CNL EXAM 3|113 Questions with Verified Answers,100% CORRECT

CNL EXAM 3|113 Questions with Verified Answers How does Stanhope define the advanced practice nurse? - CORRECT ANSWER The advanced practice nurse is a licensed professional nurse prepared at the master's level or doctoral level to take leadership roles in applying the nursing process and public health sciences to achieve specific health outcomes for the community. What organization offers the certification examinations for the advanced practice nurse? - CORRECT ANSWER American Nurses Credentialing Center (ANCC). What are the roles of the advanced practice nurse? - CORRECT ANSWER Clinician, educator, administrator, consultant, and researcher What is a clinical nurse leader and how is their role different from the BSN prepared - CORRECT ANSWER The clinical nurse leader is defined as a nurse who is a master's prepared generalist who function at the micro-system level and assumes accountability for health care outcomes for a specific group of clients within a unit or area. Their role is different from the BSN prepared nurse in the manor of the clinical nurse leader will take on the role of outcomes-based practice, and quality improvement strategies. The clinical nurse leader will collect and evaluate patient outcomes, assess cohort risk, and has the decision-making authority to change care plans when necessary. What is the nurse role and responsibility in creating a new future for healthier communities? - CORRECT ANSWER These nurses have the responsibility to provide leadership in creating a new future for healthier communities. Nurse leaders act as change agents because they foster agency adaptation. Roles include: nurse leaders, managers, and consultants. What are some of the theories community health nurse can use to explain group and individual behavior? - CORRECT ANSWER Systems theories and systems thinking emphasize the interdependence of multiple parties- dynamics of rapid interconnected change and the emergence of patterns of activity. Complex adaptive systems theory- accounts for the unpredictability of behavior of people and organizations. What are some of the competencies nurse leaders need and why do they need these? - CORRECT ANSWER Nurse leaders need the following competencies: empowerment, delegation, critical thinking, decision making, and communication skills. Empowerment is insuring nurses have the necessary knowledge, skills, and resources to effectively make the decision for which they are held accountable. This is needed as it allows for the clinical nurse leader to make their own decision about patient care, but also ensures they are held responsible for what occurs with the care given. Delegation is used to for time management. This can help the clinical nurse leader to effectively do the work that is within their scope of practice. If they are able to give a task to a position below them, it can allow for work to be done more efficiently. Critical thinking is used for the analysis and synthesis of data, using knowledge and values in making judgements, and using creative approaches in decision making and problem solving. The clinical nurse leader is responsible for evaluating client outcomes and changes plans when necessary. Critical thinking is needed to perform this task. Decision making is used when the clinical nurse leader must decide on plan of care for a client. The clinical nurse leader will have the knowledge and skill to evaluate what will work best with the patient to have best overall care. Decision making is used to help in the performance of this task, as it gives effective decisions. Communication skills are very effective in a leadership position. The clinical nurse leader needs communication skills as it allows for proper conflict resolution. The clinical nurse leader will talk with many people throughout the day either in person or through media. Communication skills will give the clinical nurse leader the ability to talk with clients effectively and resolve conflicts. What is the difference between a home health and hospice nurse? - CORRECT ANSWER A home health nurse is a specialized nurse who delivers care in the residence of the client. A hospice nurse is a specialized nurse who provides "evidence-based physical, emotional, psychological, and spiritual or existential care to individuals and families experiencing life-limiting, progressive illness". p.890 How important is the involvement of family in home health care and hospice? - CORRECT ANSWER The involvement of family in home health care and hospice is very important. Family caregivers provide many aspects of care in the home that previously provided in hospitals or in home by professional caregivers. What is transitional care and why has it become a new area for care delivery? - CORRECT ANSWER Transitional care is defined as a set of actions designed to ensure the coordination and continuity of health care as clients transfer between different locations and different levels of care in the same location. Transitional care consistently shows cost saving and improvements in clinical and quality outcomes for clients receiving the intervention compared with the usual care. The most common outcome across all populations is a consistent reduction in readmission to a hospital. What is the Omaha System model of problem-solving and what is included in the system? - CORRECT ANSWER The Omaha System model of problem-solving was developed to operationalize the nursing process and provide a practical, easily understood, computer-compatible guide for daily use in the community. The system includes the Problem Classification Scheme, the Intervention Scheme, and the Problem Rating Scale for Outcomes. When does Stanhope state that school nursing began? - CORRECT ANSWER Stanhope states that school nursing began in the late 1800s in England, where the Metropolitan Association of Nursing provided medical exams for children in the schools of London. What are key legislative acts that promoted school nursing in the U.S.? - CORRECT ANSWER What are key legislative acts that promoted school nursing in the U.S.? Key legislative acts that promoted school nursing in the U.S. include: PL 93-112 Section 504 of the Rehabilitation Act, PL 94-142 Education for All Handicapped Children Act, Americans with Disabilities Act, PL 105-17 Individuals with Disabilities Education Act (IDEA), No Child Left Behind Act, and the Child Nutrition and WIC Reauthorization Act of 2004. What is the professional body that developed standards of practice for the school nurse and what are the 11 criteria the professional standards rely on? - CORRECT ANSWER The National Association of School Nurses (NASN) is the professional body that developed standards for the school nurse. The professional standards rely on nurses to give care based on the following 11 criteria: 1. Develop school health policies and procedures 2. Evaluate their own nursing practice 3. Keep up with nursing knowledge 4. Interact with the interprofessional health care team 5. Ensure confidentiality in providing health care 6. Consult with others to provide complete care 7. Use research findings in practice 8. Ensure the safety of children, including when delegating care to other school personnel 9. Have good communication skills 10. Manage a school health program effectively 11. Teach others about wellness What are school nurse roles? - CORRECT ANSWER Direct caregiver, health educator, case manager, consultant, counselor, community outreach, and researcher Risk in epidemiology means what? - CORRECT ANSWER Risk means that some people have a higher probability of getting an illness than others. For example, people who smoke are at risk to lung cancer due to the cellular changes from smoking. What is a vulnerable population group? - CORRECT ANSWER A vulnerable population group is a subgroup within a population that is more likely to develop health problems as a result of exposure to risk or to have worse outcomes from these health problems than the rest of the population. Provide some examples of vulnerable population groups. - CORRECT ANSWER A few examples of vulnerable population groups are: the poor and homeless, pregnant adolescents, migrant workers and immigrants, the mental health population, those who abuse addictive substances, abuse victims or victims of violence, persons with communicable disease at those at risk of contracting said communicable disease, HIV positive persons, and those who have Hepatitis B or STDs. What are disadvantaged populations? - CORRECT ANSWER Disadvantaged populations are those who experience health disparities due to having fewer resources for promoting health and treating illness than the average person in the United States. Define outreach. - CORRECT ANSWER Outreach is an approach to making healthcare more easily available to certain populations by implementing health education, counseling, or support services in places where people normally congregate, such as places of worship, schools, workplaces, and community centers. What is case finding related to vulnerable populations? - CORRECT ANSWER Case finding is when nurses design methods to find these vulnerable populations and individuals especially in need of service. What is a safety net provider, and please give an example. - CORRECT ANSWER A Safety net provider is a term applied usually to community health centers or nurse-managed clinics that increase access to health and social services for vulnerable populations and those with limited financial ability to pay for care. What is food insecurity? - CORRECT ANSWER Food insecurity is an issue that those living in extreme poverty such as the homeless or those living in marginal housing face. It can be described as a state where one does not know when or where their next meal will come from. These individuals do not have a steady supply or surplus of food to rely on throughout each day. To be an effective nurse one must recognize and acknowledge what? - CORRECT ANSWER To be an effective nurse, one must recognize and acknowledge the beliefs, values, and knowledge that influence one's practice and worldview. What were the Elizabethan poor laws and how did they impact society? - CORRECT ANSWER These laws were established in the 17th century, and said that persons who were born within the boundaries of the community should be given assistance by that community. Define poverty. - CORRECT ANSWER Poverty is defined as having insufficient financial resources to meet basic living expenses. In the western cultures, poverty is most often viewed negatively; alternatively, poverty is respected in other cultures. How is poverty determined in the U.S.? - CORRECT ANSWER The official poverty level in the United States in 2011 was $22, 350. near poor mean? - CORRECT ANSWER Near poor refers to persons whose income is above the federal guidelines, yet is inadequate to meet basic needs. What is neighborhood poverty? - CORRECT ANSWER This type of poverty is based on geographically defined areas of high poverty, characterized by dilapidated housing and high levels of unemployment. These areas also have higher mortality and morbidity rates, compared to higher income neighborhoods. How is poverty related to health? - CORRECT ANSWER Poverty is associated with higher rates of chronic illness; higher infant morbidity and mortality rates; shorter life expectancy; more complex health problems; more significant complications and physical limitation from chronic diseases such as asthma, diabetes, and hypertension; and higher hospitalization rates. homelessness? - CORRECT ANSWER Homelessness is defined as "lacking a fixed, regular, and adequate night-time residence and...has a primary nighttime residency that is: (a) a supervised publicly or privately operated shelter designed to provide temporary living conditions (b) an institution that provides a temporary residence for individuals intended to be institutionalized (c) a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings" (p.743). causes of homelessness? - CORRECT ANSWER A trend in a growing shortage of affordable housing, along with an increase in poverty, are the two main causes of homelessness. Deinstitutionalization of chronically mentally ill individuals from the public psychiatric hospitals is also a major cause of homelessness. What effects does homelessness have on health? - CORRECT ANSWER Homeless people suffer greater incidences of acute and chronic illnesses, AIDS, and trauma. This population has limited access to adequate health care resources. Furthermore, this population often give lower priority to health promotion and health maintenance than to obtaining food and shelter. What is the role of the nurse with homeless and poor populations? - CORRECT ANSWER The nurse creates a trusting environment; shows respect compassion, and concern; does not make assumptions; coordinate a number of services and providers; advocate for accessible health care services; focus on prevention; know when to walk beside the client and when to encourage the client to walk ahead; and develops a network of support for oneself. What is the definition of the migrant farm worker? - CORRECT ANSWER An individual whose principal employment within the past 24 months is in agriculture on a seasonal basis and who establishes for the purpose of such employment a temporary abode. What is the definition of the seasonal farm worker? - CORRECT ANSWER A seasonal farmworkers work cyclically in agriculture but do not migrate. Migrant Health Act? - CORRECT ANSWER The Migrant Health Act was signed in 1962 and provides funds for primary and supplemental health services to migrant workers and their families. These funds are disbursed to 154 migrant health centers in 42 states that serve as models for delivery of services to a difficult-to-reach migrant population. What are some of the occupational health risks for migrant farm workers? - CORRECT ANSWER Working conditions, such as standing on ladders, being exposed to chemicals, and using machinery, produce occupational health risks for the migrant farmworkers who may be inadequately protected or educated. Lack of a comprehensive surveillance system makes it difficult to know the extent of all injuries within the migrant population. Injuries such as sprains and strains, fractures, and lacerations are the most common. Other injuries include amputations; crush injuries from tractors, trucks, or other machinery; acute pesticide poisoning; electrical injuries; drowning in ditches; chronic back pain; and dermatitis or conjunctivitis caused from irritation from the chemicals. Pesticide exposure is common because the migrant farmworker;s dwell near fields or orchards and they may not have access to protective clothing or unable to afford it. ● Acute health effects of pesticide exposure include mild psychological and behavioral deficits such as memory loss, difficulty with concentration, mood changes, abdominal pain, nausea, vomiting, diarrhea, headache, malaise, skin rashes, and eye irritation. ● Chronic exposure might lead to cancer, blindness, Parkinson disease, infertility or sterility, liver damage, and polyneuropathy and neurobehavorial problems. What impact does migrant farm work have on children in these families? - CORRECT ANSWER ● Malnutrition (vitamin A and iron deficiencies) ● Infectious diseases (upper respiratory tract infection, gastroenteritis) ● Dental caries (from prolonged bottle-feeding, bottle-propping, and limited access to fluoride and dental care) ●Inadequate immunization status ● Pesticide exposure, injuries, overcrowding and poor housing conditions ● Disruption of their social and school life, lead to anxiety-related problems. How does Mexican cultural beliefs' concerning health differ from the U.S. culture? - CORRECT ANSWER Mexican clients may not seek care with health professionals first. Instead they may consult with knowledgeable individuals in their family or community or with folk healers. They would consult issues with the wise older woman living in the community such as their grandmother or local parish priest. Often time love for their children, rather than concern for their own health may encourage migrant parents to adopt healthier lifestyles. For example, when the parents of a child with asthma choose to stop smoking. Mexican clients may be more willing to following the advice of another Mexican individual with a similar health problem rather than advice of the health professional. The Mexican individual may not follow up with a clinic appointment because their perception of health is that a healthy person is one who can continue to work and maintain daily activities independent of symptoms or diagnosed diseases. Mexican individuals may believe that illnesses are a punishment from God and may cite this belief as a rationale for why therapies have not cured them. This often leads to more chronic conditions. What are the main causes of teen mortality in the U.S.? - CORRECT ANSWER Motor vehicle accident (usually including alcohol), homicide, suicide, and accidental injuries (such as falls, fires, or drowning) What are the reasons that teens may not seek help for their problems? - CORRECT ANSWER 1. Access to health care may be hindered due to a limited number of professionals with expertise in dealing with teenagers 2. Cost of care or availability of insurance may limit services 3. Adolescents need to believe that their visits are confidential before they will honestly reveal information 4. Health care professionals must be able to discuss sensitive topics in a non-judgemental and supportive manner and demonstrate a desire to work with youths. What are two reasons teens seek out healthcare assistance? - CORRECT ANSWER Concerns about a possible pregnancy or to find a birth control method Describe the teens that have children and explain the difference in this population. - CORRECT ANSWER Teen parents often lack self-confidence and knowledge about proper infant care. They may have unrealistic expectations for the child, and lack knowledge about infant growth and development. Due to limited knowledge about normal child development, abusive parenting is more likely to occur. The nurse can play an important role in educating the teen mother about proper infant care, expectations, and normal growth and development. The reason for the difference in this population may be related to the developmental stage of the teen mother and lack of preparedness--minimal prenatal care, lack of knowledge about infant care, etc. Name some issue for teenage mothers and what is the nurse's role with these issues. - CORRECT ANSWER Violence Nurse must observe for physical signs of abuse, as well as for controlling or intrusive partner behavior Initiation of Prenatal Care Cooperation between nurse and clinical staff can maximize client compliance with special health or nutritional needs. Nurse who makes home visits can provide additional assemssnet of the ten's condition and can solve problems about self-care, hygiene, meals, and schooling. Nutrition Nurse can reinforce the need for teen to take prenatal vitamins during pregnancy and after baby's birth. The nurse should also educate about iron-rich foods and foods that promote iron absorption, such as those containing vitamin C. Infant care Nurse observe mother response to infant cues. Specific techniques can be instructed to use in early child care. Begin early education as early as possible. Repeat pregnancies Nurses should review contraceptive options and help identify methods teen most likely use. After birth, follow up on woman's plan and identify obstacles and help problem solve with new mother. How does Healthy People 2020 define mental health? - CORRECT ANSWER Mental health is defined by Healthy People 2020 as encompassing the ability to engage in productive activities and fulfilling relationships with other people, to adapt to change, and to cope with adversity What is the National Alliance for the Mentally Ill - CORRECT ANSWER The National Alliance for the Mentally Ill is a consumer advocacy group that worked to establish education and self-help services for individuals and families with mental illness. How does managed care impact mental illness? - CORRECT ANSWER Managed care impacted mental illness by providing a method to control costs and access to mental health care in the private insurance sector, managed care became a significant factor to public mental health, and more than half of the Medicaid recipients were enrolled in a managed mental health care plan. How has the treatment of the mentally ill changed in the last 50 years? - CORRECT ANSWER First psychiatric hospital was built in Virginia, and approximately 50 years passed before widespread construction of facilities in other states. Even after the development of hospitals and site of treatment, persons with mental disorders were neglected and mistreated. There has been continued development of research and education programs, early intensive treatment for acute mental illness, and shifting the care of severely mentally ill persons away from the large hospitals to psychiatric wards in general hospitals and to community mental health clinics. Along with prevention and intervention, community services were to include aftercare services following hospitalization for individuals with major mental illness. What did deinstitutionalization do to the mentally ill and how has this impacted healthcare and nursing? - CORRECT ANSWER Deinstitutionalization involved transitioning large numbers of people from state psychiatric hospitals to communities. The goal was to improve the quality of life for people with mental disorders by providing services in the communities where they lived rather than in large institutions. To change the locus of care, large hospital wards were closed and persons with severe mental disorders were returned to the community to live. What is ATOD and why the change? - CORRECT ANSWER ATOD refers to 'alcohol, tobacco, and other drug'. The change in term was to remind the public that alcohol and tobacco are the major drugs of abuse when discussing chemical dependency. How have attitudes shifted about the use of alcohol, tobacco, and drug use in the U.S. over the last 100 years? - CORRECT ANSWER Prior attitudes were formed around the way society categorized drugs. Drugs used to categorized to be either good or bad, in which good drugs were OTC drugs and those prescribed by a doctor, but these can be just as dangerous and addictive as the 'bad drugs'. Bad drugs were those that low-life irresponsible people used including alcohol, tobacco, and other drugs. However, in 1954 the AMA listed alcohol addiction as an illness and tobacco addiction followed years after. Now these problems are viewed as medical diagnoses that require treatment. Also, previous methods to control the war on drugs aimed at criminalizing those caught using drugs that were banned in the United States. However this has led to increase money spent on law enforcement than actual treatment and eradication of the drugs. Therefore, new methods are aimed and treating addicts and helping them get over their addiction to lead to eradication of drug use. What is the role of the nurse in primary, secondary, and tertiary prevention in the use of alcohol, tobacco, and drugs? - CORRECT ANSWER Primary prevention role: Primary prevention focuses on the promotion of healthy lifestyles and resiliency factors, along with education about drugs and guidelines for their use. Nurses utilize many health promotion strategies including education on alternatives and drugs altogether to prevent the use of harmful drugs. Secondary prevention role: The nurse uses screening tools to detect ATOD problems, followed by educating the individuals to understand the connection between their drug use and the negative consequences they have. Also, early intervention can be used to treat the problems to avoid needing further more intensive treatment. Tertiary prevention role: The nurse focuses on supporting the patient along with their family through the treatment process while connecting them to all the possible resources to ensure proper treatment and care. Many addicts can get lost in the process of detox or smoking cessation programs, leading to giving up altogether. It is the nurse's role to follow the patient throughout the process to support them and keep them on track to complete treatment. What is violence? - CORRECT ANSWER Violence is non-accidental acts that occur interpersonally and intrapersonally that result in physical or psychological injury. Violence is predictable therefore preventable with community action. How has religion played a role in violence in families? - CORRECT ANSWER Although religion can help those experiencing anguish get through times, it can also lead to continuation of violence. Due to religions that do not accept divorce, men and women being abused by their partner will stay in the violent relationship to uphold their religious beliefs. Also, religious affiliation and religious conservatism have been identified as risk factors for family violence, especially child abuse. What is homicide, assault, and rape and what might be a nurse's role in dealing with victims, families, and communities of these acts? - CORRECT ANSWER Homicide: Intentional killing of one person by another. Nurse have a role in preventing homicide in families where abuse is present and detected. Nurses who understand how upbringing, living conditions, and increased stress contribute to IPV are more equipped to manage abusive families. Assault: The intentional harm of a person by another. Nurses are responsible for providing not only the physical care of assault victims, but also helping them through the emotional trauma. This includes talking through the event to try and make further sense of it and referral to other resources that may be needed. Rape: Forceful sexual acts on a victim who does not consent to the acts. Nurse play many roles in treating victims of rape. Nurses help victims cope with the stress and disruptions of their lives from the crisis. Nurses help the victims get their life on track and return to functioning prior to the rape. Sometimes the victims experience PTSD and require psychological treatment. There are also SANE nurses who specialize in assessing sexual assault victims immediately after the incident. What is a nurse's role in child and elder abuse? - CORRECT ANSWER Child Abuse Nurses are mandatory reporters of child abuse, even when only suspected, in all states.The nurse must not only teach normal parental behavior, but also address the underlying emotional needs of the parents. These parents often experience pain and poor emotional stability and need intervention as much as their children. Elder Abuse Nurses have many ways to detect elder abuse, and they have the skills and responsibility for discovering it, giving treatment, and making referrals. Many families who care for older adult members exhaust their resources and coping ability. Nurses can help them find new sources of support and aid. What is child neglect? - CORRECT ANSWER Physical neglect: Failure to provide adequare food, proper clothing, shelter, hygience, or necessary medical care and is most often associated with extreme poverty. Emotional neglect: Lack of the basic nurturing, acceptance, and caring essential for healthy personal development. What are the tools and roles of a community health nurse in primary prevention, secondary prevention, and tertiary prevention about child abuse? - CORRECT ANSWER Primary prevention: Nurses can teach parenting techniques, teach stress-reduction techniques, and provide education on developmental stages and needs of children. Secondary prevention: Nurses can reduce or end abuse early by screening: provide assessment during routine screening, provide counseling for at-risk parents, and encourage assistance with controlling anger. Tertiary prevention: Nurses can refer the client to appropriate community organizations when signs of abuse are evident. Occupational Health Nurses focus is on what? - CORRECT ANSWER These nurses focus on the promotion, prevention, and restoration of health within the context of a safe and healthy environment. What is the organization that established the standards for Occupational Health Nurses? - CORRECT ANSWER The American Association of Occupational Health Nursing (AAOHN) What are OSHA and NIOSH and why did they come into existence? - CORRECT ANSWER The Occupational Safety and Health Administration (OSHA) focuses primarily on protecting workers from work-related hazards. The National Institute for Occupational Safety and Health (NIOSH) was established as part of the Centers of Disease Control and Prevention. These two came into existence to set specific standards and information to carry out the act's purpose of ensuring "safe and healthful working conditions for working men and women." How does the Occupational Health Nurse use the epidemiological model? - CORRECT ANSWER The Occupational Health Nurse can use the epidemiological model to understand the relationship between work and health. In this model.... The host is all employed individuals and groups. The agents are occupational exposures that are classified as biological, chemical, enviro-mechanical, physical, or psychosocial. The environment includes all external conditions that influence the interaction of the host and the agents. What is the Hazard Communication Standard and why is this important to nurses and healthcare? - CORRECT ANSWER This standard requires that all worksites with hazardous substances inventory their toxic agents, label them, and provide material data sheets (MSDSs) for each agent. The employer must also have in place a hazard communication program that provides workers with education about these agents. What is Forensic Nursing? - CORRECT ANSWER Forensic nursing synthesizes the biopsychosocial and spiritual aspects of nursing care with an expert understanding of forensic science and the criminal justice process. Forensic nursing is distinguished by its unique body of knowledge and skills as well as by the practice arenas and client population served. Includes skills such as collection, documentation, and preservation of evidence and other findings that may later have implications in the prosecution of a crime. Is Health People 2020 relevant to Forensic Nursing, if so how? - CORRECT ANSWER The Healthy People 2020 goals that deal with reducing injury and violence in the United States......Objectives related to safety, violence, injury, and sexual assault are incorporated throughout the Healthy People 2020 document. These objectives relate to injuries that are both intentional and unintentional. How does the Forensic Nurse provide care to the community? - CORRECT ANSWER Forensic nursing is predominantly a community-orientated specialty. Practice arenas are associated with health care facilities such as private clinic, ER, criminal justice centers for victims of crime, medical examiner offices, police departments, correctional facilities, and mental health centers. Often time the practice sites have individuals who have experienced the effects of injury. Clients entering hospitals may have conditions that have overlying legal implications. Forensic nurses use their expert understanding of cause and effects of trauma and are in a position to investigate circumstances in order to design appropriate plan of care for these special groups of clients. They also serve as a liaison between the hospital and medical-legal community to reduce the effects of trauma. What are some of the ethical issues related to Forensic Nursing? - CORRECT ANSWER The nurse must maintain a different code of conduct when dealing with patients. Ethical principles include: respect for person, beneficence, distributive justice, respect for community, and contextual caring. These categories reflect tension that may arise when the nurse faces dilemma imposed by conflicting interests. What is Faith Community or Parish Nursing and do they have standards of practice? - CORRECT ANSWER Faith Community or Parish Nursing is the dynamic process of working with faith communities to promote wholeness of body, mind, and spirits. The Faith Community or Parish Nursing has standards of practice. They focus on intentional spiritual care as an integral part of the process of promoting holistic health and preventing or minimizing illness in the faith community. What is a faith community? - CORRECT ANSWER Faith communities are a group of people that gather in churches, homeless shelters, congregations, parishes, synagogues, temples, or mosques and acknowledge common values, beliefs and practices with a single faith or multi-faith tradition. What is a health ministry and can you think of any examples? - CORRECT ANSWER Health ministries are activities and programs in faith communities organized around health and healing in order to promote wholeness in health across the lifespan. These services include visiting the homebound, providing meals for families in crisis or when a family member returns home after hospitalization, or serving "healthy heart" meals. Examples here in Toledo are: The Cherry Street Mission Ministries, Toledo Area Ministries, and Vision Ministries of Toledo. Can you provide an example of a nursing leader that began education in a faith community? - CORRECT ANSWER Reverend Granger Westberg Please provide the example and what was the faith community? - CORRECT ANSWER The faith community existed within Chicago where Mr. Westberg along with Lutheran General Hospital started a pilot project with six congregations, of which four were Protestant and two were Roman Catholic communities. Through the creation of many holistic health centers parish nursing was founded. What is the significance of partnerships in public health and provide an example from your clinical setting? - CORRECT ANSWER Partnerships are what public health is built upon and are essential to completing the mission and goals of public health programs. Since public health is holistic and aims to improve the overall health of the community, it is clear how collaboration between partners that each specialize in different areas of health in the community is vital to success. For example, The Hope House Family Program is a partnership between The Cherry Street Mission Ministries and many local churches and other ministries. This program aims to minister families holistically and provide safe transitional housing. What is the name of the U.S. national health objectives? - CORRECT ANSWER Healthy People 2020 What is family? - CORRECT ANSWER Family refers to two or more individuals who depend on one another for emotional, physical, and/or financial support. How many Americans were without health insurance as of 2008? - CORRECT ANSWER there were 46.6 million Americans without health insurance. What are family functions? List the family functions and explain why they are important. - CORRECT ANSWER 1. Economic function: Family income is a substantial part of family economics, but it is also related to family consumerism, money management, housing decisions, insurance choices, retirement, and savings. Family economics affect and reflect the nation's economy. 2. Reproductive function: The survival of a society is linked to patterns and rates of reproduction. The family has been the traditional structure in which reproduction was organized. 3. Socialization function: A major expectation of families is that they are responsible for raising their children to fit into society and take their place in the adult world. In addition, families disseminate their culture, including religious faith and spirituality. 4. Affective function: Families provide boundaries and structure that provide a sense of belongings and identity of who the family members are individually and to their family. The purpose of the affective function is to learn about intimate reciprocal caring relationships, to learn about dependency and how to nurture future generations. 5. Health care function: It is in the family that one learns the concepts of health, health promotion, health maintenance, disease prevention, and illness management. Family members provide informal caregiving to ill family members and are primary sources of support. What does family structure connote and what aspects need to be addressed when determining the structure? - CORRECT ANSWER Family structure connote the characteristics and demographics of individual members who make up family units. The structure of the family defines the roles and the positions of family members. The aspects that need to be addressed are: 1. The individuals that compose the family. 2. The relationships between them. 3. The interactions between the family members. 4. The interactions with other social systems. Family as Context (approach to family nursing) - CORRECT ANSWER The family has a traditional focus that places the individual first and the family second. The family as context serves a either a strength or a stressor to individual health and health issues. The nurse is interested in the individual and realizes that the family influences the health of the individual. Family as Client (approach to family nursing) - CORRECT ANSWER The family is the primary focus and individuals are secondary. The family is seen as the sum of individual family members. The focus is concentrated on how the family as a whole is reacting to the event when a family member experiences a health issue. Family as a System (approach to family nursing) - CORRECT ANSWER The focus is on the family as a client, and the family is viewed as an interactional system in which the whole is more than the sum of its parts. This approach focuses on individual members and the family as a whole at the same time. The systems approach to families always implies that when something happens to one family member, the other members of the family system are affected, and vice versa. Family as a Component of Society: (approach to family nursing) - CORRECT ANSWER The family is seen as some of many institutions in society, along with health, education, and religious and financial institutions. The family is a basic or primary unit of society, as are all the other units, and they are all a part of the larger system of society. The family as a whole interacts with other institutions to receive, exchange, or give services. Family Systems Theory - CORRECT ANSWER used to understand how a family is organized whole as well as composed as individuals. The purpose of the family system is to maintain stability through adaptation to internal and external stresses that are created by change. Family Developmental and Life Cycle Theory - CORRECT ANSWER Family Developmental and Life Cycle Theory: provides a framework for understanding normal predicted stresses that families experience as they change and transition over time. The principles of development are applied to the entire family based on the age of the eldest child Bioecological Systems Theory - CORRECT ANSWER Describes how environments and systems outside the family influences the development of a child over time. A useful theory for community and public health nurses since it helps identify stresses and potential resources that can affect family adaptation. Several factors contribute to the development of healthy or unhealthy outcomes. Health risks are those factors that may cause disease or unhealthy outcomes. Can you name the categories of these risks and give an example of each? - CORRECT ANSWER Biological risk Ex. Cardiovascular disease runs in your family. Social and Physical Environment risk. Ex. low income families do not have adequate access to health care because lack of insurance. Behavioral risk: Ex. not getting enough sleep at night because of the demanding nursing program. Economic risk- relationship between fam. financial resources and demands on those resources Health Care risk: Ex. a nurse comes down with the flu after not donning the right PPE while treating a patient? What is health risk reduction? - CORRECT ANSWER By definition health risk reduction is based on the assumption that decreasing the number of risks or the magnitude of risk will result in a lower probability of an undesired event occurring What are the components of a family health risk appraisal? - CORRECT ANSWER Assessment of family health risk requires many approaches. As in any assessment, the first and most important task is to get to know the family, their strengths, and their needs. The components of a family health risk appraisal in areas of biological and age-related risk (Several illnesses have a family component that can be accounted for by either genetics or lifestyle patterns. These factors contribute to the biological risk for certain conditions), social and physical environmental risk(Living in high-crime neighborhoods, in communities without adequate recreation or health resources, in communities that have major noise pollution or chemical pollution, or in other high-stress environments, low income families increase health risk), and behavioral risk (personal health habits such as determining what food is purchased and prepared, setting sleep times, planning family activities, determining when a family member is sick and medical care should be obtained, and carrying out prescribed treatments). Box 28-3 gives definitions related to family health. How can a nurse help families reduce health risks? - CORRECT ANSWER Home visits, as compared with clinical visits, give a more accurate assessment of the family structure, the natural or home environment, and behavior in that environment. Home visits also provide opportunities to identify both barriers and supports for reaching family health promotion goals. The nurse can work with the client directly to adapt interventions to match resources. Visiting the family in their home may also contribute to the family's sense of control and active participation in meeting their health needs How many children in the U.S. live below the poverty level? - CORRECT ANSWER 73.9 million Do any children experience poverty at higher rates? - CORRECT ANSWER Minority children, mostly black and Hispanic children, have higher proportions of living in poverty. 60% of children who are born to immigrants live in poverty compared to 37% of native born. How is low income defined? - CORRECT ANSWER Low income (the amount of income necessary to provide for the family's basic needs) is two times the federal poverty level. What is low food security? Does this exist in the U.S.? - CORRECT ANSWER Low food security is the lack of available food and access to food on a regular basis, affects children's physical health, development, and school performance. Yes, more than 20% of American households with children experience low food security. Homelessness is increasing for American children and is highly correlated to poverty status. What is Medicaid and what children qualify for this program? - CORRECT ANSWER Medicaid is a state-administered health insurance program, financed jointly by the federal and state governments. Children under 18 years of age living in a household with an income level at or below 133% of the federal poverty level or children meeting disability requirements qualify for this program. What is CHIP? - CORRECT ANSWER CHIP expands health insurance to the nation's uninsured children.It is a federal and state partnership that is directed toward uninsured children and pregnant women in families with incomes too high to qualify for state Medicaid programs but usually too low to afford private coverage. What are the two developmental theories listed in Stanhope - CORRECT ANSWER Psychosocial development emphasizes that personality development culminates in the achievement of ego identity, which involves accepting oneself and having the skills for healthy functioning in society Human ecology theory emphasizes the complex relationship between the growing child and his/her immediate environment. Children are greatly influenced by the environments in which they spend time and one of the most important environments in affecting growth is the family environment. What is immunization theory? - CORRECT ANSWER The goal of immunization is to protect by using immunizing agents to stimulate antibody formation. Immunizing agents for active immunity are in the form of toxoids and vaccines What is a toxoid and how does it work? - CORRECT ANSWER "A toxoid is a bacterial toxin (e.g., from the bacteria that cause tetanus and diphtheria) that has been heated or chemically treated to decrease virulence but not antibody-producing ability." What is a vaccine and how does it work? - CORRECT ANSWER "Vaccines are suspensions of attenuated (live) or inactivated (killed) microorganisms. Examples include pertussis (inactivated bacteria); measles,mumps, and rubella (live attenuated viruses); and hepatitis B (inactivated virus) What two organizations are responsible for immunization guidelines - CORRECT ANSWER The American Academy of Pediatrics (AAP, 2009a) and the U.S. Public Health Service's Advisory Committee on Immunization Practices (ACIP What is a build environment? - CORRECT ANSWER A build environment is defined as the person's human- made or modified surroundings in which they live, work, and partake in recreation. Includes neighborhood access to recreation opportunities, grocery stores, the home environment, and the consideration of general safety for children in their physical environments. This is a major factor considering obesity, risk for injuries, and exposure to environmental toxins What is the Older Americans Act? - CORRECT ANSWER The Older Americans Act (OAA), originally passed in 1965, established the Administration on Aging (AOA) and state agencies to provide for the social service needs of older people. The mission of the AOA is to help older adults maintain dignity and live independently in their communities through a comprehensive and coordinated network across the United States. Title III of the OAA authorizes funding for non--profit area agencies on aging to coordinate social services that provide supportive and nutritional services, family caregiver support, and disease prevention and health promotion activities. The services are available to all people age 60 or over, specifically targeted to those with the greatest economic or social need. What is the Americans with Disability Act? - CORRECT ANSWER In 1990 the Americans with Disability Act (ADA) was passed, providing protection against discrimination to millions of Americans with disabilities. This legislation requires government and businesses to provide disabled individuals with equal opportunities for jobs, education, access to transportation and public buildings, and other accommodations for both physical and mental limitation Explain the evolution of the Personal Responsibility and Work Opportunity Reconciliation Act. - CORRECT ANSWER Congress passed this law which is commonly known as the "welfare reform." This law targeted women who received public assistance and Temporary Assistance for Needy Families (TANF) which was a work program that mandates that women who were head of households to help find employment so they could keep their benefits for their families. This law help supplant Job Opportunities and Basic Skills Training Program which was a welfare-to-work program. The evolution of this law led to the reassertion of America's work ethic which focused on ending welfare as an entitlement program, How does the National Center on Elder Abuse describe abuse, injury, and neglect? - CORRECT ANSWER Abuse: encompasses physical, emotional, and sexual abuse, as well as exploitation, neglect, and abandonment. Identification of abuse consists of recognizing the following: (a) The willful infliction of physical pain, (b) infliction of debilitating mental anguish and fear, (c) theft of mismanagement of money or resources, and (d) unreasonable confinement or the depriving of services. Injury: physical pain Neglect: the refusal or failure to fulfill any part of a person's obligations or duties to an elder. Neglect may also occur if the person who has fiduciary responsibilities fails to pay for items or necessary home care services or, on the part of the in-home service provider, to provide the necessary care. What is the Patient Self-Determination Act and how did this impact health care? - CORRECT ANSWER The Patient Self-Determination Act of 1991 requires those providers receiving Medicare and Medicaid funds to give clients written information regarding their legal options for treatment choices if they become incapacitated. A routine discussion of advanced medical directives can help ease the difficult discussions faced by healthcare professionals, families, and clients. Some things involved with the advanced directive is a living will, a durable medical power of attorney, and a do-not-resuscitate order if wanted. This has impacted health care because it makes it easier when the time comes for these orders to be used. If the patient does become incapacitated all their wishes are already known to the family and the health care providers. Define disability - CORRECT ANSWER The condition of being disabled; inability to pursue an occupation because of physical or mental impairment; a program providing support to one affected by disability; lack of legal qualification to do something or a disqualification, restriction, or disadvantage. What is work disability? - CORRECT ANSWER 1. Has a health problem or disability that prevents the person from working or limits the kind or amount of work the person can do 2. Has a service-connected disability or retired or left a job for health reasons 3. Did not work because of a long-term physical or mental illness or disability that prevented the performance of any kind of work 4. Did not work at all in the past 12 months because of illness or disability 5. Is under 65 years of age and covered by Medicare 6. Is under 65 years of age and a recipient of Supplemental 7. Security Income (SSI) 8. Received veterans' disability compensation How does the Social Security Administration define disability? - CORRECT ANSWER "the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s), which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months" What is functional disability and provide examples. - CORRECT ANSWER Functional limitations occur when individuals experience difficulty performing basic ADL's because of their disability. Examples include difficulty standing, walking, climbing, grasping, and reading. What is developmental disability? - CORRECT ANSWER "is a chronic impairment that occurs during development and up to age 22 and lasts throughout the person's lifetime. The disability limits the functioning of an individual in at least three of the following areas: self-help, language, learning, mobility, self-direction, independent living, and economic self-sufficiency SMILES What impact does disability have on the person, and on the family? - CORRECT ANSWER The impact of disability on the person is related health problems, self-esteem/self-concept, life expectancy and risk for infection/secondary injury, and change in role expectations related to developmental tasks. The impact on the family is stress on the family unit, need for external resources to help family meet role expectations, options limited in use of discretionary income, and the social stigma that surrounds disability, and the cost of caring