | Can have either a protective influence or increase risk for many diseases |
| D. | Does not demonstrate any noticeable effect from the environment |
ANS: C
Objective: 6. Discuss gene-environment interaction.
- 146
Heading: Gene-Environment Interaction
Integrated Processes: Teaching/Learning
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Family; Nursing Roles; Safety
Difficulty: Moderate
| Feedback |
| A | There is research that identifies an increased risk for some diseases, but no direct causation. |
| B | There is no obvious physical effect from the change of the genetic trait. |
| C | There has been research that supports both positive and negative influences on the genes from environmental exposure. |
| D | There has been such a correlation between gene expression and environmental exposure that the National Institute on Environmental Health Sciences funded a five-year initiative to study the interaction. |
PTS: 1 CON: Family | Nursing Roles | Safety
- A PHN is helping to manage a chemical spill crisis in a nearby community. In order to find out the community’s chemical response plan, the nurse consults which of the following?
| A. | The Emergency Planning and Community Right to Know Act (EPCRA) |
| B. | The Centers for Disease Control and Prevention (CDC) |
| C. | Healthy People 2020 |
| D. | The World Health Organization (WHO) |
ANS: A
Objective: 7. Describe issues related to air and water quality.
- 147
Heading: Natural Disasters and Environmental Health
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Trauma; Critical Thinking; Safety
Difficulty: Moderate
| Feedback |
| A | The EPCRA gives improved community access to information about chemical hazards and local chemical emergency response plans.
|
| B | The CDC is a global, research-driven organization that strives to give information about and monitor disease. |
| C | Healthy People 2020 is a document that includes health objectives, but it does not include local directives for environmental health. |
| D | WHO is an organization that directs global initiatives for health, not local ones. |
PTS: 1 CON: Trauma | Critical Thinking | Safety
- A PHN knows that the ambient air standard, which is the highest level of a pollutant in a specific place over a specific period of time that is not hazardous for humans, is most influenced by:
| A. | Wind |
| B. | Weather |
| C. | Population |
| D. | The surrounding built environment |
ANS: D
Objective: 7. Describe issues related to air and water quality.
- 147-149
Heading: Air > Ambient Air
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Oxygenation; Safety
Difficulty: Moderate
| Feedback |
| A | The wind can briefly improve the air quality, but the location is the key component. |
| B | The weather can briefly improve the air quality, but the location is the key component. |
| C | The population and the amount of emissions from cars and homes can decrease the quality of the air, but the location plays a key role in the air quality. |
| D | The surrounding built environment is the major influence of air quality. Whether or not a community is located next to something like an industrial plant or railroad tracks is a key factor to community health. |
PTS: 1 CON: Oxygenation | Safety
- Many outdoor air contaminants originate from various sources. The PHN recognizes that sources such as gas stations, dry cleaners, commercial building heating and cooling systems, and waste disposal facilities are referred to as:
| A. | Criteria air pollutants |
| B. | Area sources |
| C. | Mobile sources |
| D. | Point sources |
ANS: B
Objective: 7. Describe issues related to air and water quality.
- 147-149
Heading: Air > Ambient Air
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Oxygenation; Safety
Difficulty: Easy
| Feedback |
| A | Criteria air pollutants are major air pollutants, such as ozone and particulate matter. |
| B | Area sources of pollutants include gas stations, dry cleaners, commercial building heating and cooling systems, and waste disposal facilities. |
| C | Mobile sources of pollutants include buses, trucks, cars, ships, planes, and construction equipment. |
| D | Point sources of pollutants include chemical plants, power plants, refineries, and incinerators. |
PTS: 1 CON: Oxygenation | Safety
- Particulate matter varies in size, and the size determines the site of the deposition in the respiratory system. The nursing student is taught that this means that:
| A. | The larger the particulate, the more hazardous |
| B. | The smaller the particulate, the more hazardous |
| C. | The size of the particulate is not important |
| D. | The lungs and dust masks can take care of the particulates |
ANS: B
Objective: 7. Describe issues related to air and water quality.
- 147-149
Heading: Air > Ambient Air
Integrated Processes: Teaching/Learning
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Oxygenation; Nursing Roles; Safety
Difficulty: Easy
| Feedback |
| A | Larger particulates are removed in the upper airways. |
| B | Smaller particulates are not removed in the upper airways as are larger particles, and increased levels appear to affect lung function of asthma patients and are associated with lung cancer and cardiovascular deaths. |
| C | Smaller particulates have a direct effect on the respiratory health of a population. |
| D | Dust masks do not protect the lungs from the effects of small particles. |
PTS: 1 CON: Oxygenation | Nursing Roles | Safety
- According to the WHO, it is estimated that a large number of people worldwide do not have access to safe drinking water. In a lecture on water quality, a PHN learns that the main barriers to the provision of clean drinking water include all of the following except
| A. | Financial capacity |
| B. | Too many facilities for the sanitary disposal of excrement |
| C. | Sustainability of the water supply |
| D. | Sanitation and hygiene behaviors |
ANS: B
Objective: 7. Describe issues related to air and water quality.
- 151-152
Heading: Potable Water > Safe Water from a Global Perspective
Integrated Processes: Teaching/Learning
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Nursing Roles; Safety
Difficulty: Moderate
| Feedback |
| A | Financial capacity is necessary to develop systems for clean water. |
| B | WHO actually recommends increasing the number of facilities for the sanitary disposal of excrement. |
| C | Once a system is built, it has to be maintained to continue the clean water supply. |
| D | Maintaining the sanitation of an area and changing ingrained hygiene behaviors can be a challenge to improving water quality. |
PTS: 1 CON: Nursing Roles | Safety
MULTIPLE RESPONSE
- A nursing instructor is giving a lecture on environmental sustainability. The instructor explains that this is a critical issue to the global environment and an important emerging public health issue. Some of the issues addressed within environmental sustainability include which of the following?
Select all that apply.
| A. | Preventing environmental exposure |
| B. | Maintaining the funding for research and development for alternative energy |
| C. | The rates in which renewable resources are harvested |
| D. | The rates of depletion of nonrenewable resources |
| E. | The creation of pollution that can continue for an indefinite period of time |
ANS: C, D, E
Objective: 7. Describe issues related to air and water quality.
- 152
Heading: Environmental Sustainability
Integrated Processes: Teaching/Learning
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Nursing Roles; Safety
Difficulty: Moderate
| Feedback |
| 1 | This is incorrect. Preventing environmental exposure is an indirect goal of sustaining the resources to survive. |
| 2 | This is incorrect. Environmental sustainability includes carefully monitoring the dwindling resources to sustain human survival, but it does not including maintaining funding. |
| 3 | This is correct. Environmental sustainability includes monitoring agriculture and other resources that can be replenished to insure efficiency. |
| 4 | This is correct. Environmental sustainability includes monitoring non-renewable resources, such as coal and gas, as these crucial issues have been linked to world conflict. |
| 5 | This is correct. Environmental sustainability must include the monitoring and regulation of pollution to insure water and air quality. |
PTS: 1 CON: Nursing Roles | Safety
- The PHN understands that the toxicity of chemicals in children is more severe than that in older populations because of which of the following reasons?
Select all that apply.
| A. | Children play in outdoor soil, which can be contaminated. |
| B. | Children may ingest substances from unlabeled, repurposed food containers. |
| C. | Children have faster rates of absorption of toxic substances. |
| D. | Parental oversight is minimal. |
| E. | Children have less developed immune systems. |
ANS: A, B, C, D, E
Objective: 5. List social, behavioral, and physical characteristics that increase susceptibility to health effects associated with environmental exposures.
- 144
Heading: Environmental Health and Susceptible Populations > Children
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Nursing; Safety
Difficulty: Easy
| Feedback |
| 1 | This is correct. Children playing on the ground and floor may spend their time in the most contaminated areas. For example, outdoor soil is often contaminated with heavy metals and pesticides, and hand-to-mouth behavior promotes ingestion of both seen and unseen agents. |
| 2 | This is correct. Children have ingested substances from unlabeled food containers that have been repurposed to hold chemicals or were located in an easily accessible place such as under the sink. |
| 3 | This is correct. Due to their higher metabolic rate, faster rate of cell growth, and less developed body systems, children absorb chemicals at a quicker rate than older populations. |
| 4 | This is correct. Lack of parental oversight could allow an exposure to a toxic chemical as a result of a child’s desire to taste their environment. |
| 5 | This is correct. If a child is exposed to a toxic chemical, he or she does not have a fully developed immune system to handle the toxicity. |
PTS: 1 CON: Nursing | Safety
- To aid a lower income family who is struggling with a pest problem in their home, a PHN recommends a program known as integrated pest management, which offers methods to deter pests. Some of these methods include which of the following?
Select all that apply.
| A. | Caulking and sealing cracks and holes in the home |
| B. | Eating in one place |
| C. | Getting rid of clutter |
| D. | Storing food in sealed containers |
| E. | Making sure the family is vaccinated |
ANS: A, B, C, D
Objective: 4. Explain the concept of environmental justice.
- 140-143
Heading: Environmental Justice
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Promoting Health; Safety
Difficulty: Easy
| Feedback |
| 1 | This is correct. Caulking and sealing cracks and holes in the home keeps pests out and deters them from living in the home. |
| 2 | This is correct. Eating in one place helps consolidate areas that must be cleaned and limits the food supply of the pests. |
| 3 | This is correct. Getting rid of clutter gets rid of the hiding places of the pests. |
| 4 | This is correct. Storing food in sealed containers keeps the pests from finding the food by smell and keeps the food sanitary. |
| 5 | This is incorrect. Making sure the family is vaccinated is a proactive health step, but does not eliminate pests. |
PTS: 1 CON: Promoting Health | Safety
- The public health nursing student learns that the need for environmental justice extends to disadvantaged populations, who, as a result of low income, age, health status, race, or other social indices of susceptibility, are at greatest risk of exposure to environmental hazards because of which of the following problems?
Select all that apply.
| A. | Substandard housing |
| B. | Lack of access to health care |
| C. | Lack of nutritious food |
| D. | Lack of safe places to play |
| E. | Employment in risky jobs |
ANS: A, B, C, D, E
Objective: 4. Explain the concept of environmental justice.
- 140-143
Heading: Environmental Justice
Integrated Processes: Teaching/Learning
Client Need: Safe and Effective Care Environment: Safety and Infection Control
Cognitive Level: Application [Applying]
Concept: Nutrition; Economics; Nursing Roles; Safety
Difficulty: Easy
| Feedback |
| 1 | This is correct. Disadvantaged populations often live in housing that is affordable for them but not in the best condition. Problems include lead paint and pest infestations. |
| 2 | This is correct. Disadvantaged populations, due to a lack of insurance, are not able to get the best health care or have options when they are sick. |
| 3 | This is correct. Disadvantaged populations may not have access to nutritious food or the knowledge of what to eat to keep themselves healthy. |
| 4 | This is correct. Disadvantaged populations, due to where they live, may not have access to safe or healthy places to play. |
| 5 | This is correct. Disadvantaged populations may not have a choice in job selection due to a lack of education or skills, and so may be forced to take a more risky job to survive. |
PTS: 1 CON: Nutrition | Economics | Nursing Roles | Safety
Chapter 7: Health Disparities
MULTIPLE CHOICE
- A nurse is studying the increased infant mortality rate at a local hospital in a largely African American community. The nurse notes that there are very few options for prenatal care in the community and recognizes that this is an example of:
| A. | Health disparity |
| B. | Health inequity |
| C. | Health injustice |
| D. | Social determinant of health |
ANS: B
Objective: 1. Compare and contrast the concepts of health disparity, inequity, and inequality.
- 157-158
Heading: Definitions
Integrated Processes: Nursing Process
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Promoting Health; Evidence-Based Practice; Pregnancy
Difficulty: Difficult
| Feedback |
| A | A health disparity is simply a difference in health outcomes; it does not necessarily imply an unequal or unjust difference. |
| B | A health inequity is a disparity that is also unjust or unfair. |
| C | This is incorrect; a health inequity, not a health injustice, is a disparity or difference that is considered to be unjust or unfair. |
| D | A social determinant of health is one of the factors that contribute to a person’s life and health. These include the environment in which someone lives, works, or grows up. |
PTS: 1 CON: Promoting Health | Evidence-Based Practice | Pregnancy
- Which of the following is the definition of health disparity?
| A. | A difference in health outcomes |
| B. | An unequal and unjust difference in health outcomes |
| C. | A social factor that impacts health outcomes and contributes to disparity |
| D. | Access to health care for everyone without financial hardship |
ANS: A
Objective: 1. Compare and contrast the concepts of health disparity, inequity, and inequality.
- 158-160
Heading: Definitions
Integrated Processes: N/A
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health
Difficulty: Moderate
| Feedback |
| A | A health disparity is simply a difference in health outcomes. |
| B | A health disparity is simply a difference in health outcomes; it does not necessarily imply an unequal or unjust difference. |
| C | A health disparity is simply a difference in health outcomes; it is different from a social determinant of health. |
| D | A health disparity is simply a difference in health outcomes; the term does not imply objectives or goals such as the one stated here. |
PTS: 1 CON: Promoting Health
- In many countries, which factors decrease infant mortality rate?
| A. | Income |
| B. | Education level |
| C. | Neither 1 nor 2 |
| D. | Both 1 and 2 |
ANS: D
Objective: 2. Discuss the magnitude of health disparities both in the United States and internationally.
- 168-169
Heading: Social Determinants of Health, Health Disparity, and Social Justice > Role of Income and Education
Integrated Processes: N/A
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Knowledge [Remembering]
Concept: Evidence-Based Practice
Difficulty: Moderate
| Feedback |
| A | Both increased income and increased education are known to decrease infant mortality rate. |
| B | Both increased income and increased education are known to decrease infant mortality rate. |
| C | Both increased income and increased education are known to decrease infant mortality rate. |
| D | Both increased income and increased education are known to decrease infant mortality rate. |
PTS: 1 CON: Evidence-Based Practice
- In a study performed by the Center for Economic and Political Studies, researchers found that between 2003 and 2006 the cost of health inequalities in the United States was approximately:
| A. | $1 million |
| B. | $100 million |
| C. | $1 billion |
| D. | $1 trillion |
ANS: D
Objective: 2. Discuss the magnitude of health disparities both in the United States and internationally.
- 160-161
Heading: Magnitude of the Problem
Integrated Processes: N/A
Client Need: Health Promotion and Maintenance
Cognitive Level: Knowledge [Remembering]
Concept: Promoting Health; Economics; Evidence-Based Practice
Difficulty: Easy
| Feedback |
| A | In the study performed by the Center for Economic and Political Studies, researchers found that the cost of health inequalities was approximately $1 trillion dollars between 2003 and 2006. |
| B | In the study performed by the Center for Economic and Political Studies, researchers found that the cost of health inequalities was approximately $1 trillion dollars between 2003 and 2006. |
| C | In the study performed by the Center for Economic and Political Studies, researchers found that the cost of health inequalities was approximately $1 trillion dollars between 2003 and 2006. |
| D | In the study performed by the Center for Economic and Political Studies, researchers found that the cost of health inequalities was approximately $1 trillion dollars between 2003 and 2006. |
PTS: 1 CON: Promoting Health | Economics | Evidence-Based Practice
- Which of the following programs has been designed to work toward optimal health for all Americans?
| A. | Racial and Ethnic Approaches to Health (REACH) |
| B. | Universal Health Care |
| C. | Healthy People |
| D. | EURO Health for All |
ANS: C
Objective: 3. Describe the role of Healthy People 2010 in eliminating health disparities.
- 161
Heading: Magnitude of the Problem > Goal to Eliminate Health Disparities
Integrated Processes: N/A
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Promoting Health; Health-Care System
Difficulty: Easy
| Feedback |
| A | The Racial and Ethnic Approaches to Health Program, or REACH, was created to increase community-funding programs that minimize health disparities. |
| B | Universal health care, while often considered to be the optimal plan to minimize health disparities, does not exist in the United States. |
| C | Healthy People is a program established by the CDC that sets goals that work toward optimal health for all Americans. |
| D | EURO Health for All looks to reduce health disparities between European countries. It does not impact Americans. |
PTS: 1 CON: Promoting Health | Health-Care System
- Which of the following statements about Healthy People is correct?
| A. | Healthy People 2010 was successful in reaching its goal of ending health disparities. |
| B. | Healthy People 2010 focused on climate change as one of the key factors contributing to health inequities. |
| C. | The goal of Healthy People 2020 was expanded to include improving the health of all ages and groups, and to eliminate all health disparities and inequities. |
| D. | The goal of Healthy People 2010 was to reduce health disparities and inequity. |
ANS: C
Objective: 3. Describe the role of Healthy People 2010 in eliminating health disparities.
- 161
Heading: Magnitude of the Problem > Goal to Eliminate Health Disparities
Integrated Processes: N/A
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health; Health-Care System
Difficulty: Moderate
| Feedback |
| A | This is incorrect. The goals of Healthy People 2010 were not met and the program was extended to 2020. |
| B | This is incorrect. Healthy People does not address climate change and its role in health inequities. |
| C | This is correct. The goal of Healthy People 2020 was expanded to include improving the health of all ages and groups, and to eliminate all health disparities and inequities. |
| D | This is incorrect. The goal of Healthy People 2010 was to completely eliminate health disparities. The goal of Healthy People 2000 was to reduce disparity. |
PTS: 1 CON: Promoting Health | Health-Care System
- A nurse manager has been working in a community health center for many years. In the recent months, the nurse manager has noticed a dramatic increase in the number of Hispanic clients coming in to the center with uncontrolled diabetes. Which of the following is the best way to address the situation?
| A. | Speak with local providers about decreasing the length of time between follow-up visits. |
| B. | Involve pharmacists in counseling newly diagnosed patients about their insulin regimen. |
| C. | Perform a community assessment to determine why community members aren’t properly caring for themselves. |
| D. | Develop several educational handouts about managing diabetes and have them translated into Spanish. |
ANS: C
Objective: 4. Identify different actions nurses can take to alleviate health disparities within the health-care system.
- 174
Heading: A World Without Health Disparities
Integrated Processes: Nursing Process
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis [Analyzing]
Concept: Nursing Roles; Promoting Health; Critical Thinking; Metabolism
Difficulty: Moderate
| Feedback |
| A | The first step would be to perform a community assessment and establish what the community needs. The next steps, which might include speaking with local providers, would occur after the results of the assessment were determined and analyzed. |
| B | The first step would be to perform a community assessment and establish what the community needs. The next steps, which might include getting pharmacists involved, would occur after the results of the assessment were determined and analyzed. |
| C | The first step would be to perform a community assessment and establish what the community needs. The next steps would occur after the results of the assessment were determined and analyzed. |
| D | The first step would be to perform a community assessment and establish what the community needs. The next steps, which might include developing educational handouts, would occur after the results of the assessment were determined and analyzed. |
PTS: 1 CON: Nursing Roles | Promoting Health | Critical Thinking | Metabolism
- A nurse educator is preparing a lesson on the issues surrounding the Affordable Care Act and universal health care. In 2005, which organization passed a resolution that states that every person should be able to access health-care services regardless of economic status?
| A. | The Supreme Court |
| B. | The World Health Organization |
| C. | The United Nations |
| D. | The World Health Assembly |
ANS: D
Objective: 4. Identify different actions nurses can take to alleviate health disparities within the health-care system.
- 161-165
Heading: Magnitude of the Problem > Reflection of Health Disparities in Health Outcomes
Integrated Processes: Teaching/Learning
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Comprehension [Understanding]
Concept: Promoting Health
Difficulty: Easy
| Feedback |
| A | The Supreme Court does not pass regulations. It did, however, uphold that the measures included in the Affordable Care Act (which is not universal health care) are constitutional. |
| B | The World Health Assembly, not the World Health Organization, passed a resolution in 2005 that stated that every person should be able to access health-care services regardless of economic status. |
| C | The World Health Assembly, not the United Nations, passed a resolution in 2005 that stated that every person should be able to access health-care services regardless of economic status. |
| D | The World Health Assembly passed a resolution in 2005 that stated that every person should be able to access health-care services regardless of economic status. |
PTS: 1 CON: Promoting Health
- Researchers have found that investment in which of the following would have had a greater effect on health disparities than the investment in new medical technology?
| A. | Improving quality of health care |
| B. | Increasing access to education for everyone |
| C. | Implementing universal health care |
| D. | Decreasing crime rate |
ANS: B
Objective: 5. List reasons why even after 10 years health disparities have not decreased in the United States
- 165-166
Heading: Magnitude of the Problem > Health Disparities Have Not Been Solved
Integrated Processes: N/A
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Comprehension [Understanding]
Concept: Evidence-Based Practice; Promoting Health
Difficulty: Moderate
| Feedback |
| A | Researchers found that correcting the educational disparity—giving more people access to an affordable college education—had a greater effect on reducing health inequities than improving the quality of health care or investing in new medical technologies. |
| B | Researchers found that correcting the educational disparity—giving more people access to an affordable college education—had a greater effect on reducing health inequities than improving the quality of health care or investing in new medical technologies. |
| C | Researchers found that correcting the educational disparity—giving more people access to an affordable college education—had a greater effect on reducing health inequities than improving the quality of health care or investing in new medical technologies. |
| D | Researchers found that correcting the educational disparity—giving more people access to an affordable college education—had a greater effect on reducing health inequities than improving the quality of health care or investing in new medical technologies. |
PTS: 1 CON: Evidence-Based Practice | Promoting Health
- A nurse is teaching an in-service for new nurses on the importance of cultural sensitivity when caring for patients. Which of the following statements is incorrect?
| A. | Ethnic diversity of health-care staff plays little role in the reduction of health-care inequalities. |
| B. | Translators should always be used when a patient does not speak English as a primary language. |
| C. | Nurses and other health-care workers may often display discriminatory behavior without realizing it. |
| D. | Nurses must always work as patient advocates to make sure that the patient is receiving culturally sensitive care. |
ANS: A
Objective: 4. Identify different actions nurses can take to alleviate health disparities within the health-care system.
- 165
Heading: Magnitude of the Problem > Actions to Reduce Health Disparities
Integrated Processes: Teaching/Learning
Client Need: Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Ethics; Communication; Nursing Roles; Diversity
Difficulty: Moderate
| Feedback |
| A | This statement is incorrect. Increased diversity of health-care workers does play a role in decreasing health-care inequities. |
| B | This statement is correct. Translators should always be used when a patient does not speak English as a primary language. The translator could be a staff member of the hospital, a family member, or a paid interpreter with an interpreting service. |
| C | This statement is correct. Nurses are subject to behaving in the same discriminatory manner as other people. Nurses should always examine their own actions to make sure that they are behaving in a culturally sensitive manner. |
| D | This statement is correct. Nurses should always advocate for their patients to ensure that they are receiving culturally sensitive and appropriate care. |
PTS: 1 CON: Ethics | Communication | Nursing Roles | Diversity
- A nurse is working in a community center and notices a high rate of obesity in its members. The nurse suspects that poor access to fresh fruits and vegetables may be partially responsible. What should the nurse do first when formulating a plan?
| A. | Assess the social determinants in the community. |
| B. | Implement a plan to increase access to fresh produce. |
| C. | Outline the steps needed to address the disparity. |
| D. | Formulate a community diagnosis. |
ANS: A
Objective: 6. Define and explain the role of social determinants of health in contributing to health disparities.
- 166
Heading: Social Determinants of Health, Health Disparity, and Social Justice
Integrated Processes: Nursing Process
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis [Analyzing]
Concept: Nutrition; Assessment; Promoting Health; Critical Thinking
Difficulty: Moderate
| Feedback |
| A | Even though the nurse suspects that lack of access to fresh produce is one of the main factors driving the high obesity rate in the community, the nurse should still perform a community assessment first. There may be other factors, such as poor knowledge about healthy cooking techniques, which are contributory. |
| B | Even though the nurse suspects that lack of access to fresh produce is one of the main factors driving the high obesity rate in the community, the nurse should still perform a community assessment first. There may be other factors, such as poor knowledge about healthy cooking techniques, which are contributory. Implementing a plan should come after the plan is created based on the results of the community assessment. |
| C | Even though the nurse suspects that lack of access to fresh produce is one of the main factors driving the high obesity rate in the community, the nurse should still perform a community assessment first. There may be other factors, such as poor knowledge about healthy cooking techniques, which are contributory. Creating a plan should come after the results of the community assessment are known. |
| D | Even though the nurse suspects that lack of access to fresh produce is one of the main factors driving the high obesity rate in the community, the nurse should still perform a community assessment first. There may be other factors, such as poor knowledge about healthy cooking techniques, which are contributory. A diagnosis should be formulated based on the results of the community assessment. |
PTS: 1 CON: Nutrition | Assessment | Promoting Health | Critical Thinking
- A nurse is performing an assessment of a very economically diverse community and realizes that while comparing income to health outcomes, the nurse must be careful to:
| A. | Compare only the outcomes of the richest community members to the outcomes of the poorest community members. |
| B. | Recognize that income and outcomes exist on a scale, and look across the entire spectrum. |
| C. | Evaluate only the poorest health outcomes and where they land on the income spectrum. |
| D. | Evaluate only the poorest community members and their health outcomes. |
ANS: B
Objective: 6. Define and explain the role of social determinants of health in contributing to health disparities.
- 166-167
Heading: Social Determinants of Health, Health Disparity, and Social Justice > International Recognition of Social Determinants of Health
Integrated Processes: Nursing Process
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Diversity; Critical Thinking; Evidence-Based Practice; Promoting Health; Economics
Difficulty: Moderate
| Feedback |
| A | Income levels exist on a spectrum and the nurse should be careful to consider all community members along that spectrum, not just the richest and the poorest. It is especially important not to compare the health outcomes of the two extremes of the spectrum to each other. |
| B | Income levels exist on a spectrum and the nurse should be careful to consider all community members along that spectrum, not just the richest and the poorest. It is especially important not to compare the health outcomes of the two extremes of the spectrum to each other. |
| C | Income levels exist on a spectrum and the nurse should be careful to consider all community members along that spectrum, not just the richest and the poorest. It is especially important not to compare the health outcomes of the two extremes of the spectrum to each other. |
| D | Income levels exist on a spectrum and the nurse should be careful to consider all community members along that spectrum, not just the richest and the poorest. It is especially important not to compare the health outcomes of the two extremes of the spectrum to each other. |
PTS: 1
CON: Diversity | Critical Thinking | Evidence-Based Practice | Promoting Health | Economics
- A nurse is looking at reasons why members of a community are more likely to die from heart disease. The nurse finds several studies that suggest that social factors, such as ____, are more important than behavioral choices.
| A. | Smoking |
| B. | High-fat or high-sugar diets |
| C. | Poverty |
| D. | Lack of exercise |
ANS: C
Objective: 6. Define and explain the role of social determinants of health in contributing to health disparities.
- 166-167
Heading: Social Determinants of Health, Health Disparity, and Social Justice > International Recognition of Social Determinants of Health
Integrated Processes: Nursing Process
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Perfusion; Evidence-Based Practice
Difficulty: Moderate
| Feedback |
| A | Several studies have shown that social determinants of health, such as poverty and stress, may be more important than behavioral choices such as smoking. |
| B | Several studies have shown that social determinants of health, such as poverty and stress, may be more important than behavioral choices such as a high-fat or high-sugar diet. |
| C | Several studies have shown that social determinants of health, such as poverty and stress, may be more important than behavioral choices. |
| D | Several studies have shown that social determinants of health, such as poverty and stress, may be more important than behavioral choices such as lack of exercise. |
PTS: 1 CON: Perfusion | Evidence-Based Practice
- A research nurse is looking for funding to study health disparities in a community—an ethnically and economically diverse inner city neighborhood. The nurse is trying to apply evidence from controlled studies to see how they correlate in the real world. What type of study is the nurse designing?
| A. | Translational |
| B. | Causation |
| C. | Correlation |
| D. | Observational |
ANS: A
Objective: 7. Discuss solutions to decreasing health disparity caused by social determinants of health, specifically how nurses can be part of the solution.
- 170-172
Heading: Solutions to Health Disparities > Paradigm Shift
Integrated Processes: Nursing Process
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Diversity; Evidence-Based Practice; Promoting Health
Difficulty: Moderate
| Feedback |
| A | Translational studies use evidence from controlled studies and apply the findings to real world situations. |
| B | Causation studies look for the cause of the studied phenomena. This question is referring to a translational study because the nurse is going to use evidence from controlled studies and apply the findings to real world situations. |
| C | Correlational studies measure how strong a relationship is between two factors. This question is referring to a translational study because the nurse is going to use evidence from controlled studies and apply the findings to real world situations. |
| D | Observational studies involve researchers observing a group of participants to determine if certain factors are associated with an increased risk for developing a certain outcome. This question is referring to a translational study because the nurse is going to use evidence from controlled studies and apply the findings to real world situations. |
PTS: 1 CON: Diversity | Evidence-Based Practice | Promoting Health
- During a lecture on health disparities, a student asks the instructor how communities with great access to health care can still have poor health outcomes. How should the instructor respond?
| A. | Social determinants of health determine how people respond to health threats and how they access preventative care. |
| B. | The student is incorrect. Communities with good access to care have good health outcomes. |
| C. | This phenomenon only occurs in communities where the quality of health care is poor. |
| D. | Members of these communities only have access to primary-care providers, which reduces the quality of care they receive. |
ANS: A
Objective: 7. Discuss solutions to decreasing health disparity caused by social determinant of health, specifically how nurses can be part of the solution.
- 170-172
Heading: Solutions to Health Disparities > Paradigm Shift
Integrated Processes: Teaching/Learning
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Promoting Health; Nursing Roles
Difficulty: Difficult
| Feedback |
| A | This is correct. Social determinants of health determine how people respond to health threats and how frequently they access preventative measures. |
| B | The student is correct. Access to health care does not guarantee good health outcomes. Community members may not be able to afford accessing such care or may be unable to access care due to busy work schedules. |
| C | Access to good health care does not guarantee good health outcomes. If community members are not be able to afford health care or are unable to access care due to stressful work schedules, the quality of the care does not matter. |
| D | Access to only primary-care providers does not lead to poor health outcomes. Social determinants of health determine how people respond to health threats and how frequently they access preventative measures. |
PTS: 1 CON: Promoting Health | Nursing Roles
- A nurse is counseling a young man with obesity and diabetes. The nurse explains that in addition to direct medical costs, indirect costs will likely include:
| A. | Costs of medication |
| B. | Lost wages and loss of employment productivity |
| C. | Decreased lifespan |
| D. | Increased costs of health insurance |
ANS: B
Objective: 7. Discuss solutions to decreasing health disparity caused by social determinant of health, specifically how nurses can be part of the solution.
- 160-161
Heading: Magnitude of the Problem
Integrated Processes: Teaching/Learning
Client Need: Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Promoting Health; Economics; Nutrition; Metabolism
Difficulty: Moderate
| Feedback |
| A | Increased medication costs are direct costs of health disparity. Lost wages and loss of productivity are considered indirect economic costs. |
| B | Lost wage and loss of employee productivity are considered indirect economic costs. They occur as a result of the uncontrolled hypertension but are not directly related to the patient’s medical care. |
| C | Decreased lifespan is not an economic cost of chronic illness. Lost wages and loss of productivity are considered indirect economic costs. |
| D | Increased health insurance costs are a direct cost of health disparity. Lost wages and decreased worker productivity are indirect economic costs. |
PTS: 1 CON: Promoting Health | Economics | Nutrition | Metabolism
MULTIPLE RESPONSE
- A nurse is organizing a round table presentation at a conference. The nurse asks the other participants for suggestions on actions that nurses can take to reduce national health disparities. Which of the following suggestions are known to be effective measures for the reduction of health disparities?
Select all that apply.
| A. | Volunteer with an international organization that supports building infrastructure in underdeveloped areas. |
| B. | Support initiatives that increase physical education classes and healthy school meals. |
| C. | Design and create research studies that address inequities and support vulnerable populations. |
| D. | Discuss social and health disparity information with coworkers to promote awareness. |
| E. | Act as advocates for patients, families, and communities in reducing inequities. |
ANS: B, C, D, E
Objective: 7. Discuss solutions to decreasing health disparity caused by social determinant of health, specifically how nurses can be part of the solution.
- 174
Heading: Nurses Are Part of the Solution
Integrated Processes: Teaching/Learning
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Critical Thinking; Evidence-Based Practice; Nursing; Promoting Health; Nursing Roles; Collaboration
Difficulty: Moderate
| Feedback |
| 1 | This answer is incorrect. Volunteering with an international organization that supports building infrastructure in underdeveloped areas will not improve health disparities in this country. |
| 2 | This answer is correct. Supporting initiatives that increase physical education and healthy meals in schools will improve health outcomes in underserved areas and can help diminish health disparities. |
| 3 | This answer is correct. Designing and creating research studies that address health inequities and support vulnerable populations are one way that nurses can reduce health disparities. |
| 4 | Promoting awareness of health disparities through discussions with colleagues and friends is a great way for nurses to reduce health disparities. This helps other nurses be more aware of the issues surrounding health inequities and act in ways to reduce disparities. |
| 5 | While nurses should always act as advocates for their patients, advocating for particularly vulnerable populations, whether they include patients, their families, or communities, can be an effective way of reducing local disparities. |
PTS: 1
CON: Critical Thinking | Evidence-Based Practice | Nursing | Promoting Health | Nursing Roles | Collaboration
- A nurse administrator is teaching staff about populations at risk for poor health outcomes in an attempt to decrease health inequities in the hospital. Which of the following groups does the nurse administrator mention are at higher risk for poor health outcomes related to health disparities?
Select all that apply.
| A. | People who carry private health insurance |
| B. | Families receiving public assistance |
| C. | African Americans |
| D. | Native Americans |
| E. | The middle class |
ANS: B, C, D
Objective: 2. Discuss the magnitude of health disparities both in the United States and internationally.
- 157-158
Heading: Introduction
Integrated Processes: Teaching/Learning
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Promoting Health; Nursing Roles
Difficulty: Easy
| Feedback |
| 1 | People who are able to afford private health insurance are not usually at higher risk for poor health outcomes due to health disparities. |
| 2 | Families receiving public assistance are usually living under the poverty line and are therefore more likely to be at a higher risk for poor health outcomes secondary to health disparities. |
| 3 | African Americans and certain other ethnicities have been found to be at higher risk for poor health outcomes due to health disparities, regardless of their income or educational level. |
| 4 | Native Americans and certain other ethnicities have been found to be at a higher risk for poor health outcomes due to health disparities, regardless of their income or educational level. |
| 5 | The middle class is traditionally thought of as financially stable and able to afford private health insurance or health care. They are not usually vulnerable to health disparities. |
PTS: 1 CON: Promoting Health | Nursing Roles
- A public health nurse (PHN) is performing a community assessment in order to reduce the childhood obesity rate in a community. What social determinants of health should the PHN examine?
Select all that apply.
| A. | Location of primary health providers |
| B. | Nutrition and physical education classes in the public schools |
| C. | Housing security |
| D. | Presence of sidewalks within the community |
| E. | Access to fresh produce |
ANS: A, B, D, E
Objective: 7. Discuss solutions to decreasing health disparity caused by social determinants of health, specifically how nurses can be part of the solution.
- 166-167
Heading: Social Determinants of Health, Health Disparity, and Social Justice > International Recognition of Social Determinants of Health
Integrated Processes: Nursing Process
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Analysis [Analyzing]
Concept: Nutrition; Assessment; Critical Thinking; Promoting Health
Difficulty: Moderate
| Feedback |
| 1 | Location of primary health providers is an important factor to examine when performing a community health assessment. Lack of access to health care makes a population more vulnerable to health disparities. |
| 2 | Lack of proper nutrition and physical education classes is an important social determinant of health. Without them, students may not have adequate opportunities for physical activity or correct information to make proper food choices. |
| 3 | Housing security, while an important social determinant of health in certain circumstances, does not usually have a direct impact on childhood obesity rates. |
| 4 | The presence or absence of sidewalks within a community can be an important sign of how walkable the community is. A community with a lot of sidewalks and walking paths promotes walking and healthy activity. A community without sidewalks does not. |
| 5 | Access to fresh produce is an important component of health communities. Without nutritious foods, children are at higher risk for obesity and other poor outcomes. |
PTS: 1 CON: Nutrition | Assessment | Critical Thinking | Promoting Health
ORDERED RESPONSE
- A PHN is looking at creating a plan to address the high rate of uncontrolled hypertension in a community. List the following steps in the order in which the nurse should perform them (1–4).
_____ 1. Evaluate the community to see what social determinants of health need to be addressed and what is lacking within the community.
_____ 2. Review the program outcomes with evaluations from participants and local care providers to determine the effectiveness of the program.
_____ 3. Start planning a community wide health fair with representatives from local primary-care providers, fitness centers, and local produce vendors.
_____ 4. Have printed material and educational information available for community participants to take home and use after the fair.
ANS:
1, 4, 2, 3
Feedback: First, the nurse should perform a community assessment to see what social determinants of health need to be addressed and to see what is lacking within the community. Next, the nurse should formulate a nursing diagnosis and create a plan to address the needs of the community. This can be done by planning a community wide health fair with representatives from local primary-care providers, fitness centers, and local produce vendors. Next, the nurse implements the plan and tries to anticipate the needs of the participants after the fair by having printed materials and educational information available for people to take home and use after the fair. Finally, the nurse evaluates the effectiveness of the program and modifies the plan as needed.
Objective: 7. Discuss solutions to decreasing health disparity caused by social determinant of health, specifically how nurses can be part of the solution.
- 174
Heading: Nurses Are Part of the Solution
Integrated Processes: Nursing Process
Client Need: Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Perfusion; Critical Thinking; Promoting Health
Difficulty: Moderate
PTS: 1 CON: Perfusion | Critical Thinking | Promoting Health
