Question 1

According to the 1999 Institute of Medicine report,as many as 98,000 deaths each year could be attributed to:

Accepted Answer

In 1999 it was thought that our health care system was expensive and that access and quality were not optimal,but we had not considered this important fact: many people die of preventable medical errors in the United States.This number is not the correct statistic for cardiovascular disease,obesity,or drug overdose.

Question 2

A nurse is working with a community to decrease the occurrence of influenza.Which of the following U.S.Department of Health and Human Services (USDHHS; or simply HHS)goals is being applied?

Accepted Answer

One of the objectives of Advance the Health,Safety,and Well-being of the American People is to reduce the occurrence of infectious diseases.The goal of Strengthen Health Care focuses on improving health care services,quality,and coverage.The goal of Increase Efficiency,Transparency,Accountability,and Effectiveness of HHS Programs focuses on improving programming and application of found data.The goal of Advance Scientific Knowledge and Innovation focuses on scientific discovery and application of the new knowledge.

Question 3

A community health nurse reviews Healthy People 2020 when considering the health needs that will be addressed in the community.Which goal would the nurse find in this document?

Accepted Answer

Elimination of preventable disease,disability,injury,premature death; achievement of health equity; elimination of health disparities; and creation of social and physical environments that will promote good health and healthy development and behavior at every stage of life are the four major goals cited in Healthy People 2020.

Question 4

A nursing program has initiated a recruitment campaign focusing on increasing the minority students in its program.Which of the following best describes the rationale for this program?

Accepted Answer

It is thought that increasing minority representation in the health workforce not only is a commitment to diversity,but also will improve the health care delivery system.Minority health professionals can be expected to practice in underserved areas at a greater rate and health professionals who share the same culture and language with the clients they serve can provide more effective care.It has been suggested that the number of minority nurses should be representative of the population served rather than there being equal numbers of minority and nonminority nurses.Minority nurses are able to mentor other nurses; however,is not the main reason that there is a focus on increasing recruitment of minorities.

Question 5

PHC in the United States:

Accepted Answer

Although PHC has been endorsed by the United States,it faces many challenges.PHC emphasizes broad strategies,community participation,self-reliance,and a multidisciplinary health care delivery team; however,this is not the primary method of health care delivery in the United States.

Question 6

A nurse is exploring a job opportunity at a community health center.Which of the following expectations would the nurse have about the center?

Accepted Answer

Community health centers serve the entire community for primary health care (PHC)services,regardless of income.They are located in a high need or medically underserved community,which can be urban or rural.

Question 7

A community health nurse is utilizing telehealth.Which of the following best describes the rationale for its use?

Accepted Answer

Telehealth provides increased access to health care by the use of a computer monitor and telephone line.It is useful for monitoring clients with chronic disease,but is not a substitute for health care.Telehealth may or may not be accompanied by home care nursing.

Question 8

The number of uninsured Americans has dramatically increased because:

Accepted Answer

Although the majority of Americans continue to obtain health insurance from their employer as a benefit,employment does not guarantee insurance.Employer-sponsored health insurance is sensitive to both the general economy and changes in health insurance premiums.As costs for insurance premiums rose,employers either shifted more of these costs to their employees or declined to offer employment-based health coverage at all.Medicare provides coverage only to the elderly and other special populations.The costs for health care are continuing to rise regardless of the size of the population.There has not been a significant change to nursing salaries,and a change in nursing salaries would not impact the number of uninsured Americans.

Question 9

What initiative began as a result of a resolution adopted by the WHO in 1977?

Accepted Answer

The WHO adopted a resolution accepting the goal of attaining a level of health that permitted all citizens of the world to live socially and economically productive lives.The name of the resolution that was adopted was the Declaration of Alma Ata.Medicare began as part of the Social Security Act.The Healthy People initiative began as part of the 1979 Surgeon General's Report addressing the health needs of Americans.

Question 10

A nurse who was working in public health care has gotten a new job in primary care.Which of the following differences would be seen by the nurse in this new care setting?

Accepted Answer

Primary care focuses on individuals.It is also provided by generalists,is dominated by health care professionals,and is not community focused.

Question 11

A nursing student interviews a member of the local congressional district to learn more about the health care system in the United States.Which statement made by the congressman would be accurate?

Accepted Answer

Managed care has not become prominent as the original concept outlined.Consumer groups were not only accustomed to freedom of choice and unlimited service,but they did not like the ideas of short-stay maternity care and denial of bone marrow transplantation for breast cancer patients,thus managed care failed in the United States.The Affordable Care Act has not replaced managed care.

Question 12

A nursing student is researching advanced practice nursing options.Which of the following discoveries would most likely be made by the nursing student?

Accepted Answer

Nurse practitioners may work as independent practitioners and can be reimbursed by Medicare or Medicaid for services rendered.Certified nurse midwives have prescriptive authority in some form in all states.Clinical nurse specialists may provide primary care services,but often work in consultation,research,education,and administration.The Doctorate in Nursing Practice role is a clinical role.

Question 13

In the United States,the majority of health care dollars are spent on:

Accepted Answer

The largest share of health care expenditures goes to pay for hospital care,with physician services the next largest item.The money spent for PHSs is significantly lower than the other categories of expenditures.Other significant drivers of the increasingly high cost of health care include prescription drugs,technology,and chronic and degenerative disease.

Question 14

Residents of rural communities report that they must travel for long distances to obtain health care services.As a result,they seek health care only for emergencies and severe illnesses.Which aspect of the health care system in the United States is illustrated in this situation?

Accepted Answer

One significant problem is poor access to care.Access can refer to inability to pay for care and inability to access care.Cost refers to the health care expenditures that happen to pay for the services received.Quality refers to the quality of health care that is provided.Advances in technology refer to the medical advancements made to treat diseases.

Question 15

A public health agency is considering implementing an electronic health record.Which of the following best describes one of the benefits the agency will experience?

Accepted Answer

The electronic medical record facilitates interprofessional care in chronic disease management and coordination of referrals; 24-hour availability of records with downloaded laboratory results and up-to-date assessments; incorporation of protocol reminders for prevention,screening,and management of chronic disease; improvement of quality measurement and monitoring; and increased client safety and decline in medication errors.There is no data to support that the agency will have improved client compliance or cost savings.Electronic medical records are not a requirement by JCAHO.

Question 16

A nurse interacts with a 25-year-old woman at a community health center who is obtaining a gynecological examination and birth control pills.Which of the following types of care is the client receiving?

Accepted Answer

By definition,PHC includes basic health care services with the emphasis on prevention.Tertiary health care is highly specialized medical care.Public health care focuses on care for populations.Specialized care focuses on only one aspect of a patient's health.

Question 17

One of the goals of the World Health Organization (WHO)is to:

Accepted Answer

The WHO adopted a resolution in 1977 accepting the goal of attaining a level of health that permitted all citizens of the world to live socially and economically productive lives.This has been adapted to meet the needs of the new century and was deemed "Health for All in the 21st Century." The focus of this initiative is PHC services.The WHO does not prevent outbreaks of disease,prevention,transmittal of disease,or provide humanitarian support.

Question 18

The federal agency of the public health system that is most involved with the health and welfare of United States citizens is the:

Accepted Answer

The U.S.Department of Health and Human Services is charged with regulating health care and overseeing the health status of Americans.The Centers for Medicare and Medicaid Services develops and oversees the rules and regulations specific to these two insurance programs.The PHS is a major component of the Department of Health and Human Services.The PHS consists of eight agencies: (1)Agency for Healthcare Research and Quality,(2)Agency for Toxic Substances and Diseases Registry,(3)Centers for Disease Control and Prevention,(4)Food and Drug Administration,(5)Health Resources and Services Administration,(6)Indian Health Service,(7)National Institutes of Health,and (8)Substance Abuse and Mental Health Services Administration.

Question 19

A client is receiving PHC services.Which of the following expectations would the client have?

Accepted Answer

The focus of PHC is a broad range of services that are designed to be affordable for the recipients of the care and the governments who provide them.The emphasis of care is on prevention and the means of providing the care is based on practical,scientifically sound,culturally appropriate,and socially acceptable methods.All clients can receive PHC services regardless of insurance status.Those receiving primary care services may or may not need referral to a specialist.

Question 20

An 80-year-old woman comes to the community health center with a large bag of medications.She tells the nurse she can no longer afford these medications because her only income is Social Security.Which statement is the best response by the nurse?

Accepted Answer

This elderly patient probably is eligible for benefits through Part C,the Medicare Advantage program,but often a patient needs help negotiating the system.The Medicare Advantage program incorporates private insurance plans into the Medicare program including HMO and PPO managed care models and private fee-for-service plans.In addition,Medicare Part D has been added to cover prescriptions.These plans receive payments from Medicare to provide Medicare benefits,including hospital,physician,and often,prescription drug benefits.Finding prescriptive coverage through an insurance plan is a better choice than eliminating medications,trying to get medications for free (which is only a short-term solution in most cases),and telling the client to find a way to pay for the medications when she does not have the resources.

Quiz 3: The Changing U.S.Health and Public Health Care Systems