Exam 2 V1: NSG 3480 / NSG3480 (Latest 2026 / 2027) Nursing Practice – Community Health | 100% Correct Questions & Answers - Galen

Exam 2 V1: NSG 3480 / NSG3480 (Latest 2026 / 2027) Nursing Practice – Community Health | 100% Correct Questions & Answers - Galen Question: When outbreak of disease occurs, the nurse uses the three elements to inquiry to an explanation of disease. What is the model of investigation called? What are the 3 elements in the model? Answer The epidemiological triangle Agent, host, and environment Question: What is the web of causation? Answer Illustrates the complexity of relationships among causal variables of diseases Question: What is wheel model of epidemiology? Answer Multiple causes of host and environmental interactions for health problems and id's factors which are amenable to intervention Question: Dr. Snow gave an example of the epidemiological approach to solving when a disease began, what did he do? Answer He analyzed the distribution of person, place, and time with geographics/demographics sectors Question: How do we get morbidity rate along with incidence and prevalence rates? Answer 1. Compare the current rate/previous rate of disease... 2. Incidence rate is the occurrence of new cases of a disease or condition in a community over a given period. 3. Prevalence rate is the number of all cases of a specific disease or condition in a population Question: Under analytic epidemiology, what is the difference between observational, cross sectional, retrospective and prospective studies? Answer 1. Observational studies - observe disease rates in groups differentiated by exposure or experience, do not allow manipulation 2. Cross-sectional studies - examine relationships between potential causal factors and diseases at a specific time, can only make associations, impossible to make causal inferences bc they cannot establish temporal sequence of events 3. Retrospective studies - compare individuals with condition or disease and those who do not have it, data collection extends back in time 4. Prospective studies - monitor a group of disease-free individuals to determine whether or when a dz occurs Question: In decreasing global infections, what could be a low-cost strategy in treatment of disease? Answer Immunization is the most powerful and cost-effective strategy at our disposal for many infectious disease Question: What is the term: market-based healthcare system? (profit or not for profit) Answer More profit, creates more capital in treating disease, focuses on curative vs preventative factors Question: Do larger populations create problems? Answer Yes, they create pressures along with overcrowding leads to pollution, stress, disease, and violence which leads to a barrier to economic growth Question: What are the United Nations (UN)? What does the UN decisions seek? Answer 193 member nations committed to world peace and security through international cooperation and attempts to resolve global conflicts and formulates political systems UN decisions seek to reflect world opinion and the moral authority of the community of nations Question: Declaration of the Alma-Ata is defined as what? Answer ...define- health which is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important worldwide social goal. Question: In the private sector, what is central? Answer 1. Private sector - economics and business management is central with swift and proactive decisions, needs are determined by consumerism, market trends, and economics 2. Public sector - ruled by social and political theories and issues and decisions are slow, needs are determined by voting shifts, electoral realignment, and term limits Question: In private health policy, what is largely focused on? Answer Individuals while public health focus on populations Question: What is the critical step which defines the issue in policy formulation? Answer Defining the issue or describing the problem and placing it on the legislative agenda Question: Who should be involved in the role model of political activities? Answer Role models are typically the major influence on nurses choosing to become politically active Question: What is PAC? What do they vote on as a group? Answer Political Action Committees Nonpartisan entities promote the election of candidates believed to be sympathetic to their interests. Question: In the rising cost of health care, all the emphasis was placed on illness care, providers received a fee only when service was given, and all cost of services were__________. Answer reimbursed Question: The Affordable Care Act (ACA) aims to ensure than when coverage for mental health and substance use conditions is provided, it is generally comparable to what? Answer medical and surgical care Question: What is the first step a nurse can do in preventing the spread of disease? Answer Hand hygiene Question: What is a cold chain? Answer System used to ensure vaccines are kept at right temp from manufacturing time until use Question: What are the vaccine hypersensitivities and contraindications? Answer A. minor and common side effects - redness or pain at injection site, mild fever B. adverse reactions - are not common but can occur C. allergies - check pt allergies before administration of specific vaccines D. mild illness - not a contraindication but should be postponed to avoid confusion b/w side effect and illness E. pregnancy - not a contraindication but avoid live vaccines including MMR, varicella, yellow fever unless risk for getting one of those F. immunocompromised patients - do not give live vaccines, inactive vaccines can be given but may not produce optimal antibody response Question: What do you do if more than one vaccine is being administered simultaneously? Answer Use different anatomical sites Explain the benefits and risks of a vaccine to vaccine recipients, their parents, or their legal representative? (First action to given vaccines) Answer Biological rather than chemical, can produce a variety of responses, both positive and negative, given to prevent illness and not treat it What is on vaccine documentation? Answer Patient name, dates immunized, vaccine type, manufacturer, lot number, date of the VIS, and name, title, and address of person administering the vaccine What is herd immunity? Answer Those not immune to an infectious agent are protected if a certain proportion (usually 80%+) have been vaxxed or otherwise immune. What if the vaccine is exposed to high or lower temperatures? Loss of potency and vaccine failure To breaking the chain of transmission, to control the human reservoir: what do you do? quarantine What is the host, agent, and environment (Chain of Transmission)? Host - infected person Agent - infection or disease cause Environment - where it survives What type of acquired immunity is breast feeding? passive What is control of a communicable disease? Reduction in incidence (new cases) or prevalence (existing cases) rates of a given disease to a locally acceptable level Healthy People 2020 and CDC...what are STDs that are reportable to the CDC? Chlamydia, gonorrhea, and syphilis Cultural perspectives and Healthy People 2020 set goals to do what? Eliminate racial and ethnic disparities, set goals to improve the quality and increase the years of healthy life for all Americans With the increased number of immigrants, what are the standards for culturally competence? Create a relationship of mutual respect by becoming aware of cultural differences and similarities, use a guideline for cultural data to id significant ideas of difference, and know biocultural variations in health and illness Under HUD's definitions of homelessness, there are 4 different categories. Which one describe losing their primary nighttime residence? Who resided in emergency shelter? Attempting to flee, domestic violence, dating violence? Category 1: literally homeless, no nighttime residence, reside in emergency shelter Category 4: attempting to flee What are the factors to contribute homelessness? Shortage of affordable housing, income insufficiency, lack of quality and quantity of support services. None of these infer "causation" but are factors that may contribute. List individuals (chronically homeless) with the highest risk of death, who have been homeless for 6 months or more with one or more of the following features. There are 10 of them: 1. more than 3 hospitalizations or ER visits in a year 2. more than 3 ER visits in the past 3 months 3. 60+ yrs 4. cirrhosis 5. end-stage renal disease 6. hx of frostbite, immersion foot, or hypothermia 7. HIV/AIDS 8. co-ocurring psyc, sub abuse, and chronic medical conditions 9. suicide 10. drug or alcohol abuse What are the concerns with health risk, injury, and death in rural area? 1. Rural teens are = or more likely to be victims of violent bx, to engage in suicide bx, and to use drugs. In the South, more likely to be obese, smoke, engage in sedentary lifestyle 2. Nonfatal firearm injuries happen at home mostly, suicide in rural areas is a public health concern, unintentional injuries occur mostly in males aged 15-24 3. Death from unintentional injuries is high, death is 80-85% higher for females What are the acute and chronic illnesses associated with farmers work (respiratory illness, contaminated clothing and boots, etc.)? Long-term grain dust exposure = resp fx and frequency of resp symptoms Occupational asthma and more exotic fungal related conditions are Exposure risk to children are higher since farmers wear work boots inside, etc Acute pesticide poisoning (headache, N/V, sweating, dizziness that occurs during spraying season) What is human trafficking? What are the barriers in victims seeking help with healthcare? 1. Human trafficking is a global problem and public health issue both domestically and internationally, modern-day form of slavery involving illegal trade of people for exploitation. 2. Afraid of deportation, phoning CPS if it is a child, families may be harmed if organized crime is involved What are the risk factors in suicide? The rate of suicide is higher in what race? Highest in Whites Hx of depression, alcohol or sub abuse, physical illness, past hx of suicide, past hx of violence, age, environmental stressors Physical and behavioral indicators of child abuse and neglect; what are some behavioral indicators for? a. sexual abuse - neg self-esteem, inability to trust or fx in intimate relationships, cog/motor dysfunction, deficits in personal and social skills, unusual sexual bx or knowledge, delinquent or runaway bx, SI, reporting sexual assault b. physical abuse - wary if adult contact, apprehensive when other children cry, constantly on alert, extreme bx (aggressive or passive and withdrawn, or overly friendly to strangers), frightened of parents, afraid to go home c. physical and emotional neglect - begging or stealing food, alone for prolonged or inappropriate times, delinquent bx, stealing, arriving early or departing late from school, lack of affection d. emotional abuse - bx extremes from passive to aggressive, habit and conduct d/o's, neurotic traits, attempting suicide What do gangs use to control the community? Use violence and increase illegal money-making activities, which include robbery, fraud, drug, gun trafficking, prostitution, and human trafficking Why do young people join gangs? Belief that gangs will protect them, peer pressure, and need for respect and sense of belonging In the healthcare field, nurses and nurses' aides are subjected to violence... a. In what department? ER, psyc units, geriatric units, and waiting rooms b. What are the negative affects? Low morale, job stress and turnover, trust of mgmt. and coworkers, and hostile work environment c. What are the examples of risk factors? Working in high crime areas, working alone or isolated, availability of drugs at the worksite, low staffing, poorly lit parking lots, long waits, inadequate security, number of people who use substances, and access to firearms What are the interventions in prevention of violence? a. Primary - stop violence before it occurs, education plays a large role (life-skills training like family wellness, anger mgmt., etc) b. Secondary - assess, dx, and tx victims and perpetrators of violence c. Tertiary - rehab of individuals Define violence. Intentional use of physical force or power, against oneself or another which results in or may result in injury, death, harm, maldevelopment, or deprivation Epidemiology the study of the distribution and determinants of health and disease in human population Three Elements of the Epidemiological Triangle - Agent: actual cause of disease - Host: carrier of disease - Environment: any outside factors Use of Epidemiology in Disease Control and Prevention PERSON: "Who" factors, such as demographic characteristics, health, and disease status PLACE: "Where" factors, such as geographic (data) location, climate and environmental conditions, and political and social environment TIME: "When" factors, such as time of day, week, or month and secular trends over months and years Wheel Model of Epidemiology The wheel model stresses the multiplicity of host and environmental interactions have developed and understanding of disease has progressed. Which is better the triangle or the wheel? The Wheel Model subscribes to multiple-causation disease theory; therefore, it is MORE USEFUL for analyzing complex chronic conditions and identifying factors that are amendable to nursing intervention. Web of Causation Model In essence, the web of causation model is better at showing the relationships among variables. Incidence rates describe the occurrence of new cases of a disease or condition in a community Prevalence rate is the number of all cases of a specific disease or condition in a population at a given point in time Meaningful Comparisons The community nurse compares data with rates from other cities, counties, districts, or states; from the nation; and from previous records. SHOWS TRENDS Risk probability of an adverse event Risk factor any action or condition that increases the likelihood of injury, disease, or other negative outcome Descriptive Epidemiology - Focuses on the amount and distribution of health and health problems within a population - The purpose is to describe the characteristics of both people who are protected from disease and those who have a disease. Analytic Epidemiology investigates the causes of disease by determining why a disease rate is lower in one population group than in another. Observational Research Study discover the etiology of disease Cross-sectional studies (Observational) sometimes called prevalence or correlational studies, examine relationships between potential causal factors and disease at a specific time. Retrospective studies (Observational) compare individuals with a particular condition or disease and those who do not have the disease. Data collection extends back in time to determine previous exposure or risk factors. Prospective studies (Observational) monitor a group of disease-free individuals to determine whether and when disease occurs. Experimental Research Study test treatment and prevention strategies. Experimental - receives intervention Control - received placebo World Health Organization (WHO) primary role is to direct and coordinate international health efforts, disseminate global health stands and guidelines, and help countries address public health concerns within the United Nations system Pan American Health Organization (PAHO) to improve the health and living standards of the Americas. United Nations seek to reflect world opinion and the moral authority of the community of nations UNICEF to address the needs of children and women throughout the world World Bank to improve the health status of individuals living in area that lack economic development. Centers for Disease Control (CDC) to protect the health and safety of all Americans and for providing essential human services. The CDC was founded in 1946 to help control malaria Effects of Large Population Malnutrition, famine, disease, overcrowding, pollution, stress, violence, death the poor suffer disproportionately Goal of the World Health Organization (WHO) - HEALTH FOR ALL - Defined as the attainment by all citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. - Keeps getting pushed back cause the world sucks - Outlined in the Declaration of Alma-Ata - Health is a fundamental human right What makes the CDC different? applies research and findings to improve people's daily lives and responds to health emergencies Commodification of Healthcare USA has market-based system which results in curative care instead of preventative for bigger profits more people that get diabetes = more money for big pharma Policy denotes a course of action to be followed by a government, business, or institution to obtain a desired effect Public policy denotes precepts and standards formed by governmental bodies that are of fundamental concern to the state and the whole of the general public Health policy is a statement of a decision regarding a goal in health care and a plan for achieving that goal Nursing policy specifies nursing leadership that influences and shapes health policy and nursing practice Institutional policy rules that govern worksites and identify institution's goals, operation, and treatment of employees Public vs Private Health Policy private is about money and consumerism public is about social and political factors as well private insurance is greedy; public is for poor people so it can't be What makes nurses interested in politics? Role models Nurses and Political Action Committees (PAC) - Have been important sources of collective political influence since the 1970's. - These nonpartisan entities promote the election of candidates believed to be sympathetic to their interests. - The advantage of a PAC is that small donations from many members add up to a significant donation to a campaign fund in the name of the organization. - The disadvantage of a PAC is the financial contributions for special-interest legislation. However, as long as PACs are a reality of political life, nurses need to recognize their power and support those that are committed to electing candidates sympathetic to health care issues. Hill-Burton Act of 1946 Authorized federal assistance in the construction of hospitals and health centers with stipulations about services for the uninsured Tax Equity and Fiscal Responsibility Act of 1982 This law changed health care radically by introducing a new reimbursement method Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 It requires all hospitals with emergency services that participate in Medicare to treat any client in their emergency services, whether of not that client is covered by Medicare or has the ability to pay. Also. Employers who terminate an employee must continue benefits for the employee and dependents for a specified period if the employee had health benefits before the termination Health Amendment Act of 1956 Authorizes funds to aid registered nurses (RNs)in full-time study of administration, supervision, or teaching. As a result, in 1964, the Nurse Training Act provided funds for loans and scholarships for full-time study for nurses and funds for construction of nursing schools Occupational Safety and Health Act of 1970 Focuses on the health needs and risks in the workplace and environment Health Insurance Portability and Accountability Act (HIPAA) of 1996 The law offered protections for patient privacy and confidentiality Welfare Reform Act of 1996 Decreased the number of people on welfare and forced many individuals to take low-paying jobs, many of which do not offer health insurance The State Child health Improvement Act (SCHP) of 1997 Providing insurance for children and families who cannot afford health insurance Medicare Modernization Act of 2003 Provided seniors and people living with disabilities some prescription drug benefit coverage, more choices, and better benefits Nurse Reinvestment Act of 2003 It is a response to critical nursing shortage. Funding is provided to increase enrollments and the number of practicing nurses. Patient Protection and Affordable Care Act of 2010 (Health Care Reform Act) One of the primary intents of the act is to reduce the number of uninsured Americans. Induced significant insurance changes: 1. Established high-risk pools to provide health coverage to individuals with preexisting conditions. 2. Prohibits insurers from placing lifetime limits on the dollar value of coverage. 3. Prohibits insurers from disallowing coverage for some individuals because of preexisting health conditions and dropping policyholders whey they get sick 4. Requires health plans to provide some types of preventive care and screenings without consumer cost-sharing. Steps in Policy Formulation and Analysis MOST CRITICAL STEP defining the issue or describing the problem and placing it on the legislative agenda Health policy analysis determine those who benefit and those who experience a loss as the result of the policy. | These considerations are critical in order to develop health policies that are as fair as possible to all who are affected. | Then legislation is finalized, typically developed by legislative staff. Do we need more nurses in politics? Yes PUSH EDUCATION 1/44 female voters is RN Department of Agriculture administers the inspection of meat and milk and provides funds for the Women, Infants, and Children (WIC) program, the food stamp program, and the school-based nutrition program. Local Health Department Subsets - Community health services includes control of communicable disease. - Environmental health services include food hygiene such as inspection of food-producing and food-processing plants and restaurants, protection hazardous substances. - Personal health services provide care for individuals and families in clinics, schools, and correctional institutions. - Mental health services are supported by funds offered by local and regional mental health and mental retardation facilities and programs Hospital Reimbursement For Medicare a classification system that identified costs according to diagnosis and client characteristics - diagnosis-related groups (DRGs) rather than on the treatment provided. Lack of Preventive Care Until recently, little to no incentive has existed to prevent illness or promote health. - Soaring health care costs and an improved knowledge of health have heightened the public's awareness of their obligation to assume responsibility for their health by amending many unhealthy behaviors. Health Care Fraud and Abuse - False Claims Act Amendments of 1986, which allow private citizens to collect a percentage of recovered funds if they report fraudulent Medicare claims and monies are recovered as a result. - The Health Insurance Portability and Accountability Act (HIPAA) contains a set of provisions that address fraud. Including a Fraud and Abuse Control Program, the Medicare Integrity Program, and the Health Care Fraud and Abuse Data Collection Program. Each of these programs is designed to address concerns over health care fraud. Medicare federal entitlement program that is totally funded by a combination of payroll taxes, general federal taxes and beneficiary premiums. The program is intended: • Help cover the costs of health care for people 65 year of age and older • Help people who are disabled • Help people who has end-stage renal disease • Help people who has been diagnosed with amyotrophic lateral sclerosis (ALS). Medicaid a public welfare assistance program that was initially designed to finance health care coverage for the indigent. - Eligibility for this program, a joint venture with state and federal funding, is determined by each state. - Medicaid was intended to focus benefits to children, pregnant women, the disabled, and impoverished elders. This changed dramatically, however, with implementation of the ACA, as funds were made available to provide health care for all adults below the poverty line - within states that elected to participate.