Deck 7: Health Disparities and Vulnerable Populations

Question 1

A nurse is training for a new job at a community clinic after moving to Central California, an area rich in agriculture and where a large number of migrant workers are employed. The nurse asks about specific social and health issues that the migrant worker population faces, and the nurse supervisor replies: (Select all that apply.)
1)They have difficulty establishing residency in a single location, making them ineligible for government benefits.
2)Most of them lack access to worker's compensation or disability insurance.
3)Frequent travel and location changes make it difficult for them to establish continuity of care with a single provider.
4)Illegal immigration status is a problem for almost all of them.
5)Language is often a barrier.

Answer 1

1, 2, 3, 5

Question 2

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 health disparities in their country. Which of the following suggestions are known to be effective measures nurses can take that focus on the reduction of health disparities? (Select all that apply.)
1)Volunteer with an international organization that supports building infrastructure in underdeveloped areas.
2)Support initiatives that increase physical education classes and healthy school meals.
3)Design and create research studies that address inequities and support vulnerable populations.
4)Discuss social and health disparity information with coworkers to promote awareness.
5)Act as advocates for patients, families, and communities in reducing inequities.

Answer 2

2, 3, 4, 5

Question 3

A public health nurse (PHN) is performing a community assessment to better understand the underlying factors associated with the increase in the childhood obesity in the community. What social determinants of health should the PHN include in the assessment? (Select all that apply.)
1)Location of primary health providers
2)Nutrition and physical education classes in the public schools
3)Housing security
4)Presence of sidewalks and green space within the community
5)Access to fresh produce

Answer 3

1, 2, 4, 5

Question 4

A nurse is working with a group of refugees who recently arrived in the United States after suffering conflict-related violence in their country. The nurse knows that they should be assessed for:
1)Communicable diseases.
2)Injuries related to torture or sexual assault.
3)Mental illness such as post-traumatic stress disorder (PTSD).
4)All of the above.

Question 5

Which of the following programs was specifically designed to work toward optimal health for all Americans?
1)Racial and Ethnic Approaches to Health (REACH)
2)Universal Health Care
3)Healthy People
4)Agency for Health Care Research and Quality (AHRQ)

Question 6

The maternal-child nurse who is fluent in Spanish is working at the public health department located in a "sanctuary city". She is conducting a home visit with a young mother from Northern Triangle of Central America who arrived in the U.S. in 2017 and is now staying with her brother who is a U.S. citizen. The mother is very frightened and states that she fled her country because of the violence she and her children has experienced. She fears that they will not survive if they go back. The mother is eligible to apply for what status?
1)Asylee
2)Refugee
3)Immigrant
4)Permanent resident

Question 7

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:
1)Compare only the outcomes of the richest community members to the outcomes of the poorest community members.
2)Recognize that income and outcomes exist on a scale and look across the entire spectrum.
3)Evaluate only the poorest health outcomes and where they land on the income spectrum.
4)Evaluate only the poorest community members and their health outcomes.

Question 8

A community nurse-managed clinic has seen an increase in the number of patients who have immigrated to the U.S. from Central America who are experiencing poorer outcomes than other patients. A nurse working in the clinic decides to take a multiple determinants of vulnerability approach to help understand possible underlying factors for this population. Using that approach, she would take into account all but which of the following as primary factors?
1)Stigma
2)Racism
3)Discrimination
4)Health literacy

Question 9

A nurse received funding to start a mobile health unit to serve the health needs of the homeless population. In addition to a having a good understanding of noncommunicable diseases, what other specialty areas would be helpful in caring for this population?
1)Treatment of substance use disorders
2)Treatment of communicable diseases
3)Treatment of mental health disorders
4)All of the above

Question 10

A nurse is caring for a young man who is squatting in an abandoned factory a mile away from the clinic. The nurse documents that he is experiencing what type of homelessness?
1)Primary
2)Secondary
3)Tertiary
4)He is not homeless because he has an indoor shelter in which to sleep.

Question 11

A nurse is assessing a young mother who lost her job. She has no way to support her family and has found herself living on the streets because she doesn't have any other family in the area. Which of the following should she do first?
1)Look at the broader picture and see if there are any opportunities for policy change.
2)Help her find shelter at the community shelter for women and children.
3)Provide her with information on resources to help her with financial support while she seeks a new job.
4)Ask her to come back in 6 months for a re-evaluation.

Question 12

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?
1)Social determinants of health determine how people respond to health threats and how they access preventative care.
2)The student is incorrect. Communities with good access to care have good health outcomes.
3)This phenomenon only occurs in communities where the quality of health care is poor.
4)Members of these communities only have access to primary-care providers, which reduces the quality of care they receive.

Question 13

A nurse is studying the high infant mortality rate in a community with a mean household income below the poverty level within the larger community served by her hospital. She looks into the problem further and finds that the only prenatal care clinics available that accept Medicaid or offer a sliding scale payment system are not located within the community and require taking three different busses to get there. The lack of access to affordable prenatal care is an example of:
1)Health disparity.
2)Health inequity.
3)Health inequality.
4)Social justice.

Question 14

Two nurses are in the process of developing a nurse-managed free clinic for persons experiencing homelessness. They want to tailor the services for those who are at greatest risk for experiencing homelessness, which includes: (Select all that apply.)
1)Young families
2)White non-Hispanic Americans
3)Single men
4)African Americans
5)Persons diagnosed with a serious mental illness (SMI)

Question 15

A nurse working in an urban nurse-managed health clinic located in a neighborhood with a high poverty rate notices that the patients she is seeing with type 2 diabetes are having difficulty controlling their A1C levels. She suspects that they may be having difficulty accessing their medications due to cost. What would be her first step in addressing the problem?
1)Conduct a focused assessment that includes a patient survey and an evaluation of factors associated with access to medication.
2)Counsel patients on how to obtain health insurance to help with the cost of pharmaceuticals.
3)Develop a patient education information pamphlet related to controlling A1C that is culturally relevant and addresses health literacy levels of the population.
4)Formulate a community diagnosis and enlist stakeholders to help increase assess to diabetic medications.

Question 16

A maternal child nurse working in Southern Sudan is faced with lack of which main factors that contribute to the high infant mortality rate? (Select all that apply.)
1)Physicians
2)Electricity
3)Transportation
4)Equipment

Question 17

A public health nurse (PHN) is starting a study of different populations in the community to see which groups have faced marginalization and to what degree. The PHN is looking for evidence that:
1)A group has been discriminated against based on their race or ethnicity.
2)A group has been treated as if they are not important or of little consequence to the rest of society.
3)A group has been labeled by society as possessing a particular characteristic that is not valued, leading to a loss of status.
4)A group has been assigned a negative or positive belief that is believed to apply to the entire group.

Question 18

When conducting a community survey in a larger urban community, two PHNs, Mark and Jane, know that there is great diversity based on socioeconomic status. They know it is important to determine which respondents do not meet the poverty threshold. They understand that this indicator reflects: (Select all that apply.)
1)The Census Bureau adjusts it based on family size and other demographics.
2)A lack of goods and services commonly taken for granted by mainstream society.
3)The method for doing the calculations over the past 40 years has included the increasing cost of medications.
4)The method for doing the calculations over the past 40 years has included increasing the percentage spent on food.

Question 19

A nurse is working at a primary care clinic on the Mexican-Californian border. The nurse frequently takes care of refugee families when they first arrive in the United States. When meeting with a new family, the nurse makes sure to inform them that they are eligible for which of the following services?
1)Medicaid
2)Free health insurance for 1 year
3)Housing and food support
4)Free English classes

Question 20

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.
1)Smoking
2)High-fat or high-sugar diets
3)Poverty
4)Lack of exercise