Health Promotion Throughout the Life Span 8th Edition By Edelman – Test Bank
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Sample
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Chapter 03: Health Policy and the Delivery System
Edelman: Health Promotion Throughout the Life Span, 8th Edition
MULTIPLE CHOICE
1. Which
addition to a community best demonstrates the concept of the Healthy People 2020 report?
|
a. |
New cardiothoracic
intensive care unit at a major hospital |
|
b. |
New rehabilitation center |
|
c. |
New recreational health
center |
|
d. |
New children’s hospital |
ANS: C
The Healthy
People 2020 report promotes health care, not illness care. A
hospital, ICU, and rehabilitation center emphasize episodic care after an
illness. The recreation health center serves to preserve health in the
community and helps meet the goals of the Healthy People 2020 report.
DIF: Cognitive Level: Apply
(Application)
REF: p. 47 | p. 47 (Box 3-1)
2. Which
nurse is at risk of making a medical error?
|
a. |
Working overtime |
|
b. |
Works in a hospital that
advocates multidisciplinary care |
|
c. |
Caring for four clients
during the shift |
|
d. |
Attends regular continuing
education programs |
ANS: A
Health care systems are the basic cause of medical errors.
Organizational and workforce management, work design, and organizational
culture are problem areas that contribute to medical errors. Poor management
leads to increased nurse turnover, the need for increased client-to-nurse
ratios, increased need for overtime, and decreased number of nurses, all of
which can lead to medical errors. A nurse working overtime is at risk of making
a medical error.
DIF: Cognitive Level: Apply
(Application)
REF: p. 50
3. What
is the most effective policy a staff nurse can implement to help decrease medical
errors on the unit?
|
a. |
Forgo opportunities for
continuing education so the unit is never understaffed. |
|
b. |
Foster a collaborative
working environment on the unit. |
|
c. |
Check all medications a
minimum of three times before administering them. |
|
d. |
Develop a policy that
mandates the firing of any nurse who commits an error. |
ANS: B
Health care systems are the basic cause of medical errors.
Organizational and workforce management, work design, and organizational
culture are problem areas that contribute to medical errors. Creating a
collaborative working environment helps improve organizational culture, thereby
reducing the chance of medical errors.
DIF: Cognitive Level: Apply
(Application)
REF: p. 50
4. The person
known as the father of British and American public health is:
|
a. |
Lillian Wald. |
|
b. |
Edwin Chadwick. |
|
c. |
Lemuel Shattuck. |
|
d. |
Paul Ehrlich. |
ANS: B
Edwin Chadwick is known as the father of British and American
public health.
DIF: Cognitive Level: Remember
(Knowledge)
REF: p. 51
5. A
community health nurse most effectively preserves the health of a person with
tuberculosis (TB) and the community by:
|
a. |
administering and reading
the purified protein derivative (PPD) of all close contacts |
|
b. |
providing direct observed
therapy (DOT) for the individual with TB |
|
c. |
isolating the person
because it is likely drug resistant |
|
d. |
telling the person to wear
a mask when leaving the home |
ANS: B
Community health nursing practice promotes, preserves, and
maintains the health of populations and the effect of their health status on
that of the community as a whole through care provided to individuals,
families, and groups. Thus, the most effective strategy of treating the
individual and preventing the spread of TB is to provide DOT.
DIF: Cognitive Level: Analyze
(Analysis)
REF: p. 52
6. A
community planning committee is working on the development of a community
nursing center. Which of the following essential components should be included
in this center?
|
a. |
Physician as medical
director |
|
b. |
Interdisciplinary staff |
|
c. |
Nurse as chief manager |
|
d. |
Partnership with an
academic institution |
ANS: C
The essential components of a community nursing center include a
nurse as chief manager, a nursing staff that is accountable and responsible for
care and professional practice, and nurses as the primary providers of care.
DIF: Cognitive Level: Apply
(Application)
REF: p. 54
7. Considering
the provider and client perspective, which of the following is the most
autonomous form of insurance?
|
a. |
Fee-for-service plan |
|
b. |
Health maintenance organization
(HMO) |
|
c. |
Preferred provider
organization (PPO) |
|
d. |
Independent practice
association (IPA) |
ANS: A
In the fee-for-service plan, a provider provides a service and
bills the individual’s insurance company. The individual is also allowed to choose
his or her provider.
DIF: Cognitive Level: Apply
(Application)
REF: p. 55
8. Which
could result in a change in a nurse practitioner’s practice?
|
a. |
Holding a master’s degree
or higher |
|
b. |
Moving to another state when
she gets married |
|
c. |
Caring for Medicare clients |
|
d. |
Changing to another office
within the same practice |
ANS: B
Nurse practitioners generally hold master’s degrees or higher.
The nurse practice act within their states may be more comprehensive than the
institutions for which they work. Legislation exists for reimbursement of nurse
practitioners by Medicare. However, practice acts and prescriptive authority
vary from state to state and thus influence practice patterns.
DIF: Cognitive Level: Apply
(Application)
REF: p. 55 | p. 70
9. Which
health care provider represents a primary care provider?
|
a. |
Psychiatric advanced
practice nurse |
|
b. |
Clinical nurse specialist |
|
c. |
Pediatric nurse practitioner |
|
d. |
Acute care nurse
practitioner |
ANS: C
A primary care provider serves as a gatekeeper, coordinating
care of individuals by determining the need for referrals and procedures. A
primary care provider can be a physician, physician’s assistant, or advanced
practice nurse in a primary care setting. The primary care provider provides
basic and routine care usually in an office or a clinic. A pediatric nurse
practitioner is an example of a primary care provider.
DIF: Cognitive Level: Apply
(Application)
REF: p. 55 | p. 56 (Box 3-5)
10. Which
form of managed care restricts providers to caring for individuals who are
members of their organization?
|
a. |
Fee-for-service plan |
|
b. |
Health maintenance organization
(HMO) |
|
c. |
Preferred provider
organization (PPO) |
|
d. |
Independent practice
association (IPA) |
ANS: B
The traditional HMO was a group or staff model in which a group
of physicians and some specialty services provided care to its members.
Providers generally spent all their time serving members of the HMO.
Fee-for-service, IPAs, and PPOs are not restricted to serving clients for any
one organization.
DIF: Cognitive Level: Remember
(Knowledge)
REF: p. 55
11. A
Medicare client reports to the home care nurse that he is receiving care
through an accountable care organization (ACO). Which of the following
considerations should be made when delivering care to this individual?
|
a. |
The individual must see a
primary care provider before being referred to a specialist. |
|
b. |
The focus of care is
prevention and management of individuals with chronic disease. |
|
c. |
The individual has paid a
membership fee to be part of this organization. |
|
d. |
The focus of care is to
conserve money in a health savings account. |
ANS: B
The focus of care of accountable care organizations (ACOs) is to
focus on prevention and management of individuals with chronic disease out of
the hospital. In an ACO, physicians accept the responsibility for the quality
of care provided and overall costs of delivering care to a defined population
of patients. Accountable care organizations are composed of physicians,
specialists, and hospitals, so a specialist will be able to be seen within the
ACO. Individuals who are part of concierge care pay a membership fee in return
for enhanced health care services or amenities. Health savings accounts are
used in conjunction with high deductible health insurance plans and are not
related to the use of ACOs.
DIF: Cognitive Level: Apply
(Application)
REF: pp. 56-57
12. An
individual states that his family has insurance, but that paying for routine
medical costs is very expensive because most routine services are paid for out
of pocket. Which type of insurance plan does this individual most likely have?
|
a. |
High deductible health
insurance plan (HDHP) |
|
b. |
Point-of-service plan (POS) |
|
c. |
Health maintenance
organization (HMO) |
|
d. |
Preferred provider
organization (PPO) |
ANS: A
High deductible health insurance plans (HDHPs) are structured in
a way similar to traditional managed care plans and fee-for-service plans but
have a very high annual out-of-pocket deductible. Thus, a family with this type
of insurance will pay out-of-pocket until they reach the deductible, which may
make receiving health services expensive for them. Point-of-service plans allow
members, for an additional fee and higher copayment, to use providers outside
of the HMO network. Health maintenance organizations (HMOs) deliver
comprehensive health maintenance and treatment services for a group of enrolled
individuals who prepay a fixed fee. Preferred provider organizations (PPOs)
have a preselected list of providers who have agreed to provide health services
for those enrolled in the plan.
DIF: Cognitive Level: Apply
(Application)
REF: p. 58
13. Which
of the following is a health plan consisting of hospitals and physician
providers providing health care services to plan members (usually at discounted
rates) in return for expedited claims payment?
|
a. |
Health maintenance
organization (HMO) |
|
b. |
Health savings account
(HSA) |
|
c. |
Preferred provider
organization (PPO) |
|
d. |
Independent practice
association (IPA) |
ANS: C
A health plan consisting of hospitals and physician providers
providing health care services to plan members (usually at discounted rates) in
return for expedited claims payment is known as a preferred provider
organization (PPO).
DIF: Cognitive Level: Remember
(Knowledge)
REF: p. 58 | p. 56 (Box 3-5)
14. Two
working adults do not have access to health insurance for their family from
their employers and do not meet the financial criteria for Medicaid. For which
of the following federal programs may the children in this family be eligible?
|
a. |
Medicare |
|
b. |
Civilian Health Medical
Program for Uniformed Services (CHAMPUS) |
|
c. |
State Children’s Health
Insurance Program (SCHIP) |
|
d. |
Veteran’s Administration
Program |
ANS: C
The State Children’s Health Insurance Program is a public state
insurance program established to provide insurance to uninsured children whose
family is typically described as the working poor and do not meet Medicaid
requirements. In this case, both parents work but do not have access to
insurance through their employers. Additionally, they do not meet the financial
Medicaid requirement.
DIF: Cognitive Level: Apply
(Application)
REF: p. 60
15. A
nurse complies with the Patient Self-Determination Act when asking:
|
a. |
a person upon admission to
the hospital if he or she has an advanced directive |
|
b. |
the family in the recovery
room if the client has an advanced directive |
|
c. |
a person before discharge
from the hospital if he or she has an advance directive |
|
d. |
the family about an
advanced directive after the person has been intubated |
ANS: A
The Patient Self-Determination Act is designed to increase
individual involvement in decisions about life-sustaining treatments. The nurse
must ensure that advanced directives are available to physicians at the time
the medical decision is being made. Therefore, the nurse complies with the act
when she asks a person upon admission to the hospital if he or she has an advanced
directive.
DIF: Cognitive Level: Apply
(Application)
REF: p. 64
16. A
nurse discussing the care of a person on the surgical unit following gastric
bypass surgery with a friend is in violation of the:
|
a. |
Patient Self-Determination
Act |
|
b. |
Health Insurance
Portability and Accountability Act of 1996 |
|
c. |
Americans with Disabilities
Act |
|
d. |
Civil Rights Act |
ANS: B
The Health Insurance Portability and Accountability Act of 1996
(HIPAA) is a federal privacy standard that requires safeguards to protect the
security and confidentiality of health information. Disclosures without
individual authorization are allowed only to public health authorities
authorized by law to collect and receive information for the purpose of
preventing or controlling disease, injury, or disability.
DIF: Cognitive Level: Apply
(Application)
REF: p. 64
17. Which
is a violation of the Health Insurance Portability and Accountability Act of
1996?
|
a. |
Nurse reporting a case of
TB to the health department |
|
b. |
Nurse reporting a case of
child abuse to the Department of Human Services |
|
c. |
Nurse discussing the
person’s case with his or her physician |
|
d. |
Nurse discussing the
person’s case with his or her school nurse |
ANS: D
The Health Insurance Portability and Accountability Act of 1996
(HIPAA) is a federal privacy standard that requires safeguards to protect the
security and confidentiality of health information. Disclosures without
individual authorization are allowed only to public health authorities
authorized by law to collect and receive information for the purpose of
preventing or controlling disease, injury, or disability. Before speaking to
the school nurse, the nurse must obtain authorization from the client’s
parents.
DIF: Cognitive Level: Apply
(Application)
REF: p. 64
18. Which
nurse is functioning as a care manager?
|
a. |
Nurse working with a family
to coordinate care after their child experiences a second hospitalization for
an asthma exacerbation |
|
b. |
Nurse providing asthma
education in the office setting to a child with moderate, persistent asthma |
|
c. |
Nurse administering the
appropriate antiinflammatory medication to a child admitted to the hospital
with an asthma exacerbation |
|
d. |
Nurse making a home visit
for a respiratory assessment to a child following an admission for an asthma
exacerbation |
ANS: A
Care managers help determine what medical care is necessary,
monitor care, and arrange for individuals to receive the most cost-effective
care in the most appropriate settings. They must collaborate with providers and
with the client/family. Care managers are especially helpful following a client
after discharge and clients with complex needs. A nurse working with a family
to coordinate service after a hospitalization is a good example of services
provided by a care manager.
DIF: Cognitive Level: Apply
(Application)
REF: p. 71
19. A
pregnant woman with two toddlers living at less than 135% of the federal
poverty level would be eligible for:
|
a. |
Medicare Part A |
|
b. |
Medicare Part B |
|
c. |
Medicaid |
|
d. |
State Children’s Health
Insurance Program (SCHIP) |
ANS: C
State Medicaid programs must cover all pregnant women and
children up to 6 years of age with a family income of less than 133% of the
federal poverty level. States Children’s Health Insurance Program provides
insurance coverage to children whose family income is below 200% of the federal
poverty level or whose income is 50% higher than the state’s Medicaid
eligibility threshold. In this case, the woman is pregnant, her children are
under the age of 6, and they meet the financial criteria for Medicaid but not
SCHIP.
DIF: Cognitive Level: Apply (Application)
REF: pp. 74-75
20. Which
of the following is a major factor limiting health care services in the United
States?
|
a. |
Lack of nurses |
|
b. |
Lack of health care
facilities |
|
c. |
Lack of funding |
|
d. |
Lack of client interest in health
promotion |
ANS: C
The lack of nurses may prevent health care providers from
offering health promotional education activities. The cost of health care and
prescription drugs is a major limitation to health care services. The United
States has the highest proportion of population with no health insurance,
thereby limiting health care services available to Americans.
DIF: Cognitive Level: Remember
(Knowledge)
REF: pp. 75-76
21. Which
person is at highest risk for being uninsured?
|
a. |
68-year-old retired mailman |
|
b. |
48-year-old on renal
dialysis |
|
c. |
2-year-old whose parents
work but do not have benefits through their employers |
|
d. |
27-year-old who attends
college and works part time in a small pizza parlor |
ANS: D
Young adults (27 years of age or older) are not eligible to be
covered under their parents’ insurance. Medicare is available for those over
the age of 65 and for people who require dialysis. Medicaid and SCHIP are
available for children whose families meet the financial requirements. This
child would likely meet criteria for either Medicaid or SCHIP because the
parents are considered working poor. Because health care insurance is so
expensive, it would be difficult for a 27-year-old to afford his or her own
plan. Young adults often go without insurance because of the high costs.
DIF: Cognitive Level: Apply
(Application)
REF: pp. 75-76
22. Adoption
of a Canadian-style health care system in the United States has the potential
to:
|
a. |
decrease waiting times for
tests and procedures. |
|
b. |
create further health
disparities. |
|
c. |
increase the number of
HMOs. |
|
d. |
increase the amount of
funding available for health care. |
ANS: B
Canadians with private health insurance and higher incomes have
access to greater health care services and more expedient health care. This
translates to a two-tier system of health care, which can contribute to health
disparities in health care access and quality.
DIF: Cognitive Level: Analyze
(Analysis)
REF: p. 77
23. A
system used to evaluate the necessity, appropriateness, and efficiency of the
use of the health care system, the purpose of which is to lower costs by
discouraging unnecessary treatments, is known as:
|
a. |
managed care |
|
b. |
gate keeping |
|
c. |
utilization review |
|
d. |
capitation |
ANS: C
A system used to evaluate the necessity, appropriateness, and
efficiency of the use of the health care system, the purpose of which is to lower
costs by discouraging unnecessary treatments, is known as utilization review.
DIF: Cognitive Level: Remember
(Knowledge)
REF: p. 56 (Box 3-5)
24. The
country with the lowest infant mortality rate in 2011 was:
|
a. |
Canada |
|
b. |
Mexico |
|
c. |
Sweden |
|
d. |
the United States |
ANS: C
Sweden had the lowest infant mortality in 2011 with a mortality
rate of 2.74 per 1000 live births.
DIF: Cognitive Level: Remember (Knowledge)
REF: p. 48 (Table 3-1)
25. The
country with the highest life expectancy for women in 2011 was:
|
a. |
France |
|
b. |
Germany |
|
c. |
Sweden |
|
d. |
the United States |
ANS: A
France was the country with the highest life expectancy for
women (85 years of age) in 2011.
DIF: Cognitive Level: Remember
(Knowledge)
REF: p. 48 (Table 3-1)
MULTIPLE RESPONSE
1. A
community health nurse is presenting information about the current health of
the nation to a local political action group in 2011. Which of the following
information would be included in this presentation? (select all that apply)
|
a. |
Funding of public health
programs has improved the health of the nation. |
|
b. |
Provision of health care
has improved the health of the nation. |
|
c. |
Advances in technology have
improved the health of the nation. |
|
d. |
Consumer education has
improved the health of the nation. |
ANS: A, B, D
According to the 2010 Report of Health, the health of the nation
has improved in many areas as a result of substantial funding of public health
programs, research, provision of health care, and initiatives to support
consumer education.
DIF: Cognitive Level: Apply
(Application)
REF: p. 42
2. Which
of the following statements about the financing of health care in the United
States is accurate? (select all that apply)
|
a. |
Employee-sponsored health
insurance premiums experienced minimal increases from 2001 to 2011. |
|
b. |
State tax dollars must fund
at least 50% of a state’s Medicaid cost. |
|
c. |
The largest percentage of
health care dollars is spent on hospital care. |
|
d. |
Most workers who have an
employer-sponsored health insurance plan are enrolled in preferred provider organizations
(PPOs). |
ANS: C, D
In 2010, almost one third (31%) of health care dollars was spent
on hospital care. The majority of employee-covered workers were enrolled in
PPOs (55%). Employee-sponsored health insurance premiums rose dramatically from
2001 to 2011 by 113%. Federal dollars must fund a minimum of 50% of a state’s
Medicaid cost; the state is responsible for contributing whatever percentage is
not funded by the federal government.
DIF: Cognitive Level: Understand (Comprehension)
REF: p. 67
3. Which
of the following would be considered part of a vulnerable population? (select
all that apply)
|
a. |
Deaf man |
|
b. |
Cocaine-addicted teenage
girl |
|
c. |
Handicapped child |
|
d. |
College graduate |
ANS: A, B, C
Those who are physically disabled or handicapped, substance
abusers, and those with communication difficulties are considered part of the
vulnerable population in the United States.
DIF: Cognitive Level: Apply
(Application)
REF: p. 47 (Box 3-2)
Chapter 04: The Therapeutic Relationship
Edelman: Health Promotion Throughout the Life Span, 8th Edition
MULTIPLE CHOICE
1. Which
of the following statements about values is true?
|
a. |
It is impossible for
someone to understand his or her values. |
|
b. |
Values evolve over time;
they are not static. |
|
c. |
Values assimilated in
childhood are those held for a lifetime. |
|
d. |
Values clarification tells
a person how to act. |
ANS: B
Values take time to develop, and they may change with education,
experience, exposure, or a combination of these.
DIF: Cognitive Level: Understand
(Comprehension)
REF: p. 83
2. A
nurse is providing education about improving self-awareness to a small group of
women who have been victims of domestic violence. Which of the following should
the nurse recommend the clients do first to improve their self-awareness?
|
a. |
Use self-disclosure to
share aspects of self. |
|
b. |
Listen to and learn from
others. |
|
c. |
Listen to oneself and pay
attention to emotions, thoughts, and reactions. |
|
d. |
Use others to bounce back
your own thoughts and recollections. |
ANS: C
To achieve a high self-awareness, three steps must be taken. The
first step is listening to oneself and paying attention to emotions, thoughts,
memories, reactions, and impulses. The second step is listening to and learning
from others. The third step is using self-disclosure to share aspects of self.
DIF: Cognitive Level: Apply
(Application)
REF: p. 84
3. The
nurse shares with her client the news that she, the nurse, is going to be
married soon and tells the client about her wedding plans. Which of the
following best describes the nurse’s actions?
|
a. |
The nurse is sharing
inappropriate personal information with her client. |
|
b. |
The nurse is exhibiting a
communication technique called self-disclosure. |
|
c. |
The nurse is attempting to
show empathy with her client. |
|
d. |
The nurse is violating
client confidentiality rights of the Health Insurance Portability and
Accountability Act (HIPAA). |
ANS: B
Sharing aspects of the self enriches interpersonal life and is a
use of the technique labeled self-disclosure.
DIF: Cognitive Level: Apply
(Application)
REF: pp. 84-85
4. A
nurse has started admitting a new person on home care and is beginning to
establish a relationship. Which of the following would be the most important
thing for the nurse to do?
|
a. |
Complete the paperwork in a
timely fashion |
|
b. |
Establish open
communication |
|
c. |
Conduct a complete physical
health assessment |
|
d. |
Provide feedback to the
person’s questions |
ANS: B
Communication is the foundation for any professional
relationship. It is the cornerstone of a positive nurse-person relationship. It
refers to a set of strategies and actions to enhance reciprocity, mutual
understanding, and decision making.
DIF: Cognitive Level: Apply
(Application)
REF: p. 85 | p. 87
5. Which
of the following best describes person-centered communication?
|
a. |
The nurse says to the
person seeking care, “Why do you continue to drink when you know it is not
good for you?” |
|
b. |
The nurse responds to
person seeking care’s request for pain medicine by saying, “It is not time
for your pain medicine. You had it hours ago.” |
|
c. |
The client says to the
nurse, “I think my husband is cheating on me.” The nurse responds by saying,
“You think your husband is cheating on you?” |
|
d. |
The client says to the
nurse, “I can’t believe I have cancer.” The nurse responds by saying, “One of
my closest friends had cancer and had to have chemotherapy.” |
ANS: C
The nurse recognizes that the person seeking care has some
concerns that she would like to discuss and paraphrases her statement to give
the person an opportunity to elaborate on thoughts that are important to him or
her.
DIF: Cognitive Level: Analyze
(Analysis)
REF: p. 87
6. A
nurse is counseling someone who has recently been diagnosed with diabetes. The
nurse says, “Tell me more about how this diagnosis has affected your daily
activities.” Which of the following best describes the type of communication
the nurse is using?
|
a. |
Verbal communication |
|
b. |
Nonverbal communication |
|
c. |
Metacommunication |
|
d. |
Functional communication |
ANS: A
Verbal communication is the transmission of messages using
words, spoken or written. Nonverbal communication encompasses all messages that
are not spoken or written. Metacommunication refers to a message about the
message, the relationship aspect of communication.
DIF: Cognitive Level: Apply
(Application)
REF: p. 88
7. Which
of the following statements about nonverbal communication is true?
|
a. |
Nonverbal behavior is not
usually contextual. |
|
b. |
Nonverbal behavior is
culturally and situationally bound. |
|
c. |
Nonverbal communication is
the most important type of communication. |
|
d. |
Nonverbal communication is
easy to interpret. |
ANS: B
Cultural exposure and situational impact are essential
components of interpreting nonverbal communication and must be taken into
consideration in attempts to interpret nonverbal communication.
DIF: Cognitive Level: Understand
(Comprehension)
REF: p. 89
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