Deck 15: Health Planning for Primary Care Settings

Question 1

A new strain of flu has emerged, and the CDC has released a new vaccine that is for use in high-risk populations. Which population is most apt to be high-risk?
1)Pregnant women
2)Older adults
3)Children
4)All of the above

Answer 1

4

Question 2

A nurse is working in a primary health-care setting that has had a recent influx of persons immigrating from a West African country. She wants to incorporate cultural components to the care of patients from this country. What are possible aspects of the culture that she should learn more about? (Select all that apply.)
1)Kinship
2)Source of income
3)Gender roles
4)Value of children

Answer 2

1, 3, 4

Question 3

A nurse is looking to reduce the number of adolescents in her community that are using tobacco. The nurse implements a community-wide program to raise awareness about the dangers of nicotine use and creates a support group specifically aimed at teens looking to quit smoking. This is an example of:
1)Health protection.
2)Health promotion.
3)Risk reduction.
4)Tertiary prevention.

Answer 3

2

Question 4

A primary care nurse is volunteering at lead screening clinic for children living in an inner-city community. After performing the screening tests, what is the most important thing for the nurse to do for the children with a positive screen?
1)Conduct a home visit.
2)Refer them to a pediatric specialist for further screening and possible treatment.
3)Offer parents educational materials related to reducing lead exposure in children.
4)Conduct a community-wide environmental assessment to determine the source of the lead exposure.

Question 5

The nurse at a community-based primary care organization is educating newly hired nurses about the process used at the clinic for developing public health programs aimed at benefitting community members whether they attend the clinic or not. The nurse explains that even though the primary care offered at the clinic focuses on caring for an individual, the health promotion activities that they are developing for the community are focused on:
1)The family.
2)The health-care provider.
3)The health-care organization.
4)The population.

Question 6

A nurse is working with a community center that primarily serves a nearby Native American tribe. The nurse knows that many of the tribe members suffer from type 2 diabetes. Which of the following interventions is an example of a tertiary prevention?
1)Teaching school-aged children healthy exercise.
2)Conducting a blood glucose screening for program for the adults in the community.
3)Actively encouraging patients diagnosed with type 2 diabetes to have foot, eye, and hemoglobin A1C screening tests every 3 months.
4)Publishing a culturally grounded guide about preventing diabetes using input from the tribal leaders and distributing it to all persons who come to the clinic.

Question 7

A primary care nurse works at the Native American Health Center, a nonprofit organization serving the California Bay Area Native Population. The center has asked her to put together a comprehensive prevention plan related to type 2 diabetes. Which of the following interventions is an example of a primary intervention?
1)Regular foot and eye care
2)Encouraging a healthy diet and weight loss if appropriate
3)Tight blood sugar control with every meal
4)Screening blood glucose yearly

Question 8

When providing care within the context of primary health care, the most important person(s) is/are: ______________.
1)The individual/family
2)The population
3)The primary-care physician
4)The medical specialist

Question 9

A primary health nurse has observed an increase in the rate of patients being treated for pertussis in her community. The nurse has seen multiple news reports on the issue and knows that this isn't an isolated problem. The nurse decides to brainstorm strategies to reduce the pertussis rate in her community. First, the nurse should:
1)Consult with local pediatricians about increasing vaccination rates in children.
2)Begin creating patient education materials to distribute in the waiting room.
3)Perform a health and cultural evaluation of her community.
4)Begin offering vaccinations free of charge.

Question 10

A nurse is speaking with her accountant about opening a free clinic as a 501(c)(3) organization. The accountant advises the nurse:
1)To charge patients his or her regular fees.
2)To waive her professional fees but charge for testing and more advanced care.
3)To charge a nominal fee if the patient can afford to pay but provide services regardless.
4)To charge a small fee, usually around 25% of the service value.

Question 11

A nurse has worked at a community health center for many years. Over the last several months, the nurse has noticed a significant decline in community members using the resources available at the clinic. What is the first thing the nurse should do?
1)Begin offering day care services and free transportation to the clinic to make it more convenient.
2)Reach out to former patients to determine why they are no longer returning to the clinic.
3)Perform a community assessment.
4)Begin offering a new patient reduced fee rate.

Question 12

A nurse is meeting with a patient with no history of IV drug use after he has spoken with the doctor and received a diagnosis of hepatitis B and E. The patient expresses concern that someone will find out about his diagnosis. How does the nurse respond? "I can understand that you are concerned about this. ___________________."
1)"You do not need to worry because this patient information is protected by HIPAA, and I am not allowed to provide this information to anyone who is not responsible for your clinical care."
2)"However, it is your responsibility to inform all of your previous sexual partners."
3)"However, this is a reportable disease in this state. This means the public health department will ask you for all your possible contacts that might requiring counseling and/or post-exposure prophylaxis."
4)None of the above.

Question 13

A young woman presents to her primary care provider. Her mother has just been diagnosed with Huntington's disease, and several other members of her family have been diagnosed with the condition as well. She wants to know her options regarding testing to see if she is a genetic carrier. From an ethical perspective, what issue would be most important to discuss with the patient?
1)The cost of Huntington's disease screening
2)Whether the test is available at the local lab
3)What will happen when her insurance finds out the results
4)The fact that there is no known treatment that can alter the progression of the disease

Question 14

A hospital nurse is admitting a new patient and asks him if he has a primary care provider. He asks the nurse about the benefit of having a primary care provider, and the nurse replies with which of the following? (Select all that apply.)
1)Increased access to health care
2)Decreased health-care costs
3)Focused on care of disease during the acute phase
4)Increased patient education and advocacy
5)Physician-focused treatment

Question 15

In response to the increase in opioid overdoses within their community, a primary care clinic could implement which of the following with patients who are experiencing chronic pain?
1)Screen appropriately.
2)Prescribe appropriately.
3)Use a statewide automated reporting system.
4)Help patients recognize potential problems.
5)All of the above.

Question 16

A nurse is working with a primary care physician who has made the decision to move to a Patient-Centered Medical Home (PCMH) model of care after reviewing research presented in the latest issue of a prominent medical journal. The nurse is preparing some educational materials to present to the patients and mentions that the benefits of moving to this model of care include which of the following? (Select all that apply.)
1)Care focusing on the whole individual
2)Integrated care
3)Use of highly specialized PCMH physicians
4)Increased access to care
5)Access to private insurance, meaning the patient can move away from Medicaid

Question 17

A nurse working in an inner-city community health clinic is concerned that her patient education efforts related to achieving a healthy lifestyle are not resulting in any substantial changes in her patients. When she discussed this with one mother whose children are struggling with obesity, the mother explained that she is unable to find fresh fruits and vegetables in their neighborhood and resorts to the use of fast food. This information makes the nurse wonder if this is true for other families. What should she do next?
1)Ask families she sees to keep a food journal to see what food substitutions could be made.
2)Perform a problem- or health-issue-based assessment beginning with an assessment of sources of healthy foods such as supermarkets and farmers markets available in the community.
3)Arrange for free bussing from the community center to the closest supermarket.
4)Refer them to the local supplemental nutrition assistance program (SNAP) office to help them obtain benefits.

Question 18

A primary care clinic has decided to hire a nurse to serve as the clinic's case manager. The essence of case management is the incorporation of the client, the family, and the community into meeting the needs of the patient. Based on current evidence related to this approach, it is primarily hoped that this will lead to: (Select all that apply.)
1)Cost containment.
2)Increased patient satisfaction.
3)Improved patient outcomes.
4)Reduced time needed for each patient to spend with his or her primary health care provider.

Question 19

The public health department (PHD) is concerned about an outbreak of measles that has occurred in a country adjacent to theirs. Although there are currently no reported cases, as one of their actions the PHD reaches out to all the primary care providers to encourage all of their unvaccinated patients to get vaccinated and to encourage the parents of unvaccinated children to get their vaccinations up to date. Such a public health initiative is an example of:
1)A secondary prevention approach related to screening.
2)A primary prevention approach focused on health protection.
3)A primary prevention approach focused on health promotion.
4)A primary prevention approach focused on screening.