n448: chapter 24 (migrant and rural
health)
Which rural trends can create healthcare challenges that the rural public health nurse needs to consider
when assessing where services should focus? Select all that apply.
a. aging in place
b. decreasing ethnic diversity
c. outmigration of young adults
d. decline in nonmetropolitan populations
e. immigration of older persons from metro areas - correct answer ✔✔a. aging in place
c. outmigration of young adults
e. immigration of older persons from metro areas
rationale: Aging in place, outmigration of young adults, and immigration of older persons from metro
areas are presenting challenges to already stressed rural communities in relation to adequate health
care, housing, transportation, etc. Ethnic diversity of rural areas is increasing, not decreasing. Rural
(nonmetropolitan populations) population numbers are the highest in U.S. history.
According to the current Department of Health and Human Services (DHHS) guidelines, poverty
definitions are based on which family unit characteristic?
a. size
b. ages
c. composition
d. number of children under 5 - correct answer ✔✔a. size
rationale: The 2017 DHHS poverty guidelines reflect just the size of the family unit, not composition.
Ages and number of children under 5 would reflect family composition and are not currently used by
DHHS to determine poverty.
, Which leading health indicator will the nurse consider as a generally reliable predictor of overall health
status?
a. health insurance
b. social determinants
c. access to health services
d. clinical preventive services - correct answer ✔✔a. health insurance
rationale: Health insurance is considered a generally reliable predictor of overall health status. Social
determinants, access to health services, and clinical preventive services are also leading health indicators
but are not considered a generally reliable predictor of overall health status.
Which sources of health disparities will the nurse consider compositional versus contextual? Select all
that apply.
a. income
b. gender
c. ethnicity
d. unhealthy lifestyle behaviors
e. limited economic opportunities - correct answer ✔✔a. income
b. gender
c. ethnicity
d. unhealthy lifestyle behaviors
Rationale: Compositional sources of health disparities are those that arise from a concentration of
persons with certain characteristics in an area. These include income, gender, ethnicity, and unhealthy
lifestyle behaviors. Limited economic opportunities are an example of a contextual source of health
disparities.
The school health nurse in a rural community is reviewing county level data to prepare for the upcoming
year. Which demographic data concerning a large percentage of families in the district indicates a
potential need for more services?
a. higher number of female-headed households
b. lower number of families where both parents work
health)
Which rural trends can create healthcare challenges that the rural public health nurse needs to consider
when assessing where services should focus? Select all that apply.
a. aging in place
b. decreasing ethnic diversity
c. outmigration of young adults
d. decline in nonmetropolitan populations
e. immigration of older persons from metro areas - correct answer ✔✔a. aging in place
c. outmigration of young adults
e. immigration of older persons from metro areas
rationale: Aging in place, outmigration of young adults, and immigration of older persons from metro
areas are presenting challenges to already stressed rural communities in relation to adequate health
care, housing, transportation, etc. Ethnic diversity of rural areas is increasing, not decreasing. Rural
(nonmetropolitan populations) population numbers are the highest in U.S. history.
According to the current Department of Health and Human Services (DHHS) guidelines, poverty
definitions are based on which family unit characteristic?
a. size
b. ages
c. composition
d. number of children under 5 - correct answer ✔✔a. size
rationale: The 2017 DHHS poverty guidelines reflect just the size of the family unit, not composition.
Ages and number of children under 5 would reflect family composition and are not currently used by
DHHS to determine poverty.
, Which leading health indicator will the nurse consider as a generally reliable predictor of overall health
status?
a. health insurance
b. social determinants
c. access to health services
d. clinical preventive services - correct answer ✔✔a. health insurance
rationale: Health insurance is considered a generally reliable predictor of overall health status. Social
determinants, access to health services, and clinical preventive services are also leading health indicators
but are not considered a generally reliable predictor of overall health status.
Which sources of health disparities will the nurse consider compositional versus contextual? Select all
that apply.
a. income
b. gender
c. ethnicity
d. unhealthy lifestyle behaviors
e. limited economic opportunities - correct answer ✔✔a. income
b. gender
c. ethnicity
d. unhealthy lifestyle behaviors
Rationale: Compositional sources of health disparities are those that arise from a concentration of
persons with certain characteristics in an area. These include income, gender, ethnicity, and unhealthy
lifestyle behaviors. Limited economic opportunities are an example of a contextual source of health
disparities.
The school health nurse in a rural community is reviewing county level data to prepare for the upcoming
year. Which demographic data concerning a large percentage of families in the district indicates a
potential need for more services?
a. higher number of female-headed households
b. lower number of families where both parents work
