NUR 410 Study Guide - Completed Flashcards
(96 cards)
1
Q
Describe the 8 principles of public health nursing.
ESSAY QUESTION
KNOW THIS!!!!!
A
1.) The population is the patient.
2.) Public health nurses are obligated to bring the greatest good for the most amount of people possible.
3.) The nurse & patient are equal.
4.) Primary prevention is the priority.
5.) The focus is on creating healthy envirionmental, social, & economic conditions.
6.) Public health nurses are obligated to reach out to anyone and everyone who may benefit from the services they provide.
7.) The use of research & evidence-based strategies is the best way to implement improvement in the community.
8.) Collaboration is the best way to protect the health of people.
2
Q
Determinants of Health
KNOW THIS!!!!
A
1.) Physical environment
2.) Social environment
3.) Health behaviors & coping skills
4.) Access to health services
5.) Healthy child development
6.) Employment & working conditions
3
Q
List the Social Determinants of Health (SDOH)
KNOW THIS!!!!
A
- Education (access & quality)
- Health care (access & quality)
- Neighborhood & built environment
- Social & Community context
- Economic stability
4
Q
What are healthcare disparities?
KNOW THIS!!!1
A
differences in healthcare & health outcomes experienced by one population compared with another.
5
Q
What are the 3 major changes that have occured to bring about change to 21st century healthcare?
KNOW THIS!!!
A
1.) Development of patient-centered care
2.) Increased use of technology
3.) Increased personal responsibility / autonomy
6
Q
What is patient-centered care?
A
The shift toward patient-centered care means that a broader range of outcomes needs to be measured from the patient’s perspective to understand the true benefits & risk of healthcare interventions.
7
Q
What is the public health intervention wheel?
A
17 interventions
- Actions taken on behalf of individuals, families, communities, & systems to protect or improve health status
8
Q
Lemuel Shattuck
Know this
Who is he & what did he do?
A
- Published Massachusetts Sanitary Commission
- Recommended the establishment of health departments at the state level & local health boards in every town
- Created vital statistics/research from “Shattuck report” of unsanitary conditions & outcomes
1850
9
Q
Dorthea Dix
KNOW THIS!!!!
Who is she & what did she do?
A
- Lifelong campaign to improve the life of the mentally ill
- Funds to establish the 1st hospital for the mentally ill
- Worked to improve quality of life & care for mentally ill patients
1840 - 1841
10
Q
Clara Barton
KNOW THIS!!!!!
Who is she & what did she do?
A
Convinced congress to establish the American Red Cross with an extended mission to provide aid for natural disasters
- Helped create American Red Cross & provide aid for disasters
- Serviced during civil war
1882
11
Q
Lillian Wald
KNOW THIS!!!!
A
- Founder of Public Health Nursing
- 1912 National Organization for Public Health Nursing was established & Lillian Wald was the first President
- Established Henry Street Settlement in 1893 on the Lower East Side
HENRY STREET SETTLEMENT
* Acute & long-term care with payment based on client’s ability to pay
* Taught health & hygiene to immigrant women
* Services: visiting nurses association in NYC
* 1880s unsanitary – cowded areas which created prevalent disease
* Education prevention can help reduce illness
12
Q
Florence Nightingale
KNOW THIS!!!!
A
- Prevention of infections with improved sanitary conditions
- Improved environmental conditions
- Opened the first school of nursing (1860) at St. Thomas Hospital in London
- 1851 – attended Flider’s school for deaconesses
13
Q
Mary Breckinridge
KNOW THIS!!!!
A
- 1925 – Established the Frontier Nursing Service in the U.S. to provide access to healthcare in remote Appalachian regions of southeastern Kentucky
- Reduce maternal & infant mortality
- Improve health of children
- Established rural healthcare (southeastern Kentucky in Appalachian regions)
14
Q
John Snow – who was he & what did he do?
A
Physician who conducted epidemiology of cholera outbreaks due to contaminated water in broad street
15
Q
Edward Jenner: who was he & what did he do?
A
- Physician & father of immunology
- Discovered the Smallpox vaccine
16
Q
William Rathbone: who was he & what did he do?
A
Development of district nursing in England
17
Q
Edwin Chadwick: who was he & what did he do?
A
- Created reports on sanitation conditions of the laboring populations
- Poor law amendment act
- public health activist in the 1800s
- believed in using science as a means for social improvement
18
Q
Joseph Lister: who was he & what did he do?
A
Father of sterilization
- prevented infection after surgery
- introduced sterile technique which transformed surgical practice
19
Q
What is epidemiology?
A
The science of prevention
- The study of the distribution & determinants of states of health & illness in human populations
- Used both as a research method to study states of health / illness and as a body of knowledge that results from the study of a specific state of health or illness.
20
Q
Name at least 3 challenges of the 21st century related to Public Health Nursing
KNOW THIS!!!
A
- Engaging in evidence-based practice
- Helping eliminate health disparities in underserved populations
- Demonstrating cultural competence
- Planning for community change
- Contributing to a safe & healthy environment
- Responding to emergencies, disasters, & terrorism
- Responding to the global environment
21
Q
Know the difference in outreach, surveillance, screening, & case management.
KNOW THIS!!!!
A
Surveillance: monitors health events through ongoing, systematic collection, analysis, & interpretation fo health data for planning, implementing, & evaluating public health interventions
Outreach: locates populations at risk, provides information, identifies possible actions, & identifies access to services.
Screening: Identifies individuals with unrecognized risk factors or asymptomatic conditions.
Case Management: coordination of a plan or process to bring health services & the self-care capabilities of the patient together as a common whole in a cost-effective way.
22
Q
What is surveillance?
KNOW THIS!!!!!!!
Know the difference between surveillance, outreach, screening, & case management
A
Monitors health events through ongoing, systematic collection, analysis, & interpretation of health data for planning, implementing, & evaluating public health interventions
23
Q
What is Outreach?
KNOW THIS!!!!!!!
Know the difference between surveillance, outreach, screening, & case management
A
Locates populations at risk, provides information, identifies possible actions, & identifies access to service.
24
Q
What is Screening?
KNOW THIS!!!!!!!
Know the difference between surveillance, outreach, screening, & case management
A
Identifies individuals with unrecognized risk factors or asymptomatic conditions
25
**What is Case Management?**
| **KNOW THIS!!!!!!**
## Footnote
Know the difference between surveillance, outreach, screening, & case management
**Coordination of a plan or process to bring health services & the self-care capabilities of the client together as a common whole in a cost-effective way.**
26
**Explain the role of federal goverment regulation in public health.**
| **KNOW THIS!!!!!!**
**1.)** Assess healthcare problems.
**2.)** Intervene by developing relevant healthcare policies that provide access to services.
**3.)** Esnure that services are delivered & outcomes are achieved.
27
**What agencies are involved in refugees / asylees?**
| **KNOW THIS!!!!!!**
* U.S. Department of Health & Human Servies **(DHHS)**
* Nongovernmental organizations **(NGOs)**
* Philanthropic organizations
28
**How are the NIH Healthcare research & quality, the Centers for Disease Control and Prevention (CDC), & the U.S. Department of Health & Human Services is directly involved with the health & healthcare of U.S. citizens or refugees?**
For example, the National Institutes of Health, Agency for the Healthcare Research & Quality, and the Centers for Disease Control and Prevention are 3 important organizations in which research is undertaken & used effectively to address healthcare concerns such as HIV screening & care, adverse events in hospital settings, and measures to decrease the rates of emerging infectious diseases.
29
**What is the difference in private / philanthropic and government funding?**
| **KNOW THIS!!!!!!**
**Private / Philanthropic Funding:** uses endowments or private funding to address the needs of individuals, families, & populations
**Government Funding:** the federal government allocates tax funds to state governments in support of specific public health programs.
30
**Describe politics in terms of public health / community nurisng?**
**Process of influencing the allocation of resources.**
* Politics represents how conflicts are expressed & resolved in society
* May also be a factor in deciding who participates or influences governmental decision making
31
**Describe policy in terms of public health / community nursing.**
**Policies are guidelines that direct individuals' behavior toward a specific goal.**
* principles that govern an action to achieve a given outcome
* Deliberate course of action chosen by an individual or group to confront problems
32
**Describe health policy in terms of public health / community nursing.**
**Policy that has an impact on the health of an individual, family, population, or community & is created by the government, an institution, or a professional association.**
33
**What is Cost-Benefit Analysis?**
| **KNOW THIS!!!!!!**
**An economic approach or analysis tool used to evaluate the effectieness of a treatment or intervention.**
* Mathematically speaking, the net economic benefit can be calculated by **subtracting the costs for a service from the benefits of the service**
* If the value is **positive (+)**, it implies that the benefit from a specific intervention exceeds its cost.
* An intervention is judged to be unworthy if its costs exceeds the benefits gained from carrying it out.
34
**What is quality of care?**
**A concept used to evaluate the extent of how efficiently & effectively healthcare systems provide safe patient care at a reasonable cost to people in need.**
* It is a degree to which health services for individuals & populations increase the likelihood of a desired health outcome.
35
**List at least 3 benefits of the affordable care act.**
| **KNOW THIS!!!!!!**
* **Lower costs**
* **Improved access to primary care**
* **Preventative care & prescription benefits**
* **Cover pre-existing conditions**
* **Extended young adults' coverage**
36
**Explain the following statement: Nurses focus on modifiable risks.**
| **KNOW THIS!!!!!!!**
Modifiable risk factors are **what the patient is capable of changing such as lifestyle behaviors.**
37
**What are non-governmental organizations (NGOs)?**
| **KNOW THIS!!!!!!**
**Agency that acquires resources to help others from private sources**
38
**What areas will most likely be regulated by the Federal Government?**
| **KNOW THIS!!!!!!!!**
* **Food** (FDA)
* **Drugs** (FDA)
* **Devices** (FDA)
* **Occupation health**
* **Enviornment**
39
**List the steps in a policy making process**
| **KNOW THESE IN ORDER!!!!!!!**
**1.)** Setting an Agenda
**2.)** Policy Formulation
**3.)** Policy Adoption
**4.)** Policy Implementation
**5.)** Policy Assessment
**6.)** Policy Modification
## Footnote
**A**ll
**F**riends
**A**re
**I**n
**A**
**M**ood
40
**What is quality of care?**
| **KNOW THIS!!!!!!!**
**The degree to which health services for individuals & populations increase the likelihood of desired outcomes & are consistent with current knowledge**
41
**What are the 3 MAIN points of the Affordable Care Act (ACA) of 2010?**
| **KNOW THIS!!!!!**
The ACA was put in place to improve the **quality, access, & affordability** of healthcare.
42
**List the transtheoretical stages of change**
| **KNOW THIS!!!!**
**1.) Precontemplation:** no screening programs scheduled & no intention to schedule screening
**2.) Contemplation:** no screening program scheduled but intend to start a program soon
**3.) Preparation:** no definite screening program, but have taken steps to develop a program
**4.) Action:** a developed screening prgoram & intent to sustain the program
**5.) Maintenance:** have had the program in place for some time & intent to continue
**6.) Relapse:** had a program, does not have a program currently, but intends to be active with a prgoram soon
43
**Describe the health belief model**
**Threat as a motivator!!!!!**
**What is the likelihood a person is willing to change????**
* Client / Patient's perspective -- explains why they do what they do
* **Individual (microscopic)**
* Barriers, perspectives, biases
**The following is perceived in the Health Belief Model:**
* **seriousness --** what will happen to me?
* **susceptibility --** will this happen to me?
* **benefits of tx --** how will I not get the condition?
* **barriers of tx --** what is preventing me from making this change?
* **cues to action --** what is happening to me?
* **Self-efficacy --** I can do it
44
**Explain the 4 aspects of the health belief model & provide examples.**
| **KNOW THIS!!!!!**
The health belief model specifies that **individual, family or community health-related behavior depends on:**
**1.) severity of the potential illness or physical change**
**2.) level of conceivable susceptibility**
**3.) benefits of taking preventative action**
**4.) what stands in the way of taking action toward the goal of health promotion**
This model uses cues as an important way to remind people of health behaviors & to promote these actions **-- threat as a motivator**
## Footnote
**EXAMPLES:**
* "Don't overdo it at dinner" **(individual)**
* "Let's try to do one thing tonight that is not related to a television set" **(family)**
* Placing a "Got Milk" billboard in the neighborhood **(community / population)**
45
**What is health literacy?**
| **KNOW THIS!!!!!!**
**The degree to which individuals have the capacity to obtain, process, & understand basic health information & services needed to make appropriate decisions.**
46
**Who helped develop Children's Bureau?**
| **KNOW THIS!!!!!!!**
Lillian Wald
## Footnote
founder of public health nursing & created Henry Street Settlement
47
**Who helped develop the American Red Cross?**
| **KNOW THIS!!!!!!!**
**Clara Barton**
48
**Explain the Learning Model Skinner**
**Health behaviors are seen as incremental steps toward a final goal**
* A goal is established & reinforced by the nurse, with rewards given for partial accomplishment if necessary. Incremental increases are then made as the pattern of behavior is shaped toward a specific goal. Reinfrocement is used as motivation to either continue or discontinue a behavior.
**This model uses extrinsic or external factors for reinforcement.**
49
**Describe Motivational Interviewing**
| **KNOW THIS!!!!!!**
**Directive, client-centered communication style for eliciting behavior change by helping patients / groups to explore & resolve ambivalence.**
* **Focused, goal-oriented approach**
* Developed by Rollnick & Miller (1995)
50
**List actions involved in motivational interviewing**
| **KNOW THIS!!!!!**
* Seek to understand the person's frame of reference through **reflective listening**
* **Express acceptance & affirmation**
* Elicit & select reinforcing motivational statements of problem recognition, concern, desire, intention, & ability to change
* Monitor degree of readiness to change & ensure that resistance is not generated by clinician control
* **Affirm freedom of choice & direction**
51
**What is the logic model?**
| **KNOW THIS!!!!!!**
**Visual representation of how a program is organized**
*This includes:*
* activities
* resources
* short-term & immediate outcomes
* program goals
52
**What is a Community Health Assessment / SMART Goals?**
| **KNOW THIS!!!!!!**
A systematic process that may use several approaches, including key informant interviews, analysis of data on health status & health behavior indicators, observation, & community surveys.
**The goal is to identify the community health problems that are the priorities for intervention, as well as community resources available to address each health problem.**
**SMART Goals:**
* **S**pecific
* **M**easurable
* **A**chievable
* **R**elevant
* **T**ime-bound
53
**List the two assessment frameworks for community assessments.**
* **M**obilizing for **A**ction through **P**lanning and **P**artnerships **(MAPP)**
* **N**ational **A**ssociation of **C**ounty and **C**ity **H**ealth **O**fficials (NACCHO)
54
**Who developed the framework for community health assessment & strategic planning?**
**NACCHO** (National Association of County and City Health Officials)
55
**What is MAPP (M**obilizing for **A**ction through **P**lanning and **P**artnerships**)?**
**MAPP** focuses on **community engagement to help communities identify & address public health priorities.**
56
**Who is John Snow?**
| **KAHOOT**
Removed the pump handle on the community's water resource
57
**Who is Edwin Chadwick?**
| **KAHOOT**
Created reports on sanitation conditions of the laboring populations
## Footnote
**sanitation reports**
58
**Who created the smallpox immunization?**
| **KAHOOT**
**Edward Jenner**
59
**Who was Edward Jenner?**
| **KAHOOT**
Created the smallpox vaccine
60
**What governed healthcare for the poor in England & became a prototype for later U.S. laws?**
| **KAHOOT**
**Elizabethan Poor Law** (1601) **church's responsible for relief of the poor**
61
**Who was Florence Nightengale?**
| **KAHOOT**
Mother of modern nursing
**helped decrease men dying in the crimean war**
62
**True or False: Florence Nightingale used the Coxcomb Charts to direct health policy.**
| **KAHOOT**
**TRUE**
63
**True or False: In the Crimean War, equal amounts of people died on the battlefield than died of disease and battlefield injury..**
| **KAHOOT**
**TRUE**
64
**Who was Joseph Lister?**
| **KAHOOT**
**Had improved surgical success with bones when dressings were soaked in acid**
## Footnote
**STERILE TECHNIQUE**
65
**Who was Robert Kock?**
| **KAHOOT**
**Discovered causative agent for cholera and tubercle baccilus**
66
**Who was Lois Pasteur?**
| **KAHOOT**
**First to propose the existance of germs**
67
**What did Lillian Wald and Mary Brewster establish?**
| **KAHOOT**
**district nursing service on lower east side of New York** (Henry Street Settlement)
68
**The student nurse is being mentored by the RN at the ABC memorial hospital. The RN provided an example of patient centered care when...**
**a.)** When the RN took the time out of a busy day to describe the benefits of computer assisted robotic surgical techniques which the hospital recently implemented.
**b.)** When the RN had the patient fill out a self-reported dietary personal preference form.
**c.)** When the RN recorded symptoms in the EHR.
**d.)** When the RN set up continuous glucose monitoring while the patient is in the hospital.
| **Quiz #1**
**b.) When the RN had the patient fill out a self-reported dietary personal preference form.**
69
**The professor wants to ensure that the students understand the challenges going forward for Public Health Nursing. What statement below provides reassurance of the comprehenssion of these challenges?** (Select all that apply).
**a.)** Healthcare has been evolving toward a multifaceted system that empowers patients & clients.
**b.)** Rapidly advancing forms of technology are dramatically improving lives. THousands of new ideas are investigated each year, with hundreds of new medical devices submitted to the U.S. Food and Drug Administration annually.
**c.)** The burden of disease is growing disproportionately in the world & is largely affected by climate, public policy, age of the population, socioeconomic conditions, & factors that place people at risk for illness.
**d.)** By participating in the develop in the development, implementation, & evaluation of culturally appropriate, community-based programs, nurses use their expertise to remedy the conditions that contribute to health disparities.
**e.)** Change in healthcare at all levels can occur through behavior change, or through modifications in the environment, public policy, social or cultural norms, or healthcare delivery.
| **Quiz #1**
**c.) The burden of disease is growing disproportionately in the world & is largely affected by climate, public policy, age of the population, socioeconomic conditions, & factors that place people at risk for illness.**
**d.) By participating in the develop in the development, implementation, & evaluation of culturally appropriate, community-based programs, nurses use their expertise to remedy the conditions that contribute to health disparities.**
**e.) Change in healthcare at all levels can occur through behavior change, or through modifications in the environment, public policy, social or cultural norms, or healthcare delivery.**
70
**When describing competencies a public health nurse who is working at the executive level is at what level of her competency?**
**a.)** Tier 5
**b.)** Tier 3
**c.)** Tier 1
**d.)** Tier 2
**e.)** Tier 4
**b.) Tier 3**
71
**How many tiers of competency are their in public health nursing? Explain each tier.**
| **KNOW THIS!!!!!**
**3 Tiers**
* **Tier 1:** entry-level public health professionals at the basic or generalist level **(1 = RN in public health department)**
* **Tier 2:** individuals with management and/or supervisory responsibilities & are considered specialists or mid-level practitioners. **(2 = someone who may start getting involved in management)**
* **Tier 3:** senior managers & leaders at the executive level who deal with multi-systems. **(Tier 3 = in administration or executive leadership / management positions who make policy)**
| **Quiz #1**
72
**The free clinic is very community focused. Some of the programs include immunizations and classes on fire safety, health education, & car safety, to name a few. How would the nurse best explain the level of prevention used in this setting to colleagues?**
**a.)** Quaternary
**b.)** Secondary
**c.)** Tertiary
**d.)** Primary
| **Quiz #1**
**d.) Primary**
73
**Describe primary, secondary, & tertiary prevention in public health nursing.**
| **KNOW THIS!!!!!!!**
**Primary:** prevent the disease from occuring
* immunizations = primary prevention
**Secondary:** early screening / disease detection & treatment
* pap smear or mammogram = secondary prevention
**Tertiary:** attempts to manage / reduce the effects of the disease / disability that has already been established or diagnosed
* cardiac rehab for heart attack patients
74
**The federal government (U.S. Department of Health and Human Services (DHHS)) play an important role in regulation. These federal regulations relate to...**
**a.)** Drugs, treatment regimes, & specialty licenses
**b.)** Food, drugs, & occupational health clinics
**c.)** Enviornmental health, drugs, & food
**d.)** Food, drugs, devices, occupational health, & the environment
| **Quiz #1**
**d.) Food, drugs, devices, occupational health, & the environment**
75
**Which of the following statements is most accurate at describing the funding for healthcare?**
**a.)** Funding for the healthcare system in the United states comes primarily from Medicare & Medicaid systems.
**b.)** Fudning for the healthcare system in the United States comes primarily from Medicare and Medicaid systems and TRICARE for the military personnel.
**c.)** Funding for the healthcare system in the United States comes primarily from privately owned health insurance companies.
| **Quiz #1**
**c.) Funding for the healthcare system in the United States comes primarily from privately owned health insurance companies.**
76
**Where does fudning for the healthcare system in the United States primarily come from?**
| **KNOW THIS!!!!!!**
privately owned health insurance comapnies
77
**What is the federal government (U.S. Department of Health & Human Services) responsible for regulating?**
| **KNOW THIS!!!!!!**
* **Food**
* **Drugs**
* **Devices**
* **Occupational Health**
* **Environment**
78
**What is the Health Belief Model?**
| **Quiz #1**
**a behavior change model that considers the severity of the potential illness or physical callenge, the level of conceivable susceptibility, the benefits of taking preventive action, & the challenges that may be faced in taking action toward the goal of health promotion.**
79
**Which of the following describes Motivational Interviewing?** (Select all that apply)
**a.)** Talking to patients with knowledge & authority.
**b.)** Client centered communication style.
**c.)** Is used primarily in social work counseling sessions.
**d.)** A communication style that attempts to understand a client's perspectives & cultural views.
**e.)** Talking with patients to explore & resolve ambivalence.
| **Quiz #1**
**b.) Client-centered communication style**
**d.) A communication style that attempts to understand a client's perspectives & cultural views.**
**e.) Talking with patients to explore & resolve ambivalence**
80
**Describe the transtheoretical model in simple terms**
| **KNOW THIS!!!!!!**
**How ready are you to change a behavior?**
*Stages:*
1.) Precontemplation
2.) Contemplation
3.) Preparation
4.) Action
5.) Maintenance
6.) Relapse
81
**Which model of care helps a clinician understand how ready a person is to change?**
**a.)** Social learning model
**b.)** Health belief model
**c.)** Transtheoretical model
**d.)** Theory of reasoned action
| **Quiz #1**
**c.) Transtheoretical model**
82
**Which of the following is a behavior change model that considers the severity of the potential illness or physical challenge, the level of conceivable susceptibility, the benefits of taking preventive action, & the challenges that may be faced in taking action toward the goal of health promotion?**
**a.)** Theory of reasoned action
**b.)** Theory of planned behavior
**c.)** Transtheoretical model
**d.)** Health belief model
| **Quiz #1**
**d.) Health belief model**
83
**In 2001 IHI reported on points that ehanced patient quality of care. Which points were reported to ehance patient quality of care?**
**a.)** Safety, effectiveness, & equality.
**b.)** Safety, effectiveness, patient centeredness, timeliness, & equality.
**c.)** Safety, effectivness, & patient centeredness.
**d.)** Effective treatment plans that have been evaluated.
| **Quiz #2**
**b.) Safety, effectiveness, patient centeredness, timeliness, & equality.**
## Footnote
Remember **SETPE**
84
**What aspects enhance patient quality of care?** (based on report by IHI in 2001)
**S**afety
**E**ffectiveness
**T**imeliness
**P**atient centeredness
**E**quality
## Footnote
**SETPE**
85
**What are some of the current situations that present challenges for the nursing workforce to get more politically involved?** (Select all that apply)
**a.)** No money to push policies forward.
**b.)** Heavy workloads with understaffing.
**c.)** Fear of retaliation.
**d.)** Perception of powerlessness.
**e.)** Not enough time to get involved.
**f.)** No advocacy groups represent nursing.
| **Quiz #2**
**b.) Heavy workloads with understaffing.**
**c.) Fear of retaliation.**
**d.) Perception of powerlessness.**
**e.) Not enough time to get involved.**
86
**Which skill sets are importnat to have for a nurse to effectively take on a role in the state's political decision making process?** (Select all that apply)
**a.)** Social skills
**b.)** Ability to network
**c.)** Ability to lie convincingly
**d.)** Ability to understand others' behaviors
**e.)** Diagnostic skills
| **Quiz #2**
**a.) Social skills**
**b.)Ability to network**
**d.) Ability to understand others' skills**
87
**A nurse needs to understand what the correct sequence of events occurs in the policy making process. Please choose the correct order.**
**a.)** (1) policy formulation; (2) policy assessment; (3) policy adoption; (4) policy implementation; (5) policy modification; (6) setting an agenda
**b.)** (1) setting an agenda; (2) policy formulation; (3) policy adoption; (4) policy implementation; (5) policy assessment; (6) policy modification
**c.)** (1) setting an agenda; (2) policy formulation; (3) policy assessment; (4) policy modification; (5) policy adoption; (6) policy implementation
**d.)** (1) policy formulation; (2) setting an agenda; (3) policy implementation; (4) policy modification; (5) policy assessment; (6) policy adoption
| **Quiz #2**
**b.)**
**1.)** Setting an agenda
**2.)** Policy formulation
**3.)** Policy adoption
**4.)** Policy implementation
**5.)** Policy assessment
**6.)** Policy modification
88
**In regards to Force Field Analysis the Levers of Change...**
**a.)** Increase driving forces & decrease restraining forces.
**b.)** Decrease driving forces & increase restraining forces.
**c.)** Decrease driving forces.
**d.)** Increase driving forces & increase restraining forces.
| **Quiz #2**
**a.) Increase driving forces & decrease restraining forces.**
89
**What is the purpose of using levers of change?**
| **KNOW THIS!!!!!!**
**Increase driving forces and/or decrease restraining forces**
## Footnote
Public policies such as tax increases on tobacco, alcohol, or soft drinks can serve as policy levers to bring about change in community health status.
90
**For th elast 6 months the Red Cross has been utilizing the new policy in regards to a 6 feet physical distance while completing the screening questions. The director wants to know how this new policy has been working. What stage of policy making is necessary with the directors request?**
**a.)** Implementation
**b.)** Assessment
**c.)** Formulation
**d.)** Adoption
| **Quiz #2**
**b.) Assessment**
91
**What statement below best describes what a cost-benefit analysis is for the nurse?**
**a.)** The total payment.
**b.)** The out of pocket payments a patient has to pay.
**c.)** A reform that is an improvement to increase financial equity.
**d.)** The actual and direct cost of providing a service.
| **Quiz #2**
**d.) The actual & direct cost of providing a service.**
92
**Community assessments should include appropriate ways to access & assess data, validate the findings, develop a plan to address challenges, & include a plan to evaluate interventions taht are instituted. Often times, the nurse will conduct what type of assessment?** (Select all that apply)
**a.)** Chronic disease surveillance tracking system
**b.)** Windshield assessment
**c.)** Shoe leather epidemiology
**d.)** Surveillance tracker
| **Quiz #2**
**b.) Windshield assessment**
**c.) Shoe leather epidemiology**
93
**To be designated a Patient Centered Medical Home (PCMH), the services must include which of the following?** (Select all that apply).
**a.)** Providing patients with their prescriptions whiel in office to ensure they do not loose them in the system.
**b.)** Performance reporting.
**c.)** Care management.
**d.)** Limit visits to 15 minutes to provide more access to all.
**e.)** Patient tracking & registry functions.
**f.)** Improved access & communication.
| **Quiz #2**
**b.) Performance reporting.**
**c.) Care management.**
**e.) Patient tracking & registry functions.**
**f.) Improved access & communication.**
94
**The nurse is planning to apply for a grant because the clinic wants to have an educational series about diabetes. To assist in the planning, a ______ model was utilized. This model depicts what inputs, constraints, activities, outputs, & evaluations will be utilized. Described like a roadmap for the health intervention.**
| **Quiz #2**
**Logic model**
95
**What are examples of vital statistics?**
* Birth
* Death
* Marriages
* Divorces
* Adoption
96
**What do determinants of health consist of?**
Genetics + SDOH
