Question 1

An instructor is discussing the impact of the Shattuck Report on community health care. The instructor recognizes that the students understand the information by which response?

Accepted Answer

The Shattuck Report, a landmark document, made a tremendous impact on sanitary progress addressing public health concepts and methods that form the basis of public health practice today. It had no effect on getting bills passed by the legislation nor was it involved in setting up the organizational structure of the U.S. Public Health Service. The Hebrew hygienic code, probably the first written code, was the prototype for personal and community sanitation.

Question 2

Over the past century, many health-related changes have occurred affecting morbidity and mortality. As community health nurses assess and plan for services in the local level, an understanding of which changes would the nurses need to integrate into their plans? Select all that apply.

Accepted Answer

Issues today in the local communities include high levels of chronic disease, increase in teen pregnancies, abuse of multiple substances, and multidrug-resistant disease. Shortened life spans and increased maternal mortality were real issues in the 1900s but are significantly different today. With the shortened life span over 100 years ago, people were not living long enough to develop a long history of chronic disease.

Question 3

A new public health nurse graduate is evaluating the various options available for employment and decides to seek a position with an official health agency. The nurse recognizes that these types of agencies differ from others in which way?

Accepted Answer

Official health care agencies, later called public health agencies, are publicly funded; thus, they provide services determined by the federal, state, or local government. Voluntary and private agencies are privately funded. Proprietary health services are privately owned and managed and may be for profit or nonprofit.

Question 4

A discussion group of students are discussing the public health system and its structure and function. Which statement would indicate that the students need further discussion and clarification?

Accepted Answer

The Secretary of Health and Human Services is a cabinet position. Cabinet positions are appointed by the President. The Public Health Service does offer consultation through national advisory health councils and special advisory committees made up of lay experts. The Secretary of Health and Human Services is ultimately responsible for the Public Health Service. A major function of the Public Health Service is to administer grants and contracts with other government agencies.

Question 5

A community health nurse is engaged in provision of care to clients in a clinic setting at the local health department. This nurse is engaging in which core public health function?

Accepted Answer

The three core public health functions are assessment, policy development, and assurance. Assessment would involve assessing the community, policy development would involve helping to establish policies that will address the problems assessed, and assurance would involve making sure that the services indicated by policies (following assessment) are available to the community. Clinical is not a core public health function.

Question 6

A public health nurse is discussing the core public health functions with a group of student nurses. Which fact should the nurse include in the discussion?

Accepted Answer

Public health nurses practice as partners with other public health professionals within these core functions. Assessment does not involve the actual provision of services (assurance does). Public policy development builds on data from the assessment function. Assurance is the process of translating established policies into services. This function ensures that population-based services are provided, whether by public health agencies or private sources.

Question 7

Which group of actions fulfills the three core public health functions in their proper order?

Accepted Answer

The three core public health functions are assessment, policy development, and assurance. Assessment is data collection, the policy development would be based on the assessment, and assuring is the process of translating established policies into services. Counting the number of kindergarten students who are fully immunized would be assessment, encouraging the school officials to exclude children who are not fully immunized would be policy development, and offering immunization clinics at the school would be assurance. Identifying a source of pollution in the community would be assessment, educating local residents about precautions that should be taken when the pollution exceeds minimum standards would be assurance, and asking legislators to apply sanctions to the responsible party for the source of pollution would be policy development. Providing prenatal care for pregnant adolescents would be assurance, determining how many pregnant adolescents currently attend the school would be assessment, and encouraging school officials to provide an alternative school setting for pregnant adolescents would be assurance. Lobbying for a citywide ban on smoking in public would be policy development, providing smoking cessation services in the community would be assurance, and reviewing mortality data to determine the number of people in the community who die each year from lung cancer would be assessment.

Question 8

A community health nurse primarily works with mothers and their high-risk children. The nurse recognizes which local voluntary agencies can also provide services for these clients? Select all that apply.

Accepted Answer

The American Diabetes Association and National Society for Autistic Children are examples of voluntary agencies funded through private contributions and are nonprofit organizations. The U.S. Public Health Service, the National Institutes of Health, and the WIC program are federal agencies or receive federal funds to operate; thus, they are not voluntary agencies.

Question 9

An instructor is describing the various differences between government health agencies and private organizations. Which comment by the students would indicate understanding of the function of a public health agency?

Accepted Answer

Unlike private organizations that tend to have a specific focus, government health agencies exist to accomplish a broad goal of protecting and promoting the health of the total population under their jurisdiction. Public health also requires interdisciplinary and interorganizational collaboration.

Question 10

A student nurse is having difficulty understanding the differences between public health care agencies and private health care agencies. What is the best response from the instructor?

Accepted Answer

Private sector health services are complementary and supplementary to government health agencies, but this is not a difference between the two types of agencies. Private sector health care agencies usually meet the needs of people with special needs (rather than public sector health care agencies that focus on the entire population within their jurisdiction). Private sector health care agencies are less constrained than public sector health care agencies in developing innovations in health care. A part of the reason for the development of private sector health care agencies is the impatience or dissatisfaction with government (public health) programs.

Question 11

A group of students are preparing to debate about public health care agencies and private health care agencies. Which factor should the group representing the private sector include in the debate?

Accepted Answer

Private sector health agencies are more likely to promote health legislation, whereas public sector health care agencies are more likely to be responsible for carrying out health legislation. Public sector health care agencies must be ready for disasters, administer grants to help public agencies provide care, and usually focus on needs that are met where private agencies strive to detect the unmet needs.

Question 12

A group of student nurses are discussing the various international health organizations. Which statement at the end of the discussion indicates that the students understand the information?

Accepted Answer

United Nations International Children's Emergency Fund (UNICEF) promotes child and maternal health and welfare globally. The Pan American Health Organization (PAHO) is the oldest continually functioning international health organization in the world and predates the World Health Organization (WHO). Initially, the PAHO was independent from the WHO but is now the WHO regional office for the Americas and receives part of its funding from WHO. WHO focuses on the promotion of health worldwide, not just on developing countries. The U. S. Agency for International Development (USAID) focuses on developing countries.

Question 13

A group of students are discussing the results of the various legislative acts affecting health care. Which legislation will the students recognize as resulting in decreasing federal government involvement?

Accepted Answer

The Omnibus Budget Reconciliation Act caused dramatic changes affecting health care. This shifted responsibility for the public's health and welfare back to state and local governments. Large amounts of federal funding were also diverted from health care as the result of this legislation. The other choices all resulted in increased federal government involvement in providing health care for specific population groups.

Question 14

An instructor is discussing the various legislative acts that have focused on health care. Which statement by the class indicates that they understand the focus of the Social Security Act?

Accepted Answer

The Social Security Act ensured greater public health programs, as well as providing retirement income to participating workers aged 65 years and older. The Health Insurance Portability and Accountability Act (HIPAA) provided for greater client privacy. Medicare and Medicaid increased the services available to the poor. The State Children's Health Insurance Program (SCHIP) was passed in 1997 to provide greater coverage for children.

Question 15

A community health nurse working at the local level is attending an in-service program about health care economics. The nurse asks the presenter, "Why do I need to know this information? My focus is my clients." Which response by the presenter would be most appropriate?

Accepted Answer

At the local level (the community health nurse and the employing agency), health care economics is very important for survival. Resourceful use of time, talent, and materials will ensure that the services will be able to continue and that the agency stays viable. Government funding, a future role in management, and dealing with the issue in the future are inappropriate and do not emphasize the importance of the effect of health care economics.

Question 16

The instructor is leading a class discussion on macroeconomics and its effect on today's health care. Which effect should the class identify as a result of macroeconomics on health care after the discussion?

Accepted Answer

Macroeconomic theory is concerned with the broad variables that affect the status of the economy as a whole, such as factors affecting aggregate consumptions, production, investment, and international trade. The focus is on the larger view of economic stability and growth, providing a global or aggregate perspective. This can include comparing health care spending between countries or entities. Microeconomic theory addresses supply (quantity of services available) and demand (consumer's willingness to buy services) and studies how allocation and distribution affect consumer demand for goods and services.

Question 17

A community health nurse is developing a teaching plan about Medicare to present at a community event. Which points will be important to include in the presentation? Select all that apply.

Accepted Answer

Medicare is a federal health insurance program for adults aged 65 years and older who have paid into the Social Security system. It also covers certain people with disabilities (regardless of age). Medicare Part A covers medically necessary hospitalization, home care, hospice services, and limited-skilled nursing service. Prescriptions are covered under Medicare Part D. Medicare Part B is supplementary and voluntary. Medicare beneficiaries can make changes to their coverage during open enrollment periods.

Question 18

A community health nurse is teaching a community group about the Medicaid program. Which statement from the group would indicate to the nurse that additional teaching is necessary?

Accepted Answer

Medicaid monies come to the states from the federal government. Each state determines who will receive what kinds of health care services. This makes it a uniquely different program in each state. Medicaid is a free program available to individuals on the basis of financial need and legal residency status. Medicaid will provide nursing home services to eligible individuals over the age of 21. Eligibility is determined on the basis of financial need and residency status. Finally, some low-income Medicare eligible people also receive Medicaid.

Question 19

A group of students are preparing a presentation to give to the class discussing retrospective payment plans. Which situation should the students include in the discussion?

Accepted Answer

Retrospective payment is associated with encouraging sickness care rather than wellness services. Physicians and other providers were rewarded financially for treating illness and providing for additional tests and services. Clients and providers often insisted on expensive or unnecessary tests and treatment. Neither consumers nor providers were accountable for containing costs. Retrospective payment involves reimbursement for a service after it has been rendered with payment of a fee occurring after the fact.

Question 20

A community health nurse is preparing to meet with a group of students. Which statements should the nurse include when discussing how trends and issues have influenced health care? Select all that apply.

Accepted Answer

The United States has one of the least cost-effective health care systems in the world. One explanation for the high cost of U.S. Health Care System is the need to practice defensive medicine by ordering excessive tests and x-rays. In the United States, the health-related quality of life is lower than for most other countries. The United States ranks first among all WHO countries on a measure of how respectfully clients are treated. In a survey published in 2009, most U.S. physicians did not identify that their health care system worked well.

Quiz 6: Structure and Economics of Communitypublic Health Services