NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
NR503 FINAL EXAM STUDY GUIDE n n n n
Week 5 (Ch. 2) n n n
1. Discriminatenpopulationsnatnrisknforndevelopmentnofnchronicnhealthnnconditio
ns while associating the role ofthe Advanced Practice Nurse in levels of promo
n n n n n n n n n n nn n
tion.
Common risk factors: unhealthy diet, physical inactivity, and tobacco use
n n n n n n n n n
Childhood risk: There is now extensive evidence from many countries that condition
n n n n n n n n n n n
s before birth and in early childhood influence health in adult life. For example, low b
n n n n n n n n n n n n n n n
irth weight is now known to be associated with increasedrates of high blood pressure,
n n n n n n n n n n n n n
nheart disease, stroke and diabetes.
n n n n
Risk accumulation: Ageing is an important marker of the accumulation of modifiable
n n n n n n n n n n n n
risks for chronic disease: theimpact of risk factors increases over the life course.
n n n n n n n n n n n n
Underlying determinants: The underlying determinants of chronic diseases are a reflecti
n n n n n n n n n n
on of the major forces driving social, economic and cultural change –
n n n n n n n n n n n
globalization, urbanization, population ageing, and the general policyenvironment.
n n n n n n n n
Poverty: Chronic diseases and poverty are interconnected in a vicious circle. At the sa
n n n n n n n n n n n n n
me time, poverty and worsening of already existing poverty are caused by chronic di
n n n n n n n n n n n n n
seases. The poor are more vulnerable for several reasons, including greater exposure
n n n n n n n n n n n n
to risks and decreased access to health services. Psychosocial stress also plays arole.
n n n n n n n n n n n n
Preventative health actions are often categorized in three levels:
n n n n n n n n
• Primary prevention - aims to prevent disease or injury before it ever occurs.
n n n n n n n n n n n n
▪ This is done by preventing exposures to hazards that cause diseas n n n n n n n n n n
e or injury, altering unhealthy or unsafe behaviors that can lead to n n n n n n n n n n n n
disease or injury, and increasing resistance to n n n n n n
NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
, NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
disease or injury should exposure occur.n n n n n
▪ Nurses play the part of educators that offer information and c
n n n n n n n n n n
ounseling to communities andpopulations that encourage po
n n n n n n
sitive health behaviors n n
▪ Examples include: n
• legislation and enforcement to ban or control the use of ha n n n n n n n n n n
zardous products (e.g.asbestos) or to mandate safe and hea n n n n n n n n
lthy practices (e.g. use of seatbelts and bike n n n n n n n
helmets)
• education about healthy and safe habits (e.g. eating well, e n n n n n n n n n
xercising regularly, notsmoking) n n
• immunization against infectious diseases. n n n
• Secondary prevention -
n n
aims to reduce the impact of a disease or injury that has already occurred
n n n n n n n n n n n n n n
▪ This is done by detecting and treating disease or injury as soon as p
n n n n n n n n n n n n n
ossible to halt or slow its progress, encouraging personal strategies
n n n n n n n n n
to prevent reinjury or recurrence, and implementing programs to r
n n n n n n n n n n
eturn people to their original health and function to prevent long-
n n n n n n n n n n
term problems. n
▪ Nurses work with these patients to reduce and manage controlla
n n n n n n n n n
ble risks, modifying the individuals’ lifestyle choices and using
n n n n n n n n n
early detection methods to catch diseases in their beginning stag
n n n n n n n n n
es when treatment may be more effective.
n n n n n n
▪ Examples include: n
• regular exams and screening tests to detect disease in i n n n n n n n n n
ts earliest stages (e.g.mammograms to detect breast ca
n n n n n n n
ncer)
• daily, low- n
dose aspirins and/or diet and exercise programs to prevent f
n n n n n n n n n
urther heartattacks or strokes n n n
• suitably modified work so injured or ill workers can return s n n n n n n n n n n
afely to their jobs. n n n
• Tertiary prevention -
n n
aims to soften the impact of an ongoing illness or injury that has lasting effects
n n n n n n n n n n n n n n n
NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
, NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
▪ This is done by helping people manage long-term, often-
n n n n n n n n
complex health problems and injuries(e.g. chronic diseases, perma
n n n n n n n
nent impairments) in order to improve as much as possible their abil
n n n n n n n n n n n
ity to function, their quality of life and their life expectancy.
n n n n n n n n n n
▪ Nurses are tasked with helping individuals execute a care plan a
n n n n n n n n n n
nd make any additionalbehavior modifications necessary to im
n n n n n n n
prove conditions n
▪ Examples include: n
• cardiac or stroke rehabilitation programs, chronic disease n n n n n n n
management programs(e.g. for diabetes, arthritis, depress n n n n n
ion, etc.) n
• support groups that allow members to share strategies for l n n n n n n n n n
iving well n
• vocational rehabilitation programs to retrain workers for n n n n n n n
new jobs when they haverecovered as much as possible.
n n n n n n n n
Members of minorities are overrepresented on the low tiers of the socioeconomic lad
n n n n n n n n n n n n
der. Poor economic achievement is also a common characteristic among populations
n n n n n n n n n n n
at risk, such as the homeless, migrant workers, andrefugees. However, the APN shoul
n n n n n n n n n n n n
d be able to distinguish between cultural and socioeconomic class issues and not inte
n n n n n n n n n n n n n
rpret behavior as having a cultural origin when the fact is based on socioeconomic cl
n n n n n n n n n n n n n n
ass. A good resource for APNs is the Cross-
n n n n n n n n
Cultural Health Care Program (CCHCP), which has a plethora of materials to improv
n n n n n n n n n n n n
e cultural competency among healthcare providers, including a training program for
n n n n n n n n n n n
healthcare providers. In order to provide appropriate healthcare interventions, cultur
n n n n n n n n n
e and all its variants must be addressed.
n n n n n n n
(p28)APRNs may be able to access health information needed by working together w
n n n n n n n n n n n n
ith other sectors outside of health, such as housing, labor, education, and community
n n n n n n n n n n n n
-based or faith- n n
based organizations that offer services to immigrant communities. This involves the
n n n n n n n n n n n
collection, documentation, and use of data that can be used to monitor health inequali
n n n n n n n n n n n n n
ties in exposures, opportunities, and outcomes.
n n n n n
Examples of social determinants that are related to health inequalities include pover
n n n n n n n n n n n
ty, educational level, racism, income, and poor housing. These inequalities
n n n n n n n n n
NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
, NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
can leadto n
poor quality of life, poor self-
n n n n n
rated health, multiple morbidities, limited access to resources, premature death, andunne
n n n n n n n n n n
cessary risks and vulnerabilities. n n n
(p25) APRNs can best determine the effectiveness of an intervention and long-
n n n n n n n n n n n
nterm impact by focusing on an accurate assessment and interpretation of data that ar
n n n n n n n n n n n n n
e generated or collected using individual, population, andcommunity health indicato
n n n n n n n n n
rs.
(p27)APRNs can work in partnership with community members to identify what co
n n n n n n n n n n n
mmunity members see as relevant and important, build social capital, use outcome d
n n n n n n n n n n n n
ata to advocate for changes in policy, and then continue towork in partnership to iden
n n n n n n n n n n n n n n
tify strategies to intervene, monitor,and improve those outcomes
n n n n n n n
(p40-
41)APRNs have numerous resources they can access to improve quality and timely acces
n n n n n n n n n n n n
s to quality healthcareand decrease health disparities. The National Partnership for Actio
n n n n n n n n n n n
n (NPA) to End Health Disparities
n n n n n
( minorityhealth.hhs.gov/npa) was started by the Office of Minority Health
n n n n n n n n n
to mobilize individuals and groups to work to improve quality and eliminate health
n n n n n n n n n n n n n
disparities. The National Priorities includes key private and public stakeholders who
n n n n n n n n n n
nhave agreed to work on major health priorities of patients and families, palliative an
n n n n n n n n n n n n n
d end-of-
n
life care, care coordination, patient safety, and population health. The Quality Allian
n n n n n n n n n n n
ce Steering Committee is another partnership of healthcare leaders who work to imp
n n n n n n n n n n n n
rove healthcarequality and costs. Various strategies to bridge the gaps in healthcare
n n n n n n n n n n n n
quality are available at the national level andmay be applied or considered at the stat
n n n n n n n n n n n n n n
e, regional, or local level in collaboration with stakeholders as a means ofdecreasing
n n n n n n n n n n n n
nhealth disparities. n
(p43) APRNs are better prepared to develop effective interventions to eliminate or
n n n n n n n n n n n
nreduce health disparities. Suchstrategies may include advocating better health ins
n n n n n n n n n n
NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
Uploads by hustle grades n n n
NR503 FINAL EXAM STUDY GUIDE n n n n
Week 5 (Ch. 2) n n n
1. Discriminatenpopulationsnatnrisknforndevelopmentnofnchronicnhealthnnconditio
ns while associating the role ofthe Advanced Practice Nurse in levels of promo
n n n n n n n n n n nn n
tion.
Common risk factors: unhealthy diet, physical inactivity, and tobacco use
n n n n n n n n n
Childhood risk: There is now extensive evidence from many countries that condition
n n n n n n n n n n n
s before birth and in early childhood influence health in adult life. For example, low b
n n n n n n n n n n n n n n n
irth weight is now known to be associated with increasedrates of high blood pressure,
n n n n n n n n n n n n n
nheart disease, stroke and diabetes.
n n n n
Risk accumulation: Ageing is an important marker of the accumulation of modifiable
n n n n n n n n n n n n
risks for chronic disease: theimpact of risk factors increases over the life course.
n n n n n n n n n n n n
Underlying determinants: The underlying determinants of chronic diseases are a reflecti
n n n n n n n n n n
on of the major forces driving social, economic and cultural change –
n n n n n n n n n n n
globalization, urbanization, population ageing, and the general policyenvironment.
n n n n n n n n
Poverty: Chronic diseases and poverty are interconnected in a vicious circle. At the sa
n n n n n n n n n n n n n
me time, poverty and worsening of already existing poverty are caused by chronic di
n n n n n n n n n n n n n
seases. The poor are more vulnerable for several reasons, including greater exposure
n n n n n n n n n n n n
to risks and decreased access to health services. Psychosocial stress also plays arole.
n n n n n n n n n n n n
Preventative health actions are often categorized in three levels:
n n n n n n n n
• Primary prevention - aims to prevent disease or injury before it ever occurs.
n n n n n n n n n n n n
▪ This is done by preventing exposures to hazards that cause diseas n n n n n n n n n n
e or injury, altering unhealthy or unsafe behaviors that can lead to n n n n n n n n n n n n
disease or injury, and increasing resistance to n n n n n n
NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
, NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
disease or injury should exposure occur.n n n n n
▪ Nurses play the part of educators that offer information and c
n n n n n n n n n n
ounseling to communities andpopulations that encourage po
n n n n n n
sitive health behaviors n n
▪ Examples include: n
• legislation and enforcement to ban or control the use of ha n n n n n n n n n n
zardous products (e.g.asbestos) or to mandate safe and hea n n n n n n n n
lthy practices (e.g. use of seatbelts and bike n n n n n n n
helmets)
• education about healthy and safe habits (e.g. eating well, e n n n n n n n n n
xercising regularly, notsmoking) n n
• immunization against infectious diseases. n n n
• Secondary prevention -
n n
aims to reduce the impact of a disease or injury that has already occurred
n n n n n n n n n n n n n n
▪ This is done by detecting and treating disease or injury as soon as p
n n n n n n n n n n n n n
ossible to halt or slow its progress, encouraging personal strategies
n n n n n n n n n
to prevent reinjury or recurrence, and implementing programs to r
n n n n n n n n n n
eturn people to their original health and function to prevent long-
n n n n n n n n n n
term problems. n
▪ Nurses work with these patients to reduce and manage controlla
n n n n n n n n n
ble risks, modifying the individuals’ lifestyle choices and using
n n n n n n n n n
early detection methods to catch diseases in their beginning stag
n n n n n n n n n
es when treatment may be more effective.
n n n n n n
▪ Examples include: n
• regular exams and screening tests to detect disease in i n n n n n n n n n
ts earliest stages (e.g.mammograms to detect breast ca
n n n n n n n
ncer)
• daily, low- n
dose aspirins and/or diet and exercise programs to prevent f
n n n n n n n n n
urther heartattacks or strokes n n n
• suitably modified work so injured or ill workers can return s n n n n n n n n n n
afely to their jobs. n n n
• Tertiary prevention -
n n
aims to soften the impact of an ongoing illness or injury that has lasting effects
n n n n n n n n n n n n n n n
NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
, NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
▪ This is done by helping people manage long-term, often-
n n n n n n n n
complex health problems and injuries(e.g. chronic diseases, perma
n n n n n n n
nent impairments) in order to improve as much as possible their abil
n n n n n n n n n n n
ity to function, their quality of life and their life expectancy.
n n n n n n n n n n
▪ Nurses are tasked with helping individuals execute a care plan a
n n n n n n n n n n
nd make any additionalbehavior modifications necessary to im
n n n n n n n
prove conditions n
▪ Examples include: n
• cardiac or stroke rehabilitation programs, chronic disease n n n n n n n
management programs(e.g. for diabetes, arthritis, depress n n n n n
ion, etc.) n
• support groups that allow members to share strategies for l n n n n n n n n n
iving well n
• vocational rehabilitation programs to retrain workers for n n n n n n n
new jobs when they haverecovered as much as possible.
n n n n n n n n
Members of minorities are overrepresented on the low tiers of the socioeconomic lad
n n n n n n n n n n n n
der. Poor economic achievement is also a common characteristic among populations
n n n n n n n n n n n
at risk, such as the homeless, migrant workers, andrefugees. However, the APN shoul
n n n n n n n n n n n n
d be able to distinguish between cultural and socioeconomic class issues and not inte
n n n n n n n n n n n n n
rpret behavior as having a cultural origin when the fact is based on socioeconomic cl
n n n n n n n n n n n n n n
ass. A good resource for APNs is the Cross-
n n n n n n n n
Cultural Health Care Program (CCHCP), which has a plethora of materials to improv
n n n n n n n n n n n n
e cultural competency among healthcare providers, including a training program for
n n n n n n n n n n n
healthcare providers. In order to provide appropriate healthcare interventions, cultur
n n n n n n n n n
e and all its variants must be addressed.
n n n n n n n
(p28)APRNs may be able to access health information needed by working together w
n n n n n n n n n n n n
ith other sectors outside of health, such as housing, labor, education, and community
n n n n n n n n n n n n
-based or faith- n n
based organizations that offer services to immigrant communities. This involves the
n n n n n n n n n n n
collection, documentation, and use of data that can be used to monitor health inequali
n n n n n n n n n n n n n
ties in exposures, opportunities, and outcomes.
n n n n n
Examples of social determinants that are related to health inequalities include pover
n n n n n n n n n n n
ty, educational level, racism, income, and poor housing. These inequalities
n n n n n n n n n
NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
, NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
can leadto n
poor quality of life, poor self-
n n n n n
rated health, multiple morbidities, limited access to resources, premature death, andunne
n n n n n n n n n n
cessary risks and vulnerabilities. n n n
(p25) APRNs can best determine the effectiveness of an intervention and long-
n n n n n n n n n n n
nterm impact by focusing on an accurate assessment and interpretation of data that ar
n n n n n n n n n n n n n
e generated or collected using individual, population, andcommunity health indicato
n n n n n n n n n
rs.
(p27)APRNs can work in partnership with community members to identify what co
n n n n n n n n n n n
mmunity members see as relevant and important, build social capital, use outcome d
n n n n n n n n n n n n
ata to advocate for changes in policy, and then continue towork in partnership to iden
n n n n n n n n n n n n n n
tify strategies to intervene, monitor,and improve those outcomes
n n n n n n n
(p40-
41)APRNs have numerous resources they can access to improve quality and timely acces
n n n n n n n n n n n n
s to quality healthcareand decrease health disparities. The National Partnership for Actio
n n n n n n n n n n n
n (NPA) to End Health Disparities
n n n n n
( minorityhealth.hhs.gov/npa) was started by the Office of Minority Health
n n n n n n n n n
to mobilize individuals and groups to work to improve quality and eliminate health
n n n n n n n n n n n n n
disparities. The National Priorities includes key private and public stakeholders who
n n n n n n n n n n
nhave agreed to work on major health priorities of patients and families, palliative an
n n n n n n n n n n n n n
d end-of-
n
life care, care coordination, patient safety, and population health. The Quality Allian
n n n n n n n n n n n
ce Steering Committee is another partnership of healthcare leaders who work to imp
n n n n n n n n n n n n
rove healthcarequality and costs. Various strategies to bridge the gaps in healthcare
n n n n n n n n n n n n
quality are available at the national level andmay be applied or considered at the stat
n n n n n n n n n n n n n n
e, regional, or local level in collaboration with stakeholders as a means ofdecreasing
n n n n n n n n n n n n
nhealth disparities. n
(p43) APRNs are better prepared to develop effective interventions to eliminate or
n n n n n n n n n n n
nreduce health disparities. Suchstrategies may include advocating better health ins
n n n n n n n n n n
NR503 FINAL EXAM STUDY GUIDE n n n n
Uploads by hustle grades n n n
