33 - Poverty and Homelessness Flashcards

1
Q

Why is it difficult to know the exact number of homeless persons? (Select all that apply.)

a. ) Homeless people refuse to provide demographic information.
b. ) Many homeless people refuse to be interviewed.
c. ) It is difficult to generalize from one location to another.
d. ) Some persons experience short intervals of homelessness.
e. ) Homeless individuals are most likely hiding within the community.

A

b.) Many homeless people refuse to be interviewed.

c.) It is difficult to generalize from one location to another.

d.) Some persons experience short intervals of homelessness.

Those who are homeless are hard to find since they may sleep in boxcars, on building roofs, in doorways, or under freeways or pedestrian overpasses; temporarily stay with friends or family; refuse to be interviewed or deliberately hide the fact that they are homeless; have only short or intermittent episodes of being without a home; or may not fit in a general category.

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2
Q

A nurse is implementing an intervention at both the primary and tertiary levels of prevention. Which of the following best describes the nursing intervention?

a. ) Providing emergency shelter housing
b. ) Offering physical and mental health services
c. ) Developing a targeted case management program
d. ) Establishing a needle exchange program

A

d.) Establishing a needle exchange program

Establishing a needle exchange program could be considered both primary (preventing a problem before it occurs by helping clients avoid disease transmission) and tertiary (working with a population who already has a “problem” of drug abuse). Providing emergency shelter housing and offering physical and mental health services are both secondary and tertiary prevention interventions. Developing a targeted case management program is secondary prevention.

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3
Q

A community health nurse is caring for an individual who is experiencing crisis poverty. Which of the following characteristics would this individual most likely display?

a. ) Episodic homelessness
b. ) Physical disability
c. ) Mental disability
d. ) Drug abuse

A

a.) Episodic homelessness

Episodic homelessness is a characteristic of crisis poverty. Physical disability, mental disability, and drug abuse would be considered in persistent poverty.

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4
Q

A nurse is analyzing the media images that influence society’s beliefs about poor persons. Which of the following is the nurse most likely to see? (Select all that apply.)

a. ) Poor persons are often cast as lazy, shiftless folk.
b. ) Poor people are shown receiving food at soup kitchens.
c. ) Criminals are portrayed as poor, desperate persons.
d. ) Homeless people are seen sleeping on park benches.
e. ) Criminals are seen as individuals who have been discriminated against.

A

a.) Poor persons are often cast as lazy, shiftless folk.

b.) Poor people are shown receiving food at soup kitchens.

c.) Criminals are portrayed as poor, desperate persons.

d.) Homeless people are seen sleeping on park benches.

The media is a powerful influence on how people view poverty. Media images of persons who are poor influence and are influenced by cultural attitudes and values. Poor persons may be cast in negative ways by the media, which influences what we believe to be true about poor persons.

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5
Q

Which is a characteristic of persons living in poverty?

a. ) Longer life expectancy
b. ) Simple health problems
c. ) Higher rates of chronic illness
d. ) Fewer hospitalizations

A

c.) Higher rates of chronic illness

Not only do persons living in poverty have higher rates of chronic illness, but less access to care. They have a shorter life expectancy, more complex health problems, and hospitalization rates greater than those for persons with higher incomes.

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6
Q

A nurse is forced to evaluate his beliefs, values, and knowledge about poverty. Which of the following experiences most likely explains the situation the nurse is experiencing?

a. ) A client asking for a small amount of money at a clinic
b. ) Setting up a homeless shelter
c. ) Making a home visit to a home that is unkempt
d. ) Reading about poverty in a textbook

A

c.) Making a home visit to a home that is unkempt

Nurses’ behaviors in situations are influenced by their relationship with clients. It is important to evaluate clients and populations in the context of the environment to develop nursing interventions. Reading a book is not adequate. Setting up a homeless shelter or having a client ask for money does not force the nurse to self-reflect as much as when the nurse is in the client’s environment.

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7
Q

A nurse is trying to break down the barriers between the health care professionals and people who live in poverty. Which of the following actions should be taken by the nurse?

a. ) Maintain a strict professional demeanor
b. ) Call the client by name
c. ) Keep client appointments as scheduled
d. ) Smile and be friendly to clients

A

b.) Call the client by name

By calling the client by name, nurses can then begin the process of breaking down barriers of fear, isolation, uncertainty, and the unknown. It is important for the nurse to be a good listener, individualize care, and avoid making inappropriate assumptions about their needs. It is important to listen to the stories of their lives as well as examine social and cultural definitions and considerations related to poverty.

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8
Q

A nurse is referring to the federal income guidelines. Which of the following best describes why the nurse is completing this action?

a. ) To determine financial eligibility for government assistance programs
b. ) To calculate statistical occurrences in the community
c. ) To identify those with inadequate resources for basic needs
d. ) To provide guidelines for reform of social programs

A

a.) To determine financial eligibility for government assistance programs

Federal income guidelines are used primarily to determine financial eligibility for government assistance programs. The Poverty Threshold Guidelines are used primarily for statistical purposes. The federal income guidelines do not identify those with inadequate resources for basic needs or provide guidelines for reform of social programs.

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9
Q

Which statement regarding the effects of homelessness on health is accurate?

a. ) Peripheral vascular disease and hypertension are lessened by this lifestyle.
b. ) The incidence and virulence of infections are decreasing.
c. ) Trauma is a significant cause of death and disability.
d. ) Crowded living conditions result in decreased risk for exposure to infections.

A

c.) Trauma is a significant cause of death and disability.

Intended and unintended injuries such as traumas are a significant cause of morbidity and mortality in the homeless. Those who are homeless are at greater risk for peripheral vascular disease and hypertension. Because of their poor living conditions, a minor skin injury or infections left untreated can result in widespread infection.

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10
Q

A nurse is working with a family who has an income above the federal income guidelines, but is unable to meet their living expenses. Which of the following terms best describes this family?

a. ) Persistent poverty
b. ) Near poor
c. ) Impoverished
d. ) Neighborhood poverty

A

b.) Near poor

The near poor are persons and families whose income is above the federal income guidelines but insufficient to meet living expenses. Persistent poor refers to individuals and families who remain poor for long periods and who pass poverty on to their descendants. Neighborhood poverty refers to geographically defined areas of high poverty, characterized by run-down housing, high unemployment rates, and poorer health outcomes. Impoverished refers to those living in poverty.

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11
Q

A nurse is discussing eligibility for federal food assistance with a family. Which federal guideline would a nurse refer to when considering financial eligibility?

a. ) Poverty Threshold Guideline
b. ) Consumer Price Index (CPI)
c. ) Federal Income Poverty Guideline
d. ) Temporary Assistance to Needy Families (TANF)

A

c.) Federal Income Poverty Guideline

The Federal Income Poverty Guideline is issued by the U.S. Department of Health and Human Services and is used to determine if a person or family is financially eligible for assistance or services from various federal programs. The Poverty Threshold Guidelines are used primarily for statistical purposes. The CPI is a measure of the average change over time in the prices paid by households for a fixed market basket of consumer goods and services. TANF is a program, not a guideline, that assists families in need.

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12
Q

Which statement about homelessness is true?

a. ) Homeless persons are not found in rural areas.
b. ) Gentrification can lead to homelessness.
c. ) Deinstitutionalization led to a small number of homeless.
d. ) Community-based clinics provide much needed health care.

A

b.) Gentrification can lead to homelessness.

When urban housing is upgraded, the supply of low-income housing drops. It is often said that when neighborhoods were “gentrified” or upgraded, they reduced the ability of the poor people to live in them because they became unaffordable for poorer former residents. Homeless can be found in both rural and urban areas. Deinstitutionalization of the chronically mentally ill individuals from public psychiatric hospitals in the 1980s increased the number of homeless persons. After this happened, federal and state governments failed to allocate the needed funds to provide community-based services.

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13
Q

A nurse is trying to provide effective nursing care to poor persons, families, and populations in a variety of settings. Which of the following actions should be taken by the nurse?

a. ) Move to the area where people are living to understand their plight
b. ) Understand the concept of poverty on many levels
c. ) Take a trip abroad to see how poverty exists in other countries
d. ) Become fully immersed in the concept of poverty for at least a year

A

b.) Understand the concept of poverty on many levels

Understanding the concept of poverty with historical, social, political, economic, biological, psychological, and spiritual dimensions is the first step in providing effective care to this population. It is not necessary to move to the area, take a trip abroad, or become immersed in the concept of poverty in order to provide effective nursing care to this population.

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14
Q

A person is already homeless and is receiving shelter. Which type of housing is being used?

a. ) Low income
b. ) Supportive
c. ) Emergency
d. ) Adequate

A

c.) Emergency

Emergency housing is shelter for persons who are already homeless. These shelters typically are only open at night and in many cities only on extremely cold nights.

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15
Q

A nurse is providing secondary prevention when working with the homeless. Which of the following best describes what is being implemented?

a. ) Employer incentives
b. ) Safe sex education
c. ) Comprehensive case management
d. ) Soup kitchens

A

d.) Soup kitchens

Secondary preventive services target persons on the verge of homelessness as well as those who are newly homeless. An example of secondary prevention is a soup kitchen. Employer incentives and safe sex education are primary prevention strategies; comprehensive case management is a tertiary prevention strategy.

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16
Q

A nurse is providing primary prevention when working with the homeless. Which of the following best describes what is being implemented?

a. ) Providing emergency housing aid
b. ) Creating drug and alcohol treatment options
c. ) Offering effective job training programs
d. ) Evaluating comprehensive case management programs

A

c.) Offering effective job training programs

Offering effective job training programs is an example of primary prevention—attempting to prevent the problem before it occurs. Emergency housing is secondary prevention. Drug and alcohol treatment and comprehensive case management are tertiary preventions.

17
Q

A nurse is providing care to populations who are from different socioeconomic and cultural backgrounds. Which of the following barriers should the nurse be aware of that may prevent full engagement in a relationship?

a. ) Fears and misconceptions related to poverty
b. ) Lack of tangible and emotional resources
c. ) Lack of knowledge about people who live in poverty
d. ) Perception that the poor don’t need to be poor

A

a.) Fears and misconceptions related to poverty

Fears and misconceptions of nurses related to poverty is a barrier that may prevent nurses from fully engaging in relationships with people who come from different socioeconomic and cultural backgrounds. It is important for the nurse to be a good listener, individualize care, and avoid making inappropriate assumptions about their needs. It is important to listen to the stories of their lives as well as examine social and cultural definitions and considerations related to poverty.

18
Q

A nurse is conducting a community assessment in a poor neighborhood. Which of the following is the nurse most likely to find?

a. ) Fewer minority groups
b. ) Increased exposure to environmental hazards
c. ) More available health care services
d. ) Lower rates of crime and substance abuse

A

b.) Increased exposure to environmental hazards

Poor neighborhoods are more likely to have exposure to environmental hazards. Lower socioeconomic neighborhoods have been linked with poorer general health status, chronic conditions, mortality, birth outcomes, disability, injury and violence, and other health indicators. They are more likely to have higher rates of crime and poorer access to health care services.

19
Q

The public health nurse (PHN) is taking care of a poor family, whose parents, grandparents, and great-grandparents also have been poor. Which of the following terms best describes this family?

a. ) Near poor
b. ) Persistent poor
c. ) Impoverished
d. ) Neighborhood poverty

A

b.) Persistent poor

Persistent poor refers to individuals and families who remain poor for long periods and who pass poverty on to their descendants.

The near poor are persons and families whose income is above the federal income guidelines but insufficient to meet living expenses.

Neighborhood poverty refers to geographically defined areas of high poverty, characterized by run-down housing, high unemployment rates, and poorer health outcomes.

Impoverished refers to those living in poverty.

20
Q

The community health nurse is caring for a client who is living in persistent poverty. Which of the following best describes this client?

a. ) Severe mental illness
b. ) Transient homelessness
c. ) Victim of domestic violence
d. ) Temporary housing

A

a.) Severe mental illness

Those who are in persistent poverty typically are older, with physical and mental disabilities, alcohol and other drug abuse, severe mental illness, chronic health problems, and significant family difficulties. Transient homeless persons, victims of domestic violence, and persons with temporary housing would be considered in crisis poverty.

21
Q

Which group has the highest rate of poverty?

a. ) Children
b. ) Teenagers
c. ) Women
d. ) Older adults

A

a.) Children

In 2012, 21.6% of those 18 years or less were living in poverty. Poverty is highest among children, and in 2012, it was 21.8% higher than any other age group.

22
Q

A nurse is planning to assist homeless clients at a local shelter with finding community resources to meet their health care needs. Which of the following actions should the nurse take before interacting with this population?

a. ) Change personal views about homelessness
b. ) Understand the concepts of homelessness
c. ) Receive special training about where to locate homeless people
d. ) Have experience in mental health nursing and counseling

A

b.) Understand the concepts of homelessness

To implement effective nursing interventions for homeless clients, nurses need to be aware of their own beliefs and values about the homeless as well as understand the concepts of homelessness.

23
Q

A nurse refers a client to an assistance program that requires the individual to find a job and/or enroll in job training program. Which program is being used?

a. ) Aid to Families with Dependent Children (AFDC)
b. ) Medicaid
c. ) TANF
d. ) Women, Infants, and Children (WIC)

A

c.) TANF

TANF requires participants to find jobs and/or enroll in job training programs. The current TANF program was formerly called AFDC.

Medicaid provides health insurance to poor families, but does not require participants to find jobs.

WIC provides food vouchers entitling participants to free nutritious foods and infant formulas from local grocers, but does not require participants to find jobs.

24
Q

A nurse is working in the community during the industrial revolution. Which of the following population groups would have been least likely to receive community assistance?

a. ) Widowed women
b. ) Orphaned children
c. ) Mentally ill
d. ) Injured laborers

A

c.) Mentally ill

Mentally ill individuals were considered undeserving poor and did not receive any community assistance. Widowed women, orphaned children, and injured laborers were deserving poor because their poverty was considered to be beyond their control.

25
Q

Which factor influences the growing number of poor persons in the United States?

a. ) Increase in company earnings
b. ) Changes in the labor force
c. ) Better access to quality education
d. ) Adequate welfare benefits

A

b.) Changes in the labor force

Changes in the labor force affect the growing number of poor persons in the United States. Decreased company earnings, decreased access to education and job skills, and inadequate welfare benefits also influence the growing number of poor persons.

26
Q

Which statement about poverty is true?

a. ) All cultures view poverty as a pitiful existence.
b. ) Most cultures want to improve the plight of the poor.
c. ) Dangerous environments are present in all cultures.
d. ) Western cultures view poverty negatively.

A

d.) Western cultures view poverty negatively.

The meaning of poverty differs across cultures. Western cultures view poverty negatively, whereas other cultures often respect the poor.

27
Q

Which statement about poor people living in the seventeenth century is accurate?

a. ) They were likely alcoholics or prostitutes.
b. ) They were ashamed to be living in poverty.
c. ) They traveled from community to community for food and shelter.
d. ) They would be given assistance by their community.

A

d.) They would be given assistance by their community.

The Elizabethan Poor Laws began in seventeenth-century England by helping the poor receive help within the boundaries of their original community. Needy travelers would not be helped and were sent back to their original community where they would be helped by their own folk. It was no disgrace to live in poverty because nearly everyone was poor.

28
Q

The original goal of deinstitutionalization was to:

a. ) reduce state costs of caring for the chronically mentally ill.
b. ) replace state psychiatric hospitals with community-based treatment programs.
c. ) modernize psychiatric hospitals.
d. ) allow mentally ill persons to live on their own to test their life skills.

A

b.) replace state psychiatric hospitals with community-based treatment programs.

The original goal was to replace large psychiatric hospitals with community-based treatments centers. However, federal and state governments failed to allocate the needed funds.