Question 1

The Ebola virus has spread to several countries throughout Africa and Europe. As a member of an education subcommittee for the Global Alliance for Leadership in Nursing Education and Science what should the population health nurse prepare to present during the next scheduled meeting?

Accepted Answer

1. The Global Alliance for Leadership in Nursing Education and Science (GANES). GANES is an organization established to support health care policy makers and nurse educators throughout the world. GANES activities include promoting sharing among nurse educators around the world, providing information and advice to global policy makers related to nursing education issues, and supporting development of a sound evidence base for nursing practice and education. The one action that the nurse should take in preparation for the meeting would be to provide approaches to improve standard precautions in underdeveloped countries. This would support the educational purpose of GANES. Strategies to reduce travel would not be a nursing activity. Identifying ways to provide face masks to travelers could be an operationalization of an approach to reduce the spread of the infection. Documenting the number of new cases identified does not support the purpose of GANES.

Question 2

One of the feared outcomes of NAFTA was job loss within the United States to the other non-United States partners in NAFTA. The argument against this outcome cited the following advantages:

Accepted Answer

1. Concerns about United States involvement in NAFTA was related to job loss in the United States. Arguments rebutting this cited that NAFTA would increase economic opportunities for other NAFTA partners, thus increasing employment and income, which in turn would create better financial prosperity and improved health outcomes. Global health standards are not a function of the NAFTA globalization and environmental outcomes have not been addressed. Communicable disease spread was not an outcome addressed with NAFTA participation.

Question 3

A national health budget is developed to provide preventive health services to all segments of the population. The majority of the population lives in outlying rural areas. A dilemma for this health service is:

Accepted Answer

1. A rural population will traditionally be harder to reach than an urban population; therefore, this population's access to preventive services will become an additional concern. Reconciling individual practice patterns to national standards is not addressed, nor is there any indication that coordination is necessary at this time. Primary care integration with hospital and specialty services is not addressed with preventive services.

Question 4

The population health nurse is considering how best to educate the community about potential threats to health from terrorism. What is the best way to accomplish this? (Select all that apply.)

Accepted Answer

2. Holding public forums to educate the community about coping with psychological effects from terrorist threats, raising community awareness about signs and symptoms of potential biologic agents, and conducting training sessions to review preventive measures in the event of a biologic attack provides information for the community to act if a terrorist attack occurs. Raising community awareness about immigrants in the community is stereotyping. Taping windows is not necessarily the most effective method of protection in a chemical attack.
4. Holding public forums to educate the community about coping with psychological effects from terrorist threats, raising community awareness about signs and symptoms of potential biologic agents, and conducting training sessions to review preventive measures in the event of a biologic attack provides information for the community to act if a terrorist attack occurs. Raising community awareness about immigrants in the community is stereotyping. Taping windows is not necessarily the most effective method of protection in a chemical attack.
5. Holding public forums to educate the community about coping with psychological effects from terrorist threats, raising community awareness about signs and symptoms of potential biologic agents, and conducting training sessions to review preventive measures in the event of a biologic attack provides information for the community to act if a terrorist attack occurs. Raising community awareness about immigrants in the community is stereotyping. Taping windows is not necessarily the most effective method of protection in a chemical attack.

Question 5

A global health policy agenda should include which essential element?

Accepted Answer

4. A global health policy agenda should include support for participation in health policy development by the disadvantaged, who would benefit the most from having input in this process. Developing primary health care and eliminating debt are not elements of a global health policy agenda but strategies to improve health. Creating a centralized agency for health policy could be considered a strategy.

Question 6

As part of the NAFTA trade agreement, sister cities in Mexico and the United States have had cultural exchanges to learn and share health practices and treatments. This could best be described as an effort of:

Accepted Answer

2. International health involves health matters that affect two or more countries. Cultural exchanges to learn and share health practices between the United States and Mexican practitioners is an example of international health cooperation. Global health addresses multinational efforts. Cultural exchanges are not bilateral assistance but mutual learning experiences. Border protection involves actions taken to protect a national border from something occurring in another nation.

Question 7

The population health nurse is comparing global health with international health for a group of community members. What should the nurse use as an example of global health?

Accepted Answer

4. The World Bank is a multilateral agency that provides funding and technical assistance to countries. Improving a region's health infrastructure in individual countries is an example of global health where multinational efforts address health problems that cross national borders. Peace Corps volunteers working in a Third World country are helping a specific country, as are the Rotary volunteers and Doctors without Borders. These are international health efforts.

Question 8

A nurse in the maternity ward of a U.S. hospital has been asked to participate in a humanitarian mission to Haiti. What should the nurse do to support global health objectives in preparation for this mission?

Accepted Answer

3. WHO recognizes the importance of nursing (and midwifery) services to the accomplishment of global health objectives and so maintains a Nursing and Midwifery Office to assist with nursing development throughout the world. This office can provide the nurse with information about the management of nursing and midwifery personnel and nursing and midwifery education. Studying the culture, packing clothing, and learning the language will not necessarily help the nurse support the global health objectives for this humanitarian mission.

Question 9

The population nurse is reviewing the purpose of multilateral health agencies, such as the World Health Organization (WHO). What should the nurse identify as this organization's major purpose?

Accepted Answer

1. As a multilateral agency, WHO works with many countries in health-related activities. WHO is the primary agency affiliated with the UN that deals with global health issues. It does not restrict its activities to setting programs. While many of its efforts are directed to Third World countries, its focus is health for all people worldwide.

Question 10

While attending a meeting which focused on global health initiatives the status of the millennial development goal to ensure environmental stability was reviewed. What information indicates that action is being taken to address this goal? (Select all that apply.)

Accepted Answer

1. The targets for the millennial development goal to ensure environmental stability are to integrate principles of sustainable development into national policies and programs and reverse the loss of environmental resources by reducing energy use and carbon dioxide emissions, reduce by 80% the proportion of people without sustainable access to safe drinking water, and achieve significant improvement in lives of at least 100 million slum dwellers through adequate sanitation and secure housing tenure. Reducing the deaths of school age children addresses the goal of reducing child mortality. Increasing public school enrollment addresses the goal to achieve universal primary education.
4. The targets for the millennial development goal to ensure environmental stability are to integrate principles of sustainable development into national policies and programs and reverse the loss of environmental resources by reducing energy use and carbon dioxide emissions, reduce by 80% the proportion of people without sustainable access to safe drinking water, and achieve significant improvement in lives of at least 100 million slum dwellers through adequate sanitation and secure housing tenure. Reducing the deaths of school age children addresses the goal of reducing child mortality. Increasing public school enrollment addresses the goal to achieve universal primary education.
5. The targets for the millennial development goal to ensure environmental stability are to integrate principles of sustainable development into national policies and programs and reverse the loss of environmental resources by reducing energy use and carbon dioxide emissions, reduce by 80% the proportion of people without sustainable access to safe drinking water, and achieve significant improvement in lives of at least 100 million slum dwellers through adequate sanitation and secure housing tenure. Reducing the deaths of school age children addresses the goal of reducing child mortality. Increasing public school enrollment addresses the goal to achieve universal primary education.

Question 11

One of the positive aspects of exporting U.S. technology globally has been to help improve the quality of health care through health innovations and information. A negative effect of introducing U.S. technology globally has:

Accepted Answer

3. While rapid dissemination of health innovations and information from U.S. technology has benefited developing nations, it has also opened new markets and exposed these countries to the less desirable aspects of U.S. businesses, such as marketing by tobacco companies and the expansion of fast food companies. This has resulted in these populations adopting U.S. practices and higher rates of morbidity from cancer and obesity. The introduction of health innovations and information usually decreases communicable diseases, and economic growth increases do not necessarily create job inequities.

Question 12

The population health nurse has been appointed to a committee to identify actions to achieve the millennial goal of improving maternal health by reducing the maternal mortality ratio by 78%. Which strategy should the nurse recommend to assist in achieving this goal?

Accepted Answer

4. To achieve the millennial goal of improving maternal health actions must be taken to ensure that pregnant women receive adequate and timely prenatal care. Establishing portable health clinics in underdeveloped countries to provide prenatal care would help achieve this goal. Explaining dietary requirements may not be appropriate because of access to nutritionally sound food and supplements might be difficult in underdeveloped countries. Preparing educational materials would be helpful however if the actions or resources are not available, the teaching will have no impact on the achievement of the goal. Instructing on the importance of receiving prenatal care would not necessarily help achieve the goal if resources, and medical personnel are not available to provide the care.

Question 13

Identify three elements of a global health policy agenda. (Select all that apply.)

Accepted Answer

1. A global health policy health agenda includes aid to improve health and health infrastructures in all countries, and representation of health interests in other policy-making sectors, such as the economic sector. Using communication technology to provide information is needed for effective policy making. Coordinating aid to match programs and creating partnerships among agencies, the private sector, and academia are strategies to implement a global health policy agenda.
4. A global health policy health agenda includes aid to improve health and health infrastructures in all countries, and representation of health interests in other policy-making sectors, such as the economic sector. Using communication technology to provide information is needed for effective policy making. Coordinating aid to match programs and creating partnerships among agencies, the private sector, and academia are strategies to implement a global health policy agenda.
5. A global health policy health agenda includes aid to improve health and health infrastructures in all countries, and representation of health interests in other policy-making sectors, such as the economic sector. Using communication technology to provide information is needed for effective policy making. Coordinating aid to match programs and creating partnerships among agencies, the private sector, and academia are strategies to implement a global health policy agenda.

Question 14

The population health nurse has been asked to participate in an educational session about the latest Ebola virus epidemic. Which should the nurse include that demonstrates the dimensions of globalization? (Select all that apply.)

Accepted Answer

1. Globalization has spatial, temporal, cognitive, and social dimensions. The spatial dimension reflects changes in our perceptions of physical space or geographic territory. Movement back and forth across national borders is common and increasingly easy. The temporal dimension addresses changes in our experiences of time. The cognitive dimension of globalization reflects thoughts about us and our world. To work effectively to address worldwide problems, we need to begin to think of ourselves more as global citizens than as citizens of a specific nation. The social dimension of globalization addresses its effects on people in terms of its impact on livelihood and families. The importance of maintaining standard precautions does not support a dimension of globalization.
3. Globalization has spatial, temporal, cognitive, and social dimensions. The spatial dimension reflects changes in our perceptions of physical space or geographic territory. Movement back and forth across national borders is common and increasingly easy. The temporal dimension addresses changes in our experiences of time. The cognitive dimension of globalization reflects thoughts about us and our world. To work effectively to address worldwide problems, we need to begin to think of ourselves more as global citizens than as citizens of a specific nation. The social dimension of globalization addresses its effects on people in terms of its impact on livelihood and families. The importance of maintaining standard precautions does not support a dimension of globalization.
4. Globalization has spatial, temporal, cognitive, and social dimensions. The spatial dimension reflects changes in our perceptions of physical space or geographic territory. Movement back and forth across national borders is common and increasingly easy. The temporal dimension addresses changes in our experiences of time. The cognitive dimension of globalization reflects thoughts about us and our world. To work effectively to address worldwide problems, we need to begin to think of ourselves more as global citizens than as citizens of a specific nation. The social dimension of globalization addresses its effects on people in terms of its impact on livelihood and families. The importance of maintaining standard precautions does not support a dimension of globalization.
5. Globalization has spatial, temporal, cognitive, and social dimensions. The spatial dimension reflects changes in our perceptions of physical space or geographic territory. Movement back and forth across national borders is common and increasingly easy. The temporal dimension addresses changes in our experiences of time. The cognitive dimension of globalization reflects thoughts about us and our world. To work effectively to address worldwide problems, we need to begin to think of ourselves more as global citizens than as citizens of a specific nation. The social dimension of globalization addresses its effects on people in terms of its impact on livelihood and families. The importance of maintaining standard precautions does not support a dimension of globalization.

Question 15

The Gates Foundation is funding the development of a viable AIDS vaccine and the eradication of childhood diseases through immunization. Though based in the United States, this foundation is considered a:

Accepted Answer

4. Non-governmental organizations (NGOs) are agencies outside of official government-sponsored agencies that work for the public good. The Gates Foundation has committed its resources and funding to engage in activities that address worldwide health concerns. Examples of NGOs include religious groups, philanthropic foundations, corporations, and other organizations. Bilateral agencies usually involve only two countries on a project. Sector-wide approaches to health focus attention on the resolution of health-related problems by addressing conditions that affect health in a broader social sense. Unilateral agencies represent one country.

Quiz 8: Global Influences on Population Health