Deck 16: Health Planning for Primary Care Settings

Question 1

A nurse is teaching a class about different models of care. The nurse explains that ____ is the most important person in the primary health-care model.

A)The individual/family
B)The population
C)The primary-care physician
D)The medical specialist

Answer 1

The individual/family

Question 2

A student nurse is interviewing a primary care nurse about her role in the community. The student asks about the most important part of the nurse's job, outside of patient care. The nurse cites:

A)The need to network and build strong relationships in the community.
B)Continuous learning through continuing nursing education.
C)Strong assessment skills.
D)The ability to focus on the big picture.

Answer 2

The need to network and build strong relationships in the community.

Question 3

A nurse takes a new job in an inner city community health clinic. The nurse discusses with the families she sees how to achieve a healthy lifestyle without seeing any change. She finally discusses this with one mother whose children are struggling with obesity. The mother states 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 would be the nurse's next step?

A)Ask families she sees to keep a food journal to see what food substitutions could be made.
B)Perform a community assessment to determine what stores and food sources are available in the community.
C)Arrange for free bussing from the community center to the closest supermarket.
D)Refer them to the local supplemental nutrition assistance program (SNAP) office to help them obtain benefits.

Answer 3

Perform a community assessment to determine what stores and food sources are available in the community.

Question 4

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.

A)Increased access to health care
B)Decreased health-care costs
C)Focused on care of disease during the acute phase
D)Increased patient education and advocacy
E)Physician focused treatment

Question 5

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?

A)The cost of Huntington's disease screening
B)Whether the test is available at the local lab
C)What will happen when her insurance finds out the results
D)The fact that there is no known treatment that can alter the progression of the disease.

Question 6

A nurse is looking to reduce the number of teen smokers in her community. 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:

A)Health protection.
B)Health promotion.
C)Risk reduction.
D)Tertiary prevention.

Question 7

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.

A)Care focusing on the whole individual
B)Integrated care
C)Use of highly specialized PCMH physicians
D)Increased access to care
E)Access to private insurance, meaning the patient can move away from Medicaid

Question 8

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?

A)Begin offering daycare services and free transportation to the clinic to make it more convenient.
B)Reach out to former patients to determine why they are no longer returning to the clinic.
C)Perform a community assessment.
D)Begin offering a new patient reduced fee rate.

Question 9

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?

A)Teaching school aged children healthy exercise.
B)Conducting a blood glucose screening for program for the adults in the community.
C)Actively encouraging patients diagnosed with type 2 diabetes to have foot, eye, and hemoglobin A1C screening tests every three months.
D)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 10

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?

A)Pregnant women
B)Older adults
C)Children
D)All of the above

Question 11

A public health nurse (PHN) has seen an increase in the number of patient's being seen with bed bug bites. After speaking with several colleagues who also work at primary health facilities in the community, the nurse discovers that this is not an isolated issue. They decide to create a public service announcement educating the public about bed bugs. What information should be included? Select all that apply.

A)Physical description of what they look like
B)Lifespan of the bed bug
C)Bed bugs in popular culture
D)How to get rid of them
E)How to find them in the home

Question 12

A primary care nurse works with many Native Americans on the local reservation. Knowing that they are at high risk for developing diabetes, the nurse puts together a comprehensive prevention plan. Which of the following interventions is an example of a primary intervention?

A)Regular foot and eye care
B)Encouraging a healthy diet and weight loss if appropriate
C)Tight blood sugar control with every meal
D)Screening blood glucose yearly

Question 13

A nurse is doing a presentation for a group of community members who are concerned about the passage of the Affordable Care Act and how it will affect their community. They are an economically disadvantaged community with very few local physicians. What options are available for increasing the capacity for primary health care for this community under the Affordable Care Act?

A)A federal grant to help increase access to affordable primary care services
B)Permission for the local governments to increase taxes in order to open new community health centers
C)A requirement that large multispecialty medical groups must provide care to underserved communities
D)Options to increase transportation from the community to the nearest urban center

Question 14

A nurse working in a primary health-care setting is reviewing the patient education materials they keep in the office. How should the nurse consider updating the forms?

A)Review for medical accuracy and update as needed.
B)Perform a cultural assessment to see how the population has changed since the forms were created.
C)Translate into the languages of cultural groups who frequently use the community center.
D)All of the above

Question 15

A community health nurse is training new nurses about the development of public health programs to benefit community members. The nurse explains that even though primary care focuses on caring for an individual, health promotion activities need to focus on:

A)The family.
B)Each individual patient.
C)Good medical care.
D)The community.

Question 16

A nurse is speaking with her accountant about opening a free clinic as a 501(c)(3) organization. The accountant advises the nurse:

A)To charge patients his or her regular fees.
B)To waive her professional fees, but charge for testing and more advanced care.
C)To charge a nominal fee if the patient can afford to pay, but provide services regardless.
D)To charge a small fee, usually around 25% of the service value.

Question 17

A nurse is volunteering at a community-wide health fair. The nurse is performing blood pressure and blood glucose screenings for everyone who stops by the booth. After performing the screening tests, what must the nurse do for persons with a positive screen? Select all that apply.

A)Provide a prescription for blood pressure or diabetes medication as needed.
B)Review resources available within the community for further assessment and possible diagnosis with a specialist.
C)Offer them education and opportunities for improving their health such as information on lifestyle changes related to diet and exercise.
D)Provide them with information on the normal values for blood pressure and blood glucose levels so they know how to interpret their own levels.
E)Obtain funding to assist in providing needed antihypertensive medications to low income areas.

Question 18

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:

A)Consult with local pediatricians about increasing vaccination rates in children.
B)Begin creating patient education materials to distribute in the waiting room.
C)Perform a health and cultural evaluation of her community.
D)Begin offering vaccinations free of charge.

Question 19

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. ___________________."

A)"You do not need to worry since 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."
B)"However, it is your responsibility to inform all of your previous sexual partners."
C)"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."
D)None of the above