← Back

Chapter 7: Policies and Regulatory Conditions Impacting Health Outcomes

Every problem in the chapter beside the book’s answer, a chapter at a time as you scroll.

Chapter 7: Policies and Regulatory Conditions Impacting Health Outcomes

10 problems · 0 figures

7-1 §7.RQ source ↗

A community health nurse is working at a community event to help individuals obtain health insurance. For which individual would the nurse most likely recommend Medicare?
  1. a.
    A 62-year-old client with heart failure
  2. b.
    A 54-year-old client who is employed
  3. c.
    A 28-year-old client with two children and no income
  4. d.
    A healthy retired 67-year-old client

Answer

D. A healthy retired 67-year-old client
Medicare is a government health insurance program that covers Americans 65 years of age and older, regardless of their health. It may also cover some individuals with disabilities, end-stage renal disease, and amyotrophic lateral sclerosis.

7-2 §7.RQ source ↗

An older adult client has developed a pressure injury while in the hospital for the treatment of pneumonia. The nurse understands that the development of the pressure ulcer will affect Medicare reimbursement for this client in what way?
  1. a.
    There will be no reimbursement for this client’s hospital stay.
  2. b.
    Reimbursement will be increased due to the development of complications.
  3. c.
    Reimbursement will be reduced as a result of the development of a pressure injury.
  4. d.
    There will be no change in reimbursement.

Answer

C. Reimbursement will be reduced as a result of the development of a pressure injury.
The Hospital Value-Based Purchasing Program bases Medicare payments on quality of care rather than services performed. The development of a pressure injury while in the hospital is considered a negative outcome, leading to decreased reimbursement. Therefore, hospitals are incentivized to focus on health care quality.

7-3 §7.RQ source ↗

The nurse is discussing homecare instructions with a client who was treated on a medical unit for an exacerbation of heart failure. The client tells the nurse that follow-up care will be difficult since they live 30 miles away and do not drive. Which intervention by the nurse can best meet the immediate needs of this client for follow-up care?
  1. a.
    Meeting with community leaders about the need for medical facilities in the rural community
  2. b.
    Providing the client with agencies that may be able to assist with transportation
  3. c.
    Arranging for home monitoring and telehealth follow-up
  4. d.
    Reinforce that follow-up is important and that the client needs to find rides to appointments

Answer

C. Arranging for home monitoring and telehealth follow-up
The use of telehealth can provide care remotely to individuals who live in care deserts where there is limited access to health care services.

7-4 §7.RQ source ↗

A nurse works at a clinic that provides care to clients through all stages of heart failure and coordinates transitions of care. Which care delivery model is the clinic using to provide care to clients?
  1. a.
    Collaborative care
  2. b.
    Integrated service line
  3. c.
    Provider-sponsored health plan
  4. d.
    Medical home

Answer

B. Integrated service line
Care delivery models refer to how health care providers work together to provide health care to clients. In the integrated service lines, hospitals and health care systems organize around specific disease states such as heart failure throughout the continuum of client care.

7-5 §7.RQ source ↗

A community health nurse provides health care to a marginalized community. Which factor will guide the nurse’s health programming?
  1. a.
    Most members of this community are eligible for Medicaid.
  2. b.
    Community members are likely to seek preventative health care.
  3. c.
    Barriers to accessing health care may be present.
  4. d.
    Laws and policies protect the health of this community.

Answer

C. Barriers to accessing health care may be present.
A marginalized community is one that is excluded from the dominant group’s cultural, economic, educational, or social life. Marginalized communities are likely to face barriers to accessing health care, such as a lack of health insurance or a paucity of health care providers within the community.

7-6 §7.RQ source ↗

Which concept concerning LHIs will the nurse use to develop programs to improve health outcomes in the community?
  1. a.
    LHIs are primarily aimed at reducing childhood illnesses.
  2. b.
    LHIs should be included in the plan of care for every individual.
  3. c.
    LHIs improve health and well-being across the lifespan.
  4. d.
    LHIs provide standardized guidelines for caring for certain diseases.

Answer

C. LHIs improve health and well-being across the lifespan.
LHIs are a subset of high-priority Healthy People 2030 objectives aimed at improving health and well-being across the lifespan and topic areas.

7-7 §7.RQ source ↗

Which action can the community health nurse take to help an unemployed client without health insurance mitigate the high cost of prescription drugs?
  1. a.
    Assist the client to reduce the amount spent on food and other items.
  2. b.
    Ask the client which medications they feel are not necessary.
  3. c.
    Speak with the provider about lower-cost alternatives.
  4. d.
    Explain that all medications must be taken to improve health outcomes.

Answer

C. Speak with the provider about lower-cost alternatives.
Community health nurses need to recognize the impact of high drug prices on their clients who may not take their medications if they cannot afford them. Among other options, nurses should contact the prescribers to identify less costly alternatives for the client.

7-8 §7.RQ source ↗

Which category of public health policy is the nurse engaged in while performing lipid profile testing at a community health fair?
  1. a.
    Regulation
  2. b.
    Screening
  3. c.
    Education
  4. d.
    Preventative treatment

Answer

B. Screening
Mechanisms for delivering public health policy interventions include fiscal policy, regulation, education, preventative treatment, and screening. Screening involves testing to detect diseases or other issues before symptoms are apparent, such as screening for elevated lipid levels that can detect coronary artery disease before symptoms of heart disease develop.

7-9 §7.RQ source ↗

A client in a community health center is receiving team-based care for primary care needs and management of heart failure. When the nurse assesses that the client is missing appointments due to difficulties with transportation, the nurse refers the client to the team social worker. Which care delivery model is this client experiencing?
  1. a.
    Accountable care organization
  2. b.
    Integrated service line
  3. c.
    Medical home
  4. d.
    Provider-sponsored health plan

Answer

C. Medical home
The medical home model of care uses an integrated team approach to provide care for the whole person, including physical and social needs.

7-10 §7.RQ source ↗

Which component of the IHI Triple Aim is the nurse performing when working with the community to develop programs to reduce teenage smoking?
  1. a.
    System Integration and Execution
  2. b.
    Population Health Management
  3. c.
    Redesign of Primary Care Services and Structures
  4. d.
    Cost Control and Platform

Answer

B. Population Health Management
The IHI Triple Aim is a framework developed by the IHI that aims to improve health care system performance using five components. The component of Population Health Management is involved in prevention and health promotion.

Loading chapter 8…

Problems and answers are adapted from Population Health for Nurses by Jessica Ochs, Sherry L. Roper and Susan M. Schwartz, OpenStax, and are used under the CC BY-NC-SA 4.0 licence. Access for free at https://openstax.org/books/population-health/pages/1-introduction. Illustrations: Copyright Rice University, OpenStax, under CC BY-NC-SA 4.0 license. This adaptation is released under the same licence, is non-commercial, and is neither affiliated with nor endorsed by OpenStax or Rice University.