Foundations of Nursing in the Community, 3rd Edition Stanhope, Lancaster-Test Bank
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Sample
Test
Stanhope: Foundations of Nursing in the Community:
Community-Oriented Practice, 3rd Edition
Chapter 3: The U.S. Health and Public Health Care Systems
Test Bank
MULTIPLE CHOICE
1. How
would you describe ideal primary health care?
|
a. |
Based on a
multidisciplinary group of health care providers that work as a team |
|
b. |
Essential care available to
all community members, which encourages self-management and self-reliance |
|
c. |
Focused on health promotion
and disease prevention for everyone enrolled in the health center |
|
d. |
Local efforts to meet the
Declaration of Alma Ata principles |
ANS: B
Primary health care is generally defined as essential care made
universally accessible to individuals and families in a community with their
full participation and at a cost that the community can afford.
DIF: Cognitive Level:
Knowledge
REF: p. 38
2. What
is the United States’ approach to the primary health care movement, which
includes health policies, social and economic development, and provision of
health care?
|
a. |
Cooperates fully with
member World Health Organization nations in implementing the plan
internationally |
|
b. |
Disagrees that the goal of
health is for all citizens to live socially and economically productive lives |
|
c. |
Enthusiastically endorses
and has attempted to implement the goals in every way possible |
|
d. |
Has focused primarily on
disease prevention and health promotion in selected areas |
ANS: D
The primary health care movement, based on the assumption that
all citizens of the world should be able to live socially and economically
productive lives, is a political statement encouraging each country to
interpret it according to its own culture, needs, resources, and government.
The United States has endorsed primary health care as a strategy but focuses
more on disease prevention and health promotion than the other strategies.
DIF: Cognitive Level:
Knowledge
REF: p. 39
3. Medicaid
is increasingly using a managed care (MC) model in caring for enrollees. How
does this model attempt to control costs of care?
|
a. |
By requiring families to
use the point of service list of individual practice associates |
|
b. |
By requiring families to
choose a care provider from the MC network and not allowing access to other
services without their provider’s permission |
|
c. |
By moving Medicaid-eligible
families onto state Medicare enrollment |
|
d. |
By refusing permission for
families to use urgent care or emergency department services |
ANS: B
Managed care is a system in which care is delivered by a
specific network of providers. Each provider serves as a gatekeeper who
controls access to other providers and services. Cost is reduced, since members
cannot use specialists or seek hospital or other care without permission from
their primary care provider. Thus those enrolled in Medicaid managed care have
restrictions that help keep costs down for government (and for taxpayers).
DIF: Cognitive Level:
Knowledge
REF: p. 39
4. What
determines which health care services are offered at the local level in public
health clinics?
|
a. |
Local public health clinics
are restricted to those services allowed by federal legislation. |
|
b. |
Local public health clinics
may offer whatever services local taxpayers are willing to pay for. |
|
c. |
Local public health clinics
must follow the recommendations of Healthy
People 2010. |
|
d. |
Local public health clinics
must offer whatever services the state mandates they offer. |
ANS: D
At the local level, health departments provide care that is
mandated by state and federal regulations.
DIF: Cognitive Level: Knowledge
REF: p. 40
5. Which
government agency attempts to ensure delivery of health care to communities or
aggregates that are medically underserved?
|
a. |
Administration for Children
and Families |
|
b. |
Centers for Disease Control
and Prevention |
|
c. |
Health Resources and
Services Administration |
|
d. |
The National Institutes of
Health |
ANS: C
The Health Resources and Services Administration (HRSA) directs
grant programs to expand access to primary care for low-income and uninsured
people. HRSA serves as a national focus for efforts to ensure the delivery of
health care to residents of medically underserved areas and to persons with
special health care needs. HRSA funds more than 3650 health center delivery
sites in every state and in Puerto Rico.
DIF: Cognitive Level:
Knowledge
REF: p. 40
6. Which
national agency’s mission is to conduct research on patient care outcomes?
|
a. |
Agency for Health Care
Research and Quality |
|
b. |
Federal Agency for Patient
Care Outcomes |
|
c. |
National Center for Nursing
Research |
|
d. |
U.S. Agency for Patient
Care Effectiveness |
ANS: A
The Agency for Health Care Research and Quality conducts
research on health care systems, health care quality and cost issues, access to
health care, and effectiveness of medical treatments. It provides
evidence-based information on health care outcomes and quality of care.
DIF: Cognitive Level:
Knowledge
REF: pp. 40-41
7. How
is the Department of Agriculture promoting the health of U.S. citizens?
|
a. |
By collecting surplus food
left after mechanical harvests and distributing it to the poor |
|
b. |
By inspecting food, so no
foodborne illnesses can occur |
|
c. |
In collaboration with
others, by providing food or food stamps to needy persons |
|
d. |
Through direct education
and grants to dietitians and nutritionists |
ANS: C
The Department of Agriculture collaborates with state and local
government welfare agencies to provide food stamps to needy persons to increase
their food-purchasing power. Other programs include school breakfast and lunch
programs; the Supplemental Food Program for Women, Infants, and Children (WIC);
and grants to states for nutrition education training. The Department of
Agriculture also engages in plant, product, and animal inspections, but limited
funding prevents absolute surety that food is safe to eat.
DIF: Cognitive Level:
Knowledge
REF: p. 43
8. Local,
state, and federal governmental agencies have started to cooperate and collaborate
more closely in the last few years because of:
|
a. |
Administrative pressures to
demonstrate improvement in outcomes |
|
b. |
The need to focus on
emergency preparedness and response |
|
c. |
Taxpayers’ complaints and
general unhappiness |
|
d. |
Pressure to decrease
overlap in services and thereby decrease costs |
ANS: B
Since the tragedy of September 11, 2001, health departments have
increasingly focused on emergency preparedness and response. In case of an
emergency event, state and local health departments in the affected area will
be expected to collect data and accurately report the situation, to respond
appropriately to any type of emergency, and to ensure the safety of the
residents of the immediate area, while protecting those just outside the danger
zone. This goal—to enable public health agencies to anticipate, prepare for,
recognize, and respond to terrorist threats or natural disasters—has required
an unprecedented level of interstate and federal-local planning and cooperation
among these agencies.
DIF: Cognitive Level:
Knowledge
REF: p. 44
9. What
have managed care organizations done to better balance consumer and purchaser
demands and still maintain their profits?
|
a. |
Created alliances, mergers,
and joint cooperative ventures while downsizing |
|
b. |
Engaged in massive
marketing campaigns to increase the number of employers using them |
|
c. |
Publicized awards and
recognition to encourage consumers to demand to use their facilities |
|
d. |
Purchased newspaper, radio,
and TV time to share the problems that they are having in meeting everyone’s
demands |
ANS: A
Although managed care organizations might do any of these, their
primary efforts have been focused on creating alliances, mergers, and joint
ventures while also downsizing.
DIF: Cognitive Level:
Knowledge
REF: p. 45
10. The
American Nurses Association (ANA) has strongly encouraged reform based on what
principle?
|
a. |
Electronic medical records
and other high-technology interventions to reduce nursing time, effort, and
medical errors must be expanded. |
|
b. |
Nurses must be recognized
and rewarded for health promotion efforts. |
|
c. |
Nursing research into
patient care outcomes must be expanded and funded. |
|
d. |
We must implement universal
access to essential health services for all citizens. |
ANS: D
The ANA’s position is based on the belief that health care is a
basic human right. Thus a restructured health care system must ensure universal
access to a standard package of essential health care services for all citizens
and residents.
DIF: Cognitive Level:
Knowledge
REF: p. 46
11. How
would health care in the United States be most accurately described?
|
a. |
A logical rational approach
to meeting expressed needs while still trying to control costs |
|
b. |
A system in the process of
reform as problems have become increasingly apparent |
|
c. |
Private health care for
those with insurance or money and public health care for those without either |
|
d. |
The best in the world with outstanding
research and high-technology care available to all |
ANS: C
Health care in the United States consists of a personal care
system and a public health system, with overlap between the two.
DIF: Cognitive Level:
Knowledge
REF: p. 46
12. Based
on previous research, what might be an effective approach to increase
enrollment in SCHIP?
|
a. |
Explaining the program to
children enrolled in public school systems |
|
b. |
Handing out SCHIP
applications to uninsured children seen in local hospital emergency
departments |
|
c. |
Having a newspaper campaign
with information and applications printed in the newspaper |
|
d. |
Sending literature about
the SCHIP program home with school children each year |
ANS: B
Particularly among minority children not otherwise involved with
the social welfare system, handing out insurance applications in the emergency
department could be an effective SCHIP enrollment strategy. The textbook gives
a research example of the effectiveness of this approach.
DIF: Cognitive Level:
Application
REF: p. 45 (Evidence-Based Practice box)
MULTIPLE RESPONSE
1. Which
of the following statements are accurate descriptions of current social and
economic trends in the United States? Select all that apply.
|
a. |
Citizens are appreciating
the quality of life enjoyed in the United States. |
|
b. |
Enjoying life is not as
important as the need to take care of oneself. |
|
c. |
Many families are seeing
decreases in family income. |
|
d. |
Massive and unexpected
social and economic changes have occurred. |
|
e. |
Public health and
preventive health care (health promotion) have become very important. |
|
f. |
The gap between the richest
and the poorest in the United States is becoming narrower. |
ANS: C, D
The first decade of the twenty-first century has added massive
and unexpected changes to health, economic, and social conditions in the form
of terrorist attacks, hurricanes, fires, floods, and infectious diseases. In
addition to layoffs, outsourcing, and other economic forces, many families are
seeing wage decreases. The gap between the richest 25% and the poorest 25% is
widening. Unfortunately, we have still not embraced the need for health
promotion and disease prevention but continue to expend funds primarily on
acute care needs.
DIF: Cognitive Level:
Knowledge
REF: p. 34
2. What
do demographic figures suggest about the ways in which the population of the
United States is changing? Select all that apply.
|
a. |
Approximately 12% of the
U.S. population was born in a different country. |
|
b. |
Hispanics are the largest
minority group population. |
|
c. |
Households consisting
primarily of intact families continue to grow. |
|
d. |
Mortality for both genders
in all age-groups declined. |
|
e. |
Of the foreign born, most
are from Asia. |
|
f. |
Overall the population of
the United States is declining. |
ANS: A, B, D
Demographic figures confirm that 12% of the current U.S.
population was foreign-born, with most immigrants coming from Latin America and
about half as many from Asia. Families make up about 69% of all households, a
decline from 81% in 1970. Although African-Americans used to be the largest
minority group, as of 2003, Hispanics now have that distinction. The population
of the United States continues to increase, and mortality for both genders from
all age-groups has declined.
DIF: Cognitive Level:
Knowledge
REF: p. 34
3. Which
of the following are evidence that the U.S. health care system is in crisis?
Select all that apply.
|
a. |
Full-time employees may not
have health insurance as a benefit. |
|
b. |
Incompetent or negligent
nurses are an ongoing source of medical errors. |
|
c. |
Long work hours and
provider fatigue are a major factor in medical errors. |
|
d. |
More punitive measures must
be taken to decrease provider errors. |
|
e. |
The United States spends
more on health care than any other country in the world. |
|
f. |
Universities are not making
any effort to expand educational programs for health care providers. |
ANS: A, C, E
The United States spends more than any other country (16%) on
health care, but many employers cannot afford to give health care as a benefit,
even to full-time employees. As a result of the nursing shortage, nurses work
longer hours and provider fatigue is a major factor in errors. The Institute of
Medicine’s (IOM) report To
Err Is Human recommends that we stop blaming and punishing
individuals for errors and instead begin identifying and correcting system
failures by designing safety into the process of care.
DIF: Cognitive Level:
Knowledge
REF: pp. 36-37
4. What
functions do state health departments typically provide? Select all that apply.
|
a. |
Administering Medicaid |
|
b. |
Assessing the health needs
of the state’s citizens |
|
c. |
Employing and supervising school
health nurses |
|
d. |
Establishing and
maintaining free clinics for HIV-positive drug abusers |
|
e. |
Licensing facilities and
personnel |
|
f. |
Regulating the health
insurance industry |
ANS: A, B, E, F
State health departments try to prevent and respond to
infectious disease outbreaks. They also are responsible for health care
financing and administering Medicaid, providing mental health and professional
education, establishing health codes, licensing facilities and personnel, and
regulating the insurance industry. State health departments also give direct
assistance to local health departments in such areas as ongoing assessment of
health needs.
DIF: Cognitive Level:
Knowledge
REF: p. 43
Stanhope: Foundations of Nursing in the Community:
Community-Oriented Practice, 3rd Edition
Chapter 4: Ethics in Community-Oriented Nursing Practice
Test Bank
MULTIPLE CHOICE
1. Nursing’s
first code of ethics was written in:
|
a. |
1893 by Lystra Gretter |
|
b. |
1950 by the ANA House of Delegates |
|
c. |
1953 by the International
Council of Nurses (ICN) |
|
d. |
2001 by the ANA House of
Delegates |
ANS: A
The Nightingale Pledge, considered nursing’s first code of
ethics, was written by Lystra Gretter in 1893.
DIF: Cognitive Level: Knowledge
REF: p. 52
2. A
nurse didn’t know what to do when faced with a particular ethical dilemma
because an option that would have a good outcome didn’t seem possible. The
nurse finally decided to talk to the agency supervisor and let the supervisor
decide what action to take. In terms of ethics, this approach would be
considered:
|
a. |
Appropriate because the
supervisor is responsible for the nurse’s choices |
|
b. |
Intelligent because the
supervisor has access to resource persons (clergy, physicians,
administrators) who might know of options the nurse hadn’t considered |
|
c. |
Simply an opportunity to
discuss the issue because the nurse is still responsible for his or her own
personal choices |
|
d. |
Wise because the supervisor
would be more knowledgeable concerning agency priorities and traditional
practices |
ANS: C
Ethically, each nurse is responsible for his or her own
decisions and cannot avoid ethical accountability by relying on obedience to a
supervisor or any external rule or policy.
DIF: Cognitive Level:
Application
REF: p. 52
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