NR442 Community and Public Health Nursing Comprehensive Review

Comprehensive practice flashcards in question-and-answer format covering community health, disaster response, vulnerable populations, occupational and forensic nursing, home health, hospice, and global health systems.

Under the Simple Triage and Rapid Treatment (START) system, what triage tag color is assigned to an ambulatory individual with minor injuries?

Green. Ambulatory individuals who can follow commands and have minor, non-life-threatening injuries are categorized under the green tag (often referred to as the 'walking wounded').

What are the key physiological assessments evaluated sequentially in the START triage algorithm for non-ambulatory disaster casualties?

1. Respiration: Presence and rate (spontaneous breathing, rate greater or less than $30\text{ breaths/min}$\n2. Perfusion/Circulation: Presence of a radial pulse or capillary refill time\n3. Mental/Neurological Status: Ability to follow simple commands.

How does a community primarily verify whether its disaster response plan is adequate?

By conducting and following practice drills involving various feasible disaster scenarios.

In disaster management, what are the five defined stages of emergency management?

1. Preparedness\n2. Mitigation/Prevention\n3. Response\n4. Recovery\n5. Planning/Continuity.

What are the four components of the ABCD mnemonic used when conducting a cultural assessment in community health nursing?

• A (Attitude): Assess the client's meaning of illness and use of traditional healing practices versus Western healthcare.\n- B (Beliefs): Explore religious and spiritual beliefs and how to support these practices.\n- C (Context): Determine the client's background, birthplace, language spoken, degree of assimilation, and community support.\n- D (Decision-Making Style): Explore whether decisions are made individually or via family processes.

What are Madeleine Leininger's three modes of nursing care decisions and actions within the Cultural Care Theory?

1. Cultural Care Preservation or Maintenance: Helping people retain specific cultural values to maintain well-being or cope with illness/death.\n2. Cultural Care Accommodation or Negotiation: Helping people adapt or negotiate with healthcare providers to achieve beneficial health outcomes.\n3. Cultural Care Repatterning or Restructuring: Assisting clients to modify or reorder their behaviors to achieve improved health outcomes.

What are the six priority focus areas of the federal Racial and Ethnic Approaches to Community Health (REACH) program?

1. Cardiovascular diseases\n2. Immunizations\n3. Breast and cervical cancer screening and management\n4. Diabetes\n5. HIV/AIDS\n6. Infant mortality.

What service length and discharge criteria determine benefit eligibility for veterans under the Veterans Health Administration (VHA)?

Veterans must have served on active duty for $24$ consecutive months and received a discharge for any reason other than a dishonorable discharge, after which they must enroll and be assigned an eligible priority group.

How does the Social Justice Model differ fundamentally from the Market Justice Model in community healthcare delivery?

The Social Justice Model asserts that all individuals are equally entitled to key goods (healthcare, housing, minimum income) and society must bear collective burdens to distribute them fairly. The Market Justice Model asserts that individuals are entitled to benefits based solely on their own personal efforts, emphasizing individual responsibility and minimal collective or governmental intervention.

According to the Department of Housing and Urban Development (HUD), when is housing considered 'affordable'?

When housing costs a renter or homeowner no more than $30\%$ of their total household income.

In public health nursing, what distinguishes upstream interventions from downstream interventions regarding homelessness?

Downstream interventions focus on treating, managing, or alleviating acute individual health problems (e.g., ER care, treating exacerbations), whereas upstream interventions aim to eliminate root systemic contributors to homelessness (e.g., increasing affordable housing, addressing income insufficiency, and expanding social supportive programs).

What four severe conditions make up 'The Fatal Four' (CADS mnemonic) that frequently lead to complications and death in individuals with intellectual or developmental disabilities?

• C: Constipation and bowel obstruction\n- A: Aspiration and gastroesophageal reflux disease\n- D: Dehydration\n- S: Seizures.

In the disability framework, how are the terms 'impairment', 'disability', and 'handicap' differentiated?

• Impairment: A specific physical, mental, or organic limitation affecting a body part or organ.\n- Disability: A condition of the body or mind that substantially limits one or more major life activities.\n- Handicap: A disadvantage experienced by an individual resulting from environmental, social, or physical barriers in fulfilling a task or societal role.

How do Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) differ in funding sources and health insurance coverage?

• SSI: Funded through general tax revenues for individuals with limited income and resources; recipients receive Medicaid.\n- SSDI: Funded through disability trust fund monies paid via FICA payroll taxes by insured workers, employers, and the self-employed; recipients receive Medicare.

What is the primary function of the Ticket to Work and Work Incentives Improvement Act of 1999?

It redefines disability benefits to reduce employment disincentives, allowing individuals with disabilities to gradually return to the workforce without immediately forfeiting their disability and healthcare benefits.

What are the four systematic steps recommended by the Centers for Disease Control and Prevention (CDC) to prevent community violence?

1. Define the Problem\n2. Identify Risk and Protective Factors\n3. Develop and Test Prevention Strategies\n4. Adopt Successful Strategies.

According to CDC and UN data cited in lecture, what percentage of homicides in the United States involve a firearm?

$75\%$ (three-quarters) of homicides in the United States involve a firearm, compared to $54\%$ worldwide.

In school health nursing, what distinguishes early warning signs of violence from imminent warning signs of violence?

• Early warning signs: Drug/alcohol abuse, social withdrawal, feelings of rejection, being bullied, low academic interest, expressions of violence in drawings/writings, uncontrolled anger, and chronic hitting or bullying.\n- Imminent warning signs: Serious physical fighting with peers/family, severe property destruction, severe rage over minor issues, detailed threats of lethal violence, firearm possession/use, and self-injurious behavior or suicide threats.

How are frontier, rural, urban, and larger central city areas categorized based on population density and size?

• Frontier areas: Fewer than $6$ persons per square mile\n- Rural areas: Typically fewer than $20{,}000$ residents\n- Urban areas: Typically $20{,}000$ to $49{,}999$ residents\n- Larger central cities: Populations of $1{,}000{,}000$ or more.

What four mandatory criteria must an eligible rural hospital meet to obtain a Critical Access Hospital (CAH) designation from CMS?

1. Have $25$ or fewer acute care inpatient beds\n2. Be located more than $35\text{ miles}$ from another hospital\n3. Maintain an annual average length of stay of $96\text{ hours}$ or less for acute care inpatients\n4. Provide $24/7$ emergency care services.

What is the structure and purpose of the Project ECHO model in rural healthcare?

Project ECHO uses adult learning theory and interactive video teleconferencing to connect primary care clinicians in rural and Critical Access Hospital areas with multidisciplinary specialists at centers of excellence to co-manage complex diseases and address social determinants of health.

What major global health principle was established by the World Health Organization's Declaration of Alma-Ata?

It affirmed that health is a fundamental human right, established the global goal of 'Health for All', and declared that primary healthcare is essential to achieving that goal.

What is the distinction between multilateral, bilateral, and non-governmental international health agencies?

• Multilateral agencies: Funded by multiple governmental entities to coordinate international efforts (e.g., World Health Organization, UNICEF, World Bank).\n- Bilateral agencies: Single-country governmental organizations providing foreign aid to recipient countries (e.g., U.S. Agency for International Development [USAID]).\n- Non-governmental organizations (NGOs): Independent, private, or faith-based non-profit entities (e.g., Project Hope, Doctors Without Borders, International Red Cross).

What four administrative or geopolitical conditions represent the greatest threats to global health organizations?

1. Political instability\n2. Economic instability\n3. War\n4. Brain Drain (loss of skilled, trained healthcare workers from developing to developed areas).

What four checklist items must healthcare professionals verify before traveling abroad to deliver healthcare services?

1. Passport and visa requirements (evaluating host country stability and risk via the State Department)\n2. Current political relationships and U.S. embassy/ambassador presence\n3. Licensing and scope of practice regulations governing visiting providers\n4. Vaccine, prophylactic, and health examination requirements before and after travel.

Under the American Board for Occupational Health Nurses (ABOHN), what are key essential tasks performed by occupational health nurses?

• Evaluating workplace health hazards and employee-work interactions\n- Maintaining OSHA-required logs and documents\n- Managing workers' compensation cases\n- Performing audiometry\n- Conducting health surveillance for specific occupational hazards\n- Assessing work limitations and recommending job placements.

What distinguishes a Sexual Assault Nurse Examiner (SANE) from a Sexual Assault Forensic Examiner (SAFE)?

A SANE is a registered nurse who has completed specialized education and clinical training in medical-forensic examinations of sexual assault victims. A SAFE performs similar forensic examinations but is not a registered nurse (such as a physician or physician assistant).

What are the two primary responsibilities of a hospice nurse when managing a client's informal caregivers?

1. Assessing the competence of the caregiver in providing required care to the client.\n2. Evaluating the number of hours each week that the client requires caregiver services.

What is the primary difference in goal between home healthcare nursing visits and hospice nursing visits?

Home healthcare visits focus on restorative, rehabilitative, and skilled medical care (e.g., wound care, medication titration) to prevent inpatient hospitalization. Hospice nursing visits focus exclusively on palliative comfort, pain and symptom relief, emotional/spiritual support, and ensuring the client does not die alone.

What are the five core domains of the Social Determinants of Health outlined in Healthy People 2030?

1. Economic Stability\n2. Education Access and Quality\n3. Healthcare Access and Quality\n4. Neighborhood and Built Environment\n5. Social and Community Context.