Nursing Elites

1. The public health RN is working with a client who desires to quit smoking. The client says to the RN, 'I want to quit but I just don't think I have it in me to really make it happen.' According to the Health Belief Model, this response relates to which factor:

• A. Susceptibility
• B. Self-efficacy
• C. Severity
• D. Cue to action

Correct answer: B

Rationale: The correct answer is B, 'Self-efficacy.' In the Health Belief Model, self-efficacy refers to a person's belief in their capacity to execute behaviors necessary to achieve specific goals or outcomes. In this scenario, the client's statement reflects a lack of confidence in their ability to successfully quit smoking, indicating low self-efficacy. By addressing and enhancing the client's self-efficacy, the public health RN can help empower the client to take steps towards successful smoking cessation.

2. Which best describes a key principle of public health?

• A. Focusing on individual health behaviors
• B. Addressing the social determinants of health
• C. Reducing health care costs
• D. Increasing access to health services

Correct answer: B

Rationale: A key principle of public health is addressing the social determinants of health, which include factors like socioeconomic status, education, and environment. By focusing on these determinants, public health initiatives aim to improve overall health outcomes for entire populations, rather than just individual health behaviors. This approach helps in creating a healthier society and preventing diseases at a broader level.

3. Which of the following is not considered one of the four cornerstones or pillars in primary health care?

• A. Active community participation
• B. Support mechanisms made available
• C. Use of appropriate technology
• D. Inter-sectoral linkages only

Correct answer: D

Rationale: The four cornerstones of primary health care are active community participation, support mechanisms made available, and the use of appropriate technology. Inter-sectoral linkages, while important, are not part of the four core pillars in primary health care.

4. The healthcare provider should consider the following when assessing the child for chest indrawing EXCEPT

• A. Chest indrawing should be present at all times
• B. The lower chest wall does not move in when the child breathes in
• C. The lower chest moves in when the child breathes in
• D. The child should be calm

Correct answer: A

Rationale: When assessing a child for chest indrawing, it is important to note that chest indrawing should NOT be present at all times, as this would suggest a significant respiratory distress. Chest indrawing is an abnormal inward movement of the lower chest wall during inhalation, indicating increased work of breathing. Therefore, the absence of chest indrawing during normal breathing is a normal finding. The healthcare provider should observe for the lower chest moving in with each breath, which is abnormal, while ensuring that the child is calm during the assessment.

5. Fee-for-service care is best characterized by which statement:

• A. Fees are scaled based on the patient’s ability to pay and are capped.
• B. Fees reflect the fair market value of health care services being provided.
• C. Adequate fee schedules enable hospitals and clinics to function properly.
• D. Fees are not uniform throughout most states as they are fairly unregulated.

Correct answer: D

Rationale: Fee-for-service care is a payment model where providers are paid for each service performed, leading to non-uniform fees that vary by service and provider. This system is not highly regulated, resulting in differing fee structures across states and regions. Therefore, the statement that 'Fees are not uniform throughout most states as they are fairly unregulated' best characterizes fee-for-service care.

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