Exam 2 Flashcards
(149 cards)
1
Q
Employers, professional organizations, nonprofit health care organizations, for profit corporations that deliver, insure or fund health care services
A
Members of the private health sector
2
Q
Lobbying to improve community health care is an example of this nurse role
A
Advocacy
3
Q
Tool used to gather information following environmental exposure
A
IPREPARE
I—Investigate potential exposures
P—Present work
R—Residence
E—Environmental concerns
P—Past work
A—Activities
R—Referrals and resources
E—Educate
4
Q
Term refers to the rate at which a new event occurs over a specified period of time
A
Incidence rate
5
Q
one way in which case manager assists clients in discharge planning is?
A
coordinate of health care needs
6
Q
what is the epidemiological model that de-emphasizes the agent in explaining disease, but provides for multifactorial causes that transverse various pathways
A
web of causation
7
Q
clients over 65 y/o with ESRD and those with a disability, ALS
A
people eligible for medicare
8
Q
clients whom are pregnant, disabled, low income elderly
A
those eligible for medicaid
9
Q
provisions of the affordable care act include?
A
-expands coverage for low income families
-coverage up to 26 if in school
-coverage for birth control
-removal of pre existing clause
-expansion of preventive care
10
Q
this report stated the nurses should practice to the full extent of their education
A
future of nursing
11
Q
what component of medicare covers prescription drugs
A
part D
12
Q
what component of medicare covers inpatient hospital stays
A
part A (hospital insurance)
13
Q
the predominant type of payment for healthcare prior to the 1930s
A
fee for service
14
Q
first line or point of access medical care controlled by providers and focused on the individual
A
primary care
15
Q
respecting and understanding values and beliefs of a certain culture group
A
cultural competence
16
Q
connections b/t people and their environment
A
the built environment
17
Q
what component of Medicare covers outpatient provider appointments (additional purchase, monthly fee)
A
part B
18
Q
this air pollutant causes worsening respiratory symptoms, frequent asthma related medication use, decrease lung function recurrent health care utilization and increased mortality
A
particulate matter
19
Q
drinking water is monitored by which governmental agency
A
EPA
20
Q
this causes an estimated 21,000 lung cancer deaths in the US yearly and is the 2nd leading cause of lung cancer after active smoking
A
radon exposure
21
Q
assessment, communication, and management are all part of ?
A
core environmental health competencies
22
Q
most important factor in socioeconomic status
A
education
23
Q
method of healthcare delivery designed to reduce unnecessary use of services, improve cost and ensure quality
A
managed care
24
Q
what disease is growing in prevalence in developed nations
A
cardiovascular disease
25
essential services that support a healthy life
primary health care
26
federal organization that works to improve SAFETY & QUALITY of the healthcare system
Agency for Healthcare Research and Quality (AHRQ)
27
this term is the proportion of a population who have specific characteristic in a given time period
prevalence rate
28
funding for federal health related service is through ?
DHHS (department of health and human services)
**2nd largest federal department/ 2nd largest funding
29
a person's way of perceiving, evaluating, and behaving within his/her world. Determines his/her values, beliefs, practices
culture
30
approval of new drugs is regulated by which level of government
federal government
31
primary focus of case management in the community setting is on what type of client ?
high cost, high need
32
care delivered through coordinated interdisciplinary team that is cost effective and client centered
medical home
33
term refers to the measurement of the number of deaths that occur within population over a specific period of time
crude rate
34
form of primary prevention that could reduce communication disease worldwide
immunizations
35
the first nursing epidemiologist to collect and analyze data about health services to improve public health
Florence Nightingale
36
most personal health services are provided by?
private sector
37
Leininger's culture universal's general theme
there is a commonality of values and norms in all cultures
38
understanding personal culture values and beliefs is important at what time ?
when providing care for clients with different cultural background
39
this model explains infectious disease by examining the host, agent, and environment
epidemiology triangle
40
what disease is growing in prevalence in developing nations
infectious disease
41
inpatient discharge planning begins when?
upon admission
42
which group is more likely to experience health disparities in the US
minorities and lower socioeconomic class
43
largest health threat faced by developing nations
population growth
44
information critical for the community case manager to have should include
community resources
45
level of government responsible for financing of healthcare services
state government
46
public health refers to?
efforts organized by society to protect, promote, and restore people's health
47
what are the 3 levels of government
state, local, federal
48
what agency responds to health emergencies?
center for disease control (CDC)
49
a bill starts with what?
an idea!
50
which entity has higher authority
(county court, state Supreme Court, state circuit court, Supreme Court)
Supreme Court
51
what does the nursing profession need to promote nursing's policy agenda?
leaders with a vision for change
52
which model is used to determine if a common environmental factors exist? also determines if differences in living environment influence disease development
person-place-time model
53
In 2022, the journal science reported that a study of women in Finland indicated that having sons shortened the life spans of mother by about 34 weeks per son, but that daughters helped to lengthen the mother's lives. data came from church records from the period 1640 to 1870... what type of study does this describe?
retrospective
54
what mnemonic is used to help organize documentation after an environmental exposure?
iprepare
I—Investigate potential exposures
P—Present work
R—Residence
E—Environmental concerns
P—Past work
A—Activities
R—Referrals and resources
E—Educate
55
what does DRG stand for?
diagnostic related groups
56
what does medicare part A provide?
hospital insurance
57
DRGs (diagnostic related groups) categorize patients by
according to similarity of diagnoses
(also based on procedure, age, gender)
58
with a prospective payment system, the amount of money that will be paid for health services is decided:
before the care is provided
(costs according to diagnosis)
59
anyone who is bilingual and willing can be used as a medical interpreter, T or F
false
60
it's important for the nurse case manager to have ..
knowledge of available resources
61
in the epi triangle what is the cause of disease or the causative organism
agent
62
what protects health care privacy?
HIPPA
63
the nursing shortage is:
a health care crisis
64
nurse may have political roles as
change agents, lobbyist, public office
65
states are responsible for:
the finance and delivery of health services
66
components of the health care system are:
private subsystem and public subsystem
67
which of the following are part of the private health care system? (CDC, March of Dimes, USDHHS, FEMA)
March of Dimes
68
the US constitution mandates what?
the promotion of general welfare of its citizens
69
quality care is designed to:
contribute to the betterment of populations
70
the current US health care system is:
fragmented and uncoordinated
71
most services to group or individuals occur at which level (state, federal, national, local)
local level
72
which is a federal level subsystem? (managed care organization, non profit hospital, state health dept., Kroger minute clinic)
State Health Dept
73
the high cost of health care may be attributed to:
societal beliefs
74
this describes a government step to stop constantly rising costs
reimbursement based on diagnosis versus treatment
75
who is medicare for?
for individuals over 65
76
the federal government mandates services, but the state may...
exceed federal mandates
77
what has been a powerful and cost effective resource for preventing many infectious diseases?
immunizations
78
a major step for health care reform in 2010 was:
the Affordable Care Act
79
the role of public health nurse in economic may be as:
an advocate
80
environmental areas of concern may include:
the built environment
81
which of the following is an environmental concern world-wide
clean water
82
acronym used for environmental discovery is:
IPREPARE
I—Investigate potential exposures
P—Present work
R—Residence
E—Environmental concerns
P—Past work
A—Activities
R—Referrals and resources
E—Educate
83
environmental health effects may be immediate, long-term, and ?
inter-generational
84
what new science did Florence nightingale use in the Crimean war? (infection control, physics, statistics, or anthropology)
statistics
84
3 components of epidemiological triangle
host, agent, environment
85
which is an example of incidence rate?
115 of 145 students had ever had ice cream evoked headache
9 of 72 students had a headache
25% of the cautious group reported having weekly headaches
20 ice cream evoked headaches per 730 people per minute
20 ice cream evoked headaches per 730 people per minute
86
this is the number of new cases of a condition during a specific time
incidence
87
this is the number of births in a population
crude birth rate
88
this shows interaction between biological and sociobehavioral determinant of health
web of causation
89
this is the number of people with a disease in a particular population
prevalence
90
prevalence vs incidence
prevalence = this is the number of people with a disease in a particular population
incidence = this is the number of new cases of a condition during a specific time
91
when does discharge planning begin
time of admission
92
the first practicing nurse epidemiologist was who?
Florence Nightingale
93
this is a higher burden of mortality experienced by one population
health disparity
94
what does regular medicare not cover?
dental, eyes, hearing benefits
95
medicare advantage plans are also known as what part of medicare?
optional gap coverage
part C (dental, hearing, vision)
96
medicare part B covers which expenses ?
outpatient care
97
a key component of a "fee for service" plan :
provider was in control of what they charged
98
this is an area in which it's difficult to buy fresh food
food desert
99
being conscious of one's own culturally shaped values and beliefs is called what?
cultural awareness
100
this agency of health & human services works to control and prevent disease and responds to health emergencies?
(CDC) center for disease controls
101
a woman stands very close to the nurse when asking about her husband's condition. the culturally competent nurse knows:
spatial acceptances differ around cultures
102
this type of study looks back in time to compare those w/ a disease to those who don't have the disease
retrospective
103
components of the private healthcare subsystem include
personal care services from for-profit and not-for-profit entities
104
in the public health arena, the state provides what governance?
health codes and licensing of healthcare personnel
105
this critical issue in healthcare delivery includes consume rights, accountability, and reduction in errors
quality care
106
this the the structural characteristics and type of area one lives in can greatly affect one's health.
the built environment
107
host factors or intrinsic factors that influence susceptibility to an agent include:
personal behaviors such as hygiene, tobacco use, recreation diet
and genetic predisposition
108
this is reimbursement for Medicare services determined by diagnoses, age, gender, complications
prospective reimbursement
109
what new science did florence nightingale use in the Crimean War
statistics
110
John Snow's map of a London neighborhood with locations of cholera cases surrounding a water pump is an example of:
web of causation
111
what part of medicare is the advantage plan that covers dental, hearing, vision costs for a premium with deductible?
part C (medicare advantage plan)
optional gap coverage
112
transitional care management by the case manager involves what?
care coordination for 30 days after discharge from a hospital
follow up face to face visit w/ provider
113
one factor that influences healthcare cost is
lifestyle and health behaviors
114
the practice of international nurses has been..
bettered by global communication and technology
115
this is the study of the distribution and determinants of health and disease in human populations
epidemiology
116
formula for crude rate
Number of births / Total population
X 100,000
births divided by total pop then multiply 100,000
117
causality screening surveillance
Causality: establish the cause-and-effect relationship (smoking & lung cancer)
Screening: Identify risk factors or presence od disease in their earliest stages to minimize impact
Surveillance: This is the long-term monitoring of disease for change or for collection of data in the community or population. You would want to identify trends and implement interventions as appropriate.
118
descriptive vs analytic epidemiology
descriptive - Focuses on the amount and distribution of health and health problems within a population
analytic - Investigates the causes of disease by determining why a disease rate is lower in one population group than in another (uses observational/experimental studies like RCTs)
119
sensitivity vs specificity
Sensitivity = how well a test identifies a person WITH the disease (High sensitivity is good for screening because you have low false positives) ***Rules out a disease !
Specificity = How well a test identifies a person WITHOUT the disease (very few false positive results) High specificity is good for screening you have low false negatives ***rules IN a disease
120
3 branches
Executive branch- Administers and enforces laws through regulatory agencies.
Legislative branch- Enacts the statutory laws that are the basis for governance & Prohibited from interfering with the courts’ final judgements.
Judicial branch- Provided protection against oppressive governance and against professional malpractices, fraud, and abuse.
***sovereign power = independent & supreme authority of the nation or state
121
state gov vs federal gov
state: Directly involved in healthcare policy, legislation, and regulation. Also decides and provides financing for healthcare.
federal: Influences health policy, directly and indirectly through financing of healthcare for many groups (Medicare, Medicaid, etc)
122
what is an exemplar and has led the way in establishing the medical home concept to ensure efficient, quality care
Kaiser Permanente (Public health policy)
123
what is the largest source of federal funding of nursing education
The health resources and service administration (HRSA)
124
private subsystem vs public health
private- focus on the individual: personal care (non profit & profit)
public- focus on populations: prevention of disease/illness (federal, state, local)
125
The nurse who was responsible for organizing relief efforts for soldiers during the U.S. Civil War and who was the founder of the American Red Cross was
Clara Barton
126
The case manager reviews the chart of a patient to determine appropriateness and timeliness of medical care while the patient is in the hospital. This funcIon of case management is referred
to as
utilization review.
127
Which model of care was developed to provide collaboraIve, quality-driven, safe, primary
care?
Patient-centered medical home
128
Which act, established in the 1940s, provided grants to states for the purpose of new construcIon of health care institutions?
The Hill-Burton Act
129
What is the correct process a bill must take before final approval by the president?
a bill must succeed through the two legislaIve bodies, the House of
Representatives and the Senate, and then be submitted for final approval by
the president.
130
Decisions on public policy are made by which part of the federal government?
LegislaIve, execuIve, or judicial branches of the government
131
A statement of a decision regarding a goal in health care and a plan for achieving that goal is called what?
health policy
132
Groups such as professional organizations, nonprofit health care organizaIons, and corporations that sponsor health care are/is called
the private sector.
133
The Health Resources and Services AdministraIon (HRSA) assists nursing workforce
development by
providing grants to provide for education and recruitment.
134
A person who acts as a representative for another person or organization before the
legislature is called a(n)
lobbyist.
135
Politcal action commitiees (PAC) are formed by professional organizatoons, business, or labor groups for the purpose of
attracting candidates who are sympathetic to particular health care issues.
136
In the United States today, where are most personal health care services provided?
The private sector
137
Which prospecIve payment method determined the amount of reimbursement that health care providers would receive for specific illnesses from Medicare?
Diagnosis-related groups
138
How would a community health nurse use ExecuIve Order 12898?
Recognize that it would help achieve environmental justice
139
In the 1850s, a researcher studied a cholera epidemic among people living in different secIons of London. The researcher who used epidemiologic methods to study the epidemic, and used rates as an epidemiologic tool was
John Snow
140
Assisting the family of a special needs child through the complex health care system is an example of what type of case management?
Patient-centered case management
141
4 types of analytic epidemiology
1. Observational studies: (Descriptive purposes,
Etiology of disease,
No manipulation by investigator)
2. Cross-sectional studies:
aka prevalence or correlational studies,
Examine relationships between potential causal factors & disease at a specific time,
Impossible to make causal inferences
3.Retrospective studies:
Compare individuals with a particular condition or disease with those who do not have the disease,
Data collection extends back in time
4. Prospective studies:
Monitor a group of disease-free individuals to determine if/when disease occurs,
Cohort shares a common experience within a defined time period,
Monitors cohort for disease development
5. Experimental design:
Aka Randomized Clinical Trial (RCT),
Subjects assigned to experimental or control group, Apply experimental methods to test treatment & prevention strategies,
Ethical considerations with human subject rights review, useful for investigating chronic disease prevention
142
types of health care plans
- indemnity plan (BCBS) , not very common anymore, paid all costs, free choice of provider/services, managed their own health care and became costly
-HMO (health maintenance organization), more comprehensive care, preventative care, specialty care is restricted
-PPO (preferred provider organization), more flexible than HMOs, negotiated rates and reimbursements, offered incentives within network
-POS (point of service), combine HMOs and PPOs, will be responsible for cost outside of network unless referred
-HDHP (high deductible health plans), lower premiums but higher up front cost, Health savings account
143
roles of public health nurse in economics of health care
researcher, educator, provider of care, advocate
144
When making health-related decisions, clients from different cultural backgrounds depend on relaIonships. One type of relaIonship involves the client seeking assistance from other members of the family and allowing a relaIve to make decisions about important health-related issues. This relaIonship is a(n)
lineal relationship
145
a community health nurse is caring for a family that includes husband, wife, children, and other blood relatives. what type of family is this
extended family
146
what consists of the connections among people, communities, and their surrounding environments that affect health behaviors, habits, interpersonal relationships,
Cultural values ,customs
the built environment
147
Founder of Healthy People initiative. Four key indicators of meeting their goals are: Quality of Life, health status, well-being, determinants of health and disparities.
USDHHS (U.S. Department of Health and Human Services)
148
nurse roles in political activities
-coalitions
-lobbyists
-political action committees
-campaigning
-voting strength
-public office
