Deck 2: Optimizing Population Health

Question 1

Based on recent studies on risk for disease, the nurse working in a primary care clinic in a poorer urban community decides to develop an educational program on the importance of including whole grains, fruits and vegetables in her patient's diets. To help guide the development of her program she first reviews the availability of fresh fruits and vegetables in the community. Her decision to gather information on these factors best reflects the________?
1)Ecological determinants of health
2)Social determinants of health
3)Individual behavioral determinants of health
4)Genetic determinants of health

Answer 1

2

Question 2

A patient diagnosed with diabetes buys books, reads articles, talks with knowledgeable people, informs himself about what he can do to improve his health, and takes action. The nurse recognizes that this method of adult learning is best described as:
1)Pedagogy
2)Andragogy
3)Constructivism
4)Humanism

Answer 2

4

Question 3

A clinical group of nursing students was assigned, during their public health rotation, to the local public health department (LPHD). The LPHD was just beginning to start a "Breast is Best" campaign in the community. The students were asked to come up with ideas for the campaign. The LPHD had found that the lowest breastfeeding rates were in one of the ethnic communities. The students agreed to conduct a preliminary outreach program with pregnant women coming to the LPHD's prenatal clinic that had the highest number of women in that ethnic group. This is an example of what level of intervention using the Substance Abuse and Mental Health Services Administration (SAMSHA) framework?
1)Universal
2)Indicated
3)Primary
4)Selected

Answer 3

2

Question 4

When screening for, monitoring, and diagnosing disease, a health-care provider always evaluates a measurement tool for which of the following attributes? (Select all that apply.)
1)Reliability
2)Validity
3)Functionality
4)Sensitivity
5)Specificity

Question 5

A nurse working in the emergency department (ED) has noticed over the past year the increasing number of young patients being treated for conditions that could be handled in primary care. She overhears a colleague wondering why their parents don't just go to the clinic. To help better understand the issue, the nurse tells her colleague that perhaps they should be looking at other determinants of health besides the parents' behavior. She explains that the four broad levels of determinants of health included in the social ecological model would be a good start to help determine what factors might be driving the increased use of the ED for non-emergent pediatric care. Which of the following determinants of health are included in the model? (Select all that apply.)
1)Communication
2)Relationship
3)Policy
4)Genetics
5)Societal

Question 6

Two nurses working in a head, nose, and throat oncology unit noticed that many of their patients not only smoked but used alcohol. They had been to a recent conference and learned about evidence-based screening tools for alcohol use that were different from the tool they were currently using. They approached the director of the unit and suggested that they use the newer screening tools. Screening for alcohol use is primarily done:
1)Only with persons whose clinical presentation appears to indicate heavy alcohol use.
2)Only to detect those who are currently using alcohol to avoid an interaction with treatment modalities.
3)Only to detect those who may have an alcohol use disorder
4)To detect those at risk for disease or injury who do not yet meet the criteria for having an alcohol use disorder as well as those who may have an alcohol use disorder.

Question 7

In the traditional public health prevention framework, the level of prevention that includes early detection and initiation of treatment for disease, or screening, is referred to as the:
1)Clinical level
2)Primary level
3)Tertiary level
4)Secondary level

Question 8

To assess the prevalence of a disease in a population, a public health nurse (PHN) can use the prevalence pot to help better understand the occurrence of disease in her or his community. The prevalence pot: (Select all that apply.)
1)Depicts the total number of current cases in the population.
2)Takes into account duration and incidence of the disease.
3)Includes assessing the total number of cases of a disease taking into account all of the stages of the disease.
4)Is a method of calculating the potential number of new cases in a population.
5)Determines the amount of primary medications used to treat diseases in a certain population.

Question 9

A nurse working in a busy primary care clinic wonders why Mr. Smith, a 65-year old insulin dependent man recently diagnosed with type 2 diabetes, keeps coming back with elevated A1Cs. The nurse knows that he has given Mr. Smith the literature on how to manage type 2 diabetes and, as time allowed, reviewed it with him. He doesn't understand why Mr. Smith is still struggling with managing his disease. What should he check first before providing Mr. Smith with more information?
1)His level of health literacy
2)Whether or not he can afford his medication
3)His eating habits
4)His routine for checking his A1C

Question 10

Based on the Social-Ecological model of health, which of the following are components of health? (Select all that apply.)
1)Physical environments
2)Social environments
3)Social relations
4)Political systems
5)Health-care systems

Question 11

PHNs in a county with an increase in measles during the 2018-2019 outbreak used the natural history of disease framework to develop a primary prevention program aimed at preventing measles. Their first step was to:
1)Conduct an outreach to all parents to have their children vaccinated.
2)Educate health-care providers on the signs and symptoms of disease.
3)Start a screening program to identify persons who may have measles.
4)Provide an educational program for parents whose children have measles on the importance of keeping them home from school and away from public places.

Question 12

Population attributable risk (PAR) is based on the assumption that the risk factor is removed from the entire population being targeted. It also can be used to calculate the cost benefit and the ____ of a prevention program.
1)Cost effectiveness
2)Necessity
3)Population ecology
4)Percent of repeat participants

Question 13

The PHNs within the public health department experiencing a measles outbreak decide to do Public Service Announcements (PSAs) on TV aimed at improving vaccination rates among the population, and letting parents know they can come to the PHD clinic to have their children vaccinated. The county their department serves has a large population of Mexican American families, so they work together with the Mexican American community to make sure the PSAs are culturally relevant. Which learning theory best matches their approach?
1)Constructivism
2)Cognitivist
3)Bandura's theory of social learning
4)Behaviorism

Question 14

Attributable risk is the proportion of cases or injuries that would be eliminated if a risk factor did not occur, but preventable fraction is:
1)The number of cases that actually occur in a given population at a specific point in time.
2)What could be achieved with a program implemented in a community setting within the at-risk population when community members actually participate in the program.
3)The number of cases that require intervention in a community setting within the at-risk population.
4)An estimation of the number of cases with the high-risk factor(s) among the at-risk population when community members actually participate in the program.

Question 15

The school nurse in a school district in southwestern Texas is working with the school cafeteria to revise their healthy choices menus for the school year. They have used as their guide the 2012 national law that calls for school lunch programs to have larger portions of fruits and vegetables, less sodium, and no trans fats. To help increase the success of the program, the nurse conducted a survey of parents to learn more about the cultural aspects of food choices related to fruits and vegetables. Providing a culturally appropriate menu that meets federal guidelines for the school children represents:
1)An upstream approach
2)A tertiary prevention approach
3)A socioecological approach
4)A and C

Question 16

In 2011, the National Prevention Strategy released a plan to increase the number of Americans who are healthy at every stage of life. Which of the following is not one of the strategic directions included in the strategy?
1)Eliminating health disparities
2)Building healthy and safe community efforts
3)Increasing access to care
4)Empowering people to make healthy choices