Nursing Elites

1. Which is an example of a policy-level intervention in community health?

• A. Implementing new treatment protocols
• B. Educating individuals about healthy behaviors
• C. Establishing community health clinics
• D. Advocating for legislative changes

Correct answer: D

Rationale: Advocating for legislative changes is a policy-level intervention that can bring about significant improvements in community health. This involves influencing laws and regulations to create a healthier environment for the community as a whole, impacting a larger population than individual-level interventions. Implementing new treatment protocols, educating individuals about healthy behaviors, and establishing community health clinics are important interventions but are more focused on the individual or community level rather than policy-level changes.

2. In value-based care, which equation represents the focus on achieving the best outcomes relative to cost?

• A. Cost X Quality
• B. Cost X Quality/Consumer satisfaction
• C. Quality/Cost
• D. Fee for service/discount rate

Correct answer: C

Rationale: Value-based care aims to deliver the highest quality of care while efficiently managing costs. The equation Quality/Cost represents this focus by emphasizing achieving superior outcomes relative to the resources invested.

3. The public health nurse partners with the American Heart Association to develop NYS public policy priority statements to promote the expansion of the Double Up Food Bucks program. Which area and intervention on the Minnesota Public Health Wheel do these actions most closely align?

• A. Counseling - Blue wedge
• B. Advocacy - Yellow wedge
• C. Outreach - Red wedge
• D. Screening - Red wedge

Correct answer: B

Rationale: In this scenario, the public health nurse is engaging in advocacy by partnering with an organization to influence public policy through the development of public policy priority statements. Advocacy, represented by the yellow wedge on the Minnesota Public Health Wheel, aligns most closely with these actions as it involves working to influence public policy.

4. The public health RN is engaging with a teen in his community who is concerned about how he will be able to stay part of his friend group when they are all vaping and your client does not want to take part but does not want to feel awkward. Using motivational interviewing techniques, the RN says to the client, 'I understand this concern. Please tell me more about this and how it feels awkward for you.' The RN's question is an example of:

• A. Moving the teen to find a new friend group.
• B. Addressing the problem of teen awkwardness.
• C. Agreeing that awkwardness is hard.
• D. Using open-ended questioning.

Correct answer: D

Rationale: The RN's question, 'Please tell me more about this and how it feels awkward for you,' is an example of using open-ended questioning. Open-ended questions encourage clients to share more about their feelings and thoughts, allowing for a deeper exploration of their concerns and experiences. It helps in building rapport, understanding the client's perspective, and facilitating a client-centered conversation.

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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