Question 1

A community health nurse is working in a rural area providing care to families. The nurse sets up a connection between one of the families with a social service agency providing meals to homebound persons. The nurse is acting in which role?

Accepted Answer

The nurse is acting as the coordinator/case manager by connecting the family with needed health and social services and often assisting with information on transportation. As an advocate, the nurse would assist the clients, families, and populations in obtaining the best possible care. As a health teacher, the nurse would provide education to individuals, families, or groups on health promotion or other health-related topics. As a mentor, the nurse would guide new community health nurses, nursing students, and other nurses new to the rural community.

Question 2

A public health nurse is teaching a group of community health nurses about urban health. The nurse determines that the teaching was successful when the group describes urban health by which statement?

Accepted Answer

Urban health considers those characteristics of the environment as they relate to the health of the population living within large cities. Factors responsible for the health of urban residents reflect three broad themes: the physical environment, the social environment, and access to health and social services. Individuals living in ghettos and immigrants living in large cities are two segments of the urban population. Urban communities are made up of multiethnic and diverse racial communities, and these groups are often socially and economically separate from what one might believe to be mainstream urban communities. Urban planning works to improve the welfare of individuals and communities by creating more healthful, efficient, attractive, and equitable places.

Question 3

A rural community health nurse is acting in the role of a mentor. Which activity would the nurse most likely be doing?

Accepted Answer

In the role of a mentor, the rural community health nurse would engage in guiding new community health nurses, nursing students, and other nurses new to the rural community. Childbirth classes would be characteristic of the educator role. Contacting a specialist for a client reflects the nurse's role as a referral agent. Collecting immunization data for program development reflects the nurse's role as a change agent/researcher.

Question 4

A community health nurse is trying to decide where to work, an urban or rural setting. Which factors would the nurse identify as characteristic of an urban setting? Select all that apply.

Accepted Answer

Nurses working in urban settings typically have higher salaries and more opportunities for advancement or additional education. Limited resources and physical isolation are more often noted with rural nursing.

Question 5

A public health nurse is visiting a rural area and notes that there is a critical access hospital. The nurse would expect to find that this hospital has which characteristics? Select all that apply.

Accepted Answer

Critical access hospitals (CAHs) have 25 or fewer beds and must provide 24-hour emergency care, with either medical physician on site or registered nurse on site along with a medical physician on call and able to arrive within 30 minutes. They must also be over 35 miles from the next hospital or 15 miles if the terrain is difficult.

Question 6

A community health nurse is working with community leaders to address health issues in the community related to urban sprawl. The nurse identifies several new areas where parking lots have been built, replacing large open fields. Which term would the nurse use to identify this change?

Accepted Answer

Heat islands occur when green areas are exchanged for asphalt, resulting in temperature and ecosystem changes that can extend to more rural areas. Built environment refers to how living places are planned. Urbanized area refers to densely settled territory with a population of at least 50,000 people. Frontier area refers to designated sparsely populated rural places that are isolated from population centers and services.

Question 7

A community health nurse is working to address issues associated with a local migrant population. When developing plans for this population, which characteristic would the nurse need to address? Select all that apply.

Accepted Answer

Migrant workers are not often visible members of our society. They go unnoticed beyond the fringes of the camps and farms to which they travel in order to pursue their livelihood. Most come to the United States from other countries (72%), and of those, about 68% are from Mexico. The average age is 36 years, and the average level of completed education was the eighth grade. Only 6% are salaried, with the majority paid low hourly wages or by the piece. Some are legal residents, but most are undocumented aliens and live in fear of deportation. All endure backbreaking, menial labor for low wages and are often deprived of basic rights to safe working conditions, adequate sanitation/housing, health care, and a quality education for their children.

Question 8

A community health nurse is working with several rural areas to improve access to health care for the residents. Which suggestions might the nurse provide? Select all that apply.

Accepted Answer

Several strategies can be used to improve access for rural residents. These include faith-based nursing, mobile clinics, school-based clinics, and telehealth. Critical access hospitals are hospitals that have 25 or fewer beds and provide 24-hour emergency care, with either a physician or registered nurse on site with a physician D on call and able to arrive within 30 minutes. They must also have 25 beds maximum and be over 35 miles from the next hospital or 15 miles if the terrain is difficult. They provide access to care, but they do not improve access.

Question 9

A community health nurse in a small countryside community is caring for a client who has been trying to treat an upper respiratory infection with herbal supplements. The nurse suspects pneumonia and has consulted with a telemedicine physician who is planning to provide treatment. Which of the following statements would be relevant for the nurse to include in the client's medical record?

Accepted Answer

The health record should reflect some of the demographic issues that have impacted the client's treatment and care; therefore, the nurse should document that the client lives in a rural community. Because cost, weather, and travel distance are often barriers to treatment in rural areas, community members may try to treat illnesses independently with home remedies before seeking formal care. Including the client's demographic information is helpful for the telehealth care team to understand the client's current approach to treatment and future challenges the client may have attending in-person follow-up visits. The nurse does not need to communicate as most providers will develop a plan of care focusing on the health of the individual rather than how the client will pay for the treatment. Unless the client's religion has initiatives that do not allow the client to receive certain treatments, it is not relevant to note on the client's record. In this scenario, the nurse does not have any evidence that the client is at risk from the herbal treatments.

Question 10

A community health nurse is conducting a presentation on migration patterns and the impact on the community. Within the presentation, the nurse references the U.S. Census infographic. Which statements best summarize the U.S. Census infographics about the U.S. population comparing rural and urban communities from 1910 to 2020? Select all that apply.

Accepted Answer

Measuring American from the U.S. Census identifies changes of the urban and rural communities. Overall, the urban population has been steadily growing, while the rural communities have remained the same from 1910 to 2010. There is a higher poverty rate in urban communities. The median household income and home values are higher in the urban communities. Bachelor's degrees or higher are more prevalent in the urban communities.

Question 11

The community health nurse is providing statistics to the local government on poverty rates in the community. In providing comparison data, the nurse includes information across the United States and Puerto Rico. Which statement best summarizes the percentage of people living in poverty in the United States and Puerto Rico in 2017?

Accepted Answer

According to the infographic, there are five states that have a poverty rate of 18% or more: West Virginia, Mississippi, Louisiana, New Mexico, and Puerto Rico. Four states (Arkansas, Alabama, Kentucky, and District of Colombia) reported 16% to 17.9% of poverty. The largest group, with 11 states, is the group with 13% to 15.9% of poverty. Twelve states have less than 11% of reported poverty. The average U.S. poverty rate is 13.4%.

Quiz 27: Rural, Migrant, and Urban Health Care