Test Generator Questions, Chapter 6, Structure and Economics of Community/Public Health Services

Format: Multiple Choice

Chapter: 6

Client Needs: Safe and Effective Care Environment: Management of Care

Cognitive Level: Apply

Difficulty: Easy

Integrated Process: Communication and Documentation

Objective: 2

Page and Header: 112, Development of the U.S. Health Care System

1. An instructor is discussing the impact of the Shattuck Report on community health care. The instructor recognizes that the students understand the information by which response?

A) “It influenced the speed with which health-focused bills pass the legislature.”

B) “The report set up the organizational structure of the U.S. Public Health Service.”

C) “It emphasized sanitary progress forming the basis for current public health practice.”

D) “It deemphasized the issues addressed in the Hebrew hygienic code.”

Difficulty: Difficult

Integrated Process: Nursing Process

Objective: 4

Page and Header: 131, Table 6-6 Services Offered by Local Health Departments

2. Over the past century, many health-related changes have occurred affecting morbidity and mortality. As community health nurses assess and plan for services in the local level, an understanding of which changes would the nurses need to integrate into their plans? Select all that apply.

A) High levels of chronic disease

B) Shortened life spans

C) Increased teen pregnancies

D) Abuse of multiple substances

E) Multidrug-resistant diseases

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 3

Page and Header: 123, Health Care Organizations in the United States

3. A new public health nurse graduate is evaluating the various options available for employment and decides to seek a position with an official health agency. The nurse recognizes that these types of agencies differ from others in which way?

A) Voluntary

B) Publicly funded

C) Proprietary

D) Privately funded

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 2

Page and Header: 129, Figure 6-1 Department of Health and Human Services organizational chart

4. A discussion group of students are discussing the public health system and its structure and function. Which statement would indicate that the students need further discussion and clarification?

A) It offers consultation through national advisory health councils and special advisory committees made up of lay experts.

B) The Public Health Service is ultimately responsible for it.

C) The Secretary of Health and Human Services is an elected position.

D) A major function is to administer grants and contracts with other government agencies.

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 4

Page and Header: 125, Core Public Health Functions

5. A community health nurse is engaged in provision of care to clients in a clinic setting at the local health department. This nurse is engaging in which core public health function?

A) Clinical

B) Assessment

C) Policy development

D) Assurance

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 4

Page and Header: 125, Core Public Health Functions

6. A public health nurse is discussing the core public health functions with a group of student nurses. Which fact should the nurse include in the discussion?

A) Public health nurses practice as partners with other public health professionals within these core functions.

B) Assessment involves the actual provision of services.

C) Policy development relates to assessment.

D) Assurance means that the public health agency must directly provide the needed services.

Difficulty: Difficult

Integrated Process: Nursing Process

Objective: 4

Page and Header: 125, Core Public Health Functions

7. Which group of actions fulfills the three core public health functions in their proper order?

A) Counting the number of kindergarten students who are fully immunized, encouraging the school officials to exclude children who are not fully immunized, and offering immunization clinics at the school

B) Identifying a source of pollution in the community, educating local residents about precautions that should be taken when the pollution exceeds minimum standards, and asking legislators to apply sanctions to the responsible party for the source of pollution

C) Providing prenatal care for pregnant adolescents, determining how many pregnant adolescents currently attend the school, and encouraging school officials to provide an alternative school setting for the pregnant adolescents

D) Lobbying for a citywide ban on smoking in public, providing smoking cessation services in the community, and reviewing mortality data to determine the number of people in the community who die each year from lung cancer

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 1

Page and Header: 127, Local Public Health Departments

8. A community health nurse primarily works with mothers and their high-risk children. The nurse recognizes which local voluntary agencies can also provide services for these clients? Select all that apply.

A) American Diabetes Association

B) The U.S. Public Health Service

C) The National Institutes of Health

D) Women, Infant, and Children Program (WIC)

E) National Society for Autistic Children

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 2

Page and Header: 123, Health Care Organizations in the United States

9. An instructor is describing the various differences between government health agencies and private organizations. Which comment by the students would indicate understanding of the function of a public health agency?

A) Most often have a very specific focus

B) Responsible for promoting and protecting the health of everyone

C) Limits employment to nurses and environmental health practitioners

D) Works independently with complete autonomy

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 3

Page and Header: 123, Health Care Organizations in the United States

10. A student nurse is having difficulty understanding the differences between public health care agencies and private health care agencies. What is the best response from the instructor?

A) Private sector health services are complementary and supplementary to government health agencies.

B) Public sector health care agencies usually meet the needs of people with special needs.

C) Private sector health agencies usually are constrained in developing innovations in health care.

D) Public health sector agencies generally satisfy the health care needs of a community.

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 3

Page and Header: 123, Private Health Sector Organizations

11. A group of students are preparing to debate about public health care agencies and private health care agencies. Which factor should the group representing the private sector include in the debate?

A) Are ready for disasters

B) More likely to promote health legislation

C) Administers grants to provide care

D) Usually focus on needs that are met

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 4

Page and Header: 134, International Health Organizations

12. A group of student nurses are discussing the various international health organizations. Which statement at the end of the discussion indicates that the students understand the information?

A) PAHO is a separate agency from WHO.

B) UNICEF promotes child and maternal health and welfare globally.

C) WHO focuses primarily on developing countries.

D) USAID is a temporary emergency program.

Difficulty: Moderate

Integrated Process: Teaching/Learning

Objective: 5

Page and Header: 156, Competition and Regulation

13. A group of students are discussing the results of the various legislative acts affecting health care. Which legislation will the students recognize as resulting in decreasing federal government involvement?

A) Social Security Act

B) Medicare/Medicaid

C) State Children’s Health Insurance Program

D) Omnibus Budget Reconciliation Act

Difficulty: Difficult

Integrated Process: Teaching/Learning

Objective: 2

Page and Header: 134, Significant Legislation

14. An instructor is discussing the various legislative acts that have focused on health care. Which statement by the class indicates that they understand the focus of the Social Security Act?

A) Increased availability of public health programs

B) Increased privacy of client information

C) Increased services to the poor

D) Expanded coverage for children

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 8

Page and Header: 137, Microeconomics

15. A community health nurse working at the local level is attending an in-service program about health care economics. The nurse asks the presenter, “Why do I need to know this information? My focus is my clients.” Which response by the presenter would be most appropriate?

A) “You are required to know this information because your agency receives government funding.”

B) “You might be in management one day and have to deal with cost control and reimbursement.”

C) “Although it seems foreign to you, it’s an important topic that you might have to deal with someday.”

D) “This knowledge is important to the success of your practice and for the agency’s survival.”

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 8

Page and Header: 138, Macroeconomics

16. The instructor is leading a class discussion on macroeconomics and its effect on today’s health care. Which effect should the class identify as a result of macroeconomics on health care after the discussion?

A) Quantity of services available

B) Consumer’s willingness to buy services

C) Comparison of health care spending between two entities

D) Allocation of the available resources

Difficulty: Difficult

Integrated Process: Nursing Process

Objective: 8

Page and Header: 145, Medicare

17. A community health nurse is developing a teaching plan about Medicare to present at a community event. Which points will be important to include in the presentation? Select all that apply.

A) A state health insurance program for older adults and the disabled.

B) Part A covers medically necessary hospitalization.

C) Part D covers prescription drug costs.

D) Part A is supplementary and voluntary.

E) Beneficiaries can make changes at any time.

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 8

Page and Header: 146, Supplemental Security Income and Social Security Disability Insurance

18. A community health nurse is teaching a community group about the Medicaid program. Which statement from the group would indicate to the nurse that additional teaching is necessary?

A) Medicaid has a monthly fee that recipients must pay.

B) Medicaid is administered individually by each state.

C) Medicaid will provide nursing home services to those over 21 years.

D) It is possible to be on both Medicare and Medicaid.

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 3

Page and Header: 149, Retrospective Payment

19. A group of students are preparing a presentation to give to the class discussing retrospective payment plans. Which situation should the students include in the discussion?

A) Spending was limited to the most necessary tests and treatments.

B) Services for sickness were encouraged rather than wellness.

C) Consumers had to bear the increased accountability for cost containment.

D) Payments for services were based on rates calculated from predictions.

Difficulty: Moderate

Integrated Process: Caring

Objective: 4

Page and Header: 152, Trends and Issues Influencing Health Care Economics

20. A community health nurse is preparing to meet with a group of students. Which statements should the nurse include when discussing how trends and issues have influenced health care? Select all that apply.

A) The United States has the most cost-effective health care system in the world.

B) One explanation for the high cost of U.S. Health Care System is the need to practice defensive medicine by ordering excessive tests and x-rays.

C) In the United States, the health-related quality of life is lower than for most other countries.

D) The United States ranks first among all WHO countries on a measure of how respectfully clients are treated.

E) In a survey published in 2009, most U.S. physicians identified that their health care system worked well.

Difficulty: Easy

Integrated Process: Caring

Objective: 8

Page and Header: 154, Health Care Rationing

21. During a lively class discussion on health care rationing, several students indicate that they find this upsetting. What is the best response from the instructor?

A) Rationing is the end result of today’s market.

B) Fair rationing focuses on the needs of the population.

C) The main focus for rationing is to expand medical care to all.

D) Advances in knowledge and technological capabilities will eliminate the need for rationing in the future.

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 4

Page and Header: 156, Competition and Regulation

22. The community health nurse is concerned for the local community with the raising health care costs. The nurse recognizes that managed competition is a potential solution, based on which factor?

A) Promotes cost containment and universal access to health care

B) Eliminates burdensome government regulations

C) Reduces state and federal control over health care delivery

D) Discourages consumers from making responsible choices

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 6

Page and Header: 160, Implications for Community/Public Health Nursing

23. A public health nurse is asked by a group of students why they should choose public health nursing as a career focus. What is the best response by the public health nurse?

A) Public health nursing focuses only on health care, not illness.

B) Financial resources for clients are more readily available in public health nursing, enabling more to be help.

C) Public health nurses can lead the effort in making health care more accessible to all citizens.

D) Public health agencies provide the main source of employment.

Difficulty: Moderate

Integrated Process: Caring

Objective: 2

Page and Header: 122, Development of the U.S. Health Care System

24. Health care reform has brought changes to public health nursing that can benefit the community as a whole. How might the public health department clinics respond as ACA increases coverage of individuals throughout the communities?

A) Claim private insurance reimbursement

B) Decrease services available

C) Increase competition with private agencies

D) Increase participation in community assessments

Difficulty: Moderate

Integrated Process: Nursing Care

Objective: 4

Page and Header: 127, Local Public Health Departments

25. A new graduate is exploring various options in public health nursing employment. The nurse recognizes a major difference between a rural and metropolitan setting is determined by which factor.

A) Federal legislation

B) Complexity

C) State legislation

D) Leadership

Difficulty: Moderate

Integrated Process: Teaching/Learning

Objective: 4

Page and Header: 146, Medicaid

26. The public health nurse recognizes that there are various resources available to the community for financing health care and providing services, many that are influenced by legislation. An act passed in the 1990s resulted in which major adjustment for Medicaid participants?

A) Moved to managed care concept

B) Decreased number of qualified participants

C) Increased rate of reimbursement payments

D) Decreased provider availability

Difficulty: Moderate

Integrated Process: Caring

Objective: 5

Page and Header: 134, International Health Organizations

27. A nurse is exploring the options of employment as an international public health nurse. If the nurse desires to assist others who are being denied health care, which is the best option?

A) UNESCO

B) USAID

C) PAHO

D) Doctors without Borders

Difficulty: Moderate

Integrated Process: Caring

Objective: 7

Page and Header: 135, Our Current Health Care System

28. The nurse recognizes that the financial means of individuals often determines the amount of health care received. As health care has improved, the costs have increased. Which factor has contributed the most to rationing over the recent years?

A) Increased life expectancy

B) Decrease in medical staff

C) Increase in health care insurance coverage

D) Decrease in preventive health measures

Difficulty: Moderate

Integrated Process: Nursing process

Objective: 5

Page and Header: 154, Managed Care

29. A nurse is reviewing a client’s health plan before the office visit. The client has a high-deductible health plan. Which best summarizes how this plan works?

A) The plan only covers those providers and services within the network.

B) The plan will only cover out-of-network care in an emergency.

C) The plan has higher deductibles and out-of-pocket limits.

D) The plan has flexibility to use providers both in and out of network.

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 5

Page and Header: 123, Recent Calls to Action (Table 6-1)

30. A nurse is presenting information regarding the various reports from the Institute of Medicine (IOM) and their implications for public health to a group of students. At the end of the presentation, the nurse asks the students to name the IOM report that focuses on nursing’s role in health care. Which response from the students would indicate to the nurse that the teaching has been successful?

A) The Future of the Public’s Health in the 21st Century

B) For the Public’s Health: Investing in Healthier Future

C) To Err is Human: Building a Safer Health System

D) The Future of Nursing: Leading Change, Advancing Health

Difficulty: Difficult

Integrated Process: Nursing Process

Objective: 1

Page and Header: 139, Supply and Demand in Health Care Economics

31. A nurse is interviewing a client who recently visited the emergency department for an upper respiratory infection. The client states that the “hospital bill is more than my other hospital bill from a 2-day operation 1 year ago”. Which is the statement the nurse uses in teaching the client about health care economics?

A) “Different prices are often paid for similar purchases, but consumers have little information as to the costs.”

B) “The care in the emergency department must be more expensive than on the hospital floor.”

C) “The number of medications contributed to the difference in the costs between the two facilities.”

D) “Is it possible that the insurance bill has not been submitted and the insurance has not paid its share?”