Community and Public Health Nursing 2nd Ed. Harkness, DeMarco Test Bank

Origin:  Chapter 2- Public Health Systems, 1

1.

Which characterizes physicians in France?

A)

Physicians are evenly distributed between rural and urban areas

B)

About 40% of physicians are women

C)

Physician visits can take 15 to 30 minutes

D)

Physicians see about 15 clients a day

Ans:

C

Feedback:

Characteristics of physicians in France include that physicians are unevenly distributed between rural and urban areas; about 50% of physicians are women; physician visits can take 15 to 30 minutes; and physicians see about 10 clients per day.

Origin:  Chapter 2- Public Health Systems, 2

2.

A nurse is interested in exploring initiatives related to health, poverty, and development in Africa. Which organization would most likely be involved in such an initiative?

A)

Bill and Melinda Gates Foundation

B)

Living Proof Project

C)

International Committee of the Red Cross

D)

Oxfam International

Ans:

A

Feedback:

Philanthropies are organizations that are similar to NGOs but they receive funding through personal endowments. For example, the Bill and Melinda Gates Foundation focuses on health, poverty, and development in Africa, South America, Asia, and Australia. The Living Proof Project supports vaccine and nutrition programs, as well as decreasing the incidence of diseases such as polio, HIV/AIDS, and tropical illnesses. Nongovernmental organizations are private agencies that voluntarily use their resources to address a variety of healthcare initiatives in the United States. The International Committee of the Red Cross is known most for its role in disaster relief. Oxfam International focuses specifically on issues related to hunger and nutritional health.

Origin:  Chapter 2- Public Health Systems, 3

3.

Which best describes a nongovernmental organization?

A)

Agency that is based in only one country but provides services to many other countries

B)

Agency that acquires resources to help others from private rather than public sources

C)

A group that collects data related to healthcare use across a variety of professional and service parameters

D)

An organization that uses endowed funds or private fundraising to address the needs of individuals, families, and populations

Ans:

B

Feedback:

A nongovernmental organization is an agency that acquires resources to help others from private rather than public sources. A bilateral agency is one that is based in only one country but provides services to many other countries. Organization for Economic Cooperation and Development is a group that collects data related to healthcare use across a variety of professional and service parameters. A philanthropic organization is one that uses endowed funds or private fundraising to address the needs of individuals, families, and populations.

Origin:  Chapter 2- Public Health Systems, 4

4.

Which best exemplifies a bilateral agency?

A)

The United Nations

B)

The World Health Organization (WHO)

C)

The World Bank

D)

The U.S. Agency for International Development (USAID)

Ans:

D

Feedback:

Bilateral agencies and organizations conduct their services within one specific country. USAID is a good example in the United States. It is a committed initiative that works with developing countries to enhance systems to fortify the health and welfare of international populations. Multilateral agencies and organizations receive funding from both governmental and nongovernmental sources. Examples of multilateral agencies include the United Nations and the WHO. The World Bank is another multilateral organization. Its major goal is to lend money to countries in need of developing their infrastructure on a variety of fronts.

Origin:  Chapter 2- Public Health Systems, 5

5.

Which public health entities are often regulated by the U.S. federal government? (Select all that apply.)

A)

Food

B)

Medications

C)

School health

D)

Devices

E)

Environment

Ans:

A, B, D, E

Feedback:

The federal government plays an important role in the regulation of public health. Public health entities of regulation are often related to (1) food, (2) drugs, (3) devices, (4) occupation health, and (5) the environment through the Department of Health and Human Services. School health is typically regulated by state and local governments, not the federal government.

Origin:  Chapter 2- Public Health Systems, 6

6.

A nurse is coordinating an initiative in the community to make sure that the healthcare needs of local refugees and asylees are recognized and addressed. Which federal agency should this nurse contact, as it is directly involved with the health and healthcare of refugees and asylees in the United States?

A)

United States Department of Health and Human Services

B)

National Institutes of Health

C)

Agency for Healthcare Research and Quality

D)

Centers for Disease Control and Prevention

Ans:

A

Feedback:

The United States Department of Health and Human Services is the federal agency that is directly involved with the health and healthcare of U.S. citizens or refugees/asylees. The National Institutes of Health, Agency for Healthcare Research and Quality, and Centers for Disease Control and Prevention are three important organizations in which research is undertaken and used effectively to address key healthcare concerns such as HIV screening and care, address adverse events in hospital settings, and promote measures to decrease the rates of emerging infectious diseases.

Origin:  Chapter 2- Public Health Systems, 7

7.

Which best exemplifies a public health goal in the United States?

A)

To restore the ability of an 80-year-old to perform activities of daily living after a stroke

B)

To lobby for legislation that ensures the accessibility to health insurance on the basis of one’s health

C)

To develop treatments to address symptoms related to chemotherapy

D)

To establish a free exercise program at a community center to promote fitness in a low-income neighborhood with high obesity rates

Ans:

D

Feedback:

It is important to review several key components of the function public health serves through key initiatives, including a national consensus on goals, provision of systems of health insurance based on risk, not necessarily health, and the role of nongovernmental disease prevention and health promotion. In the United States, public healthcare includes disease prevention and health promotion based on science and cultural relevance. It is not focused on the health of the individual person but of the larger population. The goal of public healthcare is to keep populations healthy through a larger “reach” than connection at the individual level.

Origin:  Chapter 2- Public Health Systems, 8

8.

In the United States, the system of healthcare has historically given and continues to give stronger support to which types of care?

A)

Individual care with a focus on cure

B)

Community care with a focus on cure

C)

Individual care with a focus on prevention

D)

Community care with a focus on prevention

Ans:

A

Feedback:

The United States and its system of healthcare have historically given and continue to give stronger support to individual rather than community care and cure rather than prevention.

Origin:  Chapter 2- Public Health Systems, 9

9.

A nurse works predominantly with clients who are active military personnel. Which publically funded program provides health benefits to this population?

A)

Medicare

B)

Medicaid

C)

TRICARE

D)

CHIP

Ans:

C

Feedback:

Funding for the healthcare system in the United States comes primarily from privately owned health insurance companies. Exceptions include programs that are publically funded, such as Medicare, Medicaid, TRICARE (civilian health benefits for military personnel, retirees, and dependents), Children’s Health and Insurance Program (CHIP), and Veterans Health Administration.

Origin:  Chapter 2- Public Health Systems, 10

10.

Which best describes a philanthropic organization?

A)

Agency that is based in only one country but provides services to many other countries

B)

Agency that acquires resources to help others from private rather than public sources

C)

A group that collects data related to healthcare use across a variety of professional and service parameters

D)

An organization that uses endowed funds or private fundraising to address the needs of individuals, families, and populations

Ans:

D

Feedback:

A philanthropic organization is one that uses endowed funds or private fundraising to address the needs of individuals, families, and populations. A bilateral agency is one that is based in only one country but provides services to many other countries. A nongovernmental organization is one that acquires resources to help others from private rather than public sources. Organization for Economic Cooperation and Development is a group that collects data related to healthcare use across a variety of professional and service parameters.

Origin:  Chapter 2- Public Health Systems, 11

11.

Which country spends the most on healthcare?

A)

Canada

B)

England

C)

Japan

D)

United States

Ans:

D

Feedback:

The United States spends more on healthcare than does any other industrialized country.

Origin:  Chapter 2- Public Health Systems, 12

12.

Which is the fastest growing healthcare expenditure in the United States?

A)

Healthcare technology

B)

Hospital care

C)

Outpatient treatment and surgery

D)

Prescription medications

Ans:

D

Feedback:

Although hospital care accounts for the largest share of healthcare spending, prescription drugs are the fastest growing healthcare expenditure.

Origin:  Chapter 2- Public Health Systems, 13

13.

National Health Expenditure Accounts are a measure of expenditures on healthcare goods and services in the United States. In the most recent set of estimates, expenditures totaled what percentage of U.S. health spending?

A)

2

B)

3

C)

4

D)

5

Ans:

B

Feedback:

Government public health activity constitutes an important service category. In the most recent set of estimates, expenditures totaled $56.1 billion in 2004, or 3% of total U.S. health spending (National Health Expenditures, 2013).

Origin:  Chapter 2- Public Health Systems, 14

14.

The client is a single mother of two who earns minimum wage at a part-time job and never graduated from high school. Which healthcare-related outcomes is the client at increased risk for, based on her circumstances? (Select all that apply.)

A)

Morbidity

B)

Mortality

C)

Genetic disorder

D)

Difficulty accessing care

E)

Negative outcomes when receiving care

Ans:

A, B, D, E

Feedback:

Marginalization often occurs in people who live below the poverty level in the United States, and these people frequently are poorly educated. In the chapters that follow, higher rates of morbidity, mortality, difficulty in accessing care, and negative outcomes when receiving care, will be seen as key issues in such populations. This client’s circumstances would not increase her risk of experiencing a genetic disorder.

Origin:  Chapter 2- Public Health Systems, 15

15.

The Department of Health and Human Services has identified several areas for which health disparities exist among various demographic groups and need to be addressed. Which are included among these areas? (Select all that apply.)

A)

Infant mortality

B)

Cancer screening

C)

Cardiovascular disease

D)

Diabetes

E)

End-stage renal disease

Ans:

A, B, C, D

Feedback:

The Department of Health and Human Services has identified six areas for which it has oversight and that require effort to reduce disparities. These areas are (1) infant mortality, (2) cancer screening, (3) cardiovascular disease, (4) diabetes, (5) HIV/AIDS, and (6) immunizations. End-stage renal disease is not an area of focus.

Origin:  Chapter 2- Public Health Systems, 16

16.

A nurse in the Canadian healthcare system is concerned because a client has been denied a surgical procedure that the nurse believes is essential to the client’s recovery. Who should the nurse expect will have the most power to reverse this decision?

A)

Nurse practitioner

B)

Physicians

C)

Private insurance company

D)

Health administrator

Ans:

D

Feedback:

The most powerful individuals in the Canadian healthcare system are not physicians but health administrators, who put an emphasis on cost efficiency and social responsibility. Private insurance exists to cover services not covered under Medicare, such as vision needs, dental services, and pharmaceuticals for nonelderly people. This type of private insurance is acquired through employment contributions and represents a small portion of total health expenditures (15%). Nurses and nurse practitioners are important to the care of individuals and communities but play a lesser role in the administration of public healthcare.

Origin:  Chapter 2- Public Health Systems, 17

17.

Which is characteristic of the German healthcare system?

A)

Health insurance payments based on risk, not income

B)

Ambulatory care provided by centralized nonprofit hospitals

C)

An average hospital stay of 9 days

D)

Nurse practitioners operating independently

Ans:

C

Feedback:

The average length of hospital stay in Germany has decreased in recent years from 14 to 9 days, still considerably longer than the 5- to 6-day average in the United States. Health insurance coverage is maintained by all citizens sharing in the effort to have an insurance pool, and payment is based on income, not risk. Currently, physicians in private practice provide ambulatory care, and centralized nonprofit hospitals offer the majority of inpatient care. Nurses in the German healthcare system, called sisters, are mostly diploma-educated individuals working with a physician.

Origin:  Chapter 2- Public Health Systems, 18

18.

Which type of payment system does the Netherlands have?

A)

Universal long-term payment system

B)

Dual-level payment system

C)

Private health insurance linked to employment

D)

Free health insurance paid by the government

Ans:

B

Feedback:

The Netherlands has a dual-level healthcare payment system. All primary and acute care is financed from private mandatory insurance. Long-term care for the elderly, the dying, long-term mentally ill, and so on, is covered by money acquired from taxation and is considered a “social insurance.”

Origin:  Chapter 2- Public Health Systems, 19

19.

Which best describes a multilateral agency?

A)

Is based in only one country but provides services to many other countries

B)

Is responsible for the health and welfare of citizens nationally

C)

Receives funding from both governmental and nongovernmental sources

D)

Acquires resources to help others from private rather than public sources

Ans:

C

Feedback:

A multilateral agency is one that receives funding from both governmental and nongovernmental sources. A bilateral agency is one that is based in only one country but provides services to many other countries. The Department of Health and Human Services is a U.S. agency responsible for the health and welfare of citizens nationally. A nongovernmental organization (NGO) is an agency that acquires resources to help others from private rather than public sources.

Origin:  Chapter 2- Public Health Systems, 20

20.

The International Council of Nurses (ICN) is a federation of more than 130 national nurses associations, representing more than 13 million nurses worldwide. In which area is the International Council of Nurses particularly active?

A)

Basic nursing practice

B)

Secondary healthcare

C)

Women’s health

D)

Safe immunization programs

Ans:

C

Feedback:

ICN is particularly active in international classification of nursing practice; advanced (not basic) nursing practice; entrepreneurship; HIV/AIDS, tuberculosis, and malaria; women’s health; primary (not secondary) healthcare; family health; and safe water (not safe immunization programs).

Origin:  Chapter 2- Public Health Systems, 21

21.

A hurricane recently struck a nurse’s hometown, and the nurse on behalf of the hospital is coordinating local relief efforts with nongovernmental organizations (NGOs). Which organization should this nurse most expect to work with in this situation?

A)

Bill and Melinda Gates Foundation

B)

Living Proof Project

C)

International Committee of the Red Cross

D)

Oxfam International

Ans:

C

Feedback:

Nongovernmental organizations are private agencies that voluntarily use their resources to address a variety of healthcare initiatives in the United States. The International Committee of the Red Cross is known most for its role in disaster relief. Oxfam International focuses specifically on issues related to hunger and nutritional health. Philanthropies are organizations that are similar to NGOs but receive funding through personal endowments. For example, the Bill and Melinda Gates Foundation focuses on health, poverty, and development in Africa, South America, Asia, and Australia. The Living Proof Project supports vaccine and nutrition programs, as well as decreasing the incidence of diseases such as polio, HIV/AIDS, and tropical illnesses.