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Chapter 1- Health Care Needs for the 21st Century
MULTIPLE CHOICE
1. The nurse is teaching a class on global trends linked with nursing practice. Which response from a student indicates a need for additional teaching?
1. Technology is a huge force in global change.
2. Humans have had increasing effect on the natural environment.
3. Technology has slowed the development of new infectious diseases.
4. Medical tourism is a legitimate, growing source of income for many nations.
ANS: 3
Feedback
1 Science and technology are huge drivers of global change.
2 There is increasing awareness of humankind’s effect on the planet including environmental resources.
3 Although technology has flourished, more than 30 new infectious diseases have been identified since 1973, and the next pandemics are predicted to arise from organisms not yet identified.
4 Medical tourism is one of the fastest growing industries in the health-care sector and is a positive source of revenue for many nations.
PTS: 1
KEY: Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
2. Which of the following statements on global trends linked with nursing practice is inaccurate?
1. Globalization ensures the equal distribution of costs and benefits of health care.
2. Parts of the world may be considered more youthful than other parts of the world.
3. By 2025, the majority of the world’s population will live in urban areas.
4. As countries modernize, the risk for developing certain health problems changes.
ANS: 1
Feedback
1 The costs and benefits of globalization are not always distributed equally—globalization does not ensure equal distribution of health-care costs and benefits.
2 Trends in birth, death, immigration, and migration patterns point toward population growth in Asia and Africa that will result in them becoming the youthful areas of the world.
3 In 2009, 50% of the world’s population lived in urban areas; by 2025, this is projected to increase to 57%.
4 A shift from traditional diseases, such as those resulting from infection, to modern diseases that result from lifestyle choices has been noted in developed countries.
PTS: 1
KEY: Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
3. The nurse is coordinating care with a family whose 10-year old daughter has diabetes. Which of the following principles of care coordination guides the nurse’s actions?
1. Provide the right care at the right time for the right person.
2. Identify health problems and intervene.
3. Allow families to initiate contact as they determine all their needs.
4. Ensure family privacy by limiting interdisciplinary information exchange.
ANS: 1
Feedback
1 Providing the right care at the right time for the right person is a principle of health-care reform to obtain the best quality outcomes in the best possible way.
2 The nurse must form a partnership with the family and negotiate to create a plan that fits with the family priorities and concerns.
3 The nurse must work together with the family to determine needs and assist them in contacting resources if the family wishes the nurse to do so.
4 The nurse must consider privacy laws, institutional policies, and family preferences to create an effective care coordination communication plan.
PTS: 1
KEY: Content Area: Care coordination | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
4. The nurse is teaching a class on coordinating care for families with a chronically ill member. Which response made by a student indicates a need for further teaching in the area of family assessment?
1. Identifying accessible community resources is an important aspect of family assessment.
2. Family engagement in shared health-care decision-making has little impact on health outcomes.
3. Lifestyle factors to assess include family access to food, housing, and transportation.
4. Money spent is not always linked to better health outcomes.
ANS: 2
Feedback
1 The nurse will benefit families greatly by providing families with appropriate resource information in their home communities for health promotion and chronic disease management.
2 Shared decision-making occurs within therapeutic relationships that honor family preferences and unique circumstances.
3 Environmental factors include family access to food, housing, and transportation; lifestyle factors include tobacco use, lack of adequate nutrition, physical inactivity, and substance abuse.
4 The U.S. spends much more on health care than the other 12 industrial nations in the Organization for Economic Cooperation and Development, but the quality and availability of care varies.
PTS: 1
KEY: Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Choice
5. Health disparities occur as a result of which of the following?
1. Groups being at different risk for disease.
2. Equal distribution of health-care dollars.
3. Gender equity.
4. Multicultural understandings.
ANS: 1
Feedback
1 Health disparities refer to differences in health outcomes that occur between groups, usually in minority or at-risk groups.
2 Health disparities occur as a result of unequal distribution of health-care dollars.
3 Health disparities occur as a result of being treated differently based on gender.
4 Health disparities occur with misunderstanding of cultures that leads to differences in treatment.
PTS: 1
KEY: Content Area: Health disparities | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
6. Which statement best describes health inequity?
1. Differences in health outcomes between groups.
2. Disruptions in family health due to war.
3. Shifts in population health due to changing immigration patterns.
4. Differences in infectious disease risk between genders.
ANS: 1
Feedback
1 Health inequity refers to differences or inequalities in health outcomes between groups.
2 War is best described as a social factor that can disrupt health.
3 Change in immigration patterns is best described as a social factor that can influence health.
4 Differences in infectious disease risk leading to health inequities are typically due to poverty, not gender.
PTS: 1
KEY: Content Area: Health inequity | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Evaluation | Question Type: Multiple Choice
7. Which of the following best describes the health implications of industrialization in remote areas?
1. Economic opportunities outweigh the health risks.
2. Projects protect local health by developing indigenous crops.
3. Local people have more dollars for health care through new job opportunities.
4. Access to health-care facilities is improved.
ANS: 3
Feedback
1 Industrial processes often lead to environmental conditions such as erosion, air pollution, or contaminated ground water that have unwelcome health effects. Economic gains go to project developers, not the indigenous people.
2 Projects typically develop land for high-value nonindigenous crops that require fertilizers and irrigation, which pose health risks rather than protect health.
3 Increased employment provides economic resources to enable local people to seek health care.
4 Industrialization is not a guarantee that health-care facilities will be built and access increased.
PTS: 1
KEY: Content Area: Perspectives on health and illness | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Evaluation | Question Type: Multiple Choice
8. Which of the following is an example of the effects of globalization on health care?
1. Globalization makes the exchange of health-care information more difficult.
2. The health-care costs and benefits of globalization are distributed equitably.
3. Globalization eases the transition of foreign-educated nurses into U.S. employment.
4. Global demand for nurses continues to exceed supply.
ANS: 4
Feedback
1 Globalization includes the international exchange of ideas, languages, peoples, and popular culture, and eases the exchange of health-care information.
2 Globalization does not ensure equal distribution of the benefits and costs of health care. Manufacturers take advantage of cheap labor, and workers are not always afforded the same protections from one nation to the next.
3 Globalization does not ease the transition of foreign educated nurses into U.S. employment. Pathways for becoming a nurse differ greatly across nations, as do regulations guiding nursing practice.
4 The global demand for nurses exceeds supply. An increase of 712,000 nurses is predicted to be needed by 2020 to meet health care demand in the U.S. alone.
PTS: 1
KEY: Content Area: Globalization’s effects on health care | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
9. Which of the following statements about links between families and their community is inaccurate?
1. The negative influences of poverty and unrest continue for generations even after community conditions improve.
2. Understanding the culture of the community is essential for being able to address family health needs.
3. Families in low-resourced areas contend with malnutrition.
4. Political unrest has little effect on the health and well-being of families.
ANS: 4
Feedback
1 Employment rates do not often capture the discouragement experienced by people who have long lost hope of ever finding a job.
2 Understanding the culture of communities is essential for addressing individual and family health and illness needs.
3 Food supply is often limited by uneven food distribution in low-resourced areas.
4 Political unrest can result in displaced populations that have increased health risks.
PTS: 1
KEY: Content Area: Family and community health linkages | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
10. Which of the following statements on women and health is inaccurate?
1. Women worldwide are often able to overcome poverty and its ill effects on health.
2. Women represent two-thirds of the world’s poor people.
3. Women’s rights are a way to understanding personal health and well-being.
4. Women in developing countries often die as a result of pregnancy complications and childbirth.
ANS: 1
Feedback
1 Women often work for meager pay, have little financial security, and are unable to make personal decisions affecting their well-being.
2 Women comprise two-thirds of the world’s poor population and often experience poverty.
3 In male dominated cultures, women are often treated as second-class citizens, are primary targets of physical and sexual violence, and have little voice in society or at home.
4 Lack of prenatal care in developing countries often results in fatalities for women.
PTS: 1
KEY: Content Area: Gender perspective about health or illness | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
11. A nurse is developing an international health project on delivery of prenatal care to low-resourced communities. Which of the following principles guides the nurse’s planning?
1. Nurses are in the best position to decide what the community needs.
2. The project is dependent on political influences or partisanship.
3. Short- and long-term goals contribute to the sustainability of the project.
4. Local community leaders are best to oversee the project.
ANS: 3
Feedback
1 International projects must be based on grass-roots requests from communities.
2 Successful international projects are independent of political influence or partisanship.
3 Projects must be built for long-term sustainability through engaging community participants in identifying short- and long-term goals.
4 Successful international projects are overseen by established, qualified advisory boards.
PTS: 1
KEY: Content Area: International health project characteristics | Integrated Process: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice
MULTIPLE RESPONSE
1. Which of the following are social determinants of health?
1. Family income.
2. Presence of food and water in the home.
3. Age of the family member with an illness.
4. Distance traveled to the workplace.
ANS: 1, 2, 4
Rationale:
Social determinants of health are factors that arise from the social or physical environment that can lead to health problems. Age is not a social or physical factor; however, income is a factor that arises from the social environment, while food and water and the distance one must travel to the workplace are components of the physical environment, all of which can influence health.
PTS: 1
KEY: Content Area: Social determinants of health | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Response
2. Which of the following nursing actions are considered primary care?
1. Making sure that all family members are immunized.
2. Monitoring chronic conditions of a family member over time.
3. Supporting families in critical care situations.
4. Educating elders in the family about screening for colon cancer.
ANS: 1, 2, 4
Rationale:
Supporting families in critical care situations is typically a role for hospital-based nurses rather than primary care nurses, who work in communities and in clinics where they ensure that all family members are immunized, monitor chronic conditions of a family member over time, or educate elders in the family about screening for colon cancer. These actions can reduce modifiable risk factors and thus decrease the potential of acquiring diseases and complications at earlier ages. Education can motivate people to seek care that can prevent and detect diseases early.
PTS: 1
KEY: Content Area: Care coordination | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Response
3. Which of the following groups would be considered a vulnerable population?
1. Intergenerational households.
2. Families experiencing social isolation.
3. Frail elderly.
4. Migrating families.
ANS: 2, 3, 4
Rationale:
Vulnerable populations include those who are at risk for health problems. Intergenerational households do not pose risk for health problems; in fact, this arrangement may benefit members by providing social interactions never previously considered. Social isolation is a risk factor for health problems, although it is less common in undeveloped countries where people are less likely to live alone. Aging increases the likelihood of acquiring multiple noncommunicable diseases, while migration can increase the risk of spreading infectious diseases among populations.
PTS: 1
KEY: Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Response
4. Which of the following represent United Nations Millennium Development Goals and Targets?
1. Global education to at least the elementary level.
2. Protection and improvement of the environment.
3. Treatment of infectious diseases.
4. Improved health of fathers.
ANS: 1, 2, 3
Rationale:
Access to good education is a social indicator of health and disease risk, and improved education globally is a Millennium Goal. Erosion, contaminated groundwater, shrinking aquifers, air pollution, and urbanization are environmental factors that can result in unwelcome health effects, and thus protection of the environment is a Millennium Goal. Treating infectious diseases is a Millennium Goal, since the spread of infectious diseases can be influenced by changes in human behavior, often occurring at the family level. Improving the health of mothers, not fathers, is an international goal that improves overall population health.
PTS: 1
KEY: Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Multiple Response
COMPLETION
1. The increase in health-care-related knowledge has shifted education of health-care providers from a focus on ____________________ to a focus on ____________________.
ANS:
memorization, accessing and analyzing information.
Rationale:
Advances in communication and technologies allow nurses to draw on and select from global knowledge. The nurse must be able to search for evidence on the effectiveness of various forms of care or interventions and analyze it to identify what best alleviates a problem.
PTS: 1
KEY: Content Area: Global trends | Integrated Process: Nursing Process | Client Need: Safe and Effective Care Environment | Cognitive Level: Comprehension | Question Type: Completion
Chapter 5- Family Assessment
MULTIPLE CHOICE
1. Which of the following assessment measures would be most beneficial to complete with a 30-year-old female whose family has a history of breast cancer?
1. Ecogram
2. Ecomap
3. Genogram
4. Geographic information system
ANS: 3
Feedback
1 An ecogram is a visual representation showing relationships, activities, and influences a person has in the family system; it does not focus on illness information.
2 An ecomap helps the nurse visualize the various activities and relationships of the family with the larger ecological environment; it does not focus on illness information.
3 Detailed illness information can be added to a genogram to create a family pedigree depicting transmission of such things as genetic conditions, familial conditions, and psychosocial patterns, such as chemical dependency and suicide. The genogram can be useful to aid early diagnosis, identification of risk factors for particular conditions, and to reveal potential prevention strategies.
4 Geographic information systems capture, store, analyze, and display referenced information about specific environmental concerns that are geographically and ecologically pertinent to families; they do not focus on illness information.
PTS: 1
KEY: Content Area: Explain ways that genograms, ecograms, and ecomaps can be used to assess family from an ecological point of view | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
2. When is nursing assessment most complete?
1. When insight is gained through an assessment of individual needs before the needs of the family
2. When insight is gained through an assessment of the family needs before the needs of the individual
3. When insight is gained through an assessment of the needs of the individual and family simultaneously
4. When insight is gained through an individual-nurse-family relationship with consideration of the surrounding community
ANS: 4
Rationale:
Nursing assessment is most effective when nurses complete every assessment with ideas gained through an individual-nurse-family relationship enacted with consideration of the surrounding community.
PTS: 1
KEY: Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice
3. The nurse is working with a client to identify the factors that cause risks or benefits to health. Which questions best reflect “thinking family” to help identify factors requiring further teaching?
1. “How many cigarettes a day do you smoke? Where do you usually smoke?”
2. “Do you enjoy taking long walks in the winter? How many times a week do you walk?”
3. “Do you prefer water aerobics over floor aerobics? How many times a week do you attend aerobics class?”
4. “How many family members do you have? What do you all do together?”
ANS: 1
Feedback
1 “How many cigarettes a day do you smoke? Where do you usually smoke?” are questions about behaviors that pose a risk to the health of individuals, families, and communities. These questions best identify further teaching needs.
2 “Do you enjoy taking long walks in the winter? How many times a week do you walk?” are questions about behaviors that pose a benefit to the health of individuals, families, and communities. There is no need for teaching.
3 “Do you prefer water aerobics over floor aerobics? How many times a week do you attend aerobics class?” are questions about behaviors that pose a benefit to the health of individuals, families, and communities. There is no need for teaching.
4 “How many family members do you have? What do you all do together?” are questions about facts that pose no risk or benefit to the health of individuals, families, and communities. There is no need for teaching.
PTS: 1
KEY: Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice
4. The nurse is working with the client to assess multiple family members’ involvement in his disease process. Which questions best fit this assessment?
1. “Are you married? How long have you been married?”
2. “Do you have children? How many children do you have?”
3. “What do you usually have for dinner? Do you sit down with your family for a meal?”
4. “What do you do for yourself? What do your family members do for you?”
ANS: 4
Feedback
1 “Are you married? How long have you been married?” are direct questions asking specific information to determine the presence or absence of a spouse; they do not address family member involvement. It should not be assumed that if the person is married, the family members are involved in his care.
2 “Do you have children? How many children do you have?” are direct questions asking specific information to determine the presence or absence of children; they do not address family member involvement. It should not be assumed that if the person has children, they are involved in his care.
3 “What do you usually have for dinner? Do you sit down with your family for a meal?” are direct questions to obtain specific information related to the client and meals; they do not address family member involvement in the disease process. It should not be assumed that if a family shares meals together, the family members are involved in his care.
4 “What do you do for yourself? What do your family members do for you?” are open ended questions to obtain information about family member involvement in the client’s disease process. It is important to identify the degree of involvement of multiple members who may contribute to the health or well-being of individuals within families.
PTS: 1
KEY: Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Choice
5. What can nurses learn when using geographic information system (GIS) databases?
1. Population trends and how to target population health interventions
2. Education trends and how to target community education
3. Transmission of inherited traits from one generation to another among similar or related organisms
4. Genes that regulate human susceptibility to viruses
ANS: 1
Feedback
1 GIS databases can be successfully used to facilitate learning about population trends and how to target population health interventions.
2 GIS databases are not typically used to track education trends; they are useful in tracking population trends and how to target population health interventions.
3 GIS databases are not used to track transmission of inherited traits across generations or organisms; they are useful in learning about population trends and how to target population health interventions.
4 GIS databases are not used to learn about genes that regulate human susceptibility to viruses; they are used to track population trends and to target population health interventions.
PTS: 1
KEY: Content Area: Describe ways that computer-based geographic information systems can be used to understand family, community, and population health needs | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
6. Identification of genetic patterns of inheritance is important not only for individuals and families, but also communities. Some autosomal recessive disorders are more commonly seen among which of the following groups?
1. Persons from different economic classes
2. Certain racial/ethnic groups
3. Certain age groups
4. Certain social networks
ANS: 2
Some autosomal recessive disorders are more commonly seen among certain racial/ethnic groups such as hemochromatosis in Caucasians, and sickle cell disease in black Americans.
PTS: 1
KEY: Content Area: Recognize ways that genetics and genomics influence health, disease prevention, treatments, screening, and outcomes | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple Choice
7. When completing a family unit assessment, what would the nurse assess?
1. Family household information
2. Complaints of physical problems
3. The implications of individual differences between the family members
4. The implications of family members’ knowledge of the disease process
ANS: 1
Feedback
1 The family household is the place where health and illness are produced and thus is an important focus for assessing the family as a unit.
2 Considering complaints of physical problems is a focus of individual assessment.
3 Looking at implications of individual differences between family members focuses the assessment on individuals rather than the family as a unit.
4 Looking at implications of family members’ knowledge of the disease process focuses the assessment on individuals rather than the family as a unit.
PTS: 1
KEY: Content Area: Differentiate between individual, family, and community assessment | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple Choice
8. What is one way the nurse can maintain a broad-minded perspective when completing a family assessment?
1. By using the Family Functioning Framework.
2. By using the Family Health Model.
3. By using either the Family Functioning Framework or the Family Health Model.
4. Use of a model or framework is not necessary for a broad-minded and comprehensive approach to family assessment.
ANS: 2
Feedback
1 Family functioning is only one aspect of a comprehensive family assessment. To maintain a broad-minded stance, the nurse uses a family nursing model, framework, or theory in its entirety.
2 Clarity of assessment benefits when the nurse takes a broad-minded perspective and considers multiple health determinants in any health situation at the individual, family, or community level. One way to maintain a broad-minded stance is to guide the nursing assessment in an organized way by using a family nursing model or theory or a family science model or theory, such as the Family Health Model.
3 Family functioning is only one aspect of a comprehensive family assessment. To maintain a broad-minded stance the nurse uses a family nursing model, framework, or theory in its entirety, such as the Family Health Model.
4 One way to maintain a broad-minded stance and to obtain a comprehensive assessment is to guide the nursing assessment in an organized way by using a family nursing model or theory or a family science model or theory, such as the Family Health Model.
PTS: 1
KEY: Content Area: Differentiate between individual, family, and community assessment | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
9. Coordinated family care relies on ____ that provides an accurate picture of the ____.
1. Collection of information; actual living conditions
2. Cooperation of family members; family dynamics
3. The skill of the nurse; nurse-individual-family relationship
4. Assessment of family functioning; ways family members process information
ANS: 1
Feedback
1 Coordinated family care relies upon collection of information about the family as a unit. Assessing the family household, including living conditions where health and illness occur, gives the nurse important information to plan care.
2 An assessment of family dynamics is obtained through a comprehensive assessment of the family as a unit; it is not obtained through the cooperation of family members in coordinating care.
3 The skill of the nurse is not applied to provide an accurate picture of the nurse-individual-family relationship, but to collect information about the family as a unit in order to plan care, and to develop the nurse-individual-family relationship.
4 Coordinated family care relies upon a comprehensive family assessment, not simply on assessment of family functioning. Family processes need to be assessed in addition to family functioning.
PTS: 1
KEY: Content Area: Differentiate between individual, family, and community assessment | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Choice
MULTIPLE RESPONSE
1. Which of the following scenarios could result in greater continuity of care because of documentation by electronic health record?
1. A public health screening for hypertension
2. A 12-year-old female with an asthma flare-up during recess at school being seen by the school’s nurse
3. Walgreen’s nationwide flu shot clinics
4. An 89-year-old male dismissing home from a hospital with home-health care for assistance with dressing changes
ANS: 1, 2, 3, 4
Rationale:
All scenarios contain either intergenerational issues or connections between the individual and the family within the community that could be documented and referred to by a wide variety of providers for more effective long term treatment.
PTS: 1
KEY: Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Communication and Documentation | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Response
2. What information does the geographic expansion of family-focused assessment to the community level provide the nurse?
1. Factors supporting health
2. Existing health disparities
3. Family health history
4. Risks to health
5. Historic migration patterns
ANS: 1, 2, 4
Rationale:
A broad snapshot of a community’s health strengths (factors supporting health) and weaknesses (health disparities) can be obtained from a “windshield survey” or a geographic information system (GIS). Risks to health can also be obtained from the geographic expansion of a family-focused assessment to the community level. A family history is obtained from assessment of the family, not the community. Historic migration patterns are obtained through genetic assessment, not community assessment.
PTS: 1
KEY: Content Area: Differentiate between individual, family, and community assessment | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Response
3. Geographic information system (GIS) databases can be used to highlight geo-spatial patterns of concern and resources to nurses providing care to which of the following clients?
1. Acutely ill patients
2. Chronically ill persons being hospitalized due to environmental-related symptoms
3. Families seeking out grocery stores with affordable fresh fruits and vegetables
4. Skilled-care patients in a residential facility
5. Community members involved in community planning of transportation routes
ANS: 2, 3, 5
Rationale:
The GIS can highlight geo-spatial patterns of concern that occur in residential living environments that might contribute to exacerbations of chronic illness. Nurses can search the map based on different attributes to look for family or community resources available that may help with health promotion, disease prevention, or management of illness. Thus, it can be used to identify grocery stores with affordable fruits and vegetables, or be helpful in planning transportation routes. It would not be useful for nurses providing care for acutely ill inpatients or skilled-care patients in hospitals or residential facilities.
PTS: 1
KEY: Content Area: Describe ways that computer-based geographic information systems can be used to understand family, community, and population health needs | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Response
4. Which of the following roles for nurses exist in the genomic era?
1. Individual and family counseling
2. Clinical care and education
3. Advocacy
4. Spiritual care
5. Research
6. Ethics
ANS: 1, 2, 3, 5, 6
Rationale:
Individual and family counseling are roles for nurses in the genomic era. Clinical care and education are roles for nurses in the genomic era. Advocate is a role for nurses in the genomic era. Research roles exist for nurses involved in the genomic era. The area of ethics has roles for nurses involved in care based in genomics. Spiritual care is an important role for the nurse but it does not directly relate to genomics.
PTS: 1
KEY: Content Area: Recognize ways that genetics and genomics influence health, disease prevention, treatments, screening, and outcomes | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Knowledge | Question Type: Multiple Response
5. Which of the following would be an intended outcome of the use and maintenance of electronic personal and family health records?
1. Continuity in care
2. Improved family care planning
3. Enhanced public health
4. Identification of health risks based on geographic location
ANS: 1, 2, 3
Rationale:
Electronic records are one option to provide some form of an ongoing plan for some chronic conditions that identifies goals, strategies, supports, and outcomes linked with family unit needs and individual conditions, and that could be instrumental in family care planning to improve health outcomes and enhance public health. Identification of health risks based on geographic location is best obtained through geographic information system databases.
PTS: 1
KEY: Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Communication and Documentation | Client Need: Health Promotion and Maintenance | Cognitive Level: Comprehension | Question Type: Multiple Response
6. Which of the following are major ways that the family carries out its health-care functions?
1. Family provides preventative health care to its members at home
2. Family provides the major share of sick care to its members
3. Family pays for most health services received
4. Family has primary responsibility for initiating and coordinating health services
ANS: 1, 2, 3, 4
Rationale:
All scenarios reflect ways that the family carries out its health-care functions.
PTS: 1
KEY: Content Area: Discuss assessment that includes the predictive and protective factors that influence the health and illness of individuals, families, communities, and populations | Integrated Process: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Application | Question Type: Multiple Response
