lOMoAR cP SD |12827 373
Chapter 23: Health Equity and Care of Vulnerable Populations
Stanhope: Foundations for Population Health in Community/Public Health Nursing,
MULTIPLE CHOICE
1. Which of the following is the primary cause of vulnerability to health problems?
a. Breakdown of family structures
b. Poverty
c. Prejudice
d. Social isolation
ANS: B
People with lower incomes and less education tend to be at higher risk for health problems. Poverty is
vulnerability. Breakdown of family structures, prejudice, and social isolation may all influence vulnera
but have not been identified as a primary cause.
2. Which of the following terms is used to describe aggregates who are at high risk for having poor health
limited resources?
a. Disadvantaged families
b. Multi-problem families
c. Resilient populations
d. Vulnerable populations
ANS: D
Vulnerable populations are groups (aggregates) with an increased risk to develop adverse health outco
of populations and do not appropriately fit the definition of “aggregates.” Resilience refers to the abilit
outcomes, not to succumb to them.
3. A community health nurse would like to implement an intervention to increase lasting resilience amon
the following actions should be taken by the nurse?
a. Direct clients to English-as-second-language courses.
b. Give immigrant clients money to help them get settled.
c. Identify areas in the city where housing is less expensive.
d. Solicit donations for food, clothing, and other needs.
ANS: A
Vulnerability can be reversed by obtaining resources to increase resilience. Learning the basic languag
residence will give immigrants the ability to communicate and navigate through systems and thus remo
disenfranchisement and disadvantaged status. Although money, food, and clothing meet needs for the
the immigrant develop the power and control to improve health risks over the long term or contribute t
4. Which of the following factors predisposes many migrant farm workers to disenfranchisement?
a. Being a minority group member
b. Inability to attend religious services because of work requirements
c. Previous experiences of physical abuse
d. Short length of time in the community
ANS: D
Disenfranchisement refers to a feeling of separation from mainstream society. The person does not see
connection with any group in particular or the larger society. For migrant workers who are frequently m
of time they stay in the community does not allow for the development of social ties. Being a minority
by itself cause disenfranchisement if the minority group member lived in a community with persons fr
cultural backgrounds. A person’s inability to attend religious services or to have had experienced prev
specifically related to disenfranchisement of the population of migrant farmworkers.
5. A large financial grant was being offered to whichever health facility wanted to accept the responsibili
local vulnerable populations. Which of the following actions would most likely be taken by the local m
a. Agree to collaboratively apply for the funds in a cooperative proposal.
b. Individually compete eagerly for the additional funds now available.
, lOMoAR cP SD |12827 373
6. Which individual has the greatest risk for becoming a member of the vulnerable population of the loca
a. A male diagnosed with a cardiac issue who recently moved in with his adult child
b. A single mother who is studying for a law degree at the local university
c. A 50-year-old married female who has worked as a server in local restaurants for
her entire adult life
d. A single male who has a history that includes a learning disability and a parent
diagnosed with type 2 diabetes
ANS: D
The WHO, consistent with Healthy People 2030, describes three overall determinants of health to be
environment, (2) the physical environment, and (3) the person’s individual characteristics and behavio
individuals are unlikely to be able to directly control many of the determinants of health, and this is dir
vulnerability. The seven WHO factors are as follows (WHO, 2015, pp. 1-2):
1. Income and social status: Higher income and social status are associated with better health.
2. Education: Low education is linked with poor health, more stress, and lower self-confidence.
3. Physical environment: Safe water and clean air; healthy workplaces; safer homes, communities, and
good employment and working conditions, especially when the person has more control, all contribute
4. Social support networks: Family, friends, and community as well as culture, customs, traditions, and
5. Genetics, as well as personal behavior and coping skills, affect health.
6. Health services: Access and use of services affect health.
7. Gender: Men and women suffer from different types of diseases at different ages
The single male with a history of learning disabilities and a family history of type 2 diabetes has sever
including those related to his social support network (being single); learning disabilities (effecting edu
low
self-esteem); and a first degree family history of a chronic disease (type 2 diabetes). While the life stor
options present the individual with risks, none have multiple risks like the male depicted in the correct
7. A homeless family brought their father to the public health clinic after he reported bleeding when he w
of the following nursing actions would be most appropriate?
a. Begin tests to determine the cause of the bleeding while asking about other family
concerns from nutrition to shelter for the night.
b. Refer the man to a urologist to address the urinary bleeding.
c. Suggest that the family take him to an urgent care center immediately.
d. Treat the urinary infection and give the man medication to take to prevent the
recurrence of infection.
ANS: A
It is important to provide comprehensive, family-centered, “one-stop” services. Providing multiple ser
visit is an example of one-stop services. If social assistance and economic assistance are provided and
interdisciplinary treatment plans, services can be more responsive to the combined effects of social and
health of special population groups. If the family is referred to a different provider or agency, it is likel
never occur. Only addressing the urinary infection, and not the homeless status of this family, does not
services that are expected from a public health clinic.
8. Nursing students have been assigned to set up a health fair for the homeless population in a large urban
funds to pay for space, where should the health fair be located, assuming that all of the following sites
a. At the city’s homeless shelter, which is, by policy, vacant during the day
b. At a large medical center, where the students could get permission to use an
empty clinic in the evening
c. At the largest inner city police station, where there was a large empty space
available
d. At the local community college, where there are plenty of tables and chairs
ANS: A
The most convenient place for the clients would be the homeless shelter, where transportation and lack
place would not be issues. It is helpful to provide comprehensive services in locations where people liv
schools, churches, neighborhoods, and workplaces. Thus, for the homeless population, the homeless sh
appropriate location. Homeless persons would probably avoid the police station, and many may not wi
center—also, there would be transportation issues. Depending on the location of the community colleg
Chapter 23: Health Equity and Care of Vulnerable Populations
Stanhope: Foundations for Population Health in Community/Public Health Nursing,
MULTIPLE CHOICE
1. Which of the following is the primary cause of vulnerability to health problems?
a. Breakdown of family structures
b. Poverty
c. Prejudice
d. Social isolation
ANS: B
People with lower incomes and less education tend to be at higher risk for health problems. Poverty is
vulnerability. Breakdown of family structures, prejudice, and social isolation may all influence vulnera
but have not been identified as a primary cause.
2. Which of the following terms is used to describe aggregates who are at high risk for having poor health
limited resources?
a. Disadvantaged families
b. Multi-problem families
c. Resilient populations
d. Vulnerable populations
ANS: D
Vulnerable populations are groups (aggregates) with an increased risk to develop adverse health outco
of populations and do not appropriately fit the definition of “aggregates.” Resilience refers to the abilit
outcomes, not to succumb to them.
3. A community health nurse would like to implement an intervention to increase lasting resilience amon
the following actions should be taken by the nurse?
a. Direct clients to English-as-second-language courses.
b. Give immigrant clients money to help them get settled.
c. Identify areas in the city where housing is less expensive.
d. Solicit donations for food, clothing, and other needs.
ANS: A
Vulnerability can be reversed by obtaining resources to increase resilience. Learning the basic languag
residence will give immigrants the ability to communicate and navigate through systems and thus remo
disenfranchisement and disadvantaged status. Although money, food, and clothing meet needs for the
the immigrant develop the power and control to improve health risks over the long term or contribute t
4. Which of the following factors predisposes many migrant farm workers to disenfranchisement?
a. Being a minority group member
b. Inability to attend religious services because of work requirements
c. Previous experiences of physical abuse
d. Short length of time in the community
ANS: D
Disenfranchisement refers to a feeling of separation from mainstream society. The person does not see
connection with any group in particular or the larger society. For migrant workers who are frequently m
of time they stay in the community does not allow for the development of social ties. Being a minority
by itself cause disenfranchisement if the minority group member lived in a community with persons fr
cultural backgrounds. A person’s inability to attend religious services or to have had experienced prev
specifically related to disenfranchisement of the population of migrant farmworkers.
5. A large financial grant was being offered to whichever health facility wanted to accept the responsibili
local vulnerable populations. Which of the following actions would most likely be taken by the local m
a. Agree to collaboratively apply for the funds in a cooperative proposal.
b. Individually compete eagerly for the additional funds now available.
, lOMoAR cP SD |12827 373
6. Which individual has the greatest risk for becoming a member of the vulnerable population of the loca
a. A male diagnosed with a cardiac issue who recently moved in with his adult child
b. A single mother who is studying for a law degree at the local university
c. A 50-year-old married female who has worked as a server in local restaurants for
her entire adult life
d. A single male who has a history that includes a learning disability and a parent
diagnosed with type 2 diabetes
ANS: D
The WHO, consistent with Healthy People 2030, describes three overall determinants of health to be
environment, (2) the physical environment, and (3) the person’s individual characteristics and behavio
individuals are unlikely to be able to directly control many of the determinants of health, and this is dir
vulnerability. The seven WHO factors are as follows (WHO, 2015, pp. 1-2):
1. Income and social status: Higher income and social status are associated with better health.
2. Education: Low education is linked with poor health, more stress, and lower self-confidence.
3. Physical environment: Safe water and clean air; healthy workplaces; safer homes, communities, and
good employment and working conditions, especially when the person has more control, all contribute
4. Social support networks: Family, friends, and community as well as culture, customs, traditions, and
5. Genetics, as well as personal behavior and coping skills, affect health.
6. Health services: Access and use of services affect health.
7. Gender: Men and women suffer from different types of diseases at different ages
The single male with a history of learning disabilities and a family history of type 2 diabetes has sever
including those related to his social support network (being single); learning disabilities (effecting edu
low
self-esteem); and a first degree family history of a chronic disease (type 2 diabetes). While the life stor
options present the individual with risks, none have multiple risks like the male depicted in the correct
7. A homeless family brought their father to the public health clinic after he reported bleeding when he w
of the following nursing actions would be most appropriate?
a. Begin tests to determine the cause of the bleeding while asking about other family
concerns from nutrition to shelter for the night.
b. Refer the man to a urologist to address the urinary bleeding.
c. Suggest that the family take him to an urgent care center immediately.
d. Treat the urinary infection and give the man medication to take to prevent the
recurrence of infection.
ANS: A
It is important to provide comprehensive, family-centered, “one-stop” services. Providing multiple ser
visit is an example of one-stop services. If social assistance and economic assistance are provided and
interdisciplinary treatment plans, services can be more responsive to the combined effects of social and
health of special population groups. If the family is referred to a different provider or agency, it is likel
never occur. Only addressing the urinary infection, and not the homeless status of this family, does not
services that are expected from a public health clinic.
8. Nursing students have been assigned to set up a health fair for the homeless population in a large urban
funds to pay for space, where should the health fair be located, assuming that all of the following sites
a. At the city’s homeless shelter, which is, by policy, vacant during the day
b. At a large medical center, where the students could get permission to use an
empty clinic in the evening
c. At the largest inner city police station, where there was a large empty space
available
d. At the local community college, where there are plenty of tables and chairs
ANS: A
The most convenient place for the clients would be the homeless shelter, where transportation and lack
place would not be issues. It is helpful to provide comprehensive services in locations where people liv
schools, churches, neighborhoods, and workplaces. Thus, for the homeless population, the homeless sh
appropriate location. Homeless persons would probably avoid the police station, and many may not wi
center—also, there would be transportation issues. Depending on the location of the community colleg
