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Exam (elaborations)

Community Nursing Test Bank

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Which of the following best describes the primary reason that Americans are concerned about healthcare? a. Politicians are discussing how to improve health care. b. The media has provided mixed messages about the health care system. c. Our national health care costs keep increasing. d. The new health care system offers free services to Americans. ANS: C The primary reason for the focus on health care is the constantly increasing costs, which cannot be sustained. The costs of caring for the sick accounted for the majority of escalating health care dollars, which increased from 5.7% of the gross domestic product in 1965 to 17.6% in 2009. Politicians and the media both influence Americans’ perceptions about health care; however, they are not the primary reason why Americans are concerned. The new health care system will change the health care access and availablity, but will not necessarily be offering any free services to Americans. DIF: Cognitive Level: Understand (Comprehension) REF: p. 2 2. A nurse has begun to lobby with politicians for changes to the health care system. Why is this involvement important? a. Nurses, as central characters in several popular TV series, are currently very visible in American media. b. Nurses are primarily responsible for managing the various units in our health care system. c. Nurses are the largest group of health care providers. d. Nurses are the only group that is employed both inside and outside of hospitals. ANS: C As the largest group of health care providers, nurses are informed about the current health care system and all the problems that result from people not seeking care until they are desperately ill. Nurses, as the American Nurses Association (ANA) emphasize, usually believe that health care is a right, not a privilege. Therefore, nurses, whose work is central to our current health care delivery system, can also be instrumental in working politically to create a health care delivery system that will meet health needs. While nurses are in several current TV series and are employed both inside and outside of hospitals, physicians and other health care providers are as well. Nurses are often managers, but managers often have other backgrounds, such as business administration. DIF: Cognitive Level: Understand (Comprehension) REF: p. 2 3. What conclusion can be drawn from examining where nurses are employed? a. There is a trend toward consolidation of health care into large central medical centers. b. There is an increased emphasis on community-based health care. c. There is an obvious need to decrease health care costs by cutting positions. d. Managed care organizations (MCOs) are employing nurses to improve customer relations. ANS: B MCOs are employing nurses in many capacities. Although hospitals are closing and acute care is increasingly found in central medical centers, the same trend may be seen in an increase in neighborhood-based practice centers. While positions are cut in most industries, health care is recognized as an area where growth in employment is expected. However, nurses are increasingly employed in community settings as opposed to hospitals. This change reflects the move toward community-based care rather than hospital-based tertiary care. To help decrease the continued rise in health care costs, the increased emphasis is on disease prevention rather than high-cost treatment. DIF: Cognitive Level: Understand (Comprehension) REF: p. 2 4. Which ethical belief would be most helpful in the current health care crisis? a. Emphasis should be on individual and corporation freedom in the marketplace. b. Emphasis should be on individual autonomy and freedom of choice. c. Emphasis should be on social justice and collective responsibility. d. Emphasis should be on the effectiveness of technology in resolving problems. ANS: C Public health recognizes the necessity of collective action in keeping the environment safe and in egalitarian tradition and vision. An overinvestment in technology and seeking of cures within the market justice system has stifled the evolution of a health system to protect and preserve the health of the population. Although individual autonomy and freedom of choice are important, so is the recognition of collective responsibility in ensuring social justice, which entitles all people to basic necessities. DIF: Cognitive Level: Apply (Application) REF: p. 2 5. What is the primary problem seen in Healthy People 2020’s emphasis on choosing healthy lifestyle behaviors, such as daily exercise or healthy food choices? a. Emphasis on other lifestyle choices, such as not smoking and minimal use of alcohol or drugs, is also needed. b. All of us must work together to make unhealthy behaviors socially unacceptable. c. It costs more to make healthy choices, such as buying and eating fresh fruits and vegetables as opposed to quick and cheap fast-food choices. d. Public policy emphasizes personal responsibility but ignores social and environmental changes needed for well- being. ANS: D Although all responses are accurate, the primary problem is the emphasis on personal choices in the Healthy People 2020 objectives. Emphasis on personal choices ignores the need for community responsibility and action that addresses environmental or cultural restraints to health. DIF: Cognitive Level: Apply (Application) REF: p. 2 6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of the nurse beyond giving excellent care to patients? a. Accept longer work schedules to ensure that professional care is always available to clients b. Recognize the need for experienced nurses to mentor new graduates to help increase and expand the number of professionals available c. Support health legislation to improve accessibility and cost of health care d. Volunteer to work overtime as needed to ensure maximum quality of care ANS: C The ANA Code of Ethics promotes social reform by focusing on health policy and legislation to positively affect accessibility, quality, and cost of health care. The code does not directly address workplace issues, such as work schedules or need for overtime. DIF: Cognitive Level: Analyze (Analysis) REF: p. 2

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