NURS 2000 chapter 32: Rural Health-Test Bank
Questions and Answers
1. Which of the following descriptions is the most accurate example of a rural
community?
a. The residents of the community are subject to environmental hazards.
b. It takes longer than 30 minutes to get from the community to health care services.
c. The community has less than 20,000 residents.
d. The residents of the community say, "This is smaller than where I grew up." -
ANSWER-ANS: B
All of the descriptions could be used in an attempt to define "rural," but each aspect has
problems. A definition of "rural" has not yet been decided. However, in relation to health
care, the time needed to get to a health care facility has a major influence on care
outcomes.
2. What is the poverty rate in rural areas?
a. 10%
b. 20%
c. 30%
d. 40% - ANSWER-ANS: D
National estimates report that in rural areas, more than 40% of all families live below the
poverty level.
3. Why are children at risk on their own family's farm?
a. Children often help with the work without much regard for training or safety.
b. It is expected that children fulfill the roles that are assigned to them.
c. Machinery can injure someone faster than a parent can turn the machine off.
d. Parents are too busy completing their own tasks to supervise the children. -
ANSWER-ANS: A
Farming is one of the four most dangerous industries. Agricultural work is inherently
dangerous but also must be performed under adverse conditions such as mud or
extreme heat or cold. On family farms, spouses, children, and other relatives often help
without much regard to competency, training, or safety. Of all industries, agriculture has
by far the highest number of injuries and deaths among children.
4. An adolescent in a rural community has recently committed suicide. What is the
significance of this event in the community?
a. Rural residents are less religious than urban residents and less capable of coping
with the loss.
,b. Because of the size of the community, it is likely that no one will discuss what has
happened.
c. There could be a cluster of such deaths in small towns where everyone knows
everyone so well.
d. Without the adolescent to work, the family may have increased economic difficulties. -
ANSWER-ANS: C
Because of the cluster or "copycat" phenomenon related to self-inflicted death, in
several towns the suicide rate has reached epidemic proportions, with three or more
suicide incidents occurring in a very short time (after one suicide, there is an increased
incidence of additional suicides in a community). In small towns or rural areas, where
most people are fairly well acquainted, a sudden death can be devastating to students
and to the community as a whole.
5. What was one purpose of Rural Health Clinic (RHC) Public Law 95-210?
a. To define rural areas as underserved and therefore eligible for many tax reductions
b. To encourage utilization of advanced practice nurses by providing reimbursement for
their services under Medicare and Medicaid
c. To fund structures (building, equipment, supplies) for rural health care providers
d. To pay for physicians to serve in rural underserved areas - ANSWER-ANS: B
RHC Public Law 95-210 was originally passed by Congress in 1977. The law defined
core primary care, created reimbursement mechanisms, and encouraged utilization of
midwives and nurse practitioners, among others, by providing reimbursement even
without a full-time physician available. Reimbursement is based on cost so that
additional revenues to eligible rural practices can be generated.
6. A program to recruit advanced-practice nurses to practice in a rural community is
being developed. The program developers have applied to receive federal training
monies to help fund the costs of the program. Which of the following questions must be
addressed when they apply for these funds?
a. "Does the health of the clients improve as a result of interventions?"
b. "Have professional schools increased enrollment?"
c. "Are advanced-practice nurses taught to embrace rural cultural values?"
d. "Should improvements be made to the buildings and equipment at the agency?" -
ANSWER-ANS: A
Federal training dollars have been linked to program outcomes. The question of
whether the clients' health improves as a result of interventions is the only question that
addresses outcomes. For example, the goal is not simply to educate professionals but
to prepare providers who are capable and willing to increase access to care for
underserved and minority populations.
7. A family nurse practitioner is employed in a rural health clinic. What generalization
would the practitioner most likely be able to make about the local clients?
, a. "They carefully budget their money in order to afford health insurance."
b. "They define health as self-actualization of potential."
c. "They are fatalistic and oriented to the land, nature, and the seasons."
d. "They are open to sharing their problems and accepting my advice." - ANSWER-
ANS: C
Rural families are often fatalistic because both their work and their recreation are
dependent on the land throughout the seasons. They usually know everyone in the
community, keep their problems within the family, define health as the ability to fulfill
their work requirements, and are too poor for health insurance. These are, of course,
generalizations, to which there are many exceptions.
A new family nurse practitioner at the rural health clinic soon saw much strength in the
community. What might be some resources used and accepted by ill people in a rural
area?
a. Charity efforts that are publicized and coordinated by members of the nearby city
b. Family and friends who volunteer to help with food, cleaning, child care, and other
tasks
c. Use of the extended-care facility in the community until the ill person feels better
d. Care that is coordinated by social services and the public health agency - ANSWER-
ANS: B
Rural residents, many of whom are related to each other, typically accept help from
family, friends, and other community members with the understanding that someday
such help will be reciprocated. However, formal support from agencies cannot be
accepted because of the cost and inability to "pay back" for such support.
A nurse is working in a rural health clinic. Which of the following situations may cause
difficulties in maintaining confidentiality at the clinic?
a. Neighbors care about each other and will ask the nurse questions.
b. Neighbors recognize each others' cars in the clinic parking lot.
c. The nurse will want to share information in a quest to seek assistance for the client.
d. The nurse will have to use names in referring clients to other agencies for assistance.
- ANSWER-ANS: B
Most people in a small town are recognized by the car that they drive, so seeing the car
in the clinic parking lot can jeopardize confidentiality. Assumptions may be made about
anyone seen in the building, even if it is not to attend the clinic. Leaks in confidentiality
result from such chance encounters.
10. A new female family nurse practitioner employed at the rural health clinic became
very frustrated. What might be cause for complaint?
a. "I can't survive on this salary with the high cost of living here!"
b. "I make this incredible salary, but there is nowhere here to spend it."
c. "The men seem to make all the health decisions."
d. "The clients keep asking me when I'm going to get married." - ANSWER-ANS: D
Salaries are lower, as is the cost of living in rural areas. Although she is a professional,
as a woman she would be expected to fulfill female roles, such as wife and mother, and
may be seen primarily in relation to her family relationships.
Questions and Answers
1. Which of the following descriptions is the most accurate example of a rural
community?
a. The residents of the community are subject to environmental hazards.
b. It takes longer than 30 minutes to get from the community to health care services.
c. The community has less than 20,000 residents.
d. The residents of the community say, "This is smaller than where I grew up." -
ANSWER-ANS: B
All of the descriptions could be used in an attempt to define "rural," but each aspect has
problems. A definition of "rural" has not yet been decided. However, in relation to health
care, the time needed to get to a health care facility has a major influence on care
outcomes.
2. What is the poverty rate in rural areas?
a. 10%
b. 20%
c. 30%
d. 40% - ANSWER-ANS: D
National estimates report that in rural areas, more than 40% of all families live below the
poverty level.
3. Why are children at risk on their own family's farm?
a. Children often help with the work without much regard for training or safety.
b. It is expected that children fulfill the roles that are assigned to them.
c. Machinery can injure someone faster than a parent can turn the machine off.
d. Parents are too busy completing their own tasks to supervise the children. -
ANSWER-ANS: A
Farming is one of the four most dangerous industries. Agricultural work is inherently
dangerous but also must be performed under adverse conditions such as mud or
extreme heat or cold. On family farms, spouses, children, and other relatives often help
without much regard to competency, training, or safety. Of all industries, agriculture has
by far the highest number of injuries and deaths among children.
4. An adolescent in a rural community has recently committed suicide. What is the
significance of this event in the community?
a. Rural residents are less religious than urban residents and less capable of coping
with the loss.
,b. Because of the size of the community, it is likely that no one will discuss what has
happened.
c. There could be a cluster of such deaths in small towns where everyone knows
everyone so well.
d. Without the adolescent to work, the family may have increased economic difficulties. -
ANSWER-ANS: C
Because of the cluster or "copycat" phenomenon related to self-inflicted death, in
several towns the suicide rate has reached epidemic proportions, with three or more
suicide incidents occurring in a very short time (after one suicide, there is an increased
incidence of additional suicides in a community). In small towns or rural areas, where
most people are fairly well acquainted, a sudden death can be devastating to students
and to the community as a whole.
5. What was one purpose of Rural Health Clinic (RHC) Public Law 95-210?
a. To define rural areas as underserved and therefore eligible for many tax reductions
b. To encourage utilization of advanced practice nurses by providing reimbursement for
their services under Medicare and Medicaid
c. To fund structures (building, equipment, supplies) for rural health care providers
d. To pay for physicians to serve in rural underserved areas - ANSWER-ANS: B
RHC Public Law 95-210 was originally passed by Congress in 1977. The law defined
core primary care, created reimbursement mechanisms, and encouraged utilization of
midwives and nurse practitioners, among others, by providing reimbursement even
without a full-time physician available. Reimbursement is based on cost so that
additional revenues to eligible rural practices can be generated.
6. A program to recruit advanced-practice nurses to practice in a rural community is
being developed. The program developers have applied to receive federal training
monies to help fund the costs of the program. Which of the following questions must be
addressed when they apply for these funds?
a. "Does the health of the clients improve as a result of interventions?"
b. "Have professional schools increased enrollment?"
c. "Are advanced-practice nurses taught to embrace rural cultural values?"
d. "Should improvements be made to the buildings and equipment at the agency?" -
ANSWER-ANS: A
Federal training dollars have been linked to program outcomes. The question of
whether the clients' health improves as a result of interventions is the only question that
addresses outcomes. For example, the goal is not simply to educate professionals but
to prepare providers who are capable and willing to increase access to care for
underserved and minority populations.
7. A family nurse practitioner is employed in a rural health clinic. What generalization
would the practitioner most likely be able to make about the local clients?
, a. "They carefully budget their money in order to afford health insurance."
b. "They define health as self-actualization of potential."
c. "They are fatalistic and oriented to the land, nature, and the seasons."
d. "They are open to sharing their problems and accepting my advice." - ANSWER-
ANS: C
Rural families are often fatalistic because both their work and their recreation are
dependent on the land throughout the seasons. They usually know everyone in the
community, keep their problems within the family, define health as the ability to fulfill
their work requirements, and are too poor for health insurance. These are, of course,
generalizations, to which there are many exceptions.
A new family nurse practitioner at the rural health clinic soon saw much strength in the
community. What might be some resources used and accepted by ill people in a rural
area?
a. Charity efforts that are publicized and coordinated by members of the nearby city
b. Family and friends who volunteer to help with food, cleaning, child care, and other
tasks
c. Use of the extended-care facility in the community until the ill person feels better
d. Care that is coordinated by social services and the public health agency - ANSWER-
ANS: B
Rural residents, many of whom are related to each other, typically accept help from
family, friends, and other community members with the understanding that someday
such help will be reciprocated. However, formal support from agencies cannot be
accepted because of the cost and inability to "pay back" for such support.
A nurse is working in a rural health clinic. Which of the following situations may cause
difficulties in maintaining confidentiality at the clinic?
a. Neighbors care about each other and will ask the nurse questions.
b. Neighbors recognize each others' cars in the clinic parking lot.
c. The nurse will want to share information in a quest to seek assistance for the client.
d. The nurse will have to use names in referring clients to other agencies for assistance.
- ANSWER-ANS: B
Most people in a small town are recognized by the car that they drive, so seeing the car
in the clinic parking lot can jeopardize confidentiality. Assumptions may be made about
anyone seen in the building, even if it is not to attend the clinic. Leaks in confidentiality
result from such chance encounters.
10. A new female family nurse practitioner employed at the rural health clinic became
very frustrated. What might be cause for complaint?
a. "I can't survive on this salary with the high cost of living here!"
b. "I make this incredible salary, but there is nowhere here to spend it."
c. "The men seem to make all the health decisions."
d. "The clients keep asking me when I'm going to get married." - ANSWER-ANS: D
Salaries are lower, as is the cost of living in rural areas. Although she is a professional,
as a woman she would be expected to fulfill female roles, such as wife and mother, and
may be seen primarily in relation to her family relationships.
